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[Teaching arthroscopy techniques at the Educational Center for Clinical Anatomy and Endoscopy (ECAE), Department of Anatomy, 3rd Faculty of Medicine, Charles University in Prague].

In the period from 2000 to 2005, with support of several grants, a unique multi-media center for teaching endoscopic techniques was established at the Department of Anatomy, 3rd Faculty of Medicine, Charles University in Prague. This conditions have been provided for the repeated use of cadavers preserved by a special embalming method of Professor Thiel of the Institute for Anatomy, University of Graz, for simulation of surgical procedures. One room of the Department has been converted into a small operating theatre and an audio-visual network with wireless Internet connection covers the whole dissection unit of the Department. A graphic studio for production of teaching materials has also been set up. The course in dissection for the first- and second-year medical students also includes demo arthroscopy. In addition to the courses for students, postgraduate courses for young surgeons are organized. These provide an opportunity to learn about techniques and instruments employed in a broad range of arthroscopic procedures, using appropriate cadaver materials.

Arthroscopy↗

Role of anatomy in our contemporary age and the history of the Anatomy Museum of Naples.

This work analyzes the significance of anatomical knowledge in the contemporary age through the history of a prestigious institution, the Anatomy Museum of Naples. The museum's past was ineluctably linked not only to the local sociopolitical events but also to the scientific developments of medicine. The museum is an academic place where the importance of the anatomic science in the contemporary age both in the scientific and in the cultural fora is evident.

Anatomy↗

High-resolution MR imaging anatomy of the orbit. Correlation with comparative cryosectional anatomy.

High resolution MR imaging of the orbit enables visualization of anatomic details in the orbit, including important blood vessels, muscles, nerves and connective tissue structures. The best resolution of anatomic details currently is obtained by using surface coils and T1-weighted spin echo sequences. Some examples of clinical applications demonstrate that a detailed knowledge of orbital imaging anatomy is a prerequisite for successful interpretation of clinical MR images. Additionally, this noninvasive diagnostic technique may be used for anatomical in vivo studies.

Anatomy, Cross-Sectional↗

An early illustrated comparative anatomy of the brain: Samuel Collins' A Systeme of Anatomy (1685) and the emergence of comparative neurology in 17th century England.

The concept of comparing of the brains of various animals and of individual human brains was launched in the last half of the 17th century in England and was much influenced by the formation of the European scientific societies and their attempts to guide naturalist observations into a new systematics. An ambitious attempt to document this trend in an extensively illustrated work of encyclopedic pretensions was the singular publication of Samuel Collins (1618-1710), an energetic anatomist and president of the Royal College of Physicians. His little known tow-volume folio presentation, written in teh vernacular for broad acceptance, contains the seeds of a science of comparative neurology with the largest collection of brain illustrations (as well as of other organ systems) attempted in his era. Although lacking the conceptual insight that might derive from a true "comparative" anatomy and an understanding of the relations of different animals, the handsome engravings exemplified the new direction of the 'enlightenment' of the scientific revolution and are discussed in teh context of relevant events of this period.

Anatomy, Comparative↗

[Anatomy as theatre. From the library of the Society of the Dutch Journal of Medicine. Govard Bidloo: Ontleding des Menschelijken Lichaams (Dissection of the Human Body); 1689; and William Cowper: The Anatomy of Humane Bodies; 1698].

Opinions differ regarding the scientific quality of the atlas by Govard Bidloo, Ontleding des Menschelijken Lichaams (Dissection of the Human Body) (1689) and the plagiarism made thereof by William Cowper, The Anatomy of Humane Bodies (1698). Both books were also published in Latin; the Society of the Dutch Journal of Medicine has acquired a copy of all 4 atlases. The anatomical plates were made by the artist Gerard de Lairesse (Liège 1640-Amsterdam 1711) and their great artistic value is beyond all doubt. De Lairesse settled in Amsterdam in 1665, a few months after the reopening of the city theatre, and subsequently achieved fame as an innovative creator of theatre sets. He also became one of the favourite artists of prince William III and many other well-to-do citizens of Amsterdam. The great artistic value of his anatomical plates justifies more attention for his importance as a medical illustrator in medical history.

Anatomy, Artistic↗

A new concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. VIII. Levator hiatus and tunnel: anatomy and function.

The anatomy of the levator hiatus and tunnel has been studied, aiming at the elucidation of their functional role in mechanisms of defecation, urination, and continence. The material comprised 25 cadavers studied by dissection and serial histologic sections. The levator hiatus occupies the anterior portion of the levator plate which consists of two "crura," that bound the hiatus, and two "lateral masses." Three crural patterns could be identified: classic, crural overlap and crural scissor. The levator tunnel is a muscular tube which surrounds the intrahiatal organs along their way down from the levator hiatius to the perineum. It is double sheathed, with an inner coat of the suspensory sling and an outer of the puborectalis. Both coats are of striped muscle bundles. The inner coat is a tunnel "dilator," whereas the outer is a tunnel "constrictor." The puborectalis not only acts as a "common tunnel" sphincter but provides an "individual" sphincter for each intrahiatal organ. A detailed study of the hiatal ligament which firmly binds the levator plate to the intrahiatal organs is presented. A "tunnel septum" could be identified to line the levator tunnel, and separate it from the intrahiatal organs. Its surgical significance as a landmark for mobilizing the intrahiatal organs from within the tunnel is stressed. The levator plate consists of two functionally separate zones: a lateral "visceral support" zone and medial "dilator" one. The double sphincteric control provided to each intrahiatal organ by the "individual" and "common" sphincters would suggest that unless both sphincters are destroyed, continence could be maintained by either. The role of the "levator complex" which comprises levator crura, tunnel and hiatal ligament in fixation of intrahiatal structures, as well as in mechanisms of defecation, urination, and continence, is discussed. The understanding of the anatomic details of the levator hiatus and tunnel could be of value in mobilizing the intrahiatal structures from within the levator tunnel with preservation of their voluntary sphincteric mechanism.

Defecation↗

Upper limb vein anatomy before hemodialysis fistula creation: cross-sectional anatomy using MR venography.

Preoperative imaging is indicated to discriminate patent, adequate superficial veins of the upper limbs undetectable by clinical inspection that could be anastomosed for the creation of a durable and functional hemodialysis fistula. The aim of this pictorial review is to provide a venous anatomic map of the upper limbs using MR venography (MRV) which could help surgeons before creation of hemodialysis access fistulas (AVF). At the level of the forearm, the antebrachial cephalic vein is the most commonly identified as patent. At the level of the elbow and distal arm, the cephalic vein is patent in 80% of normal subjects, and less often patent (23-26%) than basilic vein (33-38%) in patients. Overall, reading transaxial MR views can help for assessing upper limb vein anatomy before creation of a hemodialysis access fistula.

Adolescent↗

Quantitation of human shoulder anatomy for prosthetic arm control--II. Anatomy matrices.

Part I presented mathematically continuous surfaces and origin-to-insertion centroidal trajectory data for the muscles of the human shoulder. Part II presents linear trajectory data for the same muscles, in addition to kinematic descriptions of the joints. 'Anatomy' matrices for musculature, which convert muscle forces (as estimated by cutaneously monitored EMG signals) to moments, within a prosthetic arm controller, are developed for both the linear and non-linear (centroidal) data, and then compared. Graphical analyses of the muscle functions are also presented via computer-generated 'circle diagrams'.

Arm↗

Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation.

A cadaveric study was performed to determine the insertion-site anatomy of the human menisci, their topographical relationships to adjacent intra-articular structures, and which arthroscopic portal provides for optimal visualization of each insertion site. Fifteen fresh-frozen cadaver knees were studied (ages 48 to 63 years). Ten knees underwent arthroscopy using four standard arthroscopic portals. Visualization and placement of an arthroscopic guide over each meniscal horn insertion site was attempted through the four arthroscopic portals. Guide wires were drilled to mark horn insertions followed by a gross dissection to evaluate accuracy of the guide wire gross dissection to evaluate accuracy of the guide wire placement and to isolate meniscal horn insertion sites. Insertion sites were outlined and evaluated for size and topographical relationships to other intra-articular structures. Five additional knees were dissected free of all soft tissues except the tibial insertions of the meniscal roots and anterior cruciate ligament/posterior cruciate ligament. Each tibia was mounted in a jig and a digitizing system was used to record coordinates of points along the outline of each bony meniscal horn insertion site, the ACL tibial insertion, and the articular surface of each tibial plateau. The x, y, z coordinates for each point were calculated and loaded into a computer program allowing for surface area determination and computer-generated topographical maps to assess relative position of each specific insertion site. Placement of the arthroscope in the anterolateral portal allows optimal visualization and guide wire placement for both lateral meniscal horn insertion sites. Medial meniscal anterior and posterior horn insertion sites are best visualized with the arthroscope in the anteromedial and posteromedial portals respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthroscopy↗

Anatomy of the iliolumbar ligament: a review of its anatomy and a magnetic resonance study.

Data of the postmortem studies of the iliolumbar ligament are controversial because of the number, complexity, and variability of the structures present in the lumbosacral region. The objective of this work was to study the anatomy of the iliolumbar ligament to resolve some clinical problems: (1) do anatomic bases exist that can explain the lumbar painful syndrome termed "iliolumbar syndrome?" (2) do iliolumbar ligament varieties exist that can influence lumbosacral joint stability? Magnetic resonance was used to analyze the anatomic structure of the iliolumbar ligament of live human beings. Thirty iliolumbar ligaments of 15 volunteers were analyzed with magnetic resonance. The images were acquired along the transversal and coronal planes (respectively, superoinferior and anteroposterior). The portion of the iliolumbar ligament originating from the L-5 transverse process is made up of two bands (anterior and posterior). The anterior band is broad and flat and has two different anatomic varieties. Type 1 originates from the anterior aspect of the inferolateral portion of the L-5 transverse process and fans out widely before inserting on the anterior portion of the iliac tuberosity. Type 2 originates anteriorly, laterally, and posteriorly from inferolateral aspect of the L-5 transverse process and fans out before inserting on the anterior portion of the iliac tuberosity. The posterior band of the iliolumbar ligament originates from the apex of the L-5 transverse process and is fusiform. Just before inserting on the anterior margin and apex of the iliac crest it widens, assuming the aspect of a small cone. On the transaxial plane, the anterior band of the iliolumbar ligament was placed along the horizontal line passing through the transverse processes, whereas the posterior band formed an angle of approximately 45 to 55 degrees opened posterolaterally with this line. On the coronal plane, the spatial disposition of the iliolumbar ligament varies greatly with the size of the L-5 vertebra and its position in the pelvis: (1) when L-5 is situated low in the pelvis, the bands of the iliolumbar ligament are longer and oblique; (2) when L-5 is situated high in the pelvis, the bands of the iliolumbar ligament are shorter and horizontal. The insertion manner of iliolumbar ligament posterior band in the iliac crest allows us to confirm the possibility of existence of the lumbar painful syndrome termed iliolumbar syndrome and confirms the possibility of examining its insertional site manually. Being accessible manually, various drugs can be injected directly into it or deep friction can be applied. This posterior band is thinner than the anterior, with a smaller insertional base on the iliac crest, which explains its lesser resistance to torsional overloading and also explains the frequency of this painful syndrome. It is probable that the spatial disposition of the iliolumbar ligament influences its antitorsional role. Further anatomic and biomechanic studies are needed.

Adult↗

Microsurgical anatomy of the temporal lobe: part 1: mesial temporal lobe anatomy and its vascular relationships as applied to amygdalohippocampectomy.

OBJECTIVE: We review the anatomy of the mesial temporal lobe region, establishing the relationships among the intraventricular, extraventricular, and surrounding vascular structures and their angiographic characterization. We also demonstrate the clinical application of these anatomic landmarks in an anatomic temporal lobectomy plus amygdalohippocampectomy. METHODS: Fifty-two adult cadaveric hemispheres and 12 adult cadaveric heads were studied, using a magnification ranging from 3x to 40x, after perfusion of the arteries and veins with colored latex. RESULTS: The intraventricular elements are the hippocampus, fimbria, amygdala, and choroidal fissure; the extraventricular elements are the uncus and parahippocampal and dentate gyri. The uncus has an anterior segment, an apex, and a posterior segment that has an inferior and a posteromedial surface; the uncus is related medially to cisternal elements and laterally to intraventricular elements. The anterior segment is related to the proximal sylvian fissure, internal carotid artery, proximal M1 segment of the middle cerebral artery, proximal cisternal anterior choroidal artery, and amygdala. The apex is related to the oculomotor nerve, uncal recess, and amygdala; the posteromedial surface is related to the P2A segment of the posterior cerebral artery inferiorly, to the distal cisternal anterior choroidal artery superiorly, and to the head of the hippocampus and amygdala intraventricularly. The choroidal fissure is located between the thalamus and fimbria; it begins at the inferior choroidal point behind the head of the hippocampus and constitutes the medial wall of the posterior two-thirds of the temporal horn. CONCLUSION: Not only is the knowledge of these relations useful to angiographically characterize the mesial temporal region, but it has also proven to be of extreme value during microsurgeries involving this region.

Adult↗

[Leaf anatomy study in Solanaceae of Venezuela. V. leaf anatomy of eleven species of Cestrum L] .

Leaf anatomy of the following eleven species: C. buxifolium Kunth, C. humboldtii Francey, C. lindenii Dunal, C. mariquitense Kunth, C. megalophyllum Dunal, C. olivaceum Francey, C. pariense Steyerm., C petiolare Kunth, C. scandans Vahl, C. strigilatum Ruiz et Pavón and C. tomentosum L.f. is described. Transverse sectioning, bruise and clearing according to the classical methods for optical microscopy were made. The species studied show dissimilitude in relation to a) fohar blade: thickness and sinuosity of epidermal cell walls; type, density and presence of trichornes, leaf type according the position of the stomata, thickness of both palisade and spongy parenchy-ma, number of spongy parenchyma layers, occurrence or not of paranchymatous sheath and sclerifled cells in mesophyll, tmbeculae or projection walls b) Midvein: degree of development and arrangement of the parenchyma and collenchyma, c) Petiole: size and form in transverse section, presence of ornamented cuticle, peridermis and degree of development of the sclerenctiyma next to vascular bundles.

Plant Leaves↗

New concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. II. Anatomy of the levator ani muscle with special reference to puborectalis.

A study of the surgical anatomy of the levator ani muscles, with special stress on the puborectalis, was performed on 22 cadaveric specimens. The study comprised dissection and microscopic examination. The levator ani was found to consist of two portions only: pubococcygeus and iliococcygeus, the puborectalis being a part of the external anal sphincter. Both levatores decussate at the anococcygeal raphe, which represents a "decussation line" and not a site of insertion for the muscle fibers. A "digastric" pattern of the levator is demonstrated, which is responsible for the harmonic nature of the function of the muscle bundles on each side of the pelvis. The levator hiatus was found to be formed of the medial borders of the pubococcygeus, , and not the puborectalis. A "hiatal ligament" was identified, stretched between the edges of the levator hiatus and the intrahiatal viscera. The role of the pubococcygeus in anal fixation is discussed, and a new concept that the puborectalis does not belong to the levator ani but constitutes na integral portion of the external and sphincter. The puborectalis and the deep external anal sphincter were found to be fused together and identical from the morphologic, histologic, and functional points of view as well as with respect to innervation. Both form a single U-shaped loop which is given the name "top loop."

Adolescent↗

The facial canal: normal anatomy, variations and anomalies. I. Normal anatomy of the facial canal.

Modern otologic surgery revolves around the use of the operating microscope. The surgeon must have a thorough knowledge of all structures in the temporal bone, particularly since surgery may now be directed to areas in its deeper portions. Of concern here is the whereabouts of the facial canal in its complex course through the temporal bone. A detailed descriptive anatomy with emphasis on the relations of the facial canal to adjacent structures is presented. The variations in the course of the facial canal are discussed. The location of dehiscences in the bony canal wall are described. Finally, great stress is laid upon presentation of these anomalies known to us which can occur in the course of the facial nerve through the temporal bone. These anomalies have clinical and surgical significance.

Ear Canal↗

Surface anatomy of the hand. The relationships between palmar skin creases and osseous anatomy.

Markers placed along palmar skin creases of 53 hands radiographically demonstrated creases superimposed on osseous anatomy. The distal and middle digital creases were found to be consistently proximal to associated interphalangeal joints by 7 to 8 mm and 2 to 3 mm, respectively. Proximal digital creases were consistently distal to associated metacarpophalangeal (MCP) joints by 14 to 20 mm. Distances between the distal transverse palmar crease and associated MCP joints were 6.8 to 10.3 mm. Distances between the proximal palmar crease and the associated MCP joints were 9.1 to 22.1 mm. Mean perpendicular distances between the distal wrist crease and center of selected carpal structures or joints were as follows: scaphoid, 0.7 mm; pisiform, 3.4 mm; lunate, 9.2 mm; hamate hook, 12.6 mm; ulnar styloid, 11.7 mm; trapeziometacarpal joint, 19.4 mm; radioscapholunate joint, 13.5 mm; and distal radioulnar joint, 21.1 mm. Quantification of these relationships should assist in hand examination and placement of surgical incisions and provide further insight into anatomic and functional relationships of the hand.

Adult↗