bluuebunny/crossref_metadata_2025 huggingface dataset:
Dissection study and mensuration of the pulmonary arteries in man
Authors: Wright N. L.
Published: February 2005

Descriptions are given of the main pulmonary arteries and of their lobar branches in man. The numbers of lobar branches and certain dimensions (mainly external diameters) of parent vessels (at specified fixed points) and of branch vessels (at their origins) are also given. This information has been obtained from studies made in living subjects. Attention is drawn to the relative frequency of incidence of a large proximally sited branch to the upper lobe in both lungs, also to the site of origin of the lower lobe apical artery, relative to the middle lobe artery or lingular artery. Certain anomalous and small arterial branch arrangements are described.
Three‐dimensional reconstructions from serial X‐ray tomography of an Egyptian mummified head
Authors: Lewin Peter K. , Trogadis Judy E. , Stevens John K.
Published: February 2005

Three dimensional images of both the surface and the underlying skull of an Egyptian mummified head from the Greco‐Roman Period were obtained from the reconstruction of sequential computerized tomographic scans of the head.

The images produced by this new technique provide morphological and pathological data previously available only through destructive measures. As a descriptive anatomical tool, this technique, as demonstrated by the reported Egyptian mummy example, is a valuable non‐destructive method of obtaining data from unique anatomical specimens.
Post‐traumatic stress among medical students in the anatomy dissection laboratory
Authors: Finkelstein Peter , Mathers Lawrence H.
Published: February 2005

The emotional and psychological responses of medical students to the human anatomy laboratory at Stanford University School of Medicine were studied over four successive years. Students' reactions to dissection were assessed by interview, questionnaire, recording of laboratory conversations, and analysis of dreams. Data were collected from approximately 175 of the 350 students enrolled in Human Anatomy over this period. Interviews were also conducted with faculty and staff. Approximately 5% of the students reported marked disturbances including nightmares, intrusive visual images, insomnia, depression, and learing impairments. A large fraction of the remaining students reported similar but less severe responses to dissection in the Anatomy laboratory. These reactions strongly resemble the psychological entity known as posttraumatic stress disorder (PTSD). We suggest that the Anatomy laboratory represents a significant emotional challenge to many medical students, in that it may be the student's first intimate experience with illness and death. Further, the Anatomy laboratory may be compared to subsequent clinical encounters because it asks that a student concentrate on data collection and simultaneously deal with disturbing thoughts and feelings. Those involved in Anatomy instruction are in a unique position to help impart desirable professional values to young physicians as they adjust to these stresses.
Variations in the anatomic relationship of the left renal vein to the left renal artery at the aorta
Authors: Valentine R. James , MacGillivray Dougald C. , Blankenship Charles L. , Wind Gary G.
Published: February 2005

Anatomic textbook descriptions imply that there is little variability in the relationships of the left renal vein, abdominal aorta, and left renal artery. However, previous studies of the renal pedicle have documented a significant amount of variability in the anatomy of the left renal vein, calling the consistency of the regional anatomy into question. To determine the validity of using the left renal vein as an anatomic landmark, the renal vessels of 57 postmortem subjects were examined. Seven subjects with anomalies or pathology which distorted the regional anatomy were excluded from the study group. In the remaining 50 subjects, the relationship of the left renal vein to the origin of the left renal artery was determined. The left renal artery was directly beneath the left renal vein in 52%, below (caudal to) the corresponding vein in 14%, and above (craniad to) the corresponding vein in 34%. The mean distance between the midpoint of the origin of the left renal artery and the cephalad margin of the left renal vein was 3.1 mm (P = 0.034). These data validate the assumption that the left renal vein is a reliable anatomic landmark for locating the left renal artery and juxtarenal aorta in cases where anomalous vascular anatomy or previous retroperitoneal dissection are not present.
Histology of mucous membrane of human inferior nasal concha
Authors: Trotter C. M. , Hall G. H. , Salter D. M. , Wilson J. A.
Published: February 2005

The light microscopic features of the mucous membrane of intact inferior nasal concha are described. A proposal is made to standardize the terminology of tissue deep to the basement membrane as superficial or deep tunica propria. The range of epithelia found and the distribution of the various cell types and fibers present in the conchae are described. The variability of the tissue is stressed, both at gross and cellular levels. Mast cells are stained by using an Alcian blue and safranin technique in which the critical electrolyte concentration is adjusted to 0.3M MgCl2 This demonstrates two sub‐types of mast cell. One is a relatively small, pale staining, spindle‐shaped, superficially located cell, containing turquoise granules, while the other is generally more deeply located, larger, round or ovoid, containing granules of dark purplish‐red. The variability of mast cell distribution shown in this study emphasizes the need for large tissue samples in any estimation of mast cell numbers.
Development of the human sacroiliac joint
Authors: Salsabili N. , Hogg D. A.
Published: February 2005

To provide further details of the development of the sacroiliac joint, which might help to explain some of its unusual adult features, the development of the bones, joint cavity, synovial membrane, articular cartilages, joint capsule, and ligaments has been examined by light microscopy in a series of 13 human embryos and fetuses ranging from 21 mm greatest length (G.L.) to 185 mm crown‐rump length (C.R.).

Perichondral ossification of the ilium was first seen at 39 mm C.R. and led to the formation of bone on the external and internal surfaces of the ala of the ilium. In the sacrum, centers of endochondral ossification were first recognized at 100 mm C.R. within the bodies and arches of the sacral vertebrae.

Cavitation commenced at around 39 mm C.R. as separate, small spaces within the middle layer of the interzone in the cranial region of the joint, which was avascular prior to the onset of cavitation and showed evidence of pyknotic cells around the sites of cavitation. The joint cavity spread caudally involving the entire joint by 185 mm C.R., but fibrous septa bridging across between the sacral and iliac articular surfaces were still present.

Vascularization of synovial mesenchyme was first observed at 155 mm C.R. and synovial villi at 185 mm C.R. The outer layers of the interzone contributed fibrous layers to the articular surfaces of the sacrum and ilium, which were still present at 185 mm C.R., that on the ilium being the thicker and showing evidence of continuing proliferation and differentiation into cartilage, responsible for further bone growth of the ilium.
Anatomical mythology? A study of surface markings of the inguinal region
Authors: Scott P. D. , Willan P. L. T.
Published: February 2005

The surface markings used by authors for structures in the inguinal region were reviewed and differences noted. In this study of 40 cadaveric limbs the surface markings of both the deep inguinal ring and the femoral artery were found to lie closer to the midinguinal point than to the midpoint of the inguinal ligament, which lay lateral to both structures considered. Usually the femoral artery was located lateral to the medial margin of the deep inguinal ring, but occasionally lay medial. In some subjects poor definition of the bony features rendered precise localisation of the positions of the pubic tubercle and anterior superior iliac spine difficult. The origin of the inferior epigastric artery, often used to identify the medial margin of the deep inguinal ring, was subject to variation. A single surface marking, namely the midinguinal point, is suggested for both the femoral artery and the deep inguinal ring on grounds of accuracy, simplicity, and ease of identification.
Movements of the elbow and shoulder during pronation of the forearm
Authors: Barton B. A. , Evans E. J.
Published: February 2005

It is known that medial and lateral movements of the lower end of the ulna occur during pronation and supination of the forearm, but there is little clear evidence as to where these movements originate. Twenty normal subjects pronated their forearm about either an undefined, lateral, or medial axis. Measurements were made from paired photographs taken at increments of 45° during the movement. Abduction of the ulna always occurred but its magnitude did not vary significantly with differing axes of pronation. During pronation about an undefined axis the abduction at the elbow produced a lateral movement of the ulna which was usually appropriate for the axis of pronation in use. Medial or lateral rotation of the humerus was used to increase or decrease the amount of lateral movement of the lower end of the ulna to suit the requirements of pronation about a medial or lateral axis.
Blood supply of the human levator and tensor veli palatini muscles
Authors: Freedlander Eric
Published: February 2005

In spite of its clinical importance in cleft palate, there are few detailed accounts of the blood supply of the soft palate and palatal muscles. A series of dissections was carried out to investigate the supply of the levator and tensor veli palatini muscles. Ten adult cadavers and 12 fetuses were used, all of which had been previously injected with a variety of media to outline the vascular tree. Conventional dissection was performed on the cadavers, and microsurgical instruments and a dissection microscope were utilized for fetal dissections.

In 70% of dissections the m. levator veli palatini had a dual arterial supply, from the ascending palatine and ascending pharyngeal arteries. In the remainining cases the muscle was supplied by a single artery, either the ascending palatine or ascending pharyngeal. In 79% of dissections the tensor muscle had a dual supply from the accessory meningeal artery along with either the ascending palatine, ascending pharyngeal, or, in one case, the lesser palatine arteries.

The results suggest that in careful surgical closure of the cleft soft palate the normal dual arterial supply would protect the tensor and levator muscles from vascular damage. In the minority of patients where only a single vessel supplies the levator, a radical intrapalatal dissection may jeopardize its vascularity.
The synovial folds of the patellofemoral joint: A dynamic study
Authors: Donell S. T.
Published: February 2005

The synovial folds of the patellofemoral joint have been studied in five fresh cadaveric knees through a window cut in the patella. When the knee is extended, the superior part of the patellar articular surface lies on the synovium lining the supracondylar fat pad of the femur, which has a distal leading edge and a distal excursion of 2 to 3 mm. As the knee flexes, the contact area of the patella on the femur sweeps superiorly, and the inferior articular surface is covered by the alar folds of the infrapatellar fat pad which face towards one another, and the midline of the joint. On flexion beyond 90° the alar folds move away like a curtain opening, to face away from one another. The synovium lining the infrapatellar fat pad then lies on the medial facet of the patella.
Comparison of collagen in the intact linea alba with that in midline abdominal scars: An electron microscopic study
Authors: Cohen Andrew , Skepper Jeremy , Ellis Harold
Published: February 2005

“Late” incisional hernias are those which appear more than 1 year after surgery. However, they are not associated with the same causal factors as “early” incisional hernias. In this study, scanning (SEM) and transmission electron microscopy (TEM) were used to compare the collagen of 12 samples of intact linea alba with 8 samples of scar tissue, aged between 6 weeks and 10 years, taken from patients who had undergone previous midline abdominal incisions. No differences of collagen organization were observed using qualitative SEM. TEM, however, showed that intact tissue has collagen fibrils with larger mean diameters and differs from scar tissue in the shape of its fibril diameter distribution. Collagen fibrils from scar tissue in elderly subjects resembled collagen fibrils from intact tissue of young subjects. Neither TEM or SEM revealed any differences between scars of different maturity. © 1992 Wiley‐Liss, Inc.
Segmental patterns of rib‐vertebra angles in chest radiographs of children: Changes related to rib level, age, sex, side and significance for scoliosis
Authors: Grivas Theodoros B. , Burwell R. G. , Purdue M. , Webb J. K. , Moulton A.
Published: February 2005

Rib‐vertebra angles (RVAs) were measured (T1–12) on the chest radiographs of 412 children aged 0–17 years attending the hospital with minimal disorders or diseases (boys 193, girls 219). A new method for measuring RVAs is used and the asymmetry of rib‐vertebra angles is calculated as rib‐vertebra angle differences (RVADs). The data are analysed in three age groups—infancy, childhood, and puberty, after the classification of Karlberg (1989).

The findings show the following:(1) RVAs decrease from T1–12, especially so between (T8 and T12.2) Between infancy and childhood, RVAs of the upper ribs incrase, more so in boys than girls. (3) Between childhood and adolescence there is a further elevation of ribs, involving more ribs in boy than girls (boy T1–10, girls T1–8). (4) Between infancy and childhood, the lower ribs droop more in girls than boys (boys T9–10/12, girls T7/8–12). There is no change in the RVAs of the lower ribs between childhood and puberty in either boys or girls. (5) The hypothesis is suggested that RVAs are influenced by the central nervous system through its influence on trunk muscle activity. (6) Ribvertebra angle asymmetries (or differences, RVADs) are related to age and sex; their pattern reflects the common age, sex, and laterality patterns of idiopathic scoliosis. Extremes of such asymmetries may be an etiological factor for both infantile and adolescent idiopathic scoliosis. © 1992 Wiley‐Liss, Inc.
Intermediate inguinal ring
Authors: Yeager Vernon L.
Published: February 2005

The purpose of this paper is to reintroduce the concept that the cremasteric muscle and fascie (intermediate spermatic covering) arise from an intermediate inguinal ring, similar to the internal spermatic fascia arising from the deep inguinal ring and the external spermatic fascia arising from the superficial inguinal ring. This will help students learn the anatomy of the inguinal region. © 1992 Wiley‐Liss, Inc.
Segmental patterns of sagittal spinal curvatures in children screened for scoliosis: Kyphotic angulation at the thoracolumbar region and the mortice joint
Authors: Kiel A. W. , Burwell R. G. , Moulton A. , Purdue M. , Webb J. K. , Wojcik A. S.
Published: February 2005

This paper reports a segmental analysis of the lateral spinal radiographs of 37 children referred to hospital in a school screening study of 4,890 school children aged 12–13 years. On each lateral radiograph a line was drawn along the posterior surface of each vertebral body from T5‐L5 and the angle of this line from the vertical was recorded.

After measuring the scoliosis curve (Cobb) angle and using conventional criteria for diagnosis, three groups of patients are defined, namely, 1) a control group (average scoliosis curve angle (Cobb) of 5°, n = 14), 2) a group with lumbar curves (average Cobb angle 21°, n = 7), and 3) a group with thoracic curves (average Cobb angle 19 degrees, n = 10). Individual lateral spinal profiles are also analyzed.

The findings show: (1) In the control group, there are different degrees of vertical backward tilt (declivity) from T7–L3, with a maximum tilt at T12 (mean 26°). The most vertical vertebrae are T6 and L4, with forward tilting (proclivity) at each of (T5 and L5.2) In the lumbar curve group, the segmental sagittal tilt is not significantly different from that in the control group. The mean declivity at T12 is 25°. (3) In the thoracic curve group, the segmental sagittal tilt is significantly less than that in the control group at each of T10–L1. The mean declivity at T12 is 17°. A more vertical T12 is associated with a larger Cobb angle. (4) The individual sagittal spinal profiles of the thoracic curve group (but no other group) show lordosis in the region of the lateral spinal curve (scoliosis) and a kyphotic angulation at an average of three vertebrae below the apical vertebrae of the scoliosis curve. (5) It is suggested that as a thoracic lordoscoliosis develops, the appearance of a kyphotic angulation in the thoracolumbar and upper lumbar spine is determined by the compressibility of each disc in relation to the length of the articular processes at the corresponding level. Where the combination of disc weakness to facet length is most adverse, forward flexion occurs, as in a spinal fracture, to produce the kyphotic angulation. © 1992 Wiley‐Liss, Inc.
J.C. Boileau grant and the changing face of anatomy
Authors: Tobias Phillip V.
Published: February 2005

John C. Boileau Grant was one of the most outstanding teachers of anatomy in the 20th century. His life's work is honored by the thirty editions to which, collectively, his three textbooks have run; by the J.C.B. Grant Museum in the Anatomy Department of the University of Toronto; and by the establishment by the Faculty of Medicine of that university of a John C.B. Grant Memorial Award and Lecture. The present article is an abridgement of the first lecture in this new eponymous series. An account and an appraisal are given of Grant's life and contributions. Reference is made to the deleterious impact on anatomy of overspecialization—not of research methods and goals, but of the minds of anatomists. The catalytic and revitalizing effect that an array of new imaging techniques is exerting on the interest in, and emphasis upon, gross human morphology is stressed and the author underlines R. Ger's claim that, thereby, all gross anatomy has become clinical anatomy. © 1992 Wiley‐Liss, Inc.
Antero‐medial menisco‐femoral ligament
Authors: McCormack Damian , McGrath Joseph
Published: February 2005

The case of a 34‐year‐old man is reported, in whom a ligament was found at arthrotomy connecting the anterior horn of the medial meniscus of the knee joint to the medial aspect of the lateral femoral condyle.

It appeared to be an example of a rare accessory meniscal ligament, previous reports of which are reviewed. © 1992 Wiley‐Liss, Inc.
The uniform anatomical gift act: What every clinical anatomist should know
Authors: Dalley Arthur F. , Driscoll Robert E. , Settles Harry E.
Published: February 2005

Although many are aware of the existence of a document called the Uniform Anatomical Gift Act (UAGA), few are aware that there are actually two such Acts (1968 and 1987), and even fewer have read the Acts themselves. Consequently, there are many different and frequently false impressions about their purpose and content. This paper is an attempt to acquaint readers with the two UAGAs. The historical background leading to the unprecedented rapid, uniform and unanimous adoption of the 1968 Act is presented. The content, rationale, and significance of that Act are outlined. The perceived shortcomings of the first Act resulting in the much less successful and less widely‐adopted 1987 Act is explained and the major changes incorporated in the second Act are outlined. Specific features of the Acts of concern to anatomists involved in willed‐body programs, and clinicians who may become involved in body/body part donation or utilization are addressed. Finally, the relationship of the UAGA to other lines of regulation and the need to be aware of them is indicated. © 1993 Wiley‐Liss, Inc.
Design of heart valves: A review
Authors: Navaratnam V.
Published: February 2005

Each of the major cardiac valves (two arterial and two atrioventricular) is made up of a fibrous annulus with a characteristic configuration, and cusps or leaflets comprising a layer of endocardium folded over a fibrous lamina. Each of the arterial valves (aortic and pulmonary) has an annulus shaped like a three‐pronged coronet to which are attached three equal‐sized semilunar cusps. The arterial wall beyond each cusp forms a pocket or sinus which is crucial in the efficient closure of these valves. The coronary arterial orifices in the aorta lie high in two of the sinuses or above them and are unaffected by valve action. Narrowing of the annulus is a significant component of closure of each cardiac valve, more so for the atrioventricular valves than the arterial. Despite their traditional terminology, the left and right atrioventricular valves (mitral and tricuspid) both possess more than three leaflets each. Closure of these valves is not dependent on the number of leaflets and it is easiest to regard leaflet tissue as a continuous veil or skirt tapering towards the ventricles, where it is tethered to papillary muscles by means of chordae tendineae. Closure of these valves is biphasic, an incomplete phase in late diastole and complete closure during ventricular systole. Movement of atrioventricular leaflet tissue is slight as it is held down by tension of the chordae tendineae. © 1993 Wiley‐Liss, Inc.
Grooves in the superior surface of the liver
Authors: Newell Richard L. M. , Morgan‐Jones Rhidian
Published: February 2005

A group of cadaveric livers bearing anteroposterior grooves or furrows in the superior surface of the right lobe is described. Such grooves have been noted by others in living patients. The existence of these grooves has been recognized since at least 1888, but there seems to be no agreement as to their cause. It appears from this study that different types of groove or indentation occur, according to their orientation relative to the median plane of the body. Two major groups of theories of causation are recognized, but no firm conclusions are drawn. © 1993 Wiley‐Liss, Inc.
Observation of anomalus triplication of unilateral anterior digastric muscle
Authors: Çelik H. Hamdi , Yilmaz Engin , Atasever Alper , Durgun Barbaros , Taner Doǧan
Published: February 2005

We describe a rare anomaly in the submental region of a single male cadaver specimen. The anterior belly of the right digastric muscle was observed to have three separate insertions. Most medial of these crossed the midline and inserted to the digastric fossa with the opposite digastric muscle. These muscle bands were united in a common tendon as they continued with the posterior belly. This is an anatomical variation in the mylohyoid digastric muscle group in the floor of the mouth. Consideration of such variations of the anterior bellies of the digastric muscles should be noted during the evaluation of the floor of the mouth in the CT examination or MR imaging. © 1993 Wiley‐Liss, Inc.
Incisional/ventral herniorrhaphy employing bilateral reversed anterior rectus abdominis sheath
Authors: Le Tam H. , Fendley Steven O. , Graves Ernest D. , Thomas William O. , Rodning Charles B.
Published: February 2005

Repair of a symptomatic incisional/ventral hernia that is not amenable to simple primary closure is problematic. Therapeutic options include: (1) fascial reapproximation after unilateral/bilateral horizontal parasagittal relaxing incisions (obliquus externusand transversus abdominis) with or without pre‐operative pneumoperitoneum; (2) bridging a fascial defect with autologous devascularized (lata femoris, anterior rectus abdominissheath) or vascularized (abdominal wall fascia, tensor fasciae latae, myofascial, or myofascial/cutaneous rotational flaps) tissue; or (3) insertion of prosthetic/synthetic material (polypropylene, polytetrafluoroethylene, polygalactin). In the presence of abdominal infection or contaminated operative wounds use of autologous tissue is preferred, because of the risks of infection and gastroenterocolonic fistulization.

Since 1985 the authors have observed excellent results with use of a bilateral reversed anterior rectus abdominissheath technique of incisional/ventral herniorrhaphy. Although the parasagittal incision parallel to the linea semilunarisand mobilization medially undoubtedly caused partial devascularization (interruption of segmental and intermuscular arteriovenous arcades, respectively), the sheath coapted in the midline maintained its integrity as evaluated clinically and radiographically. This implies that the Sheath is relatively hypometabolic, that collateral circulation is maintained and/or develops, and/or sustenance is obtained by contiguity with peritoneal secretions and subcutaneous tissue.

Twenty‐three patients (13 males, 10 females, age range 19–79 years) with large symptomatic mid‐abdominal hernias of 8–16 months duration were so treated. Each of these patients had required multiple (three to seven) exploratory celiotomies for traumatic, infectious, inflammatory., or neoplastic entities. To date all patients have healed per primumwithout recurrence. Only one patient, who had previously received pelvic irradiation, manifested eventration. This qualitative analysis suggests that this technique has validity for patients requiring incisional/ventral herniorrhaphy with an otherwise intact rectus abdominismuscle and sheath. © 1994 Wiley‐Liss, Inc.
Human dissection and attitudes of preclinical students to death and bereavement
Authors: Druce Maralyn , Johnson Martin H.
Published: February 2005

Two questionnaires were used to gather information about preclinical education concerning death and bereavement. One was mailed to Heads of Anatomy Departments of 26 UK medical schools. The other was distributed to 220 first‐ and 210 second‐year preclinical students in Cambridge. Among curricular organizers (77% response rate), the motivation for giving such education was primarily to improve knowledge about dissection, and only secondarily and infrequently to prepare students for clinical practice or to address their attitudes or feelings. In contrast, the primary concern of students (response rate 54%) was preparation for encounters with death in clinical practice (61–85%), lesser concerns being to address their own fears and feelings (30–40%) or knowledge about the dissecting room, cadavers, etc. (23–37%). Students were also asked about their reactions to dissection in order to determine whether the dissecting room might provide an opportunity for teaching about death. Most (66%) admitted experiencing moderate to extreme apprehension in advance of dissection. Apprehension was associated, on starting dissection, with very strong reactions, which in some cases interfered with learning. Some (27%) dealt with this by depersonalization. The only previous experiences that showed a significant association with the occurrence during dissection of interfering and/or non‐task‐related thoughts and feelings were (i) for both men and women the occurrence and quality of handling of death experience(s) at school, and (ii) for a group of male students the experience of the death of more than one close non‐family friend. A strategy for effective use of the dissecting room in studies on death is outlined. © 1994 Wiley‐Liss, Inc.
Right ventricular protection with coronary sinus retrograde cardioplegia
Authors: Sutter Francis P. , Nielson David H. , Goldman Scott M. , Mitchell John M. , Garwood Alexander P. , King Sheila , Gallagher Joseph F. , Clancy Michael
Published: February 2005

Fifteen consecutive patients having open heart surgery using retrograde cardioplegia were studied to demonstrate that important venous collateralization exists between the coronary sinus (CS) and its left ventricular branches and the right ventricle (RV). The venous collateralization makes possible RV myocardial protection during retrograde cardioplegia. Right ventricular venous drainage principally occurs via anterior cardiac veins, which drain into the right atrium, and thebesian veins, which drain into both the RV and the atrium, generally without connection to the CS. Retrograde cardioplegia used during open heart surgery should, therefore, give inadequate myocardial protection to the RV. Two RV temperature probes used as markers for RV perfusion were monitored continuously during cardiac arrest. Systemic temperature while on cardiopulmonary bypass was 25°C, and the retrograde perfusate solution temperature was 4°C. Coronary sinus pressure during the bypass procedure was maintained between 20 torr and 50 torr. Mean temperatures at the two probe sites were 16.1°C and 14.5°C. We conclude that a complex network of venous collaterals between the coronary sinus and left ventricle and the right ventricle allow excellent myocardial protection during retrograde cardioplegia. © 1994 Wiley‐Liss, Inc.
Real minimal diameter of the lower thoracic and lumbar vertebral pedicles
Authors: İslam Ci̇hangi̇r , Şakul Bayram Ufuk , Güzel Mehmet Bahaddi̇n
Published: February 2005

Transpedicular screw fixation is a widely used method in vertebral surgery, but it suffers from complications due to mismatches between the screw and pedicle. Therefore, information on the real minimal diameter of pedicle is needed for the development of instrumentation techniques and implantable devices. A total of 4,212 measurements from 1,404 pedicles of 702 human vertebrae were made from thoracic (T11, T12) to lumbar (L1–L5). We found that there was a real minimal diameter which was different from the vertical and transverse diameters of pedicles. This is the smallest diameter which cannot be definitely determined by the imaging methods currently in use, such as anteroposterior and lateral radiographs, and computed tomography; direct measurements excepted. Based on these results, we suggest that neither vertical nor transverse diameter gives accurate measurements of minimal diameter. However, minimal diameter size may be estimated using the ratio of vertical or transverse diameter to minimal diameter reported in this study for each level. © 1994 Wiley‐Liss, Inc.
Status of gross anatomy in the U.S. and Canada: Dilemma for the 21st century
Authors: Collins Thomas J. , Given Randall L. , Hulsebosch Claire E. , Miller Brian T.
Published: February 2005

As a component of a recent academic review, the Department of Anatomy and Neurosciences faculty at the University of Texas Medical Branch in Galveston, Texas, developed a questionnaire designed to compare the curricula, direction, and challenges of their department with the approximately 140 anatomy departments in the U. S. and Canada. The response was overwhelming in that over 80% of the schools returned a completed questionnaire. One of the areas of interest revealed by this survey was a growing concern over significant changes in both medical school curricula and the future of anatomy departments. Most departments still used traditional lectures to present course material and the majority of the scheduled contact hours were in the dissection laboratory; however, other teaching formats, such as case studies and small group discussions, accounted for significantly more of the teaching effort. Nearly 20% of the schools were making major modifications in their teaching methods. The general trend was to include more integrated, problem‐based learning and computer‐assisted teaching while reducing overall content, didactic lectures, and rote memorization. The role and need for traditionally trained gross anatomists in medical education appeared to be diminishing as curricular reform moved toward more student‐directed, faculty‐facilitated programs. Concurrently, the recruitment and career development of gross anatomy faculty appeared to be influenced more by funding status than by academic training or teaching experience, as most departmental chairman were willing to hire non‐anatomists and “train” them to assume an often reduced teaching load in gross anatomy courses. In addition, fewer graduate students were being trained in classical gross anatomy, a trend that better suited the emerging student‐directed medical school curricula. The reduction in classically trained anatomists also appeared to reflect the widespread practice whereby anatomy faculty were rewarded far more for research than for teaching. Although the continued inclusion of gross anatomy in medical education appeared to be assured, its traditional mode of presentation and academic prominence will likely change by the turn of the century. © 1994 Wiley‐Liss, Inc.
The use of small group case‐based exercises in human gross anatomy: A method for introducing active learning in a traditional course format
Authors: Hansen John T. , Krackov Sharon K.
Published: February 2005

As part of the curricular change at the University of Rochester School of Medicine and Dentistry, we focused on active learning and greater integration of basic and clinical sciences. With these objectives in mind, this report describes the use of small‐group, case‐based exercises in our gross anatomy course and provides one example of integrating such activities into a traditional course. In addition to formal lectures and laboratory dissection, students meet approximately every fourth class period in small groups to discuss a clinical case which focuses on the relevant anatomy taught at that time. Two first‐year students lead each small group; one fourth‐year student facilitator also attends to provide clinical correlations, answer questions, and reinforce the anatomy. Formative feedback suggests students enthusiastically endorse the self‐directed active learning; they feel these exercises offer both a valuable approach to learning and an opportunity to practice presentation and leadership skills. First‐year students enjoy the interaction with fourth‐year facilitators and the fourth‐year students appreciate the opportunity to review basic science material. Our data suggest that students learn to “think” about the anatomy, and we hope learn to use their understanding and knowledge base in a practical fashion. Moreover, these case‐based exercises can fit nicely into a variety of curricular formats, especially where problem‐based tutorials may not be feasible or desirable. © 1994 Wiley‐Liss, Inc.
Compromising abnormalities of the brachial plexus as displayed by magnetic resonance imaging
Authors: Collins James D. , Shaver Marla L. , Disher Anthony C. , Miller Theodore Q.
Published: February 2005

Magnetic resonance images (MRI) of brachial plexus anatomy bilaterally, not possible by plain radiographs or CT, were presented to the Vascular Surgery, Neurology, and the Neurosurgery departments. Patients were requested for MRI of their brachial plexus. They were referred for imaging and the imaging results were presented to the faculty and housestaff. Our technique was accepted and adopted to begin referrals for MRI evaluation of brachial plexopathy. Over 175 patients have been studied. Eighty‐five patients were imaged with the 1.5 Tesla magnet (Signa; General Electric Medical Systems, Milwaukee, WI) 3‐D reconstruction MRI. Coronal, transverse (axial), oblique transverse, and sagittal plane T1‐weighted and selected T2‐weighted pulse sequences were obtained at 4–5 mm slice thickness, 40–45 full field of view, and a 512 × 256 size matrix. Saline water bags were used to enhance the signal between the neck and the thorax. Sites of brachial plexus compromise were demonstrated. Our technique with 3‐D reconstruction increased the definition of brachial plexus pathology. The increased anatomical definition enabled the vascular surgeons and neurosurgeons to improve patient care. Brachial plexus in vivo anatomy as displayed by MRI, magnetic resonance angiography (MRA), and 3‐D reconstruction offered an opportunity to augment the teaching of clinical anatomy to medical students and health professionals. Selected case presentations (body builder, anomalous muscle, fractured clavicle, thyroid goiter, silicone breast implant rupture, and cervical rib) demonstrated compromise of the brachial plexus displayed by MRI. The MRI and 3‐D reconstruction techniques, demonstrating the bilateral landmark anatomy, increased the definition of the clinical anatomy and resulted in greater knowledge of patient care management. © 1995 WiIey‐Liss, Inc.
Topographic relationship of the ventromedial lymphatic bundle and the superficial inguinal nodes to the subcutaneous veins
Authors: Kubik S. , Manestar M.
Published: February 2005

The relationships between lymph vessels and veins are of clinical importance for the prevention of injury to collectors and resulting edema after removal of veins. Injection preparations of the lymph vessels and veins showed that on the dorsum of the foot the collectors overcross the veins; however, in all remaining areas they undercross them. Only the great saphenous vein is overcrossed by lymph collectors. It also has accompanying lymph vessels but its vascular sheath, however, does not contain any lymph vessels. The position of the collectors depends on the thickness of the subcutaneous adipose tissue. On the dorsum of the foot the lymphatics are often closely bound up with the corium; on the lower leg, however, they are embedded in the adipose tissue. Some collectors are closely related to perforator veins. In the knee region the lymph bundle ascends dorsomedially to the medial condylus of the femur. On the thigh, where the subcutaneous fatty tissue is thick, the collectors form three layers. The superficial inguinal lymph nodes draining the leg and the external genitalia are situated around the saphenous opening and are closely related to the subinguinal venous star, so that in surgical intervention the collectors of this region are more exposed to danger than in other regions. © 1995 WiIey‐Liss, Inc.
Superior laryngeal nerve block: An anatomical study
Authors: Stockwell Martin , Lang Scott A. , Lozanoff Scott , Nyssen J.
Published: February 2005

Superior laryngeal nerve anaesthesia is frequently used to facilitate endotracheal intubation in the awake patient. We have modified the transcutaneous approach to this nerve block to employ a short bevel needle. This improves tactile perception in performing the procedure thus simplifying identification of the correct depth of injection. This study was designed to determine the anatomical basis of superior laryngeal nerve anaesthesia and to estimate the success rate using our modified technique. At autopsy, 20 cadavers had nerve block performed substituting 0.02% methylene blue for local anaesthetic. Dissection was then performed to identify the anatomical structures stained by the simulated local anaesthetic. Additional dissections were performed in formalin‐fixed cadavers. We found that the dye was injected into the paraglottic space bounded laterally by the thyrohyoid membrane and thyroid cartilage, medially by the laryngeal submucosa, caudad by the conus elasticus, cephalad by the hyoid bone, and anteriorly and posteriorly by the anterior and posterior thyrohyoid ligaments, respectively. The internal laryngeal nerve, the sensory branch of the superior laryngeal nerve, passed through this compartment and was heavily stained with simulated local anaesthetic. Resistance to the passage of the short bevel needle was provided by the lateral glossoepiglottic fold, not the thyrohyoid membrane as we had expected. Of 40 injections, 39 were deemed successful for a success rate of 97.5%. We conclude that this is a simple and highly successful technique for performing superior laryngeal nerve anaesthesia. © 1995 WiIey‐Liss, Inc.
Use of duplex sonography to investigate the effect of active and passive movement at the ankle joint for promoting venous return
Authors: Staubesand J. , Heisterkamp T. , Stege H.
Published: February 2005

Among the joint and muscle pumps that are hemodynamically active and, in particular, bring about venous return in the lower limb, the so‐called ankle pump is of paramount importance. The basic anatomical relationship of the talocrural joint to the venous network around the ankle is reviewed.

Duplex sonographic measurement of the rate of blood flow in the great saphenous vein at the saphenous opening, at rest and during active and passive movements at the ankle joint, shows that such movements have an important effect on the rate of flow through the adjacent veins.

Passive movement of the foot relative to the leg was brought about by a newly developed apparatus that can be either pneumatically or electrically operated. The action of the ankle pump against venous stasis, the arthrogenic congestive syndrome, and chronic venous insufficiency has demonstrated the prophylactic importance of this physiological mechanism. It can, when necessary, be replaced by an appropriately designed apparatus. © 1995 WiIey‐Liss, Inc.
Blood supply of subcutaneous tissue in the leg and its clinical application
Authors: Zbrodowski Andrzej , Gajisin Stanislav , Bednarkiewicz Marek , Gumener Raphaëul , Montandon Denys
Published: February 2005

The vascular anatomy of the subcutaneous or adipose layer of the leg is described. The major arteries of the distal thigh and leg were injected with either a colored latex or an India ink and gelatin mixture to demonstrate the principal sources of blood supply to the skin and the superficial tissues of the leg. Microdissection and the techinique of Spalteholz for dehydrating and clearing the tissues (rendering them transparent) facilitated the study of the direct and indirect arterial branches which form the three principal networks: the deep fascia, the subcutaneous or adipose layer, and the skin or the dermoepidermic layer. The results are of practical importance since the fascio‐subcutaneous tissue layer can be used as a flap for covering soft tissue defects of the leg. © 1995 WiIey‐Liss, Inc.
Tortuosity of the human splenic artery
Authors: Sylvester P. A. , Stewart R. , Ellis H.
Published: February 2005

Arantius (1571) was the first to describe tortuosity of the splenic artery. The present study investigated the variations in its tortuosity in man, and possible relationships with age, sex, and presence of atheroma.

Twenty‐nine cadaveric specimens and forty‐four celiac angiograms were studied. The straight distance from the origin of the splenic artery, from the celiac trunk, to the point of commencement of the hilar branches was measured, as was the total length of the artery between these two points. The ratio of these two measurements is called the “index of tortuosity.” The cadaveric arteries were then opened and graded for the presence of atheroma on a scale of 0 to 3.

Marked variation in the index was found in both the cadavers and the angiograms. No definite relationship was found with sex. However, there was a suggestion of increasing tortuosity with age, although in one 10‐year‐old girl, marked tortuosity was demonstrated on angiography. No significant correlation was shown between increased tortuosity and the extent of atheroma.

At present, there is apparently no satisfactory explanation for tortuosity of the splenic artery. © 1995 WiIey‐Liss, Inc.
Fiber orientation of posterior cruciate ligament: An experimental morphological and functional study, part 2
Authors: Inderster A. , Benedetto K. P. , Künzel K. H. , Gaber O. , Klestil T.
Published: February 2005

The posterior cruciate ligament (PCL) can be anatomically divided into three bundles: anterolateral, posteromedial, and posterior oblique. The changes in distance between the femoral and tibial attachment sites of these three bundles were measured in 10 human knee specimens with intact ligamental structures. The femoral to tibial distance (and thus the length) of the posterior oblique bundle remained nearly the same throughout flexion between 0° and 90°. The femoral to tibial distance of the anterolateral and the posteromedial bundles distinctly changed throughout the same range of motion.

For a truly functional replacement of the PCL, correct isometric placement of the transplant is especially important. Based on the results of the present study, an isometric reconstruction of the PCL is achieved by positioning the graft within the original attachment site of the posterior oblique bundle. © 1995 WiIey‐Liss, Inc.
The menisco‐femoral ligaments
Authors: Wan A. C. T. , Felle Patric K.
Published: February 2005

The menisco‐femoral ligaments were studied in 60 knees from 30 dissecting room cadavers. The anterior horns of the menisci were attached to the intercondylar area of the femur by discrete antero‐medial or antero‐lateral menisco‐femoral ligaments, separate from the anterior cruciate ligament, in 15% of knees for each meniscus, more frequently than previously appreciated; these anterior horn ligaments may exacerbate a meniscal tear. The posterior horn of the lateral meniscus was connected with the intercondylar area of the femur in 100% of knees. In 93% of knees a ligament ran behind the posterior cruciate ligament while in 33% of knees a ligament ran in front of the posterior eruciate ligament. We propose renaming these the pre‐cruciate postero‐lateral menisco‐femoral ligament and post‐cruciate postero‐lateral menisco‐femoral ligament, respectively, to avoid confusion with the ligaments of the anterior horns.

The menisco‐femoral ligaments may function in controlling movement of the menisci, especially during rotation of the knee. The posterior horn of the medial meniscus has no direct femoral attachment and this may be a factor in the increased risk of injury to this meniscus. © 1995 WiIey‐Liss, Inc.
Topographical relations between the posterior cricothyroid ligament and the inferior laryngeal nerve
Authors: Reidenbach Martina Maria
Published: February 2005

The posterior cricothyroid ligament and its topographic relation to the inferior laryngeal nerve were studied in 54 human adult male and female larynges. Fourteen specimens were impregnated with curable polymers and cut into 600–800 μm sections along different planes. Forty formalin‐fixed hemi‐larynges were dissected and various measurements were made. The posterior cricothyroid ligament provides a dorsal strengthening for the joint capsule of the cricothyroid joint. Its fibers spread in a fan‐like manner from a small area of origin at the cricoid cartilage to a more extended area of attachment at the inferior thyroid cornu. The ligament consists of one (7.5%) to four (12.5%), in most cases of three (45.0%) or two (35.0%), individual parts oriented from mediocranial to latero‐caudal. The inferior laryngeal nerve courses immediately dorsal to the ligament. In 60% it is covered by fibers of the posterior cricoarytenoid muscle, in the remaining 40% it is not. In this latter topographic situation there is almost no soft tissue interposed between the nerve and the hypopharynx. Therefore, the nerve may be exposed to pressure forces exerted from dorsally. It may be pushed against the unyielding posterior cricothyroid ligament and suffer functional or structural impairment. Probably, this mechanism may explain some of the laryngeal nerve lesions described in the literature after insertion of gastric tubes. © 1995 WiIey‐Liss, Inc.
Removal of the brain for teaching and examination
Authors: Felle P. , Lockman A. K. , Kellaghan P.
Published: February 2005

The brain was removed from cadavers using a modified technique involving additionally the removal of most of the squamous occipital bone and laminae of the upper cervical vertebrae. The resulting specimens were superior to the usual ones in that the medulla oblongata, the upper spinal cord, and all the cranial nerves and cerebral arteries were intact. Fears of slow‐virus contamination and legislative changes are precluding the use of brains obtained in the necropsy room for neuroanatomy teaching, so it is paramount that complete brains are removed from dissecting room cadavers. The method described herein takes a little longer than the traditional method, but is within the capability of an anatomy technician and yields better specimens for use in teaching and examinations. © 1995 WiIey‐Liss, Inc.