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At least 577 records · Page 32Linked to original sources
PubMed2006

Retrosigmoid intradural suprameatal approach: advantages and disadvantages from an anatomical perspective.

OBJECTIVE: To assess the advantages and disadvantages of the retrosigmoid intradural suprameatal approach by studying the microsurgical anatomy. This study was performed primarily to assess the advantages of the retrosigmoid intradural suprameatal approach by measuring the amount of increased exposure it provides for lesions of the cerebellopontine and petroclival region as well as to identify the disadvantages of the approach. METHODS: Twenty sides of 10 cadaver heads (embalmed and injected) were dissected under x3 to x40 magnification. A standard retrosigmoid craniotomy was made. The cerebellopontine cistern was entered to expose the neurovascular structures, and the internal auditory canal was opened by drilling the margin of the internal auditory meatus. After this, the suprameatal tubercle was drilled, followed by additional drilling to resect the petrous apex. The trigeminal root was mobilized completely after opening Meckel's cave. During drilling, care was taken to preserve the posterior and superior semicircular canals, petrosal sinus, and the internal carotid artery. RESULTS: The approach enhanced the exposure of the cerebellopontine cistern and Meckel's cave. There was an additional exposure of 10.7 +/- 1.16 mm length of trigeminal nerve on the right side and an additional 10.7 +/- 1.25 mm on the left. This helped to mobilize and further retract the trigeminal root. Although it facilitated the view of the neurovascular structures medial to the internal acoustic meatus, the depth of exposure did not vary much from a traditional retrosigmoid approach nor did it increase the angle of exposure or the visualization of the clivus and more medially located structures. CONCLUSION: This approach is suitable for lesions mainly in the posterior fossa with some extension into the middle fossa in the anterolateral direction. The key benefits of this approach are the length of trigeminal nerve exposure and the subsequent mobilization that improves visualization of the structures medial to the internal auditory canal, to the petrous apex, Meckel's cave, and the posterior end of the cavernous sinus.

Brain Stem↗
PubMed2001

A three-dimensional finite element model from computed tomography data: a semi-automated method.

Three-dimensional finite element analysis is one of the best ways to assess stress and strain distributions in complex bone structures. However, accuracy in the results may be achieved only when accurate input information is given. A semi-automated method to generate a finite element (FE) model using data retrieved from computed tomography (CT) was developed. Due to its complex and irregular shape, the glenoid part of a left embalmed scapula bone was chosen as working material. CT data were retrieved using a standard clinical CT scanner (Siemens Somatom Plus 2, Siemens AG, Germany). This was done to produce a method that could later be utilized to generate a patient-specific FE model. Different methods of converting Hounsfield unit (HU) values to apparent densities and subsequently to Young's moduli were tested. All the models obtained were loaded using three-dimensional loading conditions taken from literature, corresponding to an arm abduction of 90 degrees. Additional models with different amounts of elements were generated to verify convergence. Direct comparison between the models showed that the best method to convert HU values directly to apparent densities was to use different equations for cancellous and cortical bone. In this study, a reliable method of determining both geometrical data and bone properties from patient CT scans for the semi-automated generation of an FE model is presented.

Aged↗
PubMed1990

Anthropometric estimation of muscle mass in men.

Twelve male cadavers (aged 50-94 yr) were subjected to comprehensive anthropometry, dissection, and weighing of all skeletal muscle. Correlation coefficients of limb girths with total skeletal muscle mass (MM) were high: forearm r = 0.96, mid-thigh r = 0.94, calf r = 0.84, and midarm r = 0.82. These increased when limb girths were corrected (by subtracting pi times the skinfold thickness) to estimate muscle girth. For dimensional consistency, variables in the regression analyses included the product of stature and the square of each corrected girth. For the six unembalmed cadavers, this yielded a three-girth equation for MM (r2 = 0.93; SEE = 1.56 kg), which was then validated using data from the embalmed cadavers. It predicted MM with an SEE of 1.58 kg and r2 = 0.93. Because the values of these SEEs were similar, we pooled the subjects from the two groups to generate the final estimation equation: MM = STAT (0.0553CTG2 + 0.0987FG2 + 0.0331CCG2) - 2445 (SEE = 1.53 kg, r2 = 0.97), where STAT is stature (cm), CTG is thigh circumference corrected for the front thigh skinfold thickness (cm), FG is the uncorrected forearm circumference (cm), and CCG is the calf circumference corrected for the medial calf skinfold thickness (cm). Despite the limitations of the cadaver sample, the proposed equation appears to provide the best estimate of skeletal muscle mass to date, in that it is the only cadaver-validated equation and it gives values that are consistent with all known dissection data.

Aged↗
PubMed2006

Gross morphological features of the lung and air sac in the Japanese quail.

This study was conducted to reveal the morphological characteristics of the lung and air sacs in Coturnix coturnix japonica (Japanese quails). Ten quails were allocated into two groups. Tracheas of 5 quails with neoprene latex and 5 quails with methylmetacrylate were injected to fill the trachea and air sacs. Latex embalmed animals were stored in 10% formaldehyde solution for two months. Animals given methylmetacrylate were maserated in 30% potassium hydroxide at 40 degrees C for two days. Lungs were located in the dorsal part of the thorax and very close to the thoracic vertebrae and ribs. Shorter than the dorsal border, the ventral border lied between the 3rd and 6th ribs. Cervical, clavicular, cranial thoracic, caudal thoracic and abdominal sacs were identified. These sacs had connection with the 3rd, 4th and 5th lateroventral and 4th mediolateral bronchi. Saccus cervicalis was located on the left and right portions of the vertebrae cervicales et thoraricae with a pronounced communication ventromedially. However, the cervical sac aeration of only all cervical vertebrae was present in this study. Humerus was a non-aerated bone. Pneumatic foramen was absent and did not aerate the sternum. Cranial thoracic sac connected to the 1st, 2nd and 4th medioventral bronchi and gave no diverticulum for aeration. Cranial thoracic sac received air through the 4th medioventral and the 1st and 2nd lateroventral bronchi. Left and right abdominal air sacs paramedially produced diverticulum femorale, but this diverticulum did not enter the femur.

Air Sacs↗
PubMed2002

Anatomical study of the carpal attachment of the triangular fibrocartilage complex.

There have been few descriptions of the site of attachment onto the triquetrum, the so-called meniscal homologue, of the triangular fibrocartilage complex (TFCC). We have investigated the sites of attachment onto the triquetrum of 87 TFCCs collected from embalmed cadavers. All TFCCs were smoothly attached to the triquetrum. In 79 (46 cases, 90%) they were attached to the triquetrum and fifth metacarpal bone, and in eight (5 cases, 10%) they were attached widely on the articular surface of the triquetrum. It is necessary to have accurate positional information about the normal triquetrum and TFCC in order to perform arthroscopy. The meniscal homologue attached to the triquetrum is smooth in almost all cases. In about 10% of joints the TFCC is attached to the lunotriquetral ligament, either partly or completely obscuring the articular surface of the triquetrum.

Adult↗
PubMed2003

Separate vertical wiring for the fixation of comminuted fractures of the inferior pole of the patella.

Comminuted and displaced fractures of the inferiorole of the patella are not easy to reduce and it is difficult to fix the fragments soundly enough to allow early movement of the knee. We have evaluated the clinical effectiveness of the separate vertical wiring technique in acute comminuted fractures of the inferior pole of the patella. A biomechanical study was also performed using ten pairs of embalmed cadaver knees. A four-part fracture was made on the inferior pole of the patella and fixed by two separate vertical wires on one side and two pull-out sutures after partial patellectomy on the other. The ultimate load to failure in the first group was significantly higher than in the second (250.1+/- 109.7 N v 69.7 +/- 18.9 N, p < 0.002), as was the stiffness (279.9 +/- 76.4 N/mm v 23.2 +/- 11.4 N/mm, p < 0.001). The separate wire technique was used in 25 patients with comminuted fractures of the inferior pole of the patella who were followed up for a mean period of 22 months (10 to 50). All the fractures healed at a mean of seven weeks (6 to 10). No breakage of a wire or infection occurred. The mean grading at the final follow-up was 29.5 points (27 to 30) using the Böstman method. This technique preserved the length of the patella, fixed the comminuted fragments of the inferior pole and avoided long-term immobilisation of the knee.

Adolescent↗
PubMed1998

Effect on the femur of a new hip fracture preventive system using dropped-weight impact testing.

To reduce hip fractures during falls, we devised a new hip fracture preventive system to attenuate impact on the greater trochanteric region and studied the effects of the system on the femur. Twelve coupled, embalmed, cadaveric femora were used. Right femora were fractured without protection as a control and compared with left femora covered by the protection system, which consisted of a silicone gel pad or the silicone gel pad combined with a resin cover. The impact of a fall was simulated by mounting a femur in the horizontal plane and dropping an 8.4 kg mass on its greater trochanteric region. The impact load and time were measured using a load cell within the mass. The maximum strain during impact at the inferior side of the femoral neck was determined from an attached strain gauge. Trochanteric fractures were produced in 18 of the 24 femora (75%). The mean impact load for a drop height of 25 cm was reduced from 3117 N to 2176 N by silicone gel (p < 0.01) and to 1681 N by the addition of the resin cover (p < 0.01). The mean maximum strain was similarly reduced from 2276 microvarepsilon to 1872 microvarepsilon (p = 0.15) and to a mean 1559 microvarepsilon (p < 0. 05). The mean impact time was prolonged from 13 ms to 20 ms (p < 0. 01) and 22 ms (p < 0.01), respectively. The effect of the cover became more conspicuous as height increased. We concluded that the silicone gel pad provided effective impact attenuation, and the addition of the rigid cover was even more effective for impact reduction. This system was thought to be clinically useful in preventing hip fractures.

Absorptiometry, Photon↗
PubMedDate not supplied

Relationship between the recurrent laryngeal nerve and the inferior thyroid artery: a study in corpses.

The anatomical relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) was studied in 76 embalmed corpses, 8 females and 68 males. In both sexes, the RLN lay more frequently between branches of the ITA.; it was found in this position in 47.3% of male corpses and 42.8% of female ones. On the right, RLN was found between branches of the ITA in 49.3% of the cases, anterior to it in 38.04%, and posterior in 11.26%. On the left, the RLN lay between branches of the ITA in 44.45%, posterior to the ITA in 37.05%, and anterior to it in 18.05% of the cases. In 62.68% of the cases, the relationship found on one side did not occur again on the opposite side. There was a significant difference (p<0.05) in the distribution of the 3 types of relationships between the RLN and the ITA, on the right and on the left. Racial variations could contribute to an explanation of the differences observed by authors of different countries in the relationship between the RLN and the ITA.

Arteries↗
PubMed2000

The effect of screw insertion site and unused drill holes on stability and mode of failure after fixation of basicervical femoral neck fracture.

The intent of this biomechanical study is to characterize the effect of unused drill holes and cannulated screw insertion site on the fixation stability and mode of failure after fixation of basicervical femoral neck fractures. Fourteen matched pairs of embalmed human cadaver femora were sorted into four groups according to the level of screw insertion along the lateral cortex. Screws inserted at higher positions along the lateral cortex afforded higher rigidity, thus decreasing the amount of motion at the fracture site. In addition, higher insertion positions reduced the rate of permanent displacement, thus better maintaining reduction. Although all specimens failed at the neck, post-failure inspection revealed upward translation of the inferior screw head when inserted 20 mm below the lesser trochanter. Unused drill holes and guidepin holes had no observed affect on stability or failure mode.

Biomechanical Phenomena↗
PubMed2003

Effect of fibular plate fixation on rotational stability of simulated distal tibial fractures treated with intramedullary nailing.

BACKGROUND: The effect of an intact fibula on rotational stability after a distal tibial fracture has, to the best of our knowledge, not been clearly defined. We designed a cadaver study to clarify our clinical impression that fixation of the fibula with a plate increases rotational stability of distal tibial fractures fixed with a Russell-Taylor intramedullary nail. METHODS: Seven matched pairs of embalmed human cadaveric legs and sixteen fresh-frozen human cadaveric legs, including one matched pair, were tested. To simulate fractures, 5-mm transverse segmental defects were created at the same level in the tibia and fibula, 7 cm proximal to the ankle joint in each bone. The tibia was stabilized with a 9-mm Russell-Taylor intramedullary nail that was statically locked with two proximal and two distal screws. Each specimen was tested without fibular fixation as well as with fibular fixation with a six-hole semitubular plate. A biaxial mechanical testing machine was used in torque control mode with an initial axial load of 53 to 71 N applied to the tibial condyle. Angular displacement was measured in 0.56-N-m torque increments to a maximal torque of 4.52 N-m (40 in-lb). RESULTS: Initially, significantly less displacement (p < or = 0.05) was produced in the specimens with fibular plate fixation than in those without fibular plate fixation. The difference in angular displacement between the specimens treated with and without plate fixation was established at the first torque data point measured but did not increase as the torque was increased. No significant difference in the rotational stiffness was found between the specimens treated with and without plate fixation after measurement of the second torque data point (between 1.68 and 4.48 N-m). CONCLUSIONS: Fibular plate fixation increased the initial rotational stability after distal tibial fracture compared with that provided by tibial intramedullary nailing alone. However, there was no difference in rotational structural stiffness between the specimens treated with and without plate fixation as applied torque was increased.

Aged↗
PubMed2006

Is there a safe area for the axillary nerve in the deltoid muscle? A cadaveric study.

BACKGROUND: Several authors have defined a variety of so-called safe zones for deltoid-splitting incisions. The first aim of the present study was to investigate the distance of the axillary nerve from the acromion and its relation to arm length. The second aim was to identify a safe area for the axillary nerve during surgical dissection of the deltoid muscle. METHODS: Twenty-four shoulders of embalmed adult cadavers were included in the study. The distance from the anterior edge of the acromion to the course of the axillary nerve was measured and was recorded as the anterior distance. The same measurement from the posterior edge of the acromion to the course of the axillary nerve was made and was recorded as the posterior distance for each limb. Correlation analysis was performed between the arm length and the anterior distance and the posterior distance for each limb. The ratios between arm length and the anterior and posterior distances were calculated for each case and were recorded as an anterior index and a posterior index. RESULTS: The average arm length was 30.40 cm. The average anterior distance was 6.08 cm, and the average posterior distance was 4.87 cm. There was a significant correlation between arm length and both anterior distance (r = 0.79, p < 0.001) and posterior distance (r = 0.61, p = 0.001). The axillary nerve was not found to lie at a constant distance from the acromion at every point along its course. The average anterior index was 0.20, and the average posterior index was 0.16. CONCLUSIONS: The present study describes a safe area above the axillary nerve that is quadrangular in shape, with the length of the lateral edges being dependent on the individual's arm length. Using this safe area should provide a safe exposure for the axillary nerve during shoulder operations.

Acromion↗
PubMed2002

Head and skull base features of nine Egyptian mummies: evaluation with high-resolution CT and reformation techniques.

OBJECTIVE: CT is an indispensable imaging tool in the evaluation of Egyptian mummies because it can noninvasively generate large amounts of data. We applied current CT imaging and postprocessing techniques to methodically survey the head and skull base features of nine Egyptian mummies in the hope of providing paleopathologic and radiologic information. MATERIALS AND METHODS: Nine Egyptian mummies were evaluated on helical CT using 1-mm axial scans obtained from the skull vertex to the mid cervical spine. Systematic evaluation of the skull and intracranial contents, paranasal sinuses, craniocervical junction, orbits, temporal bones including the middle and inner ears, teeth, and superficial soft tissues was undertaken. Reformatted and volume-rendered images were generated. RESULTS: CT findings indicated that the intracranial contents of the nine mummies varied tremendously. Destruction of the anterior skull base structures in mummies without intracranial contents suggested a transnasal, transethmoidal approach to excerebration. A large amount of expensive embalming material within the skull of one mummy suggests that he may have been a royal pharoah. A cleft palate deformity was identified in a child mummy. Temporal bone analysis revealed one case of asymmetric mastoid air cell erosion and dehiscence, which is strongly suggestive of prior mastoiditis. Craniocervical junction abnormalities and ossicular chain disruption in several mummies were attributed to postmortem damage. The orbital structures had intentionally been removed in several mummies. Dental disease was ubiquitous among the adult specimens. CONCLUSION. The systematic evaluation of the head and skull base of mummies with CT can provide insight into the life, disease, death, and postmortem treatment of these ancient Egyptians.

Adolescent↗
PubMed2003

Whole-body three-dimensional multidetector CT of 13 Egyptian human mummies.

OBJECTIVE: The purpose of this article is to assess the role of multidetector CT and three-dimensional (3D) reconstructions in noninvasive studies of Egyptian mummies. MATERIALS AND METHODS: We studied 13 mummies from the Egyptian Museum in Torino, Italy, dating from Dynasty III to Dynasty IV (2650-2450 B.C.) and from the Ptolemaic period (332-30 B.C.) to the Roman period (30 B.C.-A.D. 395), using a multidetector CT unit with a single volumetric acquisition of the whole body, including lower extremities, followed by 3D reconstruction. All mummies were completely wrapped; preservation conditions of external wrappings were good in all. RESULTS: The general setting, embalming techniques, sex and age assessment (from body and skeletal features), anthropometric measurements (cranial measurements and evaluation of stature), conditions of the skeleton and soft tissue, any abnormalities, and the presence of foreign objects were evaluated in each mummy, and a detailed report was drawn up. Virtual unwrapping permitted the identification of physiognomy of the whole dehydrated body placed beneath the wrappings; 3D reconstruction and virtual fly-through navigation allowed further evaluations of the internal parts of the body. CONCLUSION: The results obtained with this protocol provided important anthropologic and paleopathologic information that would have been impossible to obtain by other noninvasive techniques. Moreover, this method has great potential for studies of conservation, anthropology, and paleopathology of other Egyptian and ancient human remains. Multidisciplinary cooperation among anthropologists, paleopathologists, Egyptologists, and radiologists is essential.

Adult↗
PubMed2005

Sonography of a rupture of the tendon of the extensor pollicis longus muscle: initial clinical experience and correlation with findings at cadaveric dissection.

OBJECTIVE: The objectives of our study were to report our initial clinical experience with sonography of the wrist for diagnosing a proximal rupture of the tendon of the extensor pollicis longus (EPL) muscle and to perform sonographic-anatomic correlation of the EPL tendon. MATERIALS AND METHODS: Clinical and imaging files of five patients who underwent sonography and subsequent open wrist surgery were reviewed retrospectively. Imaging was performed by four radiologists experienced in musculoskeletal sonography. Tendon retraction was evaluated on sonography and at surgery. In cadavers, sonography was performed in concert by two musculoskeletal radiologists during progressive stages of dissection of four embalmed specimens. One specimen was sliced in the transverse plane. RESULTS: In cadavers, the EPL tendon was located on or adjacent to Lister's tubercle and extended to the base of the thumb. The EPL tendon crossed over the extensor carpi radialis tendons where it exhibited a flattened aspect. In the five patients in the study, a tubular-shaped hypoechoic area was evident at the position of the ruptured EPL tendon on sonograms. At surgery, this area corresponded to fluid, hemorrhage, and scar tissue in the EPL tendon sheath. The assessment of tendon retraction on sonography correlated with findings at surgery. CONCLUSION: Sonography may aid in diagnosing a rupture of the EPL tendon and in the preoperative assessment of gap size and position of the retracted tendon ends. A characteristic tubular hypoechoic area may be seen crossing over the extensor carpi radialis tendons.

Aged↗
PubMed2004

Determination of muscle architecture and fiber characteristics of the superficial and deep digital flexor muscles in the forelimbs of adult horses.

OBJECTIVE: To provide a quantitative description of the architecture of superficial digital flexor (SDF) and deep digital flexor (DDF) muscles in adult horses to predict muscle-tendon behavior and estimate muscle forces. SAMPLE POPULATION: 7 forelimb specimens from 7 adult Thoroughbreds. PROCEDURE: Muscle and tendon lengths and volumes were measured from 6 fixed forelimbs. After processing, fiber bundle and sarcomere lengths were measured. Optimal fascicle lengths and muscle length-to-fascicle length, muscle length-to-free tendon length, and fascicle length-to-tendon length ratios were calculated, as were tendon and muscle physiologic cross-sectional areas (PCSAs). Pennation angles were measured in 1 embalmed specimen. RESULTS: The SDF optimal fascicle lengths were uniformly short (mean +/- SD, 0.8 +/- 0.1 cm), whereas DDF lengths ranged from 0.9 +/- 0.2 cm to 10.8 +/- 1.6 cm. The DDF humeral head had 3 architectural subunits, each receiving a separate median nerve branch, suggestive of neuromuscular compartmentalization. Pennation angles were small (10 degrees to 25 degrees). The PCSAs of the SDF and DDF muscle were 234 +/- 51 cm2 and 259 +/- 30 cm2, with estimated forces of 4,982 +/- 1148 N and 5,520 +/- 544 N, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The SDF muscle appears to provide strong tendinous support with little muscle fascicular shortening and fatigue-resistance properties. The DDF muscle combines passive and dynamic functions with larger tension development and higher shortening velocities during digital motion. Architectural parameters are useful for estimation of forces and have implications for analysis of muscle-tendon function, surgical procedures involving muscle-tendon lengthening, and biomechanical modeling.

Age Factors↗
PubMed2006

The axillary arch: anatomy and suggested clinical manifestations.

The purpose of this commentary is to describe bilateral anomalous bands of the latissimus dorsi muscle observed in an 81-year-old male embalmed cadaver, and to discuss the possible clinical implications of this anomaly. The musculotendinous bands tautened and compressed the underlying axillary vessels, and the musculocutaneous, median, and ulnar nerves during passive abduction/external rotation of the shoulder. Similar variations found in the latissimus dorsi muscles in this commentary have been reported in the anatomical and surgical literature. These reports include descriptions of the anomalous bands of the latissimus dorsi attaching to the coracoid process, pectoralis major muscle, and fascia of the coracobrachialis muscle. The potential presence of an axillary arch presents several clinical considerations for the physical therapist. The existence of an axillary arch should be considered in patients with signs and symptoms consistent with upper extremity neurovascular compromise similar to thoracic outlet syndrome. Including this variant in the differential diagnostic process may assist physical therapists in the management of patients with signs and symptoms consistent with thoracic outlet syndrome.

Aged, 80 and over↗
PubMed1999

Relation of the radial nerve with the sulcus nervi radialis: a morphometric study.

The radial nerve's course from the axillary region, branch patterns and the relation of the nerve to fixed anatomical landmarks in the arm region were studied in 27 embalmed intact cadavers. The radial nerve and its relation with the sulcus nervus radialis (SNR) was analyzed. The direct contact of the nerve with humerus in SNR was observed during the dissections. The following measurements were made: the total length of the humerus (the palpable uppermost point of the tuberculum majus and the lateral epicondyle); proximal safe zone (the tuberculum majus and the proximal beginning of the SNR); distal safe zone (the intercondylar axis and the middle of SNR); lateral safe zone (the lateral epicondyle and the distal end of SNR). In conclusion, it was aimed to correlate the osseus palpable landmarks of humerus with the course of the radial nerve for a safe surgery as the sulcus nervi radialis region is one of the main risky areas for the radial nerve palsies.

Anatomy, Artistic↗
PubMed1989

After a child dies: a funeral director's perspective.

This article will describe the grieving process and look at the role of the funeral director. It explains what the family should expect during the funeral experience, outlining options available to the family concerning services, disposition of the remains, and legal requirements. It also examines the embalming and restoration of remains. Finally, the stress of the funeral process on the funeral director will be discussed.

Child↗