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Clinical Anatomy

Joe Iwanaga, Seif Eid, Emily Simonds, Maia Schumacher, Marios Loukas, R Shane Tubbs
INTRODUCTION: The piriformis muscle is clinically implicated in pain disorders, posterior approaches for total hip arthroplasty, and iatrogenic injury to the muscle and the surrounding nerves. The piriformis muscle has been said to receive innervation from L5 to S3 ventral rami with most sources using S1 and S2 ventral rami as the most common innervation this muscle. However, descriptions of the nerve in the literature are vague. Therefore, the aim of this study was to clarify the anatomy of the nerve supply to the piriformis muscle...
November 8, 2018: Clinical Anatomy
Seif Eid, Marios Loukas, R Shane Tubbs, Joe Iwanaga
Pelvic pain is a common symptom that affects women worldwide and usually presents with variable range of severity, duration, and location. Several gynecological conditions may result in pelvic pain, and may have a variable presentation among patients. Pelvic pain creates a significant challenge and frustration to both patients and clinicians, which also creates a significant burden on the economy. It is necessary to tailor the management of pelvic pain to each individual patient to achieve optimal outcomes...
November 2, 2018: Clinical Anatomy
Cody C Wyles, Andrés A Maldonado, Eric R Wagner, Matthew T Houdek, Nirusha Lachman, Robert J Spinner
INTRODUCTION: Restoration of shoulder lateral rotation remains a significant challenge following brachial plexus injury. Transfer of the accessory nerve to suprascapular nerve (SSN) has been widely performed, although with generally poor outcomes for lateral rotation. A recent report suggested a selective infraspinatus reinnervation technique using a radial nerve branch for SSN transfer. METHODS: This cadaveric study was performed in 7 specimens (14 shoulders). We present technical modifications to achieve additional length to the recipient nerve (suprascapular) that would facilitate direct repair...
October 26, 2018: Clinical Anatomy
Kimberly M Morelli, Bradley R Martin, Fatima H Charakla, Anel Durmisevic, Gordon L Warren
INTRODUCTION: The causes of degenerative rotator cuff (RTC) tears are unclear but certain acromion morphology may contribute. This study's objective was to determine using a systematic review and meta-analysis the association of acromion type and acromial index with the prevalence of RTC tears. MATERIALS AND METHODS: Six databases were searched electronically. Seventeen relevant studies between 1993 and 2017 were included in the meta-analyses determining the association of RTC tears with acromion type (n=11) or acromial index (n=10)...
October 26, 2018: Clinical Anatomy
Robert H Anderson, David Bolender, Shumpei Mori, Justin T Tretter
No abstract text is available yet for this article.
October 26, 2018: Clinical Anatomy
Veronica Macchi, Edgardo Enrico Edoardo Picardi, Aldo Morra, Andrea Porzionato, Raffaele De Caro
No abstract text is available yet for this article.
October 26, 2018: Clinical Anatomy
Graham Dupont, Cameron Schmidt, Emre Yilmaz, Rod J Oskouian, Veronica Macchi, Raffaele De Caro, R Shane Tubbs
The lymphatic system, segregated from the blood vascular system, is an essential anatomical route along which interstitial fluid, solutes, lipids, immune cells, and cellular debris, are conveyed. However, the way these mechanisms operate within the cranial compartment is mostly unknown. Herein, we review current understanding of the meningeal lymphatics, described anatomically over a century ago yet still poorly understood from a functional standpoint. We will delineate the cellular mechanisms by which the meningeal lymphatics are formed and discuss their unique anatomy...
October 26, 2018: Clinical Anatomy
R Shane Tubbs
No abstract text is available yet for this article.
October 21, 2018: Clinical Anatomy
R Shane Tubbs
No abstract text is available yet for this article.
October 21, 2018: Clinical Anatomy
Sara Gili, Angelica Abreo, Miguel GóMez-Fernández, Roma Solà, Carlos Morros, Xavier Sala-Blanch
Our objective was to define the positions of the nerves around the brachial artery and, secondarily, to assess the risk of intraneural injection during dual guided axillary block. Sixty ultrasound-guided axillary blocks were performed. The locations of the musculocutaneous, median, ulnar, and radial nerves relative to the brachial artery were determined. The position of the ulnar nerve was defined in relation to that of the brachial vein, and the position of the musculocutaneous nerve in relation to the coracobrachialis muscle...
October 20, 2018: Clinical Anatomy
Tae-Hyeon Cho, Hyun-Jin Kwon, You-Jin Choi, Jehoon O, Sung-Yoon Won, Hun-Mu Yang
INTRODUCTION: Shoulder pain is commonly associated with spasticity of the rotator cuff muscles including the subscapularis (SSC). The aim of this study was to elucidate the intramuscular innervation pattern of the SSC using the modified Sihler's staining technique in order to facilitate the targeting of botulinum neurotoxin (BoNT) injections to alleviate shoulder spasticity,. MATERIALS AND METHODS: Ten SSC specimens (mean age, 81.5 years) were used in this study...
October 17, 2018: Clinical Anatomy
Cameron Garagozlo, Omar Kadri, Mina Atalla, Fernando Polanco, Andrew Massaband, James Coey, Sara Sulaiman
INTRODUCTION: Procedures involving the small saphenous vein (SSV) can result in sural nerve (SN) damage due to the proximity of the two structures. The relationship between the SN and SSV has previously been described in cadaveric studies with limited scope on surface landmarks. This study investigates the relationship between the SN and SSV in-vivo through ultrasound. MATERIALS AND METHODS: Transverse/short-axis ultrasound scans of 128 legs (64 healthy participants) were taken by a single observer using a GE Logiq e ultrasound system with a 5-13Hz linear transducer (GE Logiq 12L-RS)...
October 16, 2018: Clinical Anatomy
Mustafa Akkaya, Nurdan Cay, Safa Gursoy, Mehmet Emin Simsek, Mesut Tahta, Metin Doğan, Murat Bozkurt
AIM: Magnetic resonance imaging (MRI) is generally the preferred method for assessing lesions of the knee cartilage and subchondral bone. There have been a few cartilage imaging studies using real-time elastosonography (RTE), which has increased in importance and range of use in recent years. The aim of this cadaveric study was to assess the efficacy of a new diagnostic method combining USG and RTE and also to perform intra-articular examinations together with arthroscopy. METHODS: A total of 12 fresh unpaired human knees were examined...
October 15, 2018: Clinical Anatomy
Roger Seiler, Lena M Öhrström, Patrick Eppenberger, Dominic Gascho, Frank J Rühli, Francesco M Galassi
Frontal sinus osteoma is a relatively common finding in the modern clinical setting. Although its paleopathological record is not in dispute, its presence in Ancient Egypt has never been clarified. The aim of this article is to contribute to the debate. An Egyptian mummy head from the Musée d'Éthnographie de Neuchâtel (Switzerland) was studied radiologically and the paleopathological evidence obtained was contextualized in the wider frame of evolutionary medicine. A 128-slice CT scanner was used for further investigation; datasets were processed with OsiriX-64 bit (version 5...
October 15, 2018: Clinical Anatomy
Vivek Perumal, Nawaporn Techataweewan, Stephanie J Woodley, Helen D Nicholson
INTRODUCTION: The ligament of the head of femur (LHF) has gained clinical attention recently and is reported to contribute to hip stability. This study explores its morphology and morphometry, information that may help inform surgical decision making. MATERIALS AND METHODS: Gross anatomical dissections were undertaken on 229 embalmed hips from European (n=105) and Thai (n=124) adult cadavers to examine LHF anatomy. Ligament morphometry was statistically compared at different sites, between sexes and sides...
October 14, 2018: Clinical Anatomy
Lei Huang, Georgios Pafitanis, Dajiang Song, Deqing Hu, Peng Niu, Xu Hong, Ruilin Qi, Xudong Wei, Heping Zheng
Soft tissue defects of the forefoot represent a challenging surgical modality to reconstructive microsurgeons. This study describes the anatomical basis and design of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap. Thirty fresh human lower limb specimens were injected with red latex and used for dissection of the dorsal vascular and neural anatomy of the foot. The direction and distribution of the intermediate dorsal cutaneous nerve and the vascular anatomy of the third dorsal artery of the plantar arch, along with the intermediate dorsal neurocutaneous nutrient vessels, were mapped...
October 14, 2018: Clinical Anatomy
Anthony V D'Antoni, Estomih P Mtui, Marios Loukas, R Shane Tubbs, Genevieve Pinto Zipp, John Dunlosky
The amount of information that medical students learn is voluminous and those who do not use evidence-based learning strategies may struggle. Research from cognitive and educational psychology provides a blueprint on how best to learn science subjects, including clinical anatomy. Students should aim for high-cognitive learning levels as defined in the SOLO taxonomy. Using a real-world example from a modern clinical anatomy textbook, we describe how to learn information using strategies that have been experimentally validated as effective...
October 11, 2018: Clinical Anatomy
Elroy Patrick Weledji, Divine Eyongeta, Eleanour Ngounou
INTRODUCTION: Normal voiding needs a coordinated, sustained bladder contraction of adequate size and duration. It requires a decrease in resistance of the bladder neck and urethra and no obstruction. Voiding problems can arise from abnormal storage of urine or problems with urinary control. The aim of this article was to review the functional anatomy and physiology of urinary control and micturition and the pathophysiology of urinary control problems. MATERIALS AND METHODS: The Medline (PubMed) database, Cochrane Library, and Science Citation Index were searched electronically to identify original published studies on bladder anatomy, function and urinary control...
October 10, 2018: Clinical Anatomy
Olivia Fox, Peter Lorentzos, Moussa Farhat, Andrew Kanawati
The axillary nerve is the most commonly injured nerve around the arm. In the deltopectoral approach, classical teaching states that lateral rotation of the humerus increases the distance between the subscapularis and the axillary nerve. This is the first anatomical study to quantify the distance change between the axillary nerve and subscapularis produced by arm rotation. Eight arms were placed in the supine position and a classical deltopectoral approach was performed. With digital calipers, measurements were made from the closest identifiable margin of the nerve to the inferior extent of the tenotomy...
October 10, 2018: Clinical Anatomy
Blanca Mompeó, Eva Maranillo, Arturo García-Touchard, Jose R Sanudo
To examine the origin and development of the renal plexus and its relationship to the renal vessels in embryos and early human fetuses. Serial sections of 34 human embryos (stages 16 to 23 of Carnegie, 4 or 5-8 weeks) and 38 fetuses (9-19 weeks) were analyzed. Throughout the embryonic period, the kidney was not innervated by the renal plexus. Those nerves appeared at the beginning of the early fetal period (9 weeks) as branches given off by the immature autonomic abdominal plexus. The renal nerves started to approach to the kidney during the early fetal period at 9-10 weeks of development...
October 9, 2018: Clinical Anatomy
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