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Anetai H, Tokita K, Kojima R, Toriumi T, Kageyama I, Kumaki K. An atypical inferior gluteal artery passing through the piriformis muscle. Surg Radiol Anat 2024; 46:59-64. [PMID: 37884741 DOI: 10.1007/s00276-023-03256-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/06/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE In this article, we report a case of an atypical inferior gluteal artery that passed through the piriformis muscle when it emerged from the pelvic cavity in an elderly Japanese female cadaver. We speculate that this atypical artery could be entrapped and compressed by the piriformis muscle and may therefore be associated with piriformis syndrome; however, the anatomical characteristics of such an atypical artery have not been previously reported. To assess this potential association, the atypical inferior gluteal artery was anatomically examined. METHODS The cadaver examined in this report was a 97-year-old Japanese female who was donated to The Nippon Dental University for use in medical education and research. The atypical inferior gluteal artery and surrounding structures in half of the pelvis were examined macroscopically. RESULTS The atypical inferior gluteal artery arose from the common arterial trunk, formed by itself and the superior gluteal artery, passed through the superior proximal part of the piriformis muscle, and left the pelvic cavity. It supplies branches to the lower half of the gluteus maximus and proximal part of the long head of the biceps femoris muscle. The piriformis muscle originates from the 2nd to 4th sacral vertebrae and attaches to the greater trochanter via a single short tendon. CONCLUSION According to our findings, when the atypical inferior gluteal artery is entrapped and compressed, ischemic signs and symptoms may emerge in the lower buttocks and proximal posterior thigh. These results provide a new perspective for the diagnosis and treatment of piriformis syndrome.
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Affiliation(s)
- Hidaka Anetai
- Department of Anatomy and Life Structure, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, Saitama, Japan.
| | - Kounosuke Tokita
- Department of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, Saitama, Japan
- Department of Anatomy, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - Ryuhei Kojima
- Department of Physical Therapy, Faculty of Health and Medical Care, Saitama Medical University, Saitama, Japan
- Department of Anatomy, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - Taku Toriumi
- Department of Anatomy, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - Ikuo Kageyama
- Department of Anatomy, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
| | - Katsuji Kumaki
- Department of Anatomy, School of Life Dentistry at Niigata, The Nippon Dental University, Niigata, Japan
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Zhong E, Fan C, Li Q, Zhao Q. A comparative study of the anatomy and MRI images of the lumbar foraminal ligaments at the L1-L5 levels. Surg Radiol Anat 2023; 45:1535-1543. [PMID: 37872310 DOI: 10.1007/s00276-023-03251-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the ability of MRI images to reveal foraminal ligaments at levels L1-L5 by comparing the results with those of anatomical studies. METHODS Eighty lumbar foramina were studied. First, the best MRI scanning parameters were selected, and the transverse and sagittal axes of each lumbar foramina were scanned to identify and record the ligament-like structures in each lumbar foramen. Then, the cadaveric specimens were anatomically studied, and all ligament structures in the lumbar foramina were retained. The number, morphology and distribution of ligaments under anatomical and MRI scanning were observed. Histological staining of the dissected ligament structures was performed to confirm that they were ligamentous tissues. Finally, the accuracy of ligament recognition in MRI images was statistically analyzed. RESULTS A total of 233 foraminal ligaments were identified in 80 lumbar intervertebral foramina through cadaveric anatomy. The radiating ligaments (176, 75.5%) were found to be attached from the nerve root to the surrounding osseous structures, while the transforaminal ligaments (57, 24.5%) traversed the intervertebral foramina without any connection to the nerve roots. A total of 42 transforaminal ligament signals and 100 radiating ligament signals were detected in the MRI images of the 80 intervertebral foramina. CONCLUSION The MRI can identify the lumbar foraminal ligament, and the recognition rate of the transforaminal ligament is higher than that of the radiating ligament. This study provides a new method for the clinical diagnosis of the relationship between the lumbar foraminal ligament and radicular pain.
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Affiliation(s)
- Enyi Zhong
- Guangzhou Women and Children's Medical Center, No. 9 Jinsui Road, Guangzhou, 510000, China
- Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Chaohui Fan
- Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Qingchu Li
- Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Qinghao Zhao
- Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China.
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Chmielewski PP. Clinical anatomy of the paranasal sinuses and its terminology. Anat Sci Int 2023:10.1007/s12565-023-00745-3. [PMID: 37807010 DOI: 10.1007/s12565-023-00745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/17/2023] [Indexed: 10/10/2023]
Abstract
Since its inception, the International Anatomical Terminology has been an indispensable and widely embraced resource for authors, anatomists, researchers, and medical professionals, ensuring standardized anatomical terminology across various disciplines. Nonetheless, it is widely acknowledged that periodic updates and enhancements are necessary to incorporate the latest scientific knowledge and advancements in imaging techniques. The current version of Terminologia Anatomica includes a section dedicated to the paranasal sinuses, encompassing ethmoidal cells and three sinuses: frontal, sphenoidal, and maxillary. However, the anatomical lexicon pertaining to the paranasal sinuses is more extensive. In clinical practice, multiple terms related to clinically significant structures are commonly employed. This article focuses on the clinical terminology associated with the paranasal sinuses, proposing significant extensions to the existing Terminologia Anatomica. These extensions aim to enrich the anatomical nomenclature and facilitate a harmonious convergence between the language of clinicians and the anatomical lexicon. Further endeavors should bridge the gap in anatomical nomenclature and improve communication between anatomists, researchers, and clinicians, thereby enhancing diagnostic accuracy and improving interdisciplinary research collaboration.
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Affiliation(s)
- Piotr Paweł Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland.
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Buch R, Tran M, Hinojosa J, Wooten D, Gokaslan S, Moeller D, Loomis M. Harnessing the Near-Peer Effect in Anatomy Education. Med Sci Educ 2023; 33:1033-1034. [PMID: 37886299 PMCID: PMC10597959 DOI: 10.1007/s40670-023-01841-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 10/28/2023]
Abstract
Benefits of near-peer teaching are well-documented, but its time requirements can be prohibitive. We integrated the near-peer effect into a clinical anatomy course with weekly student-developed handouts vetted by faculty to provide an element of near-peer teaching without the burden of extra time.
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Affiliation(s)
- R. Buch
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
| | - M. Tran
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
| | - J. Hinojosa
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
| | - D. Wooten
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
| | - S. Gokaslan
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
| | - D. Moeller
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
| | - M. Loomis
- Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, 925 City Central Ave, Conroe, TX 77304 USA
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Marí-Gorreto J, San-Millán M, Carrera A, Tubbs RS, Iwanaga J, Cateura A, Acquabona L, Reina MA, Reina F. The anatomy of the tendon of abductor pollicis longus and its morphological variations: An anatomical approach emphasizing the clinical relevance. Ann Anat 2023; 247:152068. [PMID: 36754243 DOI: 10.1016/j.aanat.2023.152068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE The anatomical literature describes the abductor pollicis longus as a muscle with a single tendon inserting on the base of the first metacarpal bone, but investigations have shown that it often exhibits morphological variations. However, methodological approaches used to describe these variations have not been useful in a clinical context. Therefore, the purpose of this investigation was to study and relate such anatomical variations in a clinical context. BASIC PROCEDURES Thirty upper limbs from the body donation program were dissected using standard procedures to identify the number of abductor pollicis longus (APL) tendons, their position, site of insertion, length, width and thickness. The presence or absence of the extensor pollicis brevis muscle was also noted. Inter and intra-observer reliability was analysed. MAIN FINDINGS A total number of 71 tendons from the APL muscle were found in the thirty limbs. The most frequent distribution pattern was a main tendon inserted on the base of the first metacarpal and an accessory tendon inserted into the abductor pollicis brevis muscle. These tendons could divide into various tendinous slips that could insert in different locations. Also, clustering algorithms and classical statistical tests showed tendons inserting on the first metacarpal were longer than tendons not inserting on the first metacarpal (p = 0.03), while medial tendons and tendons from an APL muscle with supernumerary tendons were narrower (p < 0.001). The absence of the extensor pollicis brevis muscle was not related to the presence of supernumerary APL tendons. CONCLUSIONS Radiological and surgical implications of these results are important when examining this region of the hand and wrist. The pathophysiology and treatment of de Quervain's tenosynovitis, trapeziometacarpal arthritis and trapeziometacarpal subluxation or laxity could be influenced by the results of our findings.
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Affiliation(s)
- Jesús Marí-Gorreto
- Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona, Spain.
| | - Marta San-Millán
- Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona, Spain; EUSES University School of Health and Sports, University of Girona, Salt, Girona, Spain.
| | - Ana Carrera
- Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona, Spain.
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA; University of Queensland, Brisbane, Australia.
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Aïda Cateura
- Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona, Spain.
| | - Laura Acquabona
- Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona, Spain.
| | - Miguel A Reina
- CEU-San Pablo University School of Medicine. Department of Anesthesiology, Madrid-Montepríncipe University Hospital, Madrid, Spain; Departament of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Francisco Reina
- Medical Sciences Department, Clinical Anatomy, Embryology and Neuroscience Research Group (NEOMA), Faculty of Medicine, University of Girona, Girona, Spain.
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Yazbeck A, Iwanaga J, Walocha JA, Olewnik Ł, Tubbs RS. The clinical anatomy of the accessory submandibular gland: a comprehensive review. Anat Cell Biol 2023; 56:9-15. [PMID: 36384887 PMCID: PMC9989781 DOI: 10.5115/acb.22.118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/18/2022] Open
Abstract
An accessory submandibular gland is a rare variation. As such, there is limited literature regarding the embryology, anatomy, variations, clinical imaging, and pathology of the accessory submandibular gland. In this article, we review the existing literature on the accessory submandibular gland from clinical and anatomical perspectives. The goal of this review is to provide comprehensive knowledge of this variation which can be useful for oral and maxillofacial/head and neck surgeons, radiologists, and anatomists. Within this review, the embryologic origin as well as the anatomy of the accessory submandibular gland is detailed. Several imaging modalities which can be used to visualize the accessory submandibular gland are outlined as well as its variations. Lastly, this review investigates several reported clinical considerations regarding the accessory submandibular gland including sialoliths, Wharton's duct obstruction, and pleomorphic adenoma.
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Affiliation(s)
- Andrea Yazbeck
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joe Iwanaga
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - R Shane Tubbs
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.,University of Queensland, Brisbane, Australia
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Zhang Y, Ji Z, Zhou P, Dong L, Chen Y. Clinical anatomy teaching: A promising strategy for anatomic education. Heliyon 2023; 9:e13891. [PMID: 36915571 DOI: 10.1016/j.heliyon.2023.e13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
Background Human anatomy is a predominant course that helps medical students enhance their performance in other clinical curricula. However, it is difficult for students to learn the relationship between anatomy and diseases, since the traditional teaching modality of anatomy courses does not contain enough clinical contents. Clinical anatomy education merges clinical diagnosis and treatment into anatomy learning. This study seeks to determine whether systematic clinical anatomy teaching can improve students' performance and interest in anatomy courses. Methods This study was a retrospective study conducted at West China Medical School, Sichuan University. Medical students of the 8-year program who participated in the course "HUMAN MORPHOLOGY" in the academic years of 2014-2018 did not receive a systematic clinical anatomy course, while those in the academic years of 2018-2022 did. These two groups were involved to analyze their final examination. Then, a questionnaire for students in the academic year of 2021-2022 was conducted to assess their general satisfaction and opinions on the usefulness and learning modalities of clinical anatomy courses. Results Students who received systematic clinical anatomy lessons performed significantly better than those who were not in the final examinations. The average grades were 73.64 and 79.90 in the 3rd semester of medicine (p < 0.0001) and 75.70 and 82.18 in the 4th semester of medicine (p < 0.0001) before and after 2018, respectively. The response rate of the questionnaire was 77.78%, and most of the students agreed that the clinical anatomy lessons were satisfactory, with 40 out of 71 (56.34%) strongly agreeing and 26 out of 71 (36.62%) agreeing. Conclusion Clinical anatomy education should be more emphasized and merged into the gross anatomy curriculum owing to the better performance in the final examination and high rate of satisfaction.
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Meyer ER, Cui D. Using Stereoscopic Virtual Presentation for Clinical Anatomy Instruction and Procedural Training in Medical Education. Adv Exp Med Biol 2023; 1431:145-160. [PMID: 37644291 DOI: 10.1007/978-3-031-36727-4_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
This chapter begins by exploring the current landscape of virtual and augmented reality technologies in a post-pandemic world and asserting the importance of virtual technologies that improve students' learning outcomes while also reducing costs. Next, the chapter describes clinical anatomy instruction concepts in medical education, including applied anatomy content knowledge, pedagogical anatomy content knowledge, and virtual stereoscopic visualization studies that exemplify these concept areas, respectively. The chapter then explores the concept of procedural training with a specific emphasis on virtual stereoscopic anatomy visualization studies that exemplify or have implications for procedural training in medical education. Subsequently, the chapter discusses the benefits and challenges as well as the potential future positive and negative implications of virtual stereoscopic visualizations in medical education before finally concluding with some pensive considerations for the present and future of anatomy education and training using virtual technologies.
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Affiliation(s)
- Edgar R Meyer
- Department of Advanced Biomedical Education, University of Mississippi Medical Center, Jackson, MS, USA.
| | - Dongmei Cui
- Department of Advanced Biomedical Education, University of Mississippi Medical Center, Jackson, MS, USA
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Ma R, Zheng Z, Zhou X, Zhu W, Chen J, Zhang R, Liu Z, Xu Y, Fu M, Liu Z, Zhao Q, Li Q. An anatomical study of the origins courses and distributions of the transverse branches of lumbar arteries at the L1-L4 levels. Eur Spine J 2022; 31:678-684. [PMID: 35094163 DOI: 10.1007/s00586-022-07124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/05/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
Pseudoaneurysms of the lumbar arteries following transforaminal lumbar interbody fusion (TLIF) are rare postoperative complications that usually occur around the transverse process. However, there are few detailed descriptions of the transverse branch and other branches of the dorsal branches at the L1-L4 disks. STUDY DESIGN Ten adult embalmed cadavers were anatomically studied. OBJECTIVES The purposes of the study were to describe the vascular distribution of the dorsal branches, especially the transverse branches, at the L1-L4 levels and provide information useful for TLIF. METHODS Ten embalmed cadavers studied after their arterial systems were injected with red latex. The quantity, origin, pathway, distribution range and diameter of the branches were recorded and photographed. RESULTS The transverse branch appeared in all 80 intervertebral foramina. The transverse branch was divided into 2 types: In type 1, the arteries divided into superior branches and inferior branches; the arteries in type 2 divided into 3 branches (superior, intermedius and inferior branches). CONCLUSIONS The transverse branches of the dorsal arteries are common structures from L1 to L4, and 2 types of transverse branches were found. A thorough understanding of the dorsal branches, especially the transverse branches of the lumbar artery, may be very important for reducing both intraoperative bleeding during the surgery and the occurrence of pseudoaneurysms after transforaminal lumbar interbody fusion.
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Affiliation(s)
- Runxun Ma
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Zhiyang Zheng
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Xinying Zhou
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Weijia Zhu
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Junjie Chen
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Rusen Zhang
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Zexian Liu
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Yejie Xu
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Maoqing Fu
- Department of Spine Surgery, Nanhai Hospital, Southern Medical University, Nanhai District, 528244, Foshan, Guangdong, People's Republic of China
| | - Zezheng Liu
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China
| | - Qinghao Zhao
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China.
| | - Qingchu Li
- Guangdong Province, Department of Orthopedics, Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China.
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10
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Iwanaga J, Patra A, Ravi KS, Dumont AS, Tubbs RS. Anatomical relationship between the foramen ovale and the lateral plate of the pterygoid process: application to percutaneous treatments of trigeminal neuralgia. Neurosurg Rev 2022; 45:2193-2199. [PMID: 35031899 DOI: 10.1007/s10143-021-01715-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022]
Abstract
Our aim was to clarify the variations in the positional relationship between the base of the lateral plate of the pterygoid process and the foramen ovale (FO), which block inserted needles during percutaneous procedures to the FO usually used for the treatment of trigeminal neuralgia. Ninety skulls were examined. The horizontal relationship between the FO and the posterior border of the base of the lateral plate of the pterygoid process was observed in an inferior view of the skull base. Skulls that showed injury to either the FO or the lateral plate of the pterygoid process on either side were excluded. One hundred and sixty sides of eighty skulls were eligible. The relationship between the FO and the posterior border of the base of the lateral plate was classified into four types. Among the 160 sides, type III (direct type) was the most common (35%), followed by type I (lateral type, 29%) and type IV (removed type, 21%); type II (medial type) was the least common (15%). Of the 80 specimens, 53 showed the same type bilaterally. In type IV, the posterior border of the base of the lateral plate is disconnected from the FO, so percutaneous procedures for treating trigeminal neuralgia could fail in patients with this type.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA. .,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA. .,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan. .,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India
| | - Kumar Satish Ravi
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, India
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,University of Queensland, Brisbane, Australia
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Cho TH, Kwon HJ, O J, Cho J, Kim SH, Yang HM. The pathway of injectate spread during thoracic intertransverse process (ITP) block: Micro-computed tomography findings and anatomical evaluations. J Clin Anesth 2022; 77:110646. [PMID: 35021139 DOI: 10.1016/j.jclinane.2022.110646] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/20/2021] [Accepted: 01/02/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVE To investigate the mechanism of action of the thoracic intertransverse process (ITP) block. DESIGN Three-dimensional micro-computed tomography (3D micro-CT) study and cadaveric evaluation. SETTING A translational research unit for anatomy and analgesia in a university hospital. PATIENTS Twelve embalmed and three non-embalmed human cadavers were used in this study. MEASUREMENTS Micro-CT images of the mid-thoracic paravertebral space and its adjacent ligamentous tissues were acquired and 3D images were reconstructed. Manual dissection and histologic examination of these structures complemented the images. To confirm our findings, the dye-spreading pattern after ultrasound-guided ITP injection of 20 mL dye solution at T4-T5 was evaluated. MAIN RESULTS Micro-CT and histologic findings showed that the costotransverse foramen (the medial slit of the superior costotransverse ligament) and the costotransverse space (between the rib and the transverse process) were potential pathways to the thoracic paravertebral space during ITP block. Single-level ITP injection with a dye solution resulted in a multilevel segmental paravertebral spread in cadaveric evaluation. CONCLUSIONS The space posterior to the superior costotransverse ligament, the target area for ITP blocks, has potential anatomical pathways to the thoracic paravertebral space. The costotransverse foramen and the costotransverse space provided the anatomical conduit for the anterior and intersegmental paravertebral spread of the ITP block.
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Affiliation(s)
- Tae-Hyeon Cho
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea; Translational Research Unit for Anatomy and Analgesia, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jin Kwon
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea; Translational Research Unit for Anatomy and Analgesia, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jehoon O
- Center of Biohealth Convergence and Open Sharing System, Hongik University, Seoul, Republic of Korea
| | - Jaehee Cho
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Shin Hyung Kim
- Translational Research Unit for Anatomy and Analgesia, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Hun-Mu Yang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea; Translational Research Unit for Anatomy and Analgesia, Yonsei University College of Medicine, Seoul, Republic of Korea; Surgical Anatomy Education Centre, Yonsei University College of Medicine, Seoul, Republic of Korea.
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12
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Abstract
Although the hip joint is regarded as inherently stable, hip pain and injuries caused by traumatic/non-traumatic hip instability are relatively common in active individuals. A comprehensive understanding of hip anatomy may provide better insight into the relationships between hip stability and clinical problems. In this review, we present our recent findings on the hip morphological characteristics, especially focusing on the intramuscular tendon of the gluteus medius tendon and its insertion sites, hip capsular attachment on the anterosuperior region of the acetabular margin, and composition of the iliofemoral ligament. We further discussed the hip stabilization mechanism based on these findings. The characteristics of the gluteus medius tendon suggest that even a single muscle has multiple functional subunits within the muscle. In addition, the characteristics of the hip capsular attachment suggest that the width of the capsular attachment is wider than previously reported, and its wide area shows adaptive morphology to mechanical stress, such as bony impression and distribution of the fibrocartilage. The composition of the iliofemoral ligament and its relation to periarticular structures suggest that some ligaments should be defined based on the pericapsular structures, such as the joint capsule, tendon, and aponeurosis, and also have the ability to dynamically coordinate joint stability. These anatomical perspectives provide a better understanding of the hip stabilization mechanism, and a biomechanical study or an in vivo imaging study, considering these perspectives, is expected in the future.
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Affiliation(s)
- Masahiro Tsutsumi
- Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. .,Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan.
| | - Akimoto Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiichi Akita
- Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
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13
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Ottone NE, Sandoval C, Cid-Gutierrez P, Vásquez-Balboa ML, Tubbs RS, Fuentes R. Systematic review and meta-analysis of the anatomy of the maxillary artery using the Anatomical Quality Assurance (AQUA) checklist. Surg Radiol Anat 2021; 43:1875-1886. [PMID: 34480213 DOI: 10.1007/s00276-021-02825-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The maxillary artery (MA) is one of the terminal branches of the external carotid artery (ECA) and through its branches, it is responsible for vascularizing several organs and muscles of the head and neck, including their surrounding soft tissues, the oral and sinonasal cavities, dura mater, and various cranial nerves. The aim of this study was to conduct a systematic review and meta-analysis of maxillary artery anatomy according to the Anatomical Quality Assurance (AQUA) checklist. METHODS We conducted a systematic search through PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, Springerlink, WILEY and BIREME databases. We applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the articles. RESULTS From a total of 11,759 articles found in the first search, and after applying the inclusion/exclusion criteria, in addition to eliminating duplicate articles, a final number of 24 articles were identified. The information on the maxillary artery was analyzed from each study regarding its course in relation to the lateral pterygoid muscle, the intra- and extraluminal diameters of the maxillary artery and its branches, and the types of branching of the maxillary artery in the pterygopalatine fossa. CONCLUSION From this study, it was possible to conclude the importance of anatomical knowledge of the maxillary artery, for its application in the clinical study of the head and neck, as well as the need to apply the AQUA checklist in the development of systematic anatomical reviews to ensure accurate reliability and a better assessment of the effect of anatomical publications.
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Affiliation(s)
- Nicolás E Ottone
- Laboratory of Plastination and Anatomical Techniques, Centre for Research in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile. .,Department of Integral Adults Odontology, Dental School, Universidad de La Frontera, Temuco, Chile. .,Center of Excellence in Morphological and Surgical Studies (CEMyQ), School of Medicine, Universidad de La Frontera, Temuco, Chile.
| | - Cristian Sandoval
- Escuela de Tecnología Médica, Facultad de Salud, Universidad Santo Tomás, Los Carreras 753, Osorno, Chile.,Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | | | | | - R Shane Tubbs
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Ramón Fuentes
- Laboratory of Plastination and Anatomical Techniques, Centre for Research in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile.,Department of Integral Adults Odontology, Dental School, Universidad de La Frontera, Temuco, Chile
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14
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Abstract
The framework for cadaver surgical training (CST) in Japan was established in 2012, based on the “Guidelines for Cadaver Dissection in Education and Research of Clinical Medicine” of the Japan Surgical Society (JSS) and the Japanese Association of Anatomists. Subsequently, the Ministry of Health, Labor and Welfare allocated funding from its budget for CST. By 2019, CST was being practiced in 33 medical schools and universities. Currently, the CST Promotion Committee of the JSS reviews each CST report submitted by medical schools and universities and provides guidance based on professional autonomy. This paper outlines the history of CST in Japan and presents a plan for its future. To sustain and oversee CST implementation, an operating organization, funded by stakeholders, such as government agencies, academic societies, and private companies, is needed.
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Affiliation(s)
- Toshiaki Shichinohe
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Hokkaido, Japan
| | - Eiji Kobayashi
- Department of Kidney Regenerative Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
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15
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Arráez-Aybar LA, García-Mata R, Murillo-González JA, de-la-Cuadra-Blanco C, Gómez-Martínez A, Bueno-López JL. Physicians' viewpoints on faculty anatomists and dissection of human bodies in the undergraduate medical studies. Ann Anat 2021; 238:151786. [PMID: 34153435 DOI: 10.1016/j.aanat.2021.151786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/17/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Studies abound regarding the views of faculty anatomists and medical students on the importance of anatomy and the dissection of human bodies, but very little is known about the views of practicing physicians. METHODS A survey was distributed among physicians and surgeons practicing in Spain in order to find out their views on the practice and consequences of human dissection by undergraduate students of medicine. The most relevant definition to qualify faculty anatomists of medical schools was also requested. Responses were repeatedly clustered into characteristic subgroups for analysis. RESULTS In total, 536 physicians and surgeons belonging to 36 different specialties in seven Spanish hospitals responded to the survey. The results highlighted two main facts. Firstly, faculty anatomists were perceived as teachers, above any other professional identity (namely: physician, biologist or scientist); nonetheless, the ascription of identities varied between specialties (p=0.009); and it also depended on whether the respondents had dissected in their undergraduate degree (p=0.03) and on the respondent's gender (p=0.03). Secondly, physicians and surgeons confirmed that dissecting human cadavers serves the undergraduate student not only for acquiring anatomical knowledge, but also essential skills and attitudes, including professionalism. CONCLUSIONS The results strongly suggest that dissection practice should be reinforced and enriched in undergraduate medical school. As this is important in itself, the results of the study could also help with the development of strategies to alleviate the current shortage of adequately trained anatomists for medical degrees.
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Affiliation(s)
- Luis-A Arráez-Aybar
- Department of Anatomy & Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain.
| | | | - Jorge-A Murillo-González
- Department of Anatomy & Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Crótida de-la-Cuadra-Blanco
- Department of Anatomy & Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Ana Gómez-Martínez
- Department of Surgery, Thoracic Surgery Service, Hospital Clínico "San Carlos", Madrid, Spain
| | - José Luis Bueno-López
- Department of Neurosciences, School of Medicine and Nursing, The University of the Basque Country (UPV/EHU), Leioa (Biscay), Spain
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16
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Valenzuela-Fuenzalida JJ, Cariseo C, Gold M, Díaz D, Orellana M, Iwanaga J. Anatomical variations of the mandibular canal and their clinical implications in dental practice: a literature review. Surg Radiol Anat 2021; 43:1259-72. [PMID: 33630105 DOI: 10.1007/s00276-021-02708-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The anatomical variations of the mandibular canal have been described according to the number of additional branches it presents, bifid and trifid. Within the bifids we can also find subtypes of variations such as the retromolar mandibular canal. These anatomical variations can have important clinical implications for the work of dental professionals. METHODS A systematic search of the literature was carried out in different databases that met the following criteria: articles published between 2000 and 2020, and articles that established a clinical correlation with variations in the mandibular canal. RESULTS After applying inclusion and exclusion criteria, 32 articles were obtained, in which the variations of the mandibular canal were identified, their prevalence and incidence, which was very varied between the different articles, it was also found that the CBCT was the main technique to identify the anatomical variations of the mandibular canal. Lastly, the anatomical variations of the mandibular canal have a direct clinical correlation with pre-surgical, intra-surgical and postsurgical complications in pathologies that require surgical intervention. CONCLUSIONS The anatomical variations of the mandibular canal have a high incidence, so knowing them is of vital importance both for clinicians and anatomy professors who provide morphological training. We believe that research should focus on describing and diagnosing the causes of these anatomical variations. That said, there is also a continuous challenge for all health professionals to learn about the different anatomical variations that the human body presents and how these can affect clinical practice.
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17
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Maekawa S, Nagata M, Matsushita Y, Tubbs RS, Iwanaga J. An unusual anatomical variation of the inferior alveolar nerve. Anat Cell Biol 2020; 53:519-521. [PMID: 32814705 PMCID: PMC7769098 DOI: 10.5115/acb.20.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/14/2020] [Accepted: 07/30/2020] [Indexed: 01/16/2023] Open
Abstract
A number of studies have previously shown variations of inferior alveolar, however, only a few reports focused on nearby the foramen ovale. In a formalin fixed cadaver, we identified three minor branches (anterior, middle, and posterior branches) arising from the main trunk of the mandibular nerve adjacent to the foramen ovale, passing lateral to the maxillary artery (MA), and joining the inferior alveolar nerve. The diameter of the branches was 0.68 mm, 1.43 mm, and 0.40 mm, respectively. The branches traveled inside the lateral pterygoid muscle (LPM) or between the LPM and tensor/levator veli palatini. Moreover, all of the branches were superficial to MA. Knowledge of such a variation might be helpful to dentists during, for example, anesthetic blockade and various oral surgeries.
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Affiliation(s)
- Shogo Maekawa
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Biointerfaces Institute, North Campus Research Complex, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mizuki Nagata
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Yuki Matsushita
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA , USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Fukuoka, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
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18
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Lockwood J, Mathkour M, Nerva JD, Iwanaga J, Bui CJ, Vale FL, Dumont AS, Tubbs RS. Anatomic Study Quantifying the Relationship Between the Arcuate Eminence and the Root of the Zygoma: Application to Skull Base Surgery. World Neurosurg 2020; 146:e773-e778. [PMID: 33181377 DOI: 10.1016/j.wneu.2020.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to define the structural relationship between the arcuate eminence (AE) and a known fixed external bony landmark, the root of the zygoma (ZR), and to determine its reliability as a consistent guide for guiding surgical approaches. To our knowledge, this is the only anatomic study to quantify the relationship between the AE and ZR. METHODS Twenty-one dry temporal bones were measured using digital calipers. The distance from the posterior aspect of the ZR to the midpoint of the AE was measured. Additionally, the anteroposterior distance between the ZR and AE and vertical distance between the 2 structures were measured. Student's t-test was used to compare the left and right sides. RESULTS An AE was found in every specimen. The mean ZR to AE distance was 30.9 mm. On most sides (91%), the ZR was located more inferiorly than the AE with a mean distance of 3 mm between the 2 structures. The mean distance between the AE and ZR was 17 mm. On all sides, the AE was located posterior to the ZR. No significant differences were found between sides. No anatomic variations or pathologic conditions were noted in any of the specimens. CONCLUSIONS The ZR is an easily identifiable and consistent bony landmark often used by skull base surgeons. In this investigation, we measured the anatomic relationships between the ZR and AE. Such data might assist in planning surgical trajectories and minimizing complications when skull base pathologies are approached.
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Affiliation(s)
- Joseph Lockwood
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Mansour Mathkour
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA; Neurosurgery Division, Surgery Department, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - John D Nerva
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA.
| | - C J Bui
- Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
| | - Fernando L Vale
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA; Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada
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19
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Zhao Q, Yang Y, Wu P, Huang C, Zhang R, Li Q, Shi B. Biomechanical study of the C5-C8 cervical extraforaminal ligaments. J Orthop Surg Res 2020; 15:477. [PMID: 33066804 PMCID: PMC7566063 DOI: 10.1186/s13018-020-02006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/06/2020] [Indexed: 12/02/2022] Open
Abstract
Background The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking. Methods The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement. Results The displacement of the C5, C6, C7, and C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p < 0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range. Conclusions Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.
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Affiliation(s)
- Qinghao Zhao
- Department of Spinal Surgery, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Guangzhou, 510282, China.,Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd. West, Guangzhou, China
| | - Yemei Yang
- Department of Dermatology, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd. West, Guangzhou, China
| | - Penghuan Wu
- Department of Spinal Surgery, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Guangzhou, 510282, China
| | - Chengyan Huang
- Department of Spinal Surgery, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Guangzhou, 510282, China
| | - Rusen Zhang
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd. West, Guangzhou, China
| | - Qingchu Li
- Academy of Orthopedics, Guangdong Province, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd. West, Guangzhou, China.
| | - Benchao Shi
- Department of Spinal Surgery, Zhujiang Hospital, Southern Medical University, 253 Gongye Middle Avenue, Guangzhou, 510282, China.
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20
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Boscolo-Berto R, Tortorella C, Porzionato A, Stecco C, Picardi EEE, Macchi V, De Caro R. The additional role of virtual to traditional dissection in teaching anatomy: a randomised controlled trial. Surg Radiol Anat 2021; 43:469-79. [PMID: 32940718 DOI: 10.1007/s00276-020-02551-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 08/12/2020] [Indexed: 12/20/2022]
Abstract
Introduction Anatomy has traditionally been taught via dissection and didactic lectures. The rising prevalence of informatics plays an increasingly important role in medical education. It is hypothesized that virtual dissection can express added value to the traditional one. Methods Second-year medical students were randomised to study anatomical structures by virtual dissection (intervention) or textbooks (controls), according to the CONSORT guidelines. Subsequently, they applied to the corresponding gross dissection, with a final test on their anatomical knowledge. Univariate analysis and multivariable binary logistic regression were performed. Results The rate of completed tests was 76.7%. Better overall test performance was detected for the group that applied to the virtual dissection (OR 3.75 with 95% CI 0.91–15.49; p = 0.06). A comparable performance between groups in basic anatomical knowledge (p 0.45 to 0.92) but not muscles and 2D-3D reporting of anatomical structures was found, for which the virtual dissection was of tendential benefit (p 0.08 to 0.13). Medical students who applied to the virtual dissection were over three times more likely to report a positive outcome at the post-dissection test than those who applied to textbooks of topographical anatomy. This would be of benefit with particular reference to the understanding of 2D–3D spatial relationships between anatomical structures. Conclusion The combination of virtual to traditional gross dissection resulted in a significant improvement of second-year medical students’ learning outcomes. It could be of help in maximizing the impact of practical dissection, overcoming the contraction of economic resources, and the shortage of available bodies. Electronic supplementary material The online version of this article (10.1007/s00276-020-02551-2) contains supplementary material, which is available to authorized users.
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21
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Ackermann J, Wedel T, Hagedorn H, Maass N, Mettler L, Heinze T, Alkatout I. Establishment and evaluation of a training course in advanced laparoscopic surgery based on human body donors embalmed by ethanol-glycerol-lysoformin fixation. Surg Endosc 2021; 35:1385-94. [PMID: 32444969 DOI: 10.1007/s00464-020-07523-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/26/2020] [Indexed: 02/05/2023]
Abstract
Background Education of clinical anatomy and training of surgical skills are essential prerequisites for any surgical intervention in patients. Here, we evaluated a structured training program for advanced gynecologic laparoscopy based on human body donors and its impact on clinical practice. Methods The three-step training course included: (1) anatomical and surgical lectures, (2) demonstration and hands-on study of pre-dissected anatomical specimens, and (3) surgical training of a broad spectrum of gynecological laparoscopic procedures on human body donors embalmed by ethanol-glycerin-lysoformin. Two standardized questionnaires (after the course and 6 months later) evaluated the effectiveness of each of the training modules and the benefits to surgical practice. Results Eighty participants took part in 6 training courses using a total number of 24 body donors (3 trainees/body donor). Based on a 91.3% (73/80) response rate, participants rated high or very high the tissue and organ properties of the body donors (n = 72, 98.6%), the technical feasibility to perform laparoscopic surgery (n = 70, 95.9%), and the overall learning success (n = 72, 98.6%). Based on a 67.5% (54/80) response rate at 6 months, participants rated the benefit of the course to their daily routine as very high (mean 80.94 ± 24.61%, n = 53), and this correlated strongly with the use of body donors (r = 0.74) and the ability to train laparoscopic dissections (r = 0.77). Conclusions This study demonstrates the technical feasibility and didactic effectiveness of laparoscopic training courses in a professional and true-to-life setting by using ethanol-glycerol-lysoformin embalmed body donors. This cost-efficient fixation method offers the option to integrate advanced surgical training courses into structured postgraduate educational curricula to meet both the technical demands of minimal invasive surgery and the ethical concerns regarding patients´ safety.
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22
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Xue L, Li Q, Hu GF, Shen L, Li LB, Jin ZG, Zhu ZL, Xie ZG. [Adult femur CT modeling and 3D automatic measurement of anatomical parameters]. Zhonghua Yi Xue Za Zhi 2019; 99:3093-3099. [PMID: 31648454 DOI: 10.3760/cma.j.issn.0376-2491.2019.39.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To reconstruct a 3D model from adult femur CT scan data and automate a measurement of femoral anatomical parameters to study the characteristics of Chinese femur anatomical parameters. Methods: Using Mimics17.0, models from the CT data of 148 adult patients were established. The completed model was imported into Geomagic Studio and the anatomical landmarks of the femur were extracted to establish 3D coordinate system and unified coordinate system. Programmed with Matlab, using the nearest point iterative ICP algorithm and the 3D automatic extraction algorithm of anatomical landmarks to provide precision positioning, the femoral anatomical parameters were automatically measured and analyzed. The data were compared by using independent sample t test. Results: In this group, the diameter of the male femoral condyle was (84.1±3.6) mm, and it was (74.8±3.3) mm in the female; the anteroposterior diameter of the male femoral condyle was (66.5±3.7) mm, and it was (61.2±3.5) mm in the female; the diameter of the male ball head was (48.8±2.1) mm and it was (43.4±2.2) mm in the female; the differences between the two genders were all statistically significant (t=16.21, 8.84, 15.20, all P<0.05). The male femoral moment radius was (112.5±24.5) mm, and it was (124.7±19.2) mm in the female (t=3.30, P=0.002). The neck angle in male participants was 124.9°±4.0°, and it was 126.1°±5.5° in the female (t=1.40, P>0.05). As the height growed, most of the anatomical parameters increased accordingly. Conclusions: The 3D automatic measurement of femoral anatomical parameters is more reproducible and accurate than manual measurement. It is necessary to establish and enrich the femoral anatomical database to design and develop internal fixation products that meet the needs of Chinese people.
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Affiliation(s)
- L Xue
- Department of Orthopedics, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Abstract
OBJECTIVES This study aimed to explore what factors influence and motivate medical students to undergo an intercalated degree and why they prefer to choose an intercalated MSc in Clinical Anatomy. METHODS The study consisted of 54 medical students enrolled in Queen's University Belfast which offers a range of intercalated degrees, including an iBSc in Medical Science and an iMSc in Clinical Anatomy. Five-point Likert scale survey was used to collect data, designed to discover what the influencing factors were in deciding to take an intercalating degree and if they have a desire to gain research experience. It measured the motivational features of their chosen courses. RESULTS In recent years, more students (68.5%, n = 54) opted for the iMSc rather than the iBSc. This difference in number of students was statistically significant (chi-square = 33.4, P < 0.0001). It was theorized that this was due to an interest in future surgical specialization; however, this study has shown that the prime reason 72.2% of students opt to take a year out of their medical degree to carry out an intercalated degree is simply to gain an extra qualification whilst 61.1% thought it would enhance their competitiveness in the job market. Ninety-four percent of the iMSc students recommended the intercalated degree to junior students in comparison to only 34.8% of the iBSc students. This difference in percentage was statistically significant (t = 2.78, P = 0.009). CONCLUSION The study shows no significant link to a desire to gain research experience in determining which intercalated programme to undertake. Students favoured iMSc more because they believed it will enhance their employability.
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Affiliation(s)
- Eiman Abdel Meguid
- Centre for Biomedical Sciences Education, School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7AE UK
| | - William E. Allen
- Centre for Biomedical Sciences Education, School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, Belfast, Northern Ireland BT9 7AE UK
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Lackey-Cornelison W, Bovid K, McKinney VR. Pedicle Screw Insertion: a Novel Approach to Enhance Anatomic Knowledge and Student Engagement. Med Sci Educ 2019; 29:355-356. [PMID: 34457491 PMCID: PMC8368890 DOI: 10.1007/s40670-019-00724-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A procedure experience was incorporated into the anatomy lab to advance knowledge of the spine and enhance student engagement (Nutt et al., Clin Teach 9(3):148-151, 2012). The spine lab was modified to include a scoliosis case with a pedicle screw placement simulation exercise. The experience has been a success for both undergraduate medical students and resident facilitators.
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Affiliation(s)
- Wendy Lackey-Cornelison
- Department of Biomedical Sciences, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI USA
| | - Karen Bovid
- Department of Orthopedic Surgery, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI USA
| | - Vicki R McKinney
- Department of Family Medicine, AU/UGA Medical Partnership, Athens, GA USA
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25
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Cornwall J, Finnegan M. Comment on Hannah et al. and the ongoing relevance of clinical anatomy. Musculoskelet Sci Pract 2017; 29:e19-e20. [PMID: 28215342 DOI: 10.1016/j.msksp.2017.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 01/27/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Jon Cornwall
- Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, P.O. Box 600, Wellington, New Zealand.
| | - Michelle Finnegan
- Bethesda Physiocare, Bethesda, MD, USA; Myopain Seminars, Bethesda, MD, USA
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26
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Hernández-Díaz C, Alvarez-Nemegyei J, Navarro-Zarza JE, Villaseñor-Ovies P, Kalish RA, Canoso JJ, Vargas A, Chiapas-Gasca K, Biundo JJ, de Toro Santos FJ, McGonagle D, Carette S, Saavedra MÁ. A survey of anatomical items relevant to the practice of rheumatology: pelvis, lower extremity, and gait. Clin Rheumatol 2017; 36:2813-2819. [PMID: 28573372 DOI: 10.1007/s10067-017-3702-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 05/24/2017] [Indexed: 11/30/2022]
Abstract
This study aimed to generate a minimum list of structural and functional anatomical items about the pelvis/hip, knee, ankle/foot, gait, and lower limb innervation, which are most relevant to the practice of rheumatology. To determine their perceived relevance to clinical practice, seven members of the Mexican Clinical Anatomy Task Force compiled an initial list of 470 anatomical items. Ten local and international experts according to a 0-10 Likert scale ranked these items. Of the original list, 101 (21.48%) items were considered relevant (global rate >40). These included 36/137 (26.27%) pelvis and hip items, 25/82 (30.48%) knee items, 22/168 (13.98%) ankle/foot items, 11/68 (16.17%) neurologic items, and 7/15 (46.66%) gait-related items. We propose that these 101 anatomical items of the lower extremity, when added to the 115 anatomic items of the upper extremity and spine we previously reported, may represent an approximation to the minimal anatomical knowledge central to the competent practice of rheumatology. The meager representation of ankle and foot items may reflect a lesser emphasis in these anatomical regions during rheumatologic training. Attention to these and related items during rheumatologic training and beyond may sharpen the rheumatologist's ability in the differential diagnosis of regional pain syndromes as well as strengthen an endangered art: the rheumatologic physical examination.
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Affiliation(s)
- Cristina Hernández-Díaz
- Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación, México, DF, Mexico
| | - José Alvarez-Nemegyei
- Unidad de Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, Mexico
| | - José Eduardo Navarro-Zarza
- Hospital General de Chilpancingo Raymundo Abarca Alarcón, Chilpancingo, Gro, Mexico.,Universidad Autónoma de Guerrero, Acapulco, Gro, Mexico
| | - Pablo Villaseñor-Ovies
- Hospital Ángeles de Tijuana, Tijuana, BC, Mexico.,Universidad Autónoma de Baja California, Mexicali, Mexico
| | | | - Juan J Canoso
- Centro Médico ABC, México, DF, Mexico.,Tufts Medical School, Boston, MA, USA
| | - Angélica Vargas
- Departamento de Reumatología, Instituto Nacional de Cardiología Ignacio Chávez, México, DF, Mexico
| | | | | | - Francisco Javier de Toro Santos
- Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario A Coruña (CHUAC), Sergas, Universidad La Coruña (UDC), Coruña, Spain
| | - Dennis McGonagle
- UK National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Simon Carette
- Division of Rheumatology, Mount Sinai Hospital, University Health Network, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Miguel Ángel Saavedra
- Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
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Bouman EAC, Sieben JM, Balthasar AJR, Joosten EA, Gramke HF, van Kleef M, Lataster A. Boundaries of the thoracic paravertebral space: potential risks and benefits of the thoracic paravertebral block from an anatomical perspective. Surg Radiol Anat 2017; 39:1117-1125. [PMID: 28444433 PMCID: PMC5610675 DOI: 10.1007/s00276-017-1857-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/14/2017] [Indexed: 02/01/2023]
Abstract
Purpose Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. Methods In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed. In a third unembalmed specimen, ultrasound-guided posterolateral injections at several levels of the TPVS were performed with different fluids. Results TPVS communicated with all surrounding spaces including the segmental dorsal intercostal compartments (SDICs) and the prevertebral space. TPVS transitions to the SDICs were wide, whereas the SDICs showed narrowed transitions to the lateral intercostal spaces at the costal angle. Internal subdivision of the TPVS in a subendothoracic and an extra-pleural compartment by the endothoracic fascia was not observed. Caudally injected fluids spread posteriorly to the costodiaphragmatic recess, showing segmental intercostal and slight prevertebral spread. Conclusions Our detailed anatomical study shows that TPVS is a potential space continuous with the SDICs. The separation of the TPVS in a subendothoracic and an extra-pleural compartment by the endothoracic fascia was not observed. Based on the ultrasound-guided liquid spread we conclude that the use of a more lateral approach might increase the probability of intravascular puncture or catheter position.
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Affiliation(s)
- Esther A C Bouman
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
| | - Judith M Sieben
- Department of Anatomy and Embryology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,CAPHRI School of Public Health and Primary Care, Maastricht, The Netherlands
| | - Andrea J R Balthasar
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands
| | - Elbert A Joosten
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands
| | - Hans-Fritz Gramke
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands
| | - Maarten van Kleef
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands
| | - Arno Lataster
- Department of Anatomy and Embryology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,CAPHRI School of Public Health and Primary Care, Maastricht, The Netherlands
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Villaseñor-Ovies P, Navarro-Zarza JE, Saavedra MÁ, Hernández-Díaz C, Canoso JJ, Biundo JJ, Kalish RA, de Toro Santos FJ, McGonagle D, Carette S, Alvarez-Nemegyei J. A survey of anatomical items relevant to the practice of rheumatology: upper extremity, head, neck, spine, and general concepts. Clin Rheumatol 2016; 35:3025-3030. [PMID: 27539219 DOI: 10.1007/s10067-016-3378-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 08/06/2016] [Indexed: 11/25/2022]
Abstract
This study aimed to identify the anatomical items of the upper extremity and spine that are potentially relevant to the practice of rheumatology. Ten rheumatologists interested in clinical anatomy who published, taught, and/or participated as active members of Clinical Anatomy Interest groups (six seniors, four juniors), participated in a one-round relevance Delphi exercise. An initial, 560-item list that included 45 (8.0 %) general concepts items; 138 (24.8 %) hand items; 100 (17.8 %) forearm and elbow items; 147 (26.2 %) shoulder items; and 130 (23.2 %) head, neck, and spine items was compiled by 5 of the participants. Each item was graded for importance with a Likert scale from 1 (not important) to 5 (very important). Thus, scores could range from 10 (1 × 10) to 50 (5 × 10). An item score of ≥40 was considered most relevant to competent practice as a rheumatologist. Mean item Likert scores ranged from 2.2 ± 0.5 to 4.6 ± 0.7. A total of 115 (20.5 %) of the 560 initial items reached relevance. Broken down by categories, this final relevant item list was composed by 7 (6.1 %) general concepts items; 32 (27.8 %) hand items; 20 (17.4 %) forearm and elbow items; 33 (28.7 %) shoulder items; and 23 (17.6 %) head, neck, and spine items. In this Delphi exercise, a group of practicing academic rheumatologists with an interest in clinical anatomy compiled a list of anatomical items that were deemed important to the practice of rheumatology. We suggest these items be considered curricular priorities when training rheumatology fellows in clinical anatomy skills and in programs of continuing rheumatology education.
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Affiliation(s)
- Pablo Villaseñor-Ovies
- Hospital Ángeles de Tijuana, Tijuana, BC, Mexico
- Universidad Autónoma de Baja California, Mexicali, Mexico
| | - José Eduardo Navarro-Zarza
- Hospital General de Chilpancingo Raymundo Abarca Alarcón, Chilpancingo, Gro, Mexico
- Universidad Autónoma de Guerrero, Acapulco, Gro, Mexico
| | - Miguel Ángel Saavedra
- Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
| | - Cristina Hernández-Díaz
- Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación, México, DF, Mexico
| | - Juan J Canoso
- Centro Médico ABC, México, DF, Mexico
- Tufts Medical School, Boston, MA, USA
| | | | - Robert A Kalish
- Tufts Medical School, Boston, MA, USA
- Tufts Medical Center, Boston, MA, USA
| | - Francisco Javier de Toro Santos
- Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario A Coruña (CHUAC), Sergas, Universidad La Coruña (UDC), Coruña, Spain
| | - Dennis McGonagle
- UK National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Simon Carette
- Division of Rheumatology, University Health Network, Mount Sinai Hospital, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - José Alvarez-Nemegyei
- Unidad de Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, Mexico
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Pais J, Silva A, Guimarães B, Povo A, Coelho E, Silva-Pereira F, Lourinho I, Ferreira MA, Severo M. Do item-writing flaws reduce examinations psychometric quality? BMC Res Notes 2016; 9:399. [PMID: 27516160 PMCID: PMC4982015 DOI: 10.1186/s13104-016-2202-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 08/03/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The psychometric characteristics of multiple-choice questions (MCQ) changed when taking into account their anatomical sites and the presence of item-writing flaws (IWF). The aim is to understand the impact of the anatomical sites and the presence of IWF in the psychometric qualities of the MCQ. RESULTS 800 Clinical Anatomy MCQ from eight examinations were classified as standard or flawed items and according to one of the eight anatomical sites. An item was classified as flawed if it violated at least one of the principles of item writing. The difficulty and discrimination indices of each item were obtained. 55.8 % of the MCQ were flawed items. The anatomical site of the items explained 6.2 and 3.2 % of the difficulty and discrimination parameters and the IWF explained 2.8 and 0.8 %, respectively. CONCLUSIONS The impact of the IWF was heterogeneous, the Writing the Stem and Writing the Choices categories had a negative impact (higher difficulty and lower discrimination) while the other categories did not have any impact. The anatomical site effect was higher than IWF effect in the psychometric characteristics of the examination. When constructing MCQ, the focus should be in the topic/area of the items and only after in the presence of IWF.
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Affiliation(s)
- João Pais
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Artur Silva
- Departamento de Anatomia, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Bruno Guimarães
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,Departamento de Anatomia, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Ana Povo
- Departamento de Anatomia, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Elisabete Coelho
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Fernanda Silva-Pereira
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Isabel Lourinho
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Maria Amélia Ferreira
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,Departamento de Anatomia, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Milton Severo
- Departamento de Educação e Simulação Médica, Piso 6, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. .,Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina da, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
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Saavedra MÁ, Navarro-Zarza JE, Alvarez-Nemegyei J, Canoso JJ, Kalish RA, Villaseñor-Ovies P, Hernández-Díaz C. Self-assessed efficacy of a clinical musculoskeletal anatomy workshop: A preliminary survey. ACTA ACUST UNITED AC 2014; 11:224-6. [PMID: 25544712 DOI: 10.1016/j.reuma.2014.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/11/2014] [Accepted: 11/09/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To survey the efficacy of a practical workshop on clinical musculoskeletal anatomy held in five American countries. METHODS A self-assessment competence questionnaire sent to participants 1-3 months after the workshop. Results were compared to the results of a practical, instructor-assessed, pre-workshop test. RESULTS The response rate of participants was 76.4%. The overall, self-assessed competence score for anatomical items that had been included in the pre-test was 76.9 (scale 0-100) as compared to an overall score of 48.1 in the practical, pre-workshop test (p<0.001). For items that were addressed in the workshop, but not included in the pre-test, self-assessed competence was rated at 62.9. Differences in anatomical knowledge between individuals from different countries and professional groups noted in the practical pre-test were no longer present in the post-test self-assessment. CONCLUSIONS From this preliminary data and supporting evidence from the literature we believe that our anatomy workshop provides an effective didactic tool for increasing competence in musculoskeletal anatomy.
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Affiliation(s)
- Miguel Ángel Saavedra
- Rheumatology Department, Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, IMSS, Mexico City, Mexico.
| | - José E Navarro-Zarza
- Hospital General de Chilpancingo Raymundo Abarca Alarcón, Chilpancingo, Guerrero, Mexico
| | | | | | - Robert A Kalish
- Rheumatology Department, Tufts Medical Center, Boston, MA, United States
| | | | - Cristina Hernández-Díaz
- Musculoskeletal Ultrasonography Laboratory Department, National Institute of Rehabilitation, Mexico City, Mexico
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