bluuebunny/crossref_metadata_2025 huggingface dataset:
Myocardial coverage of the coronary sinus and related veins
Authors: v. Lüdinghausen Michael , Ohmachi Nobuko , Boot Christine
Published: February 2005

The incidence and distribution of landmarks relating to the coronary sinus (c.s.) were evaluated in 240 human hearts. Special attention was directed to the myocardial coat of the c.s., the distribution and pattern of the cardiac veins, and their dimensions. In all specimens the myocardial coat of the c.s. also covered the adjacent 2 to 11 mm of the great cardiac vein. In 15% of cases this myocardial layer was thickened in a sphincter‐like fashion, the edge of which was formed obliquely, in a crescent‐like manner, or diffusely without a sharp border.

In 3% of the hearts the myocardial cover of the c.s. extended over the terminal 10 mm of the middle cardiac vein as a strong fiber cord. In 9%, single isolated belts of fibers fixated the terminal parts of the adjoining cardiac veins to the posterior wall of the left atrium, and in 8% two or three myocardial cords, embedded in the fatty tissue of the left coronary sulcus, did the same.

Because the myocardial cover extended leftwards to variable distances over the c.s., the left edge of the myocardial covering cannot serve to define the beginning of the coronary sinus. The location of the ostial valve of the great cardiac vein (valve of Vieussens) was variable as well, being found on the average 2.5 mm proximal to the opening of the oblique vein of the left atrium. Moreover, the valve of the great cardiac vein was found in only 87% of cases; therefore it is inappropriate for defining the beginning of the coronary sinus. Finally, the dot‐like ostium of the oblique vein was most constant, and from the viewpoint of embryologic development, it is the logical landmark for determining the beginning of the coronary sinus, a necessary presupposition for cardiologic procedures like reperfusion of cardiac veins.
The anatomy of the clinical examination
Authors: McDonald S. W.
Published: February 2005

“The Anatomy of the Clinical Examination” is a newly introduced component of the anatomical teaching of medical undergraduates at Glasgow University. It comes in the final term of the anatomy course and aims to lead students readily from the study of dissecting room cadavers to the examination of the living body. The organization of the course is explained; it is hoped that this course will be of interest to other anatomists involved in the training of medical students.
Peer teaching in gross anatomy at St. Louis University
Authors: Yeager Vernon L. , Young Paul A.
Published: February 2005

The gross anatomy course at St. Louis University was designed to utilize peer teaching. Eight students are assigned to each cadaver and they work in teams of two, so that every student does one out of every four dissections. During one class period, the lecture for a unit is given to all class members, followed by a prosection demonstration to only the dissectors of that unit (one‐fourth of the class). At the beginning of the following class period, the dissectors give a prosection demonstration of their dissection to the other six student assigned to their cadaver. The lecture and prosection demonstrations for the next unit are given to the next team of dissectors as above. The students anonymously evaluate the course each year. Passing Part I of the National Board Examinations is required. For 12 years, the National Board Unit Examination of gross anatomy was given as the final examination for the course.

The course is liked by the students, can be taught with a minimal number of faculty, utilizes only half the cadavers of a traditional course, has less contact hours than the national average, yet students do better than the national average on the anatomy part of the National Board Examination. © 1992 Wiley‐Liss, Inc.
The dissecting room: Reactions of first year medical students
Authors: Evans E. J. , Fitzgibbon G. H.
Published: February 2005

No published studies on the reactions of British medical students to human dissection have been found. A class of 167 first year British preclinical students completed a questionnaire covering reactions to the dissecting room (DR) and other causes of stress for medical students, 6 Weeks after starting dissection.

Five percent of students were very upset by the DR during the first few sessions while 36% were slightly upset, and 58% were unaffected. Six weeks later none were very upset and 78% were not at all upset by the DR. Those upset by the DR had higher stress levels by a standard measure than those not disturbed. Four percent of students had been so disturbed that their concentration was disrupted during the first DR session. The DR was a relatively unimportant cause of stress to students compared with work‐related stressors, such as too much work and exam anxiety. The majority of students felt themselves mentally prepared for the DR. About half had seen a dead body before and these students were signigicantly more likely to feel mentally prepared.

Some students are, understandably, upset by their first experiences of the DR but most adapt fairly quickly. It appears that a small number continue to be seriously disturbed. The possiblity of using students'reactions to the DR as an educational exercise for their medical career could be explored further. © 1992 Wiley‐Liss, Inc.
Ultrasonographic morphology of the human preovulatory follicle wall prior to ovulation
Authors: Martinuk S. D. , Chizen D. R. , Pierson R. A.
Published: February 2005

Morphologic changes in the walls (stratum granulosa and theca interna and externa) of preovulatory follicles were studied in 15 clinically normal women. Ovulation was visualized in 11 of 15 (73%) women. Images were recorded using high‐resolution transvaginal ultrasonography. Mean follicular diameter immediately before ovulation was 20.7 ± 0.6 mm. Echoes representing the cumulus oophorus/oocyte complex were observed in 10 of 11 (91%) follicles for which ovulation was ascertained. Thickness of the deep internal wall increased (P < 0.02) beginning from 4 to 5 h before ovulation. The apical wall thinned (P < 0.0001) to nondetectable limits immediately before follicular rupture. Four women (27%) did not ovulate during the imaging period [34–41 h post‐human chorionic gonadotropin hCG]. The four follicles that did not ovulate remained of uniform thickness; stigma formation was not observed. The data supported the hypothesis that ultrasonographically detectable alterations in preovulatory follicles precede ovulation. Clinical applications include prediction of the potential for, and interval to, rupture of the preovulatory follicle and timing of ova retrieval in women undergoing ovarian stimulation for amelioration of infertility. © 1992 Wiley‐Liss, Inc.
Review of the functional anatomy of the spinal ligaments and the lumbar erector spinae muscles
Authors: Aspden Richard M.
Published: February 2005

A reassessment is presented of the functional anatomy of the spine and associated musculature. Recent detailed anatomical studies of the erector spinae muscle group have shown a complex organization which is not well explained by traditional models of the mechanical behavior of the spine. In an arch‐like model for the spine this complexity is required to control the curvature and the compressive thrust along the spine to ensure mechanical stability. This model also assigns a biomechanical function to the erector spinae muscles that is consistent with their anatomical description, unlike previous lever models. Implications are that posture, the many‐curved configuration of the spine adopted during maneuvers, is important when assessing spinal function and that the spine forms a dynamic structure in which all the muscles, ligaments, discs, and vertebrae must be considered synergistically. © 1992 Wiley‐Liss, Inc.
Formaldehyde and clinical anatomy: Safe use and regulatory concerns
Authors: Mercer Don O.
Published: February 2005

The use of formaldehyde and formalin in clinical anatomy procedures presents special concerns relating to personnel safety, environmental safety, and regulatory compliance. It is incumbent on all clinical anatomy practitioners to appreciate these concerns and use formaldehyde in a manner that assures safe practice, environmental stewardship, and regulatory compliance. It is only with these needs in mind that it will be assured that formalin will continue to be an acceptable preservation media, and continued, uninterrupted clinical anatomy study will be possible. © 1992 Wiley‐Liss, Inc.
Anatomy of the anterior spinal artery in pigs
Authors: Murray Michael J. , Bower Thomas C. , Carmichael Stephen W.
Published: February 2005

The anatomy of the anterior spinal artery in pigs was studied to determine whether or not the artery was continuous, as it is humans, or discontinuous. Six porcine carcasses were embalmed, and 24 hr later injected with pigmented latex through the thoracic aorta. The spinal column was removed, and the spinal cord was dissected with analysis of the anterior spinal artery. In all cases, the artery was continuous, and perfused by 18 ± 3 medullary arteries. The pig would thus be suitable as a model for the study of human diseases in which the anatomy of the anterior spinal artery is a factor. © 1992 Wiley‐Liss, Inc.
A history of the enumeration of the cranial nerves by European and British anatomists from the time of Galen to 1895, with comments on nomenclature
Authors: Shaw J. P.
Published: February 2005

The enumerations of the modern 12 pairs of cranial nerves by a number of anatomists are reviewed in a continuous historical perspective using original texts and modern translations. The history of the numeration of the nerves is traced from Galen's classification into seven pairs (second century A.D.), through to Willis' nine pairs (1664) and Soemmerring's 12 pairs (1778). Authors describing individual structures (e.g., trochlear and olfactory nerves) for the first time are particularly noted.

The contributions made by medieval anatomists such as Achillini, Berengario da Carpi, and Massa are emphasized, as also are the political and religious constraints placed upon the practical activities of anatomists up until the 16th century. It is shown that although the classification of the nerves into 12 pairs was accepted after 1778 by European authors, British texts continued to classify them as nine pairs until the end of the 19th century. © 1992 Wiley‐Liss, Inc.
The normal vermiform appendix at computed tomography: Visualization and anatomical location
Authors: Picken G. , Ellis H. , Dixon A. K.
Published: February 2005

We prospectively studied the normal vermiform appendix in 100 patients undergoing computed tomography (CT) of the abdomen and pelvis in order to assess its rate of visualization, isolate factors affecting its successful identification, and determine its most frequent position. Our standard CT protocols were followed, as dictated by the patient's clinical circumstances; this usually meant employing a 10 mm slice‐thickness at 15 or 20 mm intervals. The appendix was confidently identified in 27 of the 79 patients who had not undergone previous appendectomy. It was most commonly seen in a retroileal position. It had a mean maximum outer diameter of 5.7 mm (range 3–10 mm) and was most often seen as a thin‐walled, air‐filled tube. Its visualization was unaffected by the position of the cecal pole in a cranio‐caudal direction, the amount of intraabdominal fat, the type of radiographic contrast media administered, or the patient's sex. Computed tomography thus appears to be a useful, if limited, radiological method of examining the normal appendix. Our study suggests that, in vivo, the uninflamed appendix may not be most commonly situated in a retrocecal position, as reported in surgical and postmortem studies. © 1993 Wiley‐Liss, Inc.
Computerized modelling of nasal capsular morphogenesis in prenatal primates
Authors: Lozanoff Scott , Zingeser Maurice R. , Diewert Virginia M.
Published: February 2005

Descriptive and comparative analysis of primate chondrocranial anatomy relies on three‐dimensional reconstructions of embryonic and fetal tissues. Typically, reconstructions are accomplished using manual techniques that are time‐consuming and laborious. Recent advances in computer technology permit computerized reconstruction, but most available systems do not interpolate surfaces so models consist of solid polygons without intervening surfaces. The purpose of this paper is to describe a new computerized surface‐modelling routine for the rapid and reliable reconstruction of nasal capsular anatomy in prenatal primates as well as to apply this system for the comparative analysis of nasal morphogenesis. Models of the nasal capsule and anterior cranial base are generated for a developmental series of prenatal specimens including Microcebus murinus, Macaca mulatta, and Homo sapiens. Results show that the computerized system reconstructs complex morphologies rapidly and automatically. The computerized models display higher anatomical resolution than that available from reconstructions generated through manual methods or algorithms used in commercially available systems and they can be viewed on a personal computer. Comparative anatomical analysis reveals that the nasal floor is highly specialized in Microcebus which displays a zona annularis. However, complexity in this region is reduced in Macaca and Homo which probably corresponds to a morphological reduction, but not elimination, of the vomeronasal organ and associated structures. © 1993 Wiley‐Liss, Inc.
The variable anatomy of the nerve to the extensor carpi radialis brevis
Authors: Colborn Gene L. , Goodrich J. Alan , Levine Monroe I. , Bhatti Nazir A.
Published: February 2005

The origin and course of the nerve to the extensor carpi radialis brevis are closely related to the lateral aspect of the elbow joint and proximal portion of the radius—both of which are frequent sites of pathology and surgical treatment. The specific origin of the nerve supply to the extensor carpi radialis brevis muscle has been attributed variably by diverse anatomic and clinical texts to be the radial nerve, its deep branch or its superficial branch. This study was undertaken to determine the most common source of the nerve to the extensor carpi radialis brevis, as well as the most predictable topographic site of its origin. A total of 111 limbs were dissected, with the most common origin (56.7%) found to be the deep radial nerve, followed by the superficial branch of the radial nerve (31.5%), and least frequently from the bifurcation of the radial nerve into its superficial and deep branches (11.7%). This nerve branch was found to arise in most individuals within one centimeter of the distal edge of the humeroradial joint and to pass distally about 3.5 centimeters before entrance into the extensor carpi radialis brevis muscle. © 1993 Wiley‐Liss, Inc.
Insertion orientation of terminal vastus lateralis obliquus and vastus medialis obliquus muscle fibers in human knees
Authors: Bennett William F. , Doherty Neville , Hallisey Michael J. , Fulkerson John P.
Published: February 2005

The quadriceps mechanism consists of the patellar ligament distally and the quadriceps tendon proximally. The quadriceps tendon is the confluence of the tendinous portions of the vastus medialis, vastus lateralis, vastus intermedius, and rectus femoris. Lieb and Perry (J. Bone Joint Surg. 50A:1535–1547, 1968) have described the vastus medialis obliquus (VMO) and Hallisey et al. (J. Bone Joint Surg. 69A:545–549, 1987) have described the vastus lateralis obliquus (VLO). These muscles are the terminal medial and lateral insertions of the vastus medialis and vastus lateralis. This study delineates and quantifies anatomic sex differences for the medial and lateral angular terminal insertions of the vastus lateralis obliquus and vastus medialis obliquus in relationship to the longitudinal axis of the patella in 40 embalmed cadaver knees. A mathematical model is developed and discussed using least steps regression equations y = Ax + B, where y = the VLO insertion angle, x = the VMO insertion angle, A = the coefficients, and B = the y intercept. These equations are different in males and females, with males having more horizontally oriented VLO fibers than females. The vastus lateralis obliquus (VLO) insertion angle can be predicted based upon measurement of the vastus medialis obliquus insertion angle and sex: Log VLO = 1.36 + .00531 VNIO − 0.000166 (S × VMO), where S = 1 for females and S = 0 for males. In embalmed cadaver knees, the angular terminal insertion of the vastus lateralis obliquus related to the longitudinal axis of the patella is more horizontally oriented in males than in females. The angular terminal insertion of the vastus medialis obliquus of males and females does not increase equally with increases in the angular terminal insertion of the vastus lateralis obliquus. © 1993 Wiley‐Liss, Inc.
Position of the fabella relative to the path of the common peroneal nerve across the lateral head of the gastrocnemius muscle
Authors: Chihlas Christopher N. , Ladocsi Lewis T. , Sholley Milton M. , Loughran Thomas P. , Krieg Richard J.
Published: February 2005

The fabella is an inconstant sesamoid bone located in the origin of the lateral head of the gastrocnemius muscle. The presence of a fabella has been associated with a number of pathologies including compression injury of the common peroneal nerve (CPN) as it crosses the lateral head of the gastrocnemius. This study was designed to determine the incidence of fabellae and the geometric relationship of the fabella to the CPN using anatomical dissection. In the 78 specimens examined, the incidence of fabellae was 27%, a figure near the high end of the previously reported range. To our knowledge, the geometric relationship of the fabella to the CPN has not previously been reported. Using measurements taken during dissection of fabellae, the zone of potential locations of the fabella overlapped 26.0% of the length of the CPN across the lateral head of the gastroenemius. © 1993 Wiley‐Liss, Inc.
Pterygospinous and pterygoalar foramina: A role in the etiology of trigeminal neuralgia?
Authors: Shaw J. P.
Published: February 2005

The pterygospinous and pterygoalar foramina are illustrated photographically. To confirm the incidence of the foramina 454 skulls from various racial groups were examined. A survey of the literature shows that the pterygospinous foramen is present in about 10% of individuals and the pterygoalar foramen in about 1%. The possibility that either foramen may trap, compress, or cause traction of anomalous cutaneous branches of the mandibular division of the trigeminal nerve, or occlude blood vessels supplying the trigeminal ganglion is discussed in relation to trigeminal neuralgia. © 1993 Wiley‐Liss, Inc.
Teaching and examining clinical skills in anatomy
Authors: Monkhouse W. S.
Published: February 2005

Basic clinical skills are taught throughout the undergraduate anatomy course at the Royal College of Surgeons in Ireland. They are tested in weekly, termly, and end‐of‐course examinations, and this material is reinforced by anatomy lectures during the clinical course. Anatomists and clinicians are involved in both teaching and examining. This fires the students' motivation for learning and enhances their knowledge of anatomy. © 1993 Wiley‐Liss, Inc.
Anatomical study of the symmetry of lateral extensor compartment of the wrist
Authors: Godwin Yvette , Ellis Harold
Published: February 2005

The anatomy of the lateral extensor compartment of the wrist has been extensively studied, since it is the site of stenosing tenosynovitis of the tendons of abductor pollicis longus and extensor pollicis brevis (de Quervain's disease). Septation of the compartment and multiplicity of the tendons within it have been thought, by some surgeons, to cause overcrowding and thus contribute to the pathogenesis of the condition.

This anatomical study of ten pairs of cadaveric hands has shown that these variations are common, confirming previous reports in the literature, and, more importantly, that they are frequently bilaterally symmetrical. Since de Quervain's disease tends to occur unilaterally, it seems unlikely that anatomical variations are important in its pathogenesis.

Appreciation of these variations is, however, important in surgical treatment.

Adequate exposure is necessary to recognize the anatomical structures, so that all subcompartments within the fibroosseous tunnel may be decompressed. © 1993 Wiley‐Liss, Inc.
A Course of study in the anatomical sciences for a problem‐based curriculum
Authors: Dinsmore Charles E. , Paul Harold A. , Sweet Fred A.
Published: February 2005

Different models of medical education in the basic sciences have arisen in the last decade, some in response to issues raised in the 1984 GPEP Report. Each model attempts to redress problems of identifying core content in any particular discipline, within which the knowledge base is continually expanding, and of providing optimal educational experience outside of the traditional lecture/laboratory format. These objectives must also be achieved within a collapsing allocation of time for instruction as it has been commonly understood. In this paper, we discuss instructional method, developed to meet these demands, which are currently used in the Anatomical Sciences Program of the Alternative Curriculum, Rush Medical College's problem‐based curriculum. Although circumstances determining curricular constraints vary among medical colleges, we offer our positive experience with this particular format as a potential guide to curricular reform in the anatomical sciences. © 1993 Wiley‐Liss, Inc.
Comparison of four methods for measuring femoral anteversion
Authors: Kirby Alanah S. , Wallace W. Angus , Moulton Alan , Burwell R. Geoffrey
Published: February 2005

This study evaluates the most valid and reproducible method for directly measuring anteversion (torsion) in dried femora using a commercially available measuring machine. Each femur was placed horizontally on the surface of the machine and readings were obtained from the head, the shaft distal to the lesser trochanter, and the distal end. Using computer software, four different anteversion angles were calculated: the center head‐neck line to the retrocondylar line (Method 1); the center head‐neck line to the transcondylar line (Method 2); the anterior head‐trochanter line to the retrocondylar line (Method 3); and the anterior head‐trochanter line to the transcondylar line (Method 4). The methods were applied to 20 femora, which were measured twice by one observer. The most reproducible method of measuring femoral anteversion uses the bone surfaces on the anterior aspect of the head and greater trochanter and on the posterior aspect of the condyles (Method 3.95% confidence limits of ± 0.4°). The other methods are shown to be reproducible to ±2.4°, ±3.3° and ±1.7° (Methods 1, 2, and 4, respectively, 95% confidence limits). Conversion factors between the different methods are: 12.5° + 0.8 x (anteversion angle) to change each of Method 2 to Method 1 and Method 4 to Method 3; and 8° + 0.7 x (anteversion angle) to change each of Method 1 to Method 3 and Method 2 to Method 4 (correct to within ±3°). © 1993 Wiley‐Liss, Inc.
Relationship of deep structures of the hand and wrist to topographical landmarks
Authors: Cobb Tyson K. , Cooney William P. , An Kai‐Nan
Published: February 2005

The relationship of topographical landmarks to the deep structures of the wrist and hand has not been clearly defined and would be of benefit to surgeons performing endoscopic carpal tunnel surgery. To this end, 10 fresh cadaveric wrist specimens had radiopaque markers placed adjacent to key anatomic structures within the wrist and hand. A new technique for localizing the hook of the hamate was established. We found that the thick segment of the flexor retinaculum, often defined as the transverse carpal ligament, was 2.2 cm in length. Its distal border was 1 cm distal to the distal aspect of the hook of the hamate. The proximal ligamentous portion had a mean length of 1.2 cm, whereas the distal aponeurotic portion (distal to the hook of the hamate) had a mean length of 1.0 cm. The position of the superficial palmar arch was 2.7 cm distal to the hook of the hamate or at a line bisecting three‐fourths of the distance from the distal flexor wrist crease to the proximal palmar crease. The relationship of the superficial palmar arch to topographical landmarks was more consistent than it was when the standard reference of Kaplan's cardinal line was used. © 1993 Wiley‐Liss, Inc.
Assessment of the accuracy of local steroid injection into the lateral extensor compartment of the wrist
Authors: Godwin Yvette
Published: February 2005

De Quervain's tenosynovitis can be treated either by conservative or operative measures. Harvey et al. (1990) have shown that treatment by local injection of corticosteroid into the lateral extensor compartment can effect cure in 80% of cases without surgical intervention. However, the lateral extensor compartment may be anatomically divided by septa into subcompartments, and this prevents the distribution of steroid throughout the compartment, and hence may lead to failure of conservative treatment. This study was undertaken to develop an injection technique that will ensure that, even if septa are present, both subcompartments are penetrated by the needle and receive steroid. The technique is shown to enhance the accuracy of injection and hence should further increase the proportion of patients treated conservatively with success. © 1993 Wiley‐Liss, Inc.
Tracheostomy: An anatomico‐clinical review
Authors: Ger Ralph , Evans James T.
Published: February 2005

Tracheostomy surgery may be accompanied by complications that lead to morbidity and mortality. The incidence of these complications is not inconsiderable, as documented by case reports that continue to appear annually. Most complications are based on failure to appreciate the anatomic relationships of the area. In an operation that often falls to the lot of the junior surgeon and that deals with normal anatomic structures, it is disappointing to find that the surgeon gets little help when consulting clinical anatomic texts. Infact, the advice given may be erroneous, indefinite, or even misleading. It is strongly urged that a tracheostomy education program be instituted at the clinical anatomic level. © 1993 Wiley‐Liss, Inc.
A reappraisal of the blood supply of the pectoralis minor muscle
Authors: Stook Frank P. , Zonnevijlle Erik D. H. , Groen Gerbrand J.
Published: February 2005

Recently the pectoralis minor muscle has been introduced as a free muscle transplant for facial reanimation in peripheral facial paralysis. However, reports on the vascular supply of this muscle are incomplete or contradictory. Therefore the pectoral region was examined in 57 human cadavers. A complex pattern of variations in the arterial supply was found: it was, however, systematically arranged and limited to a small part of the arterial tree. A topographical classification was made, based on the dominant muscle artery, to provide a useful orientation during reconstructive surgery. Related to the origin of this dominant artery, three main patterns are distinguished. In the most frequent pattern a major role is played by an artery not mentioned in Nomina Anatomica (Edinburgh: Churchill Livingstone, 1989). This artery usually arises directly from the axillary artery, accompanies the medial pectoral nerve, and supplies the major lateral part of the muscle from its deep surface. For topographical reasons we propose the name “lateral pectoral artery.” The classification, presented in this study, may provide a better insight for the reconstructive surgeon working in this area. © 1994 Wiley‐Liss, Inc.
Variation in tibial torsion
Authors: Eckhoff D. G. , Kramer R. C. , Watkins J. J. , Burke B. J. , Alongi C. A. , Stamm E. R. , Van Gerven D. P.
Published: February 2005

A skeletal collection from the African country of Sudan was examined to determine if torsion of the tibia in an African population varies from established norms for European, Asian, and American populations. A large variation in tibial torsion was observed. There was a distinct limb asymmetry with more torsion on the right than left. No association of tibial torsion with gender was identified. A small but appreciable increase in average torsion (7°) was identified when this population was compared with previously reported populations. This study documents a variation in tibial torsion not appreciated in earlier studies. © 1994 Wiley‐Liss, Inc.
Evidence for a relationship between head shape and prevalence of middle ear effusion in children
Authors: Worley Gordon , Sturner Raymond A. , Green James A. , Frothingham Thomas E.
Published: February 2005

To determine if there is an association between head shape type (brachycephaly, mesocephaly, and dolichocephaly) and prevalence of middle ear effusions, we performed tympanometry and head measurements on 203 children who were enrolling in kindergarten and who were 4 or 5 years old. Maximum head length and head breadth were measured using anthropometric spreading calipers, and the cephalic index (CI) was calculated for each child (head width/head length × 100). Children with a CI > 1 standard deviation (SD) from the mean were classified as brachycephalic, those with a CI < 1 SD as dolichocephalic, and the remainder as mesocephalic.

The overall distribution of flat tympanograms (indicative of middle ear effusions) by head shape type was unlikely to have occurred by chance (X2(2) = 6.2; P < 0.05). Brachycephalic children had a significantly greater prevalence (39%) of flat tympanograms, than did mesocephalic children (19%; P = 0. 015). There was a trend toward more dolichocephalic children having effusions (29%) than mesocephalic children (19%), but the difference was not significant (P = 0.24). Neither race nor sex affected the relationship between brachycephaly and middle ear effusions. Brachycephaly is a physical finding associated with flat tympanograms and, therefore, middle ear effusions in preschool children. © 1994 Wiley‐Liss, Inc.
Use of bequeathed and unclaimed bodies in the dissecting room
Authors: Jones D. Gareth
Published: February 2005

The bodies used in dissecting rooms have either been unclaimed or bequeathed. Although bequeathed bodies constitute the major source of bodies in many countries today, this is not a universal situation. The use of unclaimed bodies for dissection is traced historically from its origins in grave robbing and murder, and against the background of the thesis that it involves exploitation of the poor and the lack of informed consent. The ethical significance of the treatment of cadavers is considered in terms of the intrinsic and instrumental value ascribed to cadavers. The use of unclaimed bodies is assessed in relation to the ethical principles underpinning organ donation, including respect for the autonomy of the deceased, and the interests of family members, as well as reference to altruism as a basis of donations and the possible redemptive aspects of organ donations. It is argued that the use of unclaimed bodies does not correspond to any procedure we use today in the realm of organ donation. It is concluded that the use of unclaimed bodies is never to be the procedure of choice, since taking a body even for good purposes is ethically inferior to giving a body for the same purposes. Nevertheless, what is done with dead bodies for good reasons is not the most important of ethical matters, and a balance has to be attained between these ethical considerations and the potential benefits accruing to society. © 1994 Wiley‐Liss, Inc.
Untreated uveal melanoma and its metastatic spread: A case report
Authors: Nelson Marita L. , Hardman John M. , Coel Marc N.
Published: February 2005

A patient with suspected uveal melanoma died 18 months after refusing all treatment. Since this disease rarely goes untreated, its undeterred spread is of clinical interest. At the request of the patient's family and physician, we set out to verify the type, location, and extent of the tumor, and the cause of death. Post‐mortem magnetic resonance imaging (MRI) of the patient's head, followed by dissection and microscopic examination confirmed the diagnosis of primary uveal melanoma. There were large masses in the frontal part of the cranium which apparently had metastasized from the primary uveal tumor via vascular or lymphatic pathways since there were no direct extensions of the primary tumor beyond the orbital musculotendinous cuff. Metastases found in the liver, kidney, and vertebrae, is the absence of cervical, thoracic, and abdominal lymph node involvement, indicated the likelihood of hematogenous spread although small subpleural metastases were found in the lung. The cause of death appeared to be acute myocardial infarction due to obstruction of both coronary arteries and was unrelated to the malignancy.

Although MRI has been proposed as an important tool for diagnosing uveal melanoma, our findings indicate the need for caution. Misleading signal intensities resulting from variable pigmentation in these tumors impair diagnosis. © 1994 Wiley‐Liss, Inc.
Morphometric comparison of computed tomography to magnetic resonance imaging in the evaluation of the lumbar intervertebral foramina
Authors: Cramer Gregory D. , Howe Joseph , Glenn William V. , Greenstein Jay , Potvin William
Published: February 2005

The purpose of this study was to evaluate and compare the ability of computerized tomography (CT) and magnetic resonance imaging (MRI) as techniques to determine linear morphometric measurements of several parameters of the right and left lumbar intervertebral foramina (IVFs). Specifically, the greatest superior‐to‐inferior diameter and anterior‐to‐posterior diameter of the lumbar IVFs were measured in a cadaveric imaging phantom. The phantom was first measured directly with vernier calipers and then embedded in gelatin to simulate soft tissue. It was then scanned with two types of protocols each for CT and MRI. The scanned images were transferred directly from the imaging units to optical disks, which were then read using an optical disk drive. The measurements taken directly from the phantom were then taken from the scans using a Macintosh II computer interfaced with the optical disk drive. The results showed that both sagittally reformatted CT images and sagittal MRI images were clinically and statistically reliable and valid methods for linear evaluation of the IVF in the sagittal plane. However, measurements made from the MRI scans were found to be more accurate than those made from the CT scans. The results of this study should help increase understanding of the strengths and weaknesses of both imaging modalities in the sagittal evaluation of the lumbar IVFs. The results may also help with the future evaluation of the IVF in the condition known as nerve root canal stenosis. This study also indicates that a normal morphometric database from the MRI scans of normal human subjects should be developed. © 1994 Wiley‐Liss, Inc.
Typology of the subclavian and axillary lymphatics
Authors: Murakami Gen , Shimada Kazuyuki , Sato Iwao , Kunieda Hiroyuki , Suzuki Seiichi , Hoshi Hajime
Published: February 2005

Detailed dissections were performed bilaterally on 90 human adult cadavers to obtain more accurate data on the course and origin of the subclavian lymphatics and especially of the subclavian lymphatic trunk. We classified these into four types from the morphology. Type A (46.1 %): The subclavian lymphatics were located along the medial edge of the subclavian vein edge close to the lateral thoracic wall. In this type, the subclavian lymphatics consisted of the subclavian node chain, interconnecting vessels, and short lymph trunks. Type B (20.0%): A large connecting vessel ran along the lateral edge of the subclavian vein or on the subclavian artery, with the result that the trunk was located away from the thoracic wall. In the Type B configuration, the vessels originated from the nodes near the origin of the thoracoacromial artery. Type C (21.7%): The Type B large collecting vessel was observed with the Type A subclavian lymphatics. Type D (12.2%): Lymph vessels were too fine to be found and dissected in the subclavian lymphatics. These observations provide critical information for an unproved clinical examination and lymphatic resection of breast cancer. © 1994 Wiley‐Liss, Inc.
Arterial supply of the latissimus dorsi muscle: A comparative study in human, sheep, dog, and pig
Authors: Windisch Alfred , Burggasser Georg , Traxler Hannes , Grabenwöger Florian , Happak Wolfgang , Losert Udo
Published: February 2005

The latissimus dorsi muscle (LD) has been the subject of numerous studies, especially because of its variety of possible applications in plastic and reconstructive surgery.

The clinical use of functional electrical stimulation (FES) and cardiomyoplasty has raised completely new questions in recent years. It was the aim of our study to find an optimal model for animal experiments for this cardiosurgical method, in which the LD is completely removed from its origin and transferred into the thorax. For this purpose, we compared the LD's arterial supply in animals used in experimental surgery, the sheep, dog, and pig, with the LD's supply in human.

For studying the arteries of the LD macroscopically and by X‐ray, we used an injection solution of latex and barium sulfate. After injection of the solution the vascularization was photographically documented. Subsequently, the muscle was detached from the neurovascular pedicle and prepared for radiological examination of the arterial vascularization.

The planimetric computer‐assisted identification of the various areas supplied by arterial branches was based on these radiograms. In order to also assess the weight of the supplied parts, the muscles were gravimetrically analyzed.

The study showed that the blood supply in pig is very similar to that of man. This species, therefore, would be best suited for experimental cardiomyoplasty. © 1994 Wiley‐Liss, Inc.
Anatomy of membranous ventricular septum in the human heart
Authors: Walmsley Robert , Sinclair David W.
Published: February 2005

One of the most common congenital abnormalities of the human heart is a defect in the development of the membranous part of the ventricular septum which, in this study, is designated the MVS. The WS is a thin fibrous membrane, about 1 cm long, which extends upward and to the right from the muscular ventricular septum to the adjacent part of the aortic fibrous annulus that also gives attachment to the right posterior (noncoronary) and anterior (right coronary) aortic valve cusps. It is of considerable clinical importance that there lies between the muscular ventricular septum and the MVS the atrioventricular (AV) bundle of the cardiac conduction system. The MVS has an irregular quadrangular form and has right and left surfaces. This study is based on macroscopic and histological sections of more than 30 normal and abnormal hearts. © 1994 Wiley‐Liss, Inc.
Tomographical anatomy of the pelvis, visceral pelvic connective tissue, and its compartments
Authors: Fritsch Helga , Hötzinger Harald
Published: February 2005

The sectional anatomy of the pelvic connective tissue was studied in plastinated sections of fetal and adult pelves, by computed tomography and by magnetic resonance imaging. The comparative study of the different specimens shows that the pelvic connective tissue consists of three compartments: a presacral compartment, a perirectal compartment, and a paravisceral compartment. The content and the borders of the compartments are described. Furthermore the pelvic fasciae and the pelvic ligaments are studied within the different specimens. A thin pelvic visceral fascia can only be found around the perirectal compartment. In tomographical anatomy the so called supportive ligaments of the uterus are only composed of the round ligaments and the sacrouterine ligaments. © 1995 WiIey‐Liss, Inc.
Failure of the isthmus lobe to fuse in the midline
Authors: Yüksel Mehtap , Yüksel Eser , Kaymaz Figen
Published: February 2005

Four developmental anomalies of the thyroid gland are to be noted: a pyramidal lobe, failure of the lobes of thyroid tissue to develop, failure of the isthmus to fuse, and absence of a significant part of the lateral lobes. We encountered failure of the isthmus to fuse in the midline of the thyroid gland in a 48‐year‐old female cadaver. © 1995 WiIey‐Liss, Inc.
Additional renal veins: Incidence and morphometry
Authors: Satyapal K. S. , Rambiritch V. , Pillai G.
Published: February 2005

Modern surgical and radiological techniques dictate a reappraisal and definition of the renal venous anatomy. The purpose of this study was to investigate the incidence and morphometry of additional renal veins. One hundred fifty‐three morphologically normal en bloc renal specimens were randomly selected from post‐mortem examinations. Single additional renal veins were common on the right side (26%), while it was rare on the left side (2.6%). Second additional renal veins occurred infrequently on the right side (5%). Since additional renal veins may be encountered more than occasionally, it is worthwhile emphasizing their presence particularly to the transplant surgeon and the angiologist. © 1995 WiIey‐Liss, Inc.
Sacral edema: Computed tomographic and anatomical observations
Authors: Cooper Mark , Hacking Jeremy C. , Dixon Adrian K.
Published: February 2005

Sacral edema is a widely recognized clinical sign. Hitherto there has been no method of radiological confirmation, nor has the anatomy of this sign been well described. In a prospective study of 100 patients referred for abdominopelvic computed tomography (CT), 17 showed radiological evidence of sacral edema. It was demonstrated clinically in 12 of these 17 patients, leaving five patients with apparent CT evidence of sacral edema in whom this was not demonstrated clinically. In two patients with clinical evidence of sacral edema, their tissue planes in this region appeared normal on CT. The edema fluid accumulates in an intermediate plane of fibrous tissue within the subcutaneous fatty layer of the trunk. In those 17 patients with CT evidence of edema, the center of the fluid accumulation was situated over the lumbar rather than the sacral spine, suggesting that the term “sacral” edema is something of a misnomer. © 1995 WiIey‐Liss, Inc.
Human gross anatomy: A crucial time to encourage respect and compassion in students
Authors: Weeks Susan E. , Harris Eugene E. , Kinzey Warren G.
Published: February 2005

We suggest four ways in which human gross anatomy instructors can reinforce respect and compassion in students. First, encourage respectful language in the laboratory. The term “donor” should be used instead of “cadaver” or “corpse” in referring to the donated body because this promotes appreciation for the students' first “patient.” Second, provide the students with the actual name, age, history, and likely cause of death of the donor so that they more fully appreciate the donor as having once been a living human being. Third, prompt students to explore feelings and discuss topics stimulated by the intense experience of human dissection. Suggested topics include the students' feelings about dissecting a human being, the difficulty in deciding to donate one's body, the central importance of anatomy to a medical practitioner's role, and the historical development of the study of anatomy. Fourth, hold a memorial ceremony, in which both students and faculty participate, as a positive closure to an emotionally and intellectually intense course. Additionally, a ceremony reinforces salutary values in students, enhances social bonding among students, and encourages their appreciation of various cultural and religious beliefs. These methods introduce a new dimension of experience for anatomy students. We have developed these methods in response to what we view as a negative trend in the medical profession in which health care becomes technical and patients become objects. It is our role as faculty to reinforce respectful and compassionate attitudes in medical students from the very beginning. © 1995 WiIey‐Liss, Inc.
Hemicorporectomy
Authors: Stelly Terry C. , McNeil James W. , Snypes Stephen R. , Thomas William O. , Rodning Charles B.
Published: February 2005

Intractable decubitus ulcers and femoropelvic osteomyelitis are rare sequelae of paraplegia. Therapy for these conditions ranges from the simple to the complex, including; wound debridement and care, alimentary and urinary tract diversion, hip disarticulation, and myofasciocutaneous rotational flaps. Should the condition be recalcitrant to these modalities the only curative therapy is hemicorporectomy. A 28‐year‐old rendered paraplegic 3 years ago presented manifesting sepsis; marasmus; hip and knee flexion contractures; suppurative sacral and femoropelvic decubitus ulcers, exposed bone, and osteomyelitis; and fecal and urinary incontinence. Pre‐operative nutritional supplementation, wound debridement and care, and psychological counselling were provided. Hemicorporectomy was performed, including colostomy, ureteroileal conduit, gastrostomy, and translumbar amputation. Several anatomical, physiological, and operativetechnical perspectives are emphasized: a two‐staged approach may be preferable—at the first setting an intra‐peritoneal exploratory celiotomy with alimentary and urinary tract diversion; and at the second setting an extra‐peritoneal hemicorporectomy; preservation of abdominal wall musculature and fasciae to facilitate wound closure; sequential and bilateral ligation of the arteriae et venae iliaca communis; translumbar amputation between the fourth and fifth lumbar vertebrae; extirpation of the fourth lumbar processus spinosus vertebrarum; closure of the dura mater and translation of musculi sacrospinalis into the vertebral canal; avoidance of hypervolemia and hyperthermia; avoidance of wound pressure; testosterone replacement therapy for eunuchism; and physical and occupational rehabilitation including adaptation to a customized bucket prosthesis. © 1995 WiIey‐Liss, Inc.
Follow the royal road: The case for dissection
Authors: L. M. Newell Richard
Published: February 2005

It is a falsehood to assert that there is no royal road in anatomy. Dissection is the royal road and follows a pass through difficult mountains to pleasure and peace of mind. © 1995 WiIey‐Liss, Inc.