Anatomical Dissection Research Articles

The previously undescribed variant of the thyrohyoid muscle and its potential impact on surgical procedures

The thyrohyoid muscle belongs to the infrahyoid group located in the carotid triangle. It normally originates from thyroid cartilage and inserts into hyoid bone. Quite often, it is continuous with the sternohyoid muscle. Furthermore, there are variants that have their origin in the cricoid cartilage only, however, this occurs very rarely. During anatomical dissection, a two-headed variant of this muscle was found. One head had its origin in the cricoid cartilage and the other in the thyroid cartilage. This variant of thyrohyoid had not been previously described in the available literature. Therefore, we believe that it may be referred to as the cricothyrohyoid muscle. As the thyrohyoideus is often used as a landmark during surgical procedures in the prelaryngeal area and as a muscle graft, a thorough knowledge of its anatomy and variation is extremely important. We speculate that the two-headed version of this muscle may be problematic during surgical procedures in this region, however, it may also provide more options as a muscular graft.

X-ray Imaging Versus Anatomical Dissection for Identification of the Fabella.

Reported prevalence rates of the fabella sesamoid bone vary widely, particularly between studies based on either X-ray imaging or anatomical dissection approaches. The purpose of this study was to directly compare these two methodologies in their detection of fabellae and investigate whether variability in the density of fabellae could explain any discrepancies. Fifty cadaveric knee segments were examined for the presence of a fabella by both X-ray imaging and anatomical dissection. The relative density of each excised fabella specimen was then quantified using a separate set of radiographs. Results: Fabellae were detected in 40% of the sample knees via a manual dissection approachbut in just 12% of those same specimens using X-ray imaging. Relative density measurements confirmed that fabellae identifiable only via dissection were significantly less dense than fabellae visible in whole knee radiographsbut denser than the surrounding tissue. Radiology cannot reliably detect cartilaginous or incompletely ossified fabellae, which were found in 28% of the study population. Clinicians should consider the potential occurrence of a fabella when diagnosing posterolateral knee pain, even if it may not be visible via X-ray.

Standardized porcine integrated robotic inguinal hernia training: the SPIRIT model.

Implementing a robotic system for minimally invasive surgical procedures necessitates a comprehensive training regimen. This involves not only mastering the technological aspects of the robotic system but also enhancing surgical proficiency in manipulating robotic instruments. Furthermore, procedural expertise in specific surgeries is critical. Minimally invasive inguinal hernia repair is particularly suitable as an initial procedure for human application. The development of a comprehensive training model for this type of repair is a crucial element of such an educational pathway. Anatomical dissections were carried out on pigs to assess both the similarities and differences between pig and human anatomy. A structured minimally invasive inguinal hernia repair was performed to determine the suitability of the porcine inguinal region for training purposes. A detailed anatomical description of the porcine inguinal region is outlined, to provide a framework for assessing the critical view of the porcine myopectineal orifice. By integrating the human 'ten golden rules' for safe and effective minimally invasive inguinal hernia repair, the standardized porcine integrated robotic inguinal hernia training (SPIRIT) model describes a step-by-step approach to practice surgical techniques in a realistic setting. The SPIRIT model is designed to be a well-structured training model for minimally invasive inguinal hernia repair and incorporates the specific surgical steps as encountered in a human patient.

Description and Evaluation of Dye and Contrast Media Distribution of Ultrasound-Guided Rectus Sheath Block in Cat Cadavers.

The rectus sheath block is an ultrasound-guided anaesthetic technique which aims to provide analgesia to the abdominal midline. This study aimed to assess the distribution of 0.4 mL kg-1 of a mixture of methylene blue and iopromide injected into each hemiabdomen in the internal rectus sheath in cat cadavers. We hypothesise that this technique would be feasible and would cover the rami ventrales of the last thoracic and the first lumbar spinal nerves. The study was divided into two phases. Phase 1 aimed to study the anatomical structures of the ventral abdominal wall (four cats were dissected). Phase 2 (ten cadavers) consisted of an ultrasound-guided injection of the mixture mentioned above and the assessment of its distribution by computed tomography and anatomical dissection. The results showed the staining of the cranioventral abdominal wall with a craniocaudal spread of four (three to eight) vertebral bodies. Methylene blue stained three (one to four) rami ventrales, affecting T10 (60%), T11 (100%), T12 (90%), T13 (50%) and L1 (5%). Based on these results, it could be stated that this technique could supply anaesthesia to the midline of the abdominal midline cranial to the umbilicus in clinical patients, but it may not be able to provide anaesthesia to the middle and caudal midline abdominal region.

A previously unknown variant of the calcaneofibular ligament.

The lateral ankle joint is composed of three ligaments: the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL). The ATFL and CFL demonstrate morphological variation, especially regarding their shape and number of bands. During standard anatomical dissection, an unusual type of triple CFL was observed: the CFL was composed of two bands originating on the lateral malleolus, and the presence of a lateral talocalcaneal ligament (LTC) originating on the talus bone. The insertion point of each band was located on the calcaneal bone. An understanding of these anatomical patterns provides a clearer view of ankle joint biomechanics, and improved the planning and performance of surgical treatment.

Enhancing surgical expertise: 3D anatomy’s role in residency programs

Current virtual reality (VR) technology allows for the creation of instructional video formats that incorporate three-dimensional (3D) stereoscopic footage. Combined with 3D anatomic dissection, any surgical procedure or pathology can be represented virtually to supplement anatomical learning and surgical preoperative planning. The aim of this study was to evaluate the impact of virtual reality anatomical teaching. A prospective case-control study was performed. After a prerequisite anatomical knowledge assessment, participants were randomized in two groups: stereoscopic anatomical teaching program versus classic teaching with anatomical and surgical books of thoracic brachial outlet syndrome, and its related anatomy. Then, students completed a written anatomical test to assess their basic knowledge in vascular anatomy. Pre- and post-test performances were analyzed with independent t-tests for total score assessing basic anatomical knowledge, anatomical relationships and clinical inference. Before performing the teaching, the 20 students included were homogenous in term of total exam mark in abdominal aorta (mean 78,78% vs 76,34%) and carotid artery evaluations (mean 78,57% vs 74,76%). After the course, there statistical differences (p<0,05) between the stereoscopic-3D.video group (n= 10, 90%) and classical-teaching group concerning the total exam mark, descriptive anatomy, anatomical relationships and clinical inference skills. All the students thought this method seemed indispensable to their anatomical training course (100%). The teaching video with 3D stereoscopy seems to be a useful and complementary teaching tool that is approved by the residents themselves. In a future study, it will be necessary to evaluate the contribution of this teaching in the long term.

Meat productivity of quail of the Pharaoh breed after drinking a biotechnologicum supplementum (Suspension of Chlorella sorokiniana)

Currently, the use of microalgae as feed additives is gaining more and more popularity in the poultry industry. Microalgae are rich in bioactive metabolites that have demonstrated powerful antioxidant, antiinflammatory, and antiviral properties. Adding a small amount of such an additive to traditional feed has a positive effect on the health and well-being of birds, as well as the quality and quantity of products. The results of the study of meat productivity of quail of the Pharaoh breed after drinking Chlorella sorokiniana suspension are given. The research was conducted on quails during the period of cultivation from 1 to 60 days. To conduct the experiment, two groups (control and experimental) of 30 heads each were formed from day-old birds. Quails were kept in vivarium conditions, in battery cages in compliance with established microclimate requirements. Poultry of both groups received combined feed, developed taking into account age and physiological characteristics. With drinking water, the birds of the experimental group received a chlorella suspension for 60 days. Counting of the quail population and their weighing was carried out weekly, starting from day-old age. The following indicators were determined: preservation, dynamics of live weight, average daily growth of live weight. Based on the results of the control slaughter, the weight of the carcass and the weight of the edible part were determined. Slaughter qualities and morphological composition of quail carcasses were determined by anatomical dissection with determination of the following parameters: pre-slaughter weight, weight of semi-carcasses, carcases of carcases, slaughter yield, weight of edible parts. Drinking chlorella suspension of young quails increased their preservation by 3,83 %, live weight, and absolute growth by 21,0 and 0,57 g (Р<0,05), respectively. Addition of Chlorella sorokiniana suspension to drinking water of quails contributed to an increase in their pre-slaughter weight by 20,0 g, and their weight by 21,0 g compared to the control group. Quail carcasses of the research group were characterized by a higher yield of edible parts compared to birds that consumed clean water. Key words: biotechnology, Chlorella sorokiniana suspension, biotechnological parameters, cultivation, photobioreactor, quails of the Pharaoh breed, body weight, growth, slaughter parameters, weight of carcass, weight of internal organs, output of edible parts.

Anatomical eModule Curriculum: Perceptions of Undergraduate Medical Students Amidst Limited Experiential Laboratory Learning.

Over the past several years, undergraduate medical students were subject to variable learning environments amidst pandemic-related restrictions, challenging long-established experiential learning approaches. Concurrently, health science institutions have been revisiting the value (or lack thereof) of human body dissection. This study examined student experience using a supplemental gross anatomy eModule before, during, and after limitation of in-person experiential gross anatomy curriculum and which eModule attributes students find valuable. First-year medical students received a supplemental Distal Upper Limb anatomy eModule from 2019 to 2021 (n = 394). eModule users received a Post-eModule/Pre-Exam survey from 2019 to 2021, and a Post-eModule/Post-Exam survey in 2021. Both surveys included Likert-type and free-response questions. In Post-eModule/Pre-Exam surveys (2019, 2020, 2021, n = 95), students in the 2021 cohort responded most positively to the eModule's convenience, but most negatively when comparing the eModule to in-person dissection. In Post-eModule/Post-Exam surveys (2021, n = 18), > 75% of students indicated the eModule adequately prepared them to answer eModule-related exam questions.In free-response submissions, users highlighted the use of photos of anatomic dissections as the most beneficial feature. Deficiencies included the absence of figure legends and limited angles/views of specimens. This study may serve to guide the features included in future digital gross anatomy resources and aid in illustrating student perception of limited in-person experiential learning opportunities.

Cadaveric Simulation in Rib Plating is Beneficial for Helping Surgical Trainees to Assimilate New Technologies.

Rib fixation procedures are being performed more frequently as they have shown multiple advantages over traditional non-operative management in well-selected patients. We have developed a rib-fixation simulation on cadavers for use by surgical residents in attempt to improve their comfort, knowledge and ability to use this new technology. Residents in years 3 through 5 of training attended a rib-fixation simulation course with cadavers. Trauma faculty and representatives of manufacturers of rib-fixation hardware participated. The simulation consisted of groups of residents reviewing anatomy and creating adequate exposure for the entire procedure. Each group created rib fractures in the cadaver, determined which materials were needed, and then performed the rib-fixation procedure. Following the simulation, we surveyed the residents to determine the impact of the structured cadaveric rib fixation-based course on their comfort level. The survey was performed using a four- and five-level Likert questionnaire. The results were analyzed using paired t-tests. Of the participating residents, 72% of residents had performed five or fewer rib-fixation procedures in their training in the first cohort, while in the cohort for the following year, 65% had performed 5-10 procedures. The simulation had a statistically significant benefit to the residents' comfort level with rib plating (2.5 versus 3.6, p-value: 0.003). The greatest impact on the comfort level was seen in year 3 of training (2 versus 4, p-value 0.02). One hundred percent of residents found that having faculty and representatives present for the simulation was very helpful. The survey demonstrated that most residents gained new knowledge regarding the anatomy and technical dissection. In 20 of 25 encounters, residents strongly agreed that this simulation was beneficial for their surgical education, when used in addition to real operative experience. Every resident reported that they would recommend the simulation to younger resident classes. Rib-fixation simulations on cadavers were beneficial for surgical residents' self-assessed comfort level. The simulation increased residents' knowledge, comfort, and ability to perform rib-fixation procedures. We have seen a significant increase in resident participation in these cases after simulation training. Based on these findings, we will continue to incorporate these simulations into our program's curriculum.

Exploring heart dissection techniques for enhancing anatomical education: a pilot study to replicate transthoracic echocardiography.

For novice learners, converting two-dimensional (2D) images of echocardiography to three-dimensional (3D) cardiac structures is deemed challenging. This study aimed to develop an accurate dissection method of the heart to reproduce the transthoracic echocardiographic views on cadavers and elucidate new educational methods in human anatomy dissection courses. A total of 18 hearts were used in this study. After reflecting the anterior thoracic wall inferiorly, the hearts were excised from embalmed cadavers. Thereafter, three landmarks were set on the heart for each plane of the incision, and the hearts were incised to observe the three different echocardiographic views, which include the apical four-chamber view (A4C), parasternal long axis (PLAX) view, and parasternal short axis (PSAX) view at the papillary muscle level. If all structures for observation during routine echocardiography are clearly observed in each view, a successful incision is considered. All procedures and incisions were performed by the medical students. After a successful incision, hearts were returned to the original position in the pericardial sac for further observation. The success rates of incision for each view were 83.3% (5/6 success cases), 83.3% (5/6 success cases), and 66.7% (4/6 success cases) in the A4C view, PLAX view, and PSAX view at the papillary muscle level, respectively. This dissection method could probably be employed to reproduce transthoracic echocardiographic views on cadaveric hearts, which is beneficial for novice learners for a deeper understanding of the anatomy.

Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Translabyrinthine and Transcochlear Approaches

Abstract Introduction Skull base neuroanatomy is traditionally learned through two-dimensional anatomical atlases, which while are of unquestionable value, lack the nuanced association of three-dimensional relationships between fundamental anatomical structures relevant to surgical approaches. Surgically focused step-by-step anatomical dissections can augment trainee learning of complex skull base techniques, particularly multistep and nuanced techniques such as translabyrinthine and transcochlear approaches. Methods Translabyrinthine and transcochlear approaches were performed on six sides of three formalin-fixed latex-injected specimens. The study objective was the completion and photo documentation of the steps involved in the approach in order to provide a comprehensive, intelligible, and anatomically oriented resource for multilevel trainees. Illustrative case examples were prepared to supplement approach dissections. Results The translabyrinthine and transcochlear approaches offer unique lateral windows through the temporal bone into the posterior fossa, providing excellent access to pathology at the petrous apex, internal auditory canal, Meckel's cave, and anterolateral brainstem. The transcochlear approach, which is an anterior extension of the translabyrinthine, particularly provides excellent exposure of the prepontine region and clivus. Important surgical considerations include patient position, temporal bone drilling and identification of critical landmarks, dural opening and identification of neurovascular structures, and reconstruction/closure techniques. Conclusion The translabyrinthine and transcochlear approaches are fundamental techniques for lateral skull base and posterior fossa pathologies. Both approaches are hearing-sacrificing but often require minimal to no cerebellar retraction and deliver unique visualization of prepontine neurovascular structures. This step-by-step approach guide provides a unique practical and high-yield surgically oriented learning resource for neurosurgery and otolaryngology trainees.

Dissecting through the decade: a 10-year cross-sectional analysis of interprofessional experiences in the anatomy lab

ABSTRACT Interprofessional education (IPE) is prioritized as a critical component in preparing pre-licensure health professional students for effective teamwork and collaboration in the workplace to facilitate patient-centered care. Knowledge in anatomy is fundamental for healthcare professionals, making interprofessional anatomy education an attractive intervention for IPE and anatomy learning. Since 2009, the Education Program in Anatomy at McMaster University has offered an intensive 10-week IPE Anatomy Dissection elective to seven health professional programs annually. From 2011, students were invited to complete the Readiness for Interprofessional Scale (RIPLS) and Interprofessional Education Perception Scale (IEPS) before and after the elective. A total of 264 students from 2011 to 2020 completed RIPLS and IEPS. There were significant differences before and after the elective in students’ total RIPLS scores and three of the four subscales: teamwork and collaboration, positive professional identity, and roles and responsibilities. Similarly, there were statistical differences in the total IEPS scores and two of three subscales: competency and autonomy and perceived actual cooperation. Statistically significant differences in RIPLS and IEPS total scores across several disciplines were also observed. This study demonstrates the elective’s impact in improving students’ IPE perceptions and attitudes, likely from the extended learning and exposure opportunity with other disciplines.

Feasibility of teaching and assessing medical students in the metaverse: design and features for its learning efficiency

The metaverse is known as the hypothetical iteration of the Internet as a single, connected, universal and immersive virtual world that can be accessed via immersive technology devices. One approach to this concept can be achieved through the use of multi-user immersive virtual reality applications.Immersive virtual reality (IVR), which uses gadgets that allow the user to visualize and interact in an enveloping way, is a very attractive technology for teaching purposes. There are many references in the scientific literature about its use for this purpose, including encouraging results in the field of medicine. However, there have not been enough studies assessing how much this type of technology really contributes to learning medicine.This work investigates the feasibility of using the metaverse as an educational tool in medicine. We propose a multi-user immersive virtual reality application for implementing a scene of the metaverse in which medical students are taught. Our work considers that in order to ensure this type of technology is useful in the education of medical students, the technology itself (multi-user IVR) must be designed and implemented for a medical student profile. They usually spend too much time for adapting themselves to use and manage this kind of technology when they are exposed to it for learning. The technology should not be a barrier to acquiring, or disseminating the academic contents themselves. It should act as a catalyst that enhances the speed and capacity for learning medical educational topics. Thus, we present design and user experience specifications that we implemented in an anatomical dissection room in the metaverse, and with which we conducted experiments with 114 sixth-grade medical students. Our results indicate that, based on the design and user experience characteristics that we propose in this paper, the metaverse can indeed serve as a useful and effective educational resource whose technological complexity is no barrier to medical teaching.

Investigation into the effect of deltoid ligament injury on rotational ankle instability using a three-dimensional ankle finite element model.

Injury to the lateral collateral ligament of the ankle may cause ankle instability and, when combined with deltoid ligament (DL) injury, may lead to a more complex situation known as rotational ankle instability (RAI). It is unclear how DL rupture interferes with the mechanical function of an ankle joint with RAI. To study the influence of DL injury on the biomechanical function of the ankle joint. A comprehensive finite element model of an ankle joint, incorporating detailed ligaments, was developed from MRI scans of an adult female. A range of ligament injury scenarios were simulated in the ankle joint model, which was then subjected to a static standing load of 300N and a 1.5Nm internal and external rotation torque. The analysis focused on comparing the distribution and peak values of von Mises stress in the articular cartilages of both the tibia and talus and measuring the talus rotation angle and contact area of the talocrural joint. The dimensions and location of insertion points of ligaments in the finite element ankle model were adopted from previous anatomical research and dissection studies. The anterior drawer distance in the finite element model was within 6.5% of the anatomical range, and the talus tilt angle was within 3% of anatomical results. During static standing, a combined rupture of the anterior talofibular ligament (ATFL) and anterior tibiotalar ligament (ATTL) generates new stress concentrations on the talus cartilage, which markedly increases the joint contact area and stress on the cartilage. During static standing with external rotation, the anterior talofibular ligament and anterior tibiotalar ligament ruptured the ankle's rotational angle by 21.8% compared to an intact joint. In contrast, static standing with internal rotation led to a similar increase in stress and a nearly 2.5 times increase in the talus rotational angle. Injury to the DL altered the stress distribution in the tibiotalar joint and increased the talus rotation angle when subjected to a rotational torque, which may increase the risk of RAI. When treating RAI, it is essential to address not only multi-band DL injuries but also single-band deep DL injuries, especially those affecting the ATTL.

Quantitative Analysis of the Supraorbital, Transorbital Microscopic, and Transorbital Neuroendoscopic Approaches to the Anterior Skull Base and Paramedian Vasculature

Abstract Objectives Our objective was to compare transorbital neuroendoscopic surgery (TONES) with open craniotomy and analyze the effect of visualization technology on surgical freedom. Design Anatomic dissections included supraorbital craniotomy (SOC), transorbital microscopic surgery (TMS), and TONES. Setting The study was performed in a neurosurgical anatomy laboratory. Participants Neurosurgeons dissecting cadaveric specimens were included in the study. Main Outcome Measures Morphometric analysis of cranial nerve (CN) accessible lengths, frontal lobe base area of exposure, and craniocaudal and mediolateral angle of attack and volume of surgical freedom (VSF) of the paraclinoid internal carotid artery (ICA), terminal ICA, and anterior communicating artery (ACoA). Results The mean (standard deviation [SD]) frontal lobe base parenchymal exposures for SOC, TMS, and TONES were 955.4 (261.7) mm2, 846.2 (249.9) mm2, and 944.7 (158.8) mm2, respectively. Access to distal vasculature was hindered when using TMS and TONES. Multivariate analysis estimated that accessing the paraclinoid ICA with SOC would provide an 11.2- mm3 increase in normalized volume (NV) compared with transorbital corridors (p < 0.001). There was no difference between the three approaches for ipsilateral terminal ICA VSF (p = 0.71). Compared with TONES, TMS provided more access to the terminal ICA. For the ACoA, SOC produced the greatest access corridor maneuverability (mean [SD] NV: 15.6 [5.6] mm3 for SOC, 13.7 [4.4] mm3 for TMS, and 7.2 [3.5] mm3 for TONES; p = 0.01). Conclusion SOC provides superior surgical freedom for targets that require more lateral maneuverability, but the transorbital corridor is an option for accessing the frontal lobe base and terminal ICA. Instrument freedom differs quantifiably between the microscope and endoscope. A combined visualization strategy is optimal for the transorbital corridor.

Subregion preference in the long-range connectome of pyramidal neurons in the medial prefrontal cortex

BackgroundThe medial prefrontal cortex (mPFC) is involved in complex functions containing multiple types of neurons in distinct subregions with preferential roles. The pyramidal neurons had wide-range projections to cortical and subcortical regions with subregional preferences. Using a combination of viral tracing and fluorescence micro-optical sectioning tomography (fMOST) in transgenic mice, we systematically dissected the whole-brain connectomes of intratelencephalic (IT) and pyramidal tract (PT) neurons in four mPFC subregions.ResultsIT and PT neurons of the same subregion projected to different target areas while receiving inputs from similar upstream regions with quantitative differences. IT and PT neurons all project to the amygdala and basal forebrain, but their axons target different subregions. Compared to subregions in the prelimbic area (PL) which have more connections with sensorimotor-related regions, the infralimbic area (ILA) has stronger connections with limbic regions. The connection pattern of the mPFC subregions along the anterior–posterior axis showed a corresponding topological pattern with the isocortex and amygdala but an opposite orientation correspondence with the thalamus.ConclusionsBy using transgenic mice and fMOST imaging, we obtained the subregional preference whole-brain connectomes of IT and pyramidal tract PT neurons in the mPFC four subregions. These results provide a comprehensive resource for directing research into the complex functions of the mPFC by offering anatomical dissections of the different subregions.

Anatomical Landmarks for Transverse-Sigmoid Sinus Junction: A Cadaveric Study.

Accurately identifying and avoiding crucial anatomical structures within the posterior cranial fossa using superficial landmarks is essential for reducing surgical complications. Our study focuses on the top of the mastoid notch (TMN) as an external landmark of the cranium, aiming to assist in the strategic placement of the initial burr hole. In this study, we present a method for predicting the path of the transverse sinus (TS) and explore the relationship between the junction of the transverse-sigmoid sinus and the TMN. Following anatomical dissections of the brain in cadaveric specimens, we conducted intracranial drilling from the inside surface of the cranium on 10 adult skulls (20 sides). A coordinate system was established on the posterolateral surface of the skull to assist the analysis. Using a self-leveling laser level, we set up a horizontal Frankfurt line (X-axis) and identified a vertical perpendicular line passing through the TMN to serve as the Y-axis. To identify the course of the TS, we divided the segment between the two inferomedial points into six equidistant points along the Frankfurt line. No significant difference was observed between the inferomedial points of the transverse-sigmoid sinus junction (TSSJ) on the left and right sides. The inferomedial point was positioned at a median of 6.6 mm (Q1: 3.7 mm, Q3: 9.4 mm) dorsally and at a median of 19.2 mm (Q1: 16.1 mm, Q3: 23.2 mm) cranially from the TMN. The upper edge of the TS was located at distances of 6.4 mm (5.7; 12.7), 10.3 mm (8.8; 12.3), and 13.8 mm (11.9; 16.3) on the right, and 4.9 mm (4.1; 7.9), 8.6 mm (7.6; 13.0), and 12.8 mm (11.7; 17.5) on the left side from the Frankfurt horizontal plane at the ¼, ½, and ¾ line points, respectively. The bottom edge was positioned at distances of 0.6 mm (-2.7; 2.0), 2.1 mm (-0.8; 3.8), and 4.8 mm (2.4; 6.7) on the right, and 1.1 mm (-3.4; 2.4), 2.0 mm (0.2; 4.8), and 3.9 mm (3.7; 5.3) on the left from these respective points. The upper edge of the right TS was found to be statistically more distant from the Frankfurt horizontal plane at the ¼ line point (p-value = 0.027) compared to that on the left side. The confluence of the sinus center was identified as having a median distance of 7.8 mm (4.5; 8.3) and an inferior point of 1.5 mm (0.1; 3.0) cranially to the inion. In all examined bodies (n = 10), the confluens sinuum was consistently 4.7 mm (3.3; 5.6) to the right in relation to the inion. Notably, the median of the right transverse sinus diameter (median = 9.3 mm) was found to be significantly larger than that of the left transverse sinus (median = 7.0), with a statistically significant p-value of 0.048. The literature regarding the external identification of the TSSJ and the course of the TS varies. In our efforts to provide a description, we have utilized the TMN as a reliable landmark for locating the TSSJ. To delineate the trajectory of the TS after its exit from the confluence of sinuses, we employed a Frankfurt horizontal plane to the inion. These findings may assist surgeons by using external skull landmarks to identify intracranial structures within the posterior fossa, particularly when image guidance devices are not available or to complement a neuronavigational system.

Neglected Sprengel’s deformity in an 80-year-old female cadaver: a case report

BackgroundSprengel’s deformity is a congenital abnormality of the shoulder girdle. Because scapular retraction, such as the Green procedure, is usually performed during childhood to improve esthetics and shoulder function, Sprengel’s deformity is rarely found in older patients.Case presentationWe presented a unique case of a Japanese female cadaver with Sprengel’s deformity at the age of 80 years. Anatomical dissection and radiological imaging revealed musculoskeletal anomalies associated with Sprengel’s deformity, including Klippel–Feil syndrome, presence of an omovertebral bone, and absence of the trapezius muscle. In addition, bilateral cervical ribs were in contact with the brachial plexus. These anomalies may lead to numbness, pain, and limited range of motion of the neck and upper girdle with aging.ConclusionsBecause most adult patients with Sprengel’s deformity experience neck pain and limited movement of the shoulder, the presented case is a rare case of neglected Sprengel’s deformity in an 80-year-old cadaver.

Never undescribed four - headed plantaris muscle.

The plantaris is a small muscle of the superficial posterior compartment of the leg. It originates at the lateral supracondylar line of the femur and the knee joint capsule, from where it continues distally, forming a long and slender tendon distally attached to the calcaneal tuberosity. During standard anatomical dissection four-headed plantaris muscle was found and all of its heads connected to each other as a single muscle belly passing into tendinous structure which was distally attached as a standard plantaris muscle. The first head originated from the popliteal surface of the femur. The second one was originated from distal Kaplan fiber. In turn, the third and fourth heads were proximally attached to the lateral femoral epicondyle. Knowledge about morphological variations is necessary because of its potential clinical significance, which means not only neurovascular compressions, but also surgical procedures.

A primer to vascular anatomy of the brain: an overview on anterior compartment

PurposeKnowledge of neurovascular anatomy is vital for neurosurgeons, neurologists, neuro-radiologists and anatomy students, amongst others, to fully comprehend the brain’s anatomy with utmost depth. This paper aims to enhance the foundational knowledge of novice physicians in this area.MethodA comprehensive literature review was carried out by searching the PubMed and Google Scholar databases using primary keywords related to brain vasculature, without date restrictions. The identified literature was meticulously examined and scrutinized. In the process of screening pertinent papers, further articles and book chapters were obtained through analysis and additional assessing of the reference lists. Additionally, four formalin-fixed, color latex-injected cadaveric specimens preserved in 70% ethanol solution were dissected under surgical microscope (Leica Microsystems Inc, 1700 Leider Ln, Buffalo Grove, IL 60089 USA). Using microneurosurgical as well as standard instruments, and a high-speed surgical drill (Stryker Instruments 1941 Stryker Way Portage, MI 49002 USA). Ulterior anatomical dissection was documented in microscopic images.ResultsEncephalic circulation functions as a complex network of intertwined vessels. The Internal Carotid Arteries (ICAs) and the Vertebral Arteries (VAs), form the anterior and posterior arterial circulations, respectively. This work provides a detailed exploration of the neurovascular anatomy of the anterior circulation and its key structures, such as the Anterior Cerebral Artery (ACA) and the Middle Cerebral Artery (MCA). Embryology is also briefly covered, offering insights into the early development of the vascular structures of the central nervous system. Cerebral venous system was detailed, highlighting the major veins and tributaries involved in the drainage of blood from the intracranial compartment, with a focus on the role of the Internal Jugular Veins (IJVs) as the primary, although not exclusive, deoxygenated blood outflow pathway.ConclusionThis work serves as initial guide, providing essential knowledge on neurovascular anatomy, hoping to reduce the initial impact when tackling the subject, albeit the intricate vasculature of the brain will necessitate further efforts to be conquered, that being crucial for neurosurgical and neurology related practice and clinical decision-making.