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Thoracic Vertebrae (thoracic + vertebra)
Selected AbstractsReview article: Indications for thoracolumbar imaging in blunt trauma patients: A review of current literatureEMERGENCY MEDICINE AUSTRALASIA, Issue 2 2009Enda O'Connor Abstract Thoracolumbar spine injury is a common complication of blunt multitrauma and up to one third of fractures are associated with spinal cord dysfunction. Delayed fracture diagnosis increases the risk of neurological complications. While validated screening guidelines exist for traumatic c-spine injury equivalent guidelines for thoracolumbar screening are lacking. We conducted a literature review evaluating studies of thoracolumbar injury in trauma patients to generate indications for thoracolumbar imaging. We performed MEDLINE and Pubmed searches using MeSH terms "Wounds, Nonpenetrating", "Spinal Fractures", "Spinal Injuries" and "Diagnostic Errors", MeSH/subheading terms "Thoracic Vertebrae/injuries" and "Lumbar Vertebrae/injuries" and keyword search terms "thoracolumbar fractures", "thoracolumbar injuries", "thoracolumbar trauma", "missed diagnoses" and "delayed diagnoses". Limits and inclusion criteria were defined prior to searching. We evaluated 16 articles; 5 prospective observational studies (1 cohort study) and 11 retrospective observational studies. Predictors of TL injury in prospective studies , high-risk injury mechanism, distracting injury, impaired cognition, symptoms/signs of vertebral fracture and known cervical fracture , were defined and used to construct a decision algorithm, which in a total of 14189 trauma patients from all eligible studies recommended TL screening in 856(99.1%) of 864 patients with TL fractures and would probably have directed TL imaging in the remaining 8 patients. There is limited low level evidence guiding surveillance TL imaging in adult blunt trauma patients. Despite this, we propose and evaluate an algorithm with a high negative predictive value for TL fractures. This should be incorporated into spinal injury assessment protocols. [source] Bone Strength at Clinically Relevant Sites Displays Substantial Heterogeneity and Is Best Predicted From Site-Specific Bone DensitometryJOURNAL OF BONE AND MINERAL RESEARCH, Issue 1 2002Felix Eckstein Ph.D. Abstract In this study we test the hypotheses that mechanical bone strength in elderly individuals displays substantial heterogeneity among clinically relevant skeletal sites, that ex situ dual-energy X-ray absorptiometry (DXA) provides better estimates of bone strength than in situ DXA, but that a site-specific approach of bone densitometry is nevertheless superior for optimal prediction of bone failure under in situ conditions. DXA measurements were obtained of the lumbar spine, the left femur, the left radius, and the total body in 110 human cadavers (age, 80.6 ± 10.5 years; 72 female, 38 male), including the skin and soft tissues. The bones were then excised, spinal and femoral DXA being repeated ex situ. Mechanical failure tests were performed on thoracic vertebra 10 and lumbar vertebra 3 (compressive loading of a functional unit), the left and right femur (side impact and vertical loading configuration), and the left and right distal radius (fall configuration, axial compression, and 3-point-bending). The failure loads displayed only very moderate correlation among sites (r = 0.39 to 0.63). Ex situ DXA displayed slightly higher correlations with failure loads compared with those of in situ DXA, but the differences were not significant and relatively small. Under in situ conditions, DXA predicted 50-60% of the variability in bone failure loads at identical (or closely adjacent) sites, but only around 20-35% at distant sites, advocating a site-specific approach of densitometry. These data suggest that mechanical competence in the elderly is governed by strong regional variation, and that its loss in osteoporosis may not represent a strictly systemic process. [source] Cephalad origin of the superior vena cava and the level of the central venous catheter tip on chest radiographsPEDIATRIC ANESTHESIA, Issue 1 2005TOSHIMI ARAI MD Summary Background :,There are suggested radiographic landmarks for the lower margin of the superior vena cava (SVC), but none for the cephalad origin of the SVC in children. Therefore, we determined the cephalad origin of the SVC in relation to the level of thoracic vertebrae in children. Methods :,Sixty-five patients (2,96 months) scheduled for routine diagnostic cardiac catheterization were the subjects of the study. Vena cavogram was obtained. The crossing point between the SVC and the innominate vein was considered as the cephalad origin of the SVC, then this point was related to the level of the thoracic vertebra as a radiographic landmark. Results :,In approximately 90% of the patients studied the proximal origin of the SVC was situated above the level of Th4/5 interspace. Conclusion :,We would like to suggest that the position of the tip of central venous line, when inserted via the right internal jugular vein, should optimally be at the level of Th4/5 interspace on the postoperative chest radiograph. [source] Macroscopic Anatomy of the Great Vessels and Structures Associated with the Heart of the Ringed Seal (Pusa hispida)ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 3 2009H. Smodlaka Summary The ringed seal [Pusa (Phoca) hispida], as well as other seals, exhibits unique anatomical properties when compared to its terrestrial counterparts. In the ringed seal, the most conspicuous marine adaptation is the aortic bulb. This large dilatation of the ascending aorta is comparable to that found in other seal species and marine mammals. The branches of the ascending aorta (brachiocephalic trunk, left common carotid artery and left subclavian artery) are similar to those of higher primates and man. The peculiarities of the venous system are: three pulmonary veins, a pericardial venous plexus, a caval sphincter, a hepatic sinus with paired caudal vena cavae and a large extradural venous plexus. Generally, three common pulmonary veins (right, left and caudal) empty into the left atrium. The pericardial venous plexus lies deep to the mediastinal pericardial pleura (pleura pericardica) on the auricular (ventral) surface of the heart. The caval sphincter surrounds the caudal vena cava as it passes through the diaphragm. Caudal to the diaphragm, the vena cava is dilated (the hepatic sinus), and near the cranial extremity of the kidneys, it becomes biphid. The azygos vein is formed from the union of the right and left azygos veins at the level of the 5th thoracic vertebra. Cardiovascular physiological studies show some of these anatomical variations, especially of the venous system and the ascending aorta, to be modifications for diving. This investigation documents the large blood vessels associated with the heart and related structures in the ringed seal. [source] CT-Soft Tissue Window of the Cranial Abdomen in Clinically Normal Dogs: An Anatomical description using Macroscopic Cross-Sections with Vascular InjectionANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 1 2009M. A. Rivero Summary The aim of this study was to provide a detailed anatomic atlas of the cranial abdomen by means of computed tomography (CT). Three mature dogs, all mixed breed males, were used. The dogs were sedated, anaesthetized and positioned in sternal recumbency. CT scans from the eighth thoracic vertebra to the fourth lumbar vertebra were performed using a third-generation equipment (TOSHIBA 600HQ scanner) with 1 cm slice thickness. CT-images of the cranial abdomen were taken with soft-tissue window (WL: ,14, WW: 658) settings. Dogs were killed and vascular-injection technique was performed: red and blue latex filled the vascular system. Injected dogs were frozen in the same position as used for CT examination and sectioned with an electric bandsaw at 1-cm-thick intervals. The cuts matched as closely as possible to the CT-images. The anatomic sections were compared and studied with the corresponding CT-images, and clinically relevant abdominal anatomic structures were identified and labelled on the corresponding CT-images. The results of our study could be used as a reference for evaluating CT-images of the canine cranial abdomen with abdominal diseases. [source] Acquired arachnoid cyst in a catAUSTRALIAN VETERINARY JOURNAL, Issue 7 2009T Sugiyama A 5-year-old Birman cat presented with paraparesis associated with a fracture of the third thoracic vertebra and was managed conservatively. Voluntary function was regained over the next 6 months, but the cat was referred 4 years after the trauma because of recurrence of hindlimb paresis and ataxia. Magnetic resonance imaging (MRI) showed a spinal arachnoid cyst at the level of the fourth thoracic vertebra, which was treated surgically by dorsal laminectomy and durectomy, and hindlimb function subsequently recovered. The cat re-presented 4 years later for recurrent hindlimb paresis. Myelography and computed tomography,myelography (CT-M) showed dorsolateral pooling of cerebrospinal fluid (CSF) at the previous laminectomy site. The neurological signs after the second surgery improved, but not as much as after the first surgery and the cat remained ataxic with moderate paresis. Seven months later repeat CT-M revealed an atrophic spinal cord, but negligible pooling of CSF at the previous site of the arachnoid cyst. The cat could walk, but was being treated for self-induced trauma of the left hindlimb that was thought to be related to paraesthesia. The neurological signs gradually deteriorated over 3 months and the cat was euthanased. [source] Paleopathology and health of native and introduced animals on Southern Peruvian and Bolivian Spanish Colonial sitesINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 5 2010S. D. Defrance Abstract Spanish colonial sites in southern Peru and Bolivia contain remains of native camelids and introduced bovids with examples of degenerative paleopathologies that are interpreted as reflecting changes in herd management, animal use and animal health following the Spanish conquest. The archaeological contexts include three Spanish colonial wineries from Moquegua in southern Peru and the nearby colonial village of Torata Alta where indigenous people were forced to resettle under Spanish control. Also from Peru is faunal material from the 14th to 16th century rural agropastoral village of Pillistay located near Camana. Animal remains with bone abnormalities are also present in residential, commercial and industrial sites associated with Spanish silver mining near Potosí, Bolivia at Tarapaya and Cruz Pampa. Eighteen pathological specimens are described including examples of degenerative changes to phalanges, vertebrae, tarsals, limb elements and ribs. Paleopathologies present include exostoses, osteophytes, porosity, grooving and eburnation. Examples of phalangeal exostoses on bovid phalanges indicate the use of these introduced animals as draught cattle. Exostoses on camelid first phalanges suggests their use as cargo animals as do thoracic vertebrae with severe cases of degenerative pathology. Introduced caprines contain few pathologies indicating their primary use as food animals. The bone abnormalities from colonial sites are more severe than those reported for prehispanic faunal assemblages. These data provide insights into the health and work behaviour of indigenous Andean camelids and introduced Eurasian animals following the Spanish conquest. Copyright © 2009 John Wiley & Sons, Ltd. [source] A high status burial from Ripon Cathedral, North Yorkshire, England: differential diagnosis of a chest deformityINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 6 2003S. Groves Abstract Excavations beneath the crossing at Ripon Cathedral in North Yorkshire recently revealed a burial radiocarbon dated to the late 15th century AD. The burial was that of a young adult female; the location of the grave suggests a person of relatively high status. The very well preserved skeleton revealed abnormal changes to the bones of the thoracic cavity including anterior bowing of the sternum, flattening of the spinous processes of thoracic vertebrae three to nine against the processes below each one, and changes to the ribs that suggested anterior displacement of the rib cage. The skeletal changes are described and differential diagnoses presented. Treatment to an underlying chest deformity, ,pectus carinatum', is thought to be the underlying cause of the skeletal changes; this study may lend direct insight into the concepts of body image in the Medieval period. Copyright © 2003 John Wiley & Sons, Ltd. [source] Biomechanical comparison of a novel multilevel hex-head pedicle screw design with a conventional head designJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 8 2007Qi Liu Abstract The objective of the study was to determine the biomechanical effect during insertion of multilevel hex-head design pedicle screws compared to a conventional screw-head design. Eighteen lumbar vertebrae and thoracic vertebrae from human cadavers were instrumented with a novel, multilevel hexagonal head pedicle screw on one side and a conventional head pedicle screw on the contralateral side. Screws were inserted at a constant rate and insertion and removal torques were recorded. A further 14 lumbar and thoracic vertebrae were used to test alterability of screw direction and operational effort required. Electromagnetic sensors recorded the change in angular direction for both screw and screwdriver. The force applied through the insertion screwdriver required to produce the directional change was also recorded. No significant differences were found between the two screw types for insertion or removal torque in either lumbar or thoracic vertebrae. Multilevel hex-head screws had significantly greater directional alterability than conventional head screws in both lumbar and thoracic specimens. Multilevel hex-head screws also required less force applied through the screwdriver than conventional screws to alter direction of screw insertion in both lumbar and thoracic specimens. The multilevel hex-head design did not affect the insertion or removal torque in comparison to a conventional head design. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:1115,1120, 2007 [source] Cephalad origin of the superior vena cava and the level of the central venous catheter tip on chest radiographsPEDIATRIC ANESTHESIA, Issue 1 2005TOSHIMI ARAI MD Summary Background :,There are suggested radiographic landmarks for the lower margin of the superior vena cava (SVC), but none for the cephalad origin of the SVC in children. Therefore, we determined the cephalad origin of the SVC in relation to the level of thoracic vertebrae in children. Methods :,Sixty-five patients (2,96 months) scheduled for routine diagnostic cardiac catheterization were the subjects of the study. Vena cavogram was obtained. The crossing point between the SVC and the innominate vein was considered as the cephalad origin of the SVC, then this point was related to the level of the thoracic vertebra as a radiographic landmark. Results :,In approximately 90% of the patients studied the proximal origin of the SVC was situated above the level of Th4/5 interspace. Conclusion :,We would like to suggest that the position of the tip of central venous line, when inserted via the right internal jugular vein, should optimally be at the level of Th4/5 interspace on the postoperative chest radiograph. [source] Evolution of the Respiratory System in Nonavian Theropods: Evidence From Rib and Vertebral MorphologyTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 9 2009Emma R. Schachner Abstract Recent reports of region-specific vertebral pneumaticity in nonavian theropod dinosaurs have brought attention to the hypothesis that these animals possessed an avian-style respiratory system with flow-through ventilation. This study explores the thoracic rib and vertebral anatomy of Sinraptor, Allosaurus, Tyrannosaurus, and Deinonychus; four nonavian theropods that all show well-preserved thoracic vertebrae and ribs. Comparisons to the osteology and soft tissue anatomy of extant saurians provide new evidence supporting the hypothesis of flow-through ventilation in nonavian theropods. Analyses of diapophyseal and parapophyseal position and thoracic rib morphology suggest that most nonavian theropods possessed lungs that were deeply incised by the adjacent bicapitate thoracic ribs. This functionally constrains the lungs as rigid nonexpansive organs that were likely ventilated by accessory nonvascularized air sacs. The axial anatomy of this group also reveals that a crocodilian-like hepatic-piston lung would be functionally and biomechanically untenable. Taken together with the evidence that avian-like air sacs were present in basal theropods, these data lead us to conclude that an avian-style pulmonary system was likely a universal theropod trait. Anat Rec, 292:1501,1513, 2009. 2009. © 2009 Wiley-Liss, Inc. [source] Vertebral anatomy in the Florida manatee, Trichechus manatus latirostris: A developmental and evolutionary analysisTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 6 2007Emily A. Buchholtz Abstract The vertebral column of the Florida manatee presents an unusual suite of morphological traits. Key among these are a small precaudal count, elongate thoracic vertebrae, extremely short neural spines, lack of a sacral series, high lumbar variability, and the presence of six instead of seven cervical vertebrae. This study documents vertebral morphology, size, and lumbar variation in 71 skeletons of Trichechus manatus latirostris (Florida manatee) and uses the skeletons of Trichechus senegalensis (west African manatee) and Dugong dugon (dugong) in comparative analysis. Vertebral traits are used to define morphological, and by inference developmental, column modules and to propose their hierarchical relationships. A sequence of evolutionary innovations in column morphology is proposed. Results suggest that the origin of the fluke and low rates of cervical growth originated before separation of trichechids (manatees) and dugongids (dugongs). Meristic reduction in count is a later, trichechid innovation and is expressed across the entire precaudal column. Elongation of thoracic vertebrae may be an innovative strategy to generate an elongate column in an animal with a small precaudal count. Elimination of the lumbus through both meristic and homeotic reduction is currently in progress. Anat Rec, 290:624,637, 2007. © 2007 Wiley-Liss, Inc. [source] Thoracic paravertebral spread using two different ultrasound-guided intercostal injection techniques in human cadaversCLINICAL ANATOMY, Issue 7 2010Tilemachos Paraskeuopoulos Abstract The continuity between the intercostal and paravertebral space has been established by several studies. In this study, the paravertebral spread of a colored dye was attempted with two different ultrasound-guided techniques. The posterior area of the trunk was scanned with a linear probe between the level of the fifth and the seventh thoracic vertebrae in eleven embalmed human cadavers. In the first technique, the probe was placed transversely below the inferior margin of the rib, and a needle was inserted between the internal intercostal membrane and the pleura. In the second technique, the probe was placed longitudinally at the intercostal space 5 cm lateral to the spinous processes, and the needle was inserted between the internal intercostal membrane and the pleura. In both techniques, 1 ml of methylene blue was injected, and both the intercostal and paravertebral spaces were prepared. In total, 33 injections were performed: 19 with the transverse technique and 14 with the longitudinal technique. Successful spread of the dye to the thoracic paravertebral space was recorded in 89.5% cases using the transverse technique and 92.8% cases using the longitudinal technique. No intrapleural spread of the dye was recorded in either technique. Ultrasound-guided injection into the intercostal space may offer an alternative approach to the thoracic paravertebral space. Clin. Anat. 23:840,847, 2010. © 2010 Wiley-Liss, Inc. [source] | |||||||||||||