Pub Date : 2024-11-09DOI: 10.1016/j.aanat.2024.152353
Mayra Aparecida Côrtes , Rafaela Franco Moreira , Isadora Ribeiro Doria , Jislaine Debacker , Izadora Mellanie Silva de Oliveira , Augusto Costa Ataides , José Mariedson da Silva Junior , Flávio César Vieira Valentim , Gilberto Santos Cerqueira , Renata de Sousa Alves
This scoping review was conducted based on the Joanna Briggs Institute's theoretical framework and registered with the Open Science Framework (https://osf.io/b27wc). The study analyzed 29 manuscripts published between 2013 and 2023, focusing on imaging exams to synthesize evidence on the anatomy and clinical correlations of the upper urinary tract. The results revealed significant findings, highlighting the intrarenal pelvis as a possible predictive indicator of urinary loss after partial nephrectomy. This emphasizes the importance of anatomical assessment of the renal pelvis. Brödel's avascular plane has been categorized into three types relevant to pre-surgical patient planning. Multiple renal arteries and venous variations have also been reported, including retro-aortic and circum-aortic renal veins. A movable section related to the ureter was described in the perirenal space, delimited by the point of intersection with the gonadal vessels. The ureteropelvic and ureterovesical junctions were found to be anatomical points susceptible to ureteral constriction. On the other hand, the point at which the ureter crosses the iliac vessels is no longer considered a site prone to ureteral obstruction. The authors emphasize the need to adopt a standardized terminology to describe the anatomical variations of the blood vessels related to the kidney. Using diverse and unclear terms can hinder teaching and research in this area and lead to inaccuracies. From the authors' perspective, imaging exams have enhanced anatomical accuracy, benefiting the teaching of human anatomy and significantly contributing to continuous medical breakthroughs.
{"title":"Advances in upper urinary tract anatomy through imaging techniques","authors":"Mayra Aparecida Côrtes , Rafaela Franco Moreira , Isadora Ribeiro Doria , Jislaine Debacker , Izadora Mellanie Silva de Oliveira , Augusto Costa Ataides , José Mariedson da Silva Junior , Flávio César Vieira Valentim , Gilberto Santos Cerqueira , Renata de Sousa Alves","doi":"10.1016/j.aanat.2024.152353","DOIUrl":"10.1016/j.aanat.2024.152353","url":null,"abstract":"<div><div>This scoping review was conducted based on the Joanna Briggs Institute's theoretical framework and registered with the Open Science Framework (<span><span>https://osf.io/b27wc</span><svg><path></path></svg></span>). The study analyzed 29 manuscripts published between 2013 and 2023, focusing on imaging exams to synthesize evidence on the anatomy and clinical correlations of the upper urinary tract. The results revealed significant findings, highlighting the intrarenal pelvis as a possible predictive indicator of urinary loss after partial nephrectomy. This emphasizes the importance of anatomical assessment of the renal pelvis. Brödel's avascular plane has been categorized into three types relevant to pre-surgical patient planning. Multiple renal arteries and venous variations have also been reported, including retro-aortic and circum-aortic renal veins. A movable section related to the ureter was described in the perirenal space, delimited by the point of intersection with the gonadal vessels. The ureteropelvic and ureterovesical junctions were found to be anatomical points susceptible to ureteral constriction. On the other hand, the point at which the ureter crosses the iliac vessels is no longer considered a site prone to ureteral obstruction. The authors emphasize the need to adopt a standardized terminology to describe the anatomical variations of the blood vessels related to the kidney. Using diverse and unclear terms can hinder teaching and research in this area and lead to inaccuracies. From the authors' perspective, imaging exams have enhanced anatomical accuracy, benefiting the teaching of human anatomy and significantly contributing to continuous medical breakthroughs.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152353"},"PeriodicalIF":2.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.aanat.2024.152352
Andreas Posa , Christiane Barthel , Malte Kornhuber
Background
Inguinal hernia is one of the most common visceral surgical conditions in industrialised countries. The aim of the present observational clinical study was to investigate the dermatome patterns after nerve injury following inguinal hernia surgery and to demonstrate the marked individual anatomical and topographical variability of peripheral nerves in the inguinal region.
Methods
220 patients were followed up for one year after inguinal herniotomy. Surgical treatment was performed either with tension-free mesh techniques or open according (Lichtenstein).
Results
One year after inguinal herniotomy, 25 patients (11.4 %) reported postoperative symptoms. Of these, 15 patients showed evidence of a distinct nerve lesion. The results of the clinical neurological examination sometimes differed considerably from the subjective perceptions of the patients. In addition, a marked individual variability in the dermatomes of surgically lesioned nerves was found, with discrepancies to the classical and conventional dermatome data in textbooks.
Conclusions
This study has shown that it is hardly possible to assign a specific lesional inguinal dermatome to a specific nerve, as nerves show a large individual variability in their anatomical, topographical location and thus in their dermatome boundaries. Therefore, we propose a descriptive approach to the terminology of peripheral inguinal nerve lesions using common regional landmarks. This will avoid a potentially erroneous dermatome assignment to a certain nerve and facilitate the reproducibility of lesion descriptions between different observers, thus facilitating communication in clinical practice.
{"title":"How to deal with the variability of peripheral nerve lesion patterns after inguinal herniotomy? A descriptive approach for a new terminology in clinical practice","authors":"Andreas Posa , Christiane Barthel , Malte Kornhuber","doi":"10.1016/j.aanat.2024.152352","DOIUrl":"10.1016/j.aanat.2024.152352","url":null,"abstract":"<div><h3>Background</h3><div>Inguinal hernia is one of the most common visceral surgical conditions in industrialised countries. The aim of the present observational clinical study was to investigate the dermatome patterns after nerve injury following inguinal hernia surgery and to demonstrate the marked individual anatomical and topographical variability of peripheral nerves in the inguinal region.</div></div><div><h3>Methods</h3><div>220 patients were followed up for one year after inguinal herniotomy. Surgical treatment was performed either with tension-free mesh techniques or open according (Lichtenstein).</div></div><div><h3>Results</h3><div>One year after inguinal herniotomy, 25 patients (11.4 %) reported postoperative symptoms. Of these, 15 patients showed evidence of a distinct nerve lesion. The results of the clinical neurological examination sometimes differed considerably from the subjective perceptions of the patients. In addition, a marked individual variability in the dermatomes of surgically lesioned nerves was found, with discrepancies to the classical and conventional dermatome data in textbooks.</div></div><div><h3>Conclusions</h3><div>This study has shown that it is hardly possible to assign a specific lesional inguinal dermatome to a specific nerve, as nerves show a large individual variability in their anatomical, topographical location and thus in their dermatome boundaries. Therefore, we propose a descriptive approach to the terminology of peripheral inguinal nerve lesions using common regional landmarks. This will avoid a potentially erroneous dermatome assignment to a certain nerve and facilitate the reproducibility of lesion descriptions between different observers, thus facilitating communication in clinical practice.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152352"},"PeriodicalIF":2.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.aanat.2024.152349
Chong Liu , Jiarui Chen , Chengqian Huang , Tianyou Chen , Jiang Xue , Sitan Feng , Zhongxian Zhou , Sen Mo , Rongqing He , Xiaopeng Qin , Boli Qin , Yingying Qin , Wendi Wei , Hao Li , Zhaojun Lu , Shixin Pan , Jiakun Li , Xiangtao Xie , Xinli Zhan , Cheng Wei
Background and objective
There is currently a lack of anatomical research on the C7 pedicle and lateral mass in children aged 0–14 years, and experience with pediatric lower cervical spine surgeries remains limited. This study aims to investigate the anatomical structure of the C7 pedicle and lateral mass in a large pediatric sample to understand their growth patterns, providing imaging and anatomical references for pediatric lower cervical spine surgeries and the design of pediatric C7 screws.
Methods
We measured 12 parameters, including the width, length, height, and angles of the C7 pedicle and lateral mass in children aged 0–14 years. The t-test was used to analyze bilateral and gender differences, and least squares regression was applied for curve fitting analysis.
Results
The size parameters of the C7 pedicle and lateral mass generally increased with age, while angular parameters fluctuated within specific ranges. The average values for each parameter between ages 0–14 were as follows: D1: 2.78–5.28 mm, D2: 18.15–30.54 mm, D3: 2.44–6.01 mm, angle A: 38.05–44.48°; D4: 6.81–10.94 mm, D5: 5.37–11.23 mm, D6: 8.07–13.28 mm, D7: 1.94–4.88 mm, D8: 5.67–9.39 mm, angle C: 18.50–28.80°, angle D: 43.23–52.01°, angle E: 33.74–44.96°. Bilateral analysis showed no significant differences for most parameters across most age groups, with differences mainly observed in angle A, angle C, D6, and D8. Gender differences were primarily noted in length parameters across different age groups, especially in the 3–4, 6–7, 9–11, and 13–14 age groups. Regression analysis indicated that most parameters followed cubic function curves, while a few followed power or quadratic function curves.
Conclusion
This study provides detailed CT imaging anatomy of the C7 pedicle and lateral mass in children aged 0–14 years. Preoperative thin-slice CT scans and careful measurements of key parameters are essential for pediatric lower cervical spine surgeries. The findings offer valuable imaging and anatomical references for pediatric posterior cervical fixation surgery and screw design.
{"title":"CT imaging analysis of the C7 pedicle and lateral mass in children aged 0–14 years","authors":"Chong Liu , Jiarui Chen , Chengqian Huang , Tianyou Chen , Jiang Xue , Sitan Feng , Zhongxian Zhou , Sen Mo , Rongqing He , Xiaopeng Qin , Boli Qin , Yingying Qin , Wendi Wei , Hao Li , Zhaojun Lu , Shixin Pan , Jiakun Li , Xiangtao Xie , Xinli Zhan , Cheng Wei","doi":"10.1016/j.aanat.2024.152349","DOIUrl":"10.1016/j.aanat.2024.152349","url":null,"abstract":"<div><h3>Background and objective</h3><div>There is currently a lack of anatomical research on the C7 pedicle and lateral mass in children aged 0–14 years, and experience with pediatric lower cervical spine surgeries remains limited. This study aims to investigate the anatomical structure of the C7 pedicle and lateral mass in a large pediatric sample to understand their growth patterns, providing imaging and anatomical references for pediatric lower cervical spine surgeries and the design of pediatric C7 screws.</div></div><div><h3>Methods</h3><div>We measured 12 parameters, including the width, length, height, and angles of the C7 pedicle and lateral mass in children aged 0–14 years. The t-test was used to analyze bilateral and gender differences, and least squares regression was applied for curve fitting analysis.</div></div><div><h3>Results</h3><div>The size parameters of the C7 pedicle and lateral mass generally increased with age, while angular parameters fluctuated within specific ranges. The average values for each parameter between ages 0–14 were as follows: D1: 2.78–5.28 mm, D2: 18.15–30.54 mm, D3: 2.44–6.01 mm, angle A: 38.05–44.48°; D4: 6.81–10.94 mm, D5: 5.37–11.23 mm, D6: 8.07–13.28 mm, D7: 1.94–4.88 mm, D8: 5.67–9.39 mm, angle C: 18.50–28.80°, angle D: 43.23–52.01°, angle E: 33.74–44.96°. Bilateral analysis showed no significant differences for most parameters across most age groups, with differences mainly observed in angle A, angle C, D6, and D8. Gender differences were primarily noted in length parameters across different age groups, especially in the 3–4, 6–7, 9–11, and 13–14 age groups. Regression analysis indicated that most parameters followed cubic function curves, while a few followed power or quadratic function curves.</div></div><div><h3>Conclusion</h3><div>This study provides detailed CT imaging anatomy of the C7 pedicle and lateral mass in children aged 0–14 years. Preoperative thin-slice CT scans and careful measurements of key parameters are essential for pediatric lower cervical spine surgeries. The findings offer valuable imaging and anatomical references for pediatric posterior cervical fixation surgery and screw design.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152349"},"PeriodicalIF":2.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-23DOI: 10.1016/j.aanat.2024.152348
Smadar Peleg , Ruth Pelleg Kallevag , Gali Dar , Nili Steinberg , Ziv Lenzner , Hila May
Background
Evolutionary changes in human rib cage morphology rendered it prone to pathologies like Scheuermann's kyphosis (SK). However, the impact of SK on rib cage morphology is unclear.
Purpose
This study aimed to examine differences in rib cage morphology (e.g., ribs and sternum) between SK patients and a control group.
Methods
Measurements of the vertebral body, transverse process angle, sternum, and rib size were taken from the skeletons of SK patients (76) and a control group (96). Statistical tests were carried out to examine differences between the study and control groups and between the right and left sides. Correlations were obtained to examine the associations between the extent of the kyphosis (kyphosis angle) and rib cage variables.
Results
The SK group yielded significantly longer and flatter ribs than the control group in both sexes. However, males had the largest differences in the 9th rib and females in the upper ribs (5−7). Inconsistency in symmetry results was found between the sexes. In summary, SK patients had a larger anteroposterior diameter in relation to the transverse diameter than the control group.
Discussion and Conclusions
SK affects the morphology of the entire thorax and changes rib proportions similarly in males and females. These changes might have a role in bipedal stability and locomotion efficiency. Moreover, understanding the unique anatomy of SK patients is essential when performing an anterior release and anterior fusion operative approach. Finally, it provides insights into respiratory complications and poor prognosis related to individuals suffering from severe hyperkyphosis.
背景：人类肋骨笼形态的进化变化使其容易发生病变，如舍尔曼氏脊柱侧弯症（SK）。目的：本研究旨在探讨SK患者与对照组之间在肋骨笼形态（如肋骨和胸骨）方面的差异：从 SK 患者（76 例）和对照组（96 例）的骨骼中测量椎体、横突角、胸骨和肋骨的尺寸。对研究组和对照组之间以及左右两侧之间的差异进行了统计检验。对脊柱后凸的程度（后凸角度）和肋骨笼变量之间的相关性进行了检验：结果：SK 组的肋骨明显比对照组的肋骨更长、更平，男女均是如此。然而，男性第 9 肋骨和女性上肋骨的差异最大（5-7）。性别间的对称性结果不一致。总之，与对照组相比，SK 患者的前胸直径相对于横径较大：讨论和结论：SK 会影响整个胸廓的形态，并同样改变男性和女性的肋骨比例。这些变化可能会影响两足的稳定性和运动效率。此外，在采用前路松解和前路融合手术方法时，了解 SK 患者的独特解剖结构至关重要。最后，它还为患有严重脊柱后凸的患者的呼吸系统并发症和不良预后提供了见解。
{"title":"The effect of Scheuermann's kyphosis on rib cage morphology: A skeletal study","authors":"Smadar Peleg , Ruth Pelleg Kallevag , Gali Dar , Nili Steinberg , Ziv Lenzner , Hila May","doi":"10.1016/j.aanat.2024.152348","DOIUrl":"10.1016/j.aanat.2024.152348","url":null,"abstract":"<div><h3>Background</h3><div>Evolutionary changes in human rib cage morphology rendered it prone to pathologies like Scheuermann's kyphosis (SK). However, the impact of SK on rib cage morphology is unclear.</div></div><div><h3>Purpose</h3><div>This study aimed to examine differences in rib cage morphology (e.g., ribs and sternum) between SK patients and a control group.</div></div><div><h3>Methods</h3><div>Measurements of the vertebral body, transverse process angle, sternum, and rib size were taken from the skeletons of SK patients (76) and a control group (96). Statistical tests were carried out to examine differences between the study and control groups and between the right and left sides. Correlations were obtained to examine the associations between the extent of the kyphosis (kyphosis angle) and rib cage variables.</div></div><div><h3>Results</h3><div>The SK group yielded significantly longer and flatter ribs than the control group in both sexes. However, males had the largest differences in the 9th rib and females in the upper ribs (5−7). Inconsistency in symmetry results was found between the sexes. In summary, SK patients had a larger anteroposterior diameter in relation to the transverse diameter than the control group.</div></div><div><h3>Discussion and Conclusions</h3><div>SK affects the morphology of the entire thorax and changes rib proportions similarly in males and females. These changes might have a role in bipedal stability and locomotion efficiency. Moreover, understanding the unique anatomy of SK patients is essential when performing an anterior release and anterior fusion operative approach. Finally, it provides insights into respiratory complications and poor prognosis related to individuals suffering from severe hyperkyphosis.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152348"},"PeriodicalIF":2.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-20DOI: 10.1016/j.aanat.2024.152347
Barbora Veselá , Jana Bzdúšková , Alice Ramešová , Kateřina Holomková , Eva Matalová
Caspase-12 is a molecule whose functions are still not well understood. Although its expression has been found in various tissues, specific roles have been described in only a few cases. These include the effect of caspase-12 on murine bone cell differentiation during craniofacial development. This work focused on the development of the limbs taking place through endochondral ossification, which precedes the formation of the cartilaginous growth plate. Caspase-12 was described here for the first time in growth plate chondrocytes during physiological development. Using pharmacological inhibition, caspase-12 was found to affect chondrogenesis. Limb-derived micromass cultures showed a significantly increased area of chondrogenic nodules after caspase-12 inhibition and there were changes in gene expression, the most significant of which was the reduction of Mmp9. These data point to potential new functions of caspase-12 in chondrogenesis.
{"title":"Caspase-12 affects chondrogenesis in mice","authors":"Barbora Veselá , Jana Bzdúšková , Alice Ramešová , Kateřina Holomková , Eva Matalová","doi":"10.1016/j.aanat.2024.152347","DOIUrl":"10.1016/j.aanat.2024.152347","url":null,"abstract":"<div><div>Caspase-12 is a molecule whose functions are still not well understood. Although its expression has been found in various tissues, specific roles have been described in only a few cases. These include the effect of caspase-12 on murine bone cell differentiation during craniofacial development. This work focused on the development of the limbs taking place through endochondral ossification, which precedes the formation of the cartilaginous growth plate. Caspase-12 was described here for the first time in growth plate chondrocytes during physiological development. Using pharmacological inhibition, caspase-12 was found to affect chondrogenesis. Limb-derived micromass cultures showed a significantly increased area of chondrogenic nodules after caspase-12 inhibition and there were changes in gene expression, the most significant of which was the reduction of <em>Mmp9</em>. These data point to potential new functions of caspase-12 in chondrogenesis.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152347"},"PeriodicalIF":2.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-13DOI: 10.1016/j.aanat.2024.152344
Mingjie Gao , Guopeng Shi , Zhuoqun He , Malian Bao , Kai Zhang , Jing Li , Feng Li , Yong Zhu , Xiaohe Li , Haiyan Wang
Objective
The purpose of this study was to establish an anatomical foundation for minimally invasive lumbar spine surgery in adolescents by assessing the 3D anatomical parameters of the lumbar vertebrae in the age group of 12–21 years.
Methods
We collected CT data from 90 adolescents and performed 3D reconstructions using Mimics 16.0 software. The dimensions assessed included the height and sagittal diameter of the intervertebral foramen, as well as the length and widths of the transverse and spinous processes.
Results
The intervertebral foramen height exhibited variation corresponding to the vertebral level, being smallest at L5/S1 and largest at L3/4. The sagittal diameter of the intervertebral foramen increased with age, reaching a minimum at L1/2 and a maximum at L4/5. Significant gender differences were observed in the 12–14 age group, with females exhibiting larger measurements than males. The length and width of the transverse processes were maximal at L3 and L5, respectively. The spinous process length was greatest at L3 and smallest at L5, with notable gender differences present in the 12–14 and 19–21 age groups.
Conclusion
The study reveals that gender and age are significant factors influencing the anatomy of the adolescent lumbar spine, which is essential for the development of minimally invasive surgical techniques. Our findings contribute valuable insights for the design and surgical planning of spinal devices tailored to adolescents.
{"title":"3D digital anatomical measurements for clinical application of minimally invasive lumbar foraminal surgery in adolescents aged 12–21 years","authors":"Mingjie Gao , Guopeng Shi , Zhuoqun He , Malian Bao , Kai Zhang , Jing Li , Feng Li , Yong Zhu , Xiaohe Li , Haiyan Wang","doi":"10.1016/j.aanat.2024.152344","DOIUrl":"10.1016/j.aanat.2024.152344","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to establish an anatomical foundation for minimally invasive lumbar spine surgery in adolescents by assessing the 3D anatomical parameters of the lumbar vertebrae in the age group of 12–21 years.</div></div><div><h3>Methods</h3><div>We collected CT data from 90 adolescents and performed 3D reconstructions using Mimics 16.0 software. The dimensions assessed included the height and sagittal diameter of the intervertebral foramen, as well as the length and widths of the transverse and spinous processes.</div></div><div><h3>Results</h3><div>The intervertebral foramen height exhibited variation corresponding to the vertebral level, being smallest at L5/S1 and largest at L3/4. The sagittal diameter of the intervertebral foramen increased with age, reaching a minimum at L1/2 and a maximum at L4/5. Significant gender differences were observed in the 12–14 age group, with females exhibiting larger measurements than males. The length and width of the transverse processes were maximal at L3 and L5, respectively. The spinous process length was greatest at L3 and smallest at L5, with notable gender differences present in the 12–14 and 19–21 age groups.</div></div><div><h3>Conclusion</h3><div>The study reveals that gender and age are significant factors influencing the anatomy of the adolescent lumbar spine, which is essential for the development of minimally invasive surgical techniques. Our findings contribute valuable insights for the design and surgical planning of spinal devices tailored to adolescents.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152344"},"PeriodicalIF":2.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.aanat.2024.152343
George Triantafyllou , Nektarios Belimezakis , Orestis Lyros , George Tsakotos , George Botis , Maria Piagkou
Background
The current evidence-based systematic review with meta-analysis presents a detailed overview of the cystic artery (CA) surgical anatomy, including its origin, number, topography, and morphometry. Moreover, the surgical implications of these variants are further discussed.
Methods
According to the Evidence-Based Anatomy Workgroup and PRISMA 2020 guidelines, the systematic review was performed using four online databases. The Anatomical Quality Assurance Tool was used to evaluate the risk of bias. Meta-analysis was performed with the R programming software. The pooled prevalence and pooled mean of different CA parameters were calculated.
Results
The CA most commonly originated from the right hepatic artery (a pooled prevalence of 85.75 %). Other described origins (in order of frequency) were the aberrant right hepatic artery, the common hepatic, the left hepatic, the gastroduodenal, the superior mesenteric, and the middle hepatic arteries. The CA was single in 88.59 %, while it can be identified as double, triple, or absent. Most commonly, it was located inside the cystohepatic triangle in 83.83 %. Most commonly, it was superomedially to the cystic duct (77.80 %) and posteriorly to the common hepatic duct (35.08 %). The CA pooled mean length was 21.34 mm, and its diameter was more commonly over 1 mm.
Conclusion
The CA surgical anatomy is paramount when operating on the gallbladder. The CA's altered anatomy and adjacent area could lead to confusion, iatrogenic injury, and prolonged surgical time. The CA depicts high morphological variability; therefore, surgeons should consider the typical anatomy and possible (usual and unusual) variants.
背景：当前的循证系统综述和荟萃分析详细概述了囊状动脉（CA）的手术解剖，包括其起源、数量、地形和形态。此外，还进一步讨论了这些变异的手术意义：根据循证解剖学工作组和 PRISMA 2020 指南，利用四个在线数据库进行了系统性综述。解剖学质量保证工具用于评估偏倚风险。使用 R 编程软件进行元分析。计算了不同CA参数的集合患病率和集合平均值：结果：CA最常见的来源是肝右动脉（合计发生率为85.75%）。其他描述的起源（按频率排序）为异常右肝动脉、肝总动脉、左肝动脉、胃十二指肠动脉、肠系膜上动脉和肝中动脉。88.59% 的患者为单侧 CA，也有可能是双侧、三侧或无 CA。最常见的是，83.83%的 CA 位于膀胱肝三角内。最常见的是位于膀胱导管的上方（77.80%）和肝总管的后方（35.08%）。CA集合平均长度为21.34毫米，直径通常超过1毫米：结论：在对胆囊进行手术时，CA的手术解剖结构至关重要。结论：在对胆囊进行手术时，CA 的解剖结构是最重要的。CA 的解剖结构和邻近区域的改变可能会导致混乱、先天性损伤和手术时间延长。CA 的形态变化很大，因此，外科医生应考虑典型的解剖结构和可能的（常见的和不常见的）变异。
{"title":"Surgical anatomy of the cystic artery: A systematic review with meta-analysis","authors":"George Triantafyllou , Nektarios Belimezakis , Orestis Lyros , George Tsakotos , George Botis , Maria Piagkou","doi":"10.1016/j.aanat.2024.152343","DOIUrl":"10.1016/j.aanat.2024.152343","url":null,"abstract":"<div><h3>Background</h3><div>The current evidence-based systematic review with meta-analysis presents a detailed overview of the cystic artery (CA) surgical anatomy, including its origin, number, topography, and morphometry. Moreover, the surgical implications of these variants are further discussed.</div></div><div><h3>Methods</h3><div>According to the Evidence-Based Anatomy Workgroup and PRISMA 2020 guidelines, the systematic review was performed using four online databases. The Anatomical Quality Assurance Tool was used to evaluate the risk of bias. Meta-analysis was performed with the R programming software. The pooled prevalence and pooled mean of different CA parameters were calculated.</div></div><div><h3>Results</h3><div>The CA most commonly originated from the right hepatic artery (a pooled prevalence of 85.75 %). Other described origins (in order of frequency) were the aberrant right hepatic artery, the common hepatic, the left hepatic, the gastroduodenal, the superior mesenteric, and the middle hepatic arteries. The CA was single in 88.59 %, while it can be identified as double, triple, or absent. Most commonly, it was located inside the cystohepatic triangle in 83.83 %. Most commonly, it was superomedially to the cystic duct (77.80 %) and posteriorly to the common hepatic duct (35.08 %). The CA pooled mean length was 21.34 mm, and its diameter was more commonly over 1 mm.</div></div><div><h3>Conclusion</h3><div>The CA surgical anatomy is paramount when operating on the gallbladder. The CA's altered anatomy and adjacent area could lead to confusion, iatrogenic injury, and prolonged surgical time. The CA depicts high morphological variability; therefore, surgeons should consider the typical anatomy and possible (usual and unusual) variants.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152343"},"PeriodicalIF":2.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1016/j.aanat.2024.152340
Younes Kamali
Background
The anatomy of the pectoral nerves and the two nerve loops on the course of the axillary artery was revisited to complement current general descriptions as well as to argue whether the nerves contributing to the formation of the pectoral loop are the cranial pectoral nerves. Besides, the positional relationship between the scalene muscles and the nerve roots of the brachial plexus, which contribute to the nerves aimed in this study, was also examined at the same time as the dissection.
Methods
Twenty brachial plexuses of 10 domestic adult goats (8 females and 2 males) were examined using gross dissection in this study.
Results
In many dissections (95 %), the last bundle of scalenus ventralis muscle was found to pass between the roots of C7 and C8, dividing the brachial plexus into the cranial (ventral) and caudal (dorsal) parts. Two pectoral nerves were noted to contribute to the formation of the first nerve loop around the axillary artery. The first pectoral nerve arose predominantly from the ventral branches of C6 and C7 in company with the n. musculocutaneus, while the second pectoral nerve arose directly from C8 in 70 % of the dissections or as the first branch of the n. thoracicus lateralis (C8, T1) in the remaining 30 %. After the nerve loop, the second pectoral nerve branched off to innervate the superficial surface of the m. pectoralis profundus toward its insertion. The m. subclavius was found to receive its innervation from several sources, including the ventral branches of the brachial plexus. Interestingly, in 4 of the 14 dissections a communication between the n. subclavius and the n. phrenicus heretofore not found in the animal anatomy literature was found. In 16 of the 20 dissections (60 %), the ramus muscularis proximalis of the n. musculocutaneus received the communicating branch(s) from the n. medianus at the site of the second nerve loop, ansa axillaris.
Conclusion
The second pectoral nerve contributing to the pectoral loop would be better described as the caudal pectoral nerve rather than the cranial pectoral nerve. Besides the evolutionary perspectives, understanding the findings of this study would be helpful for teaching veterinary anatomy.
{"title":"Revisiting the anatomy of the pectoral nerves and nerve loops of the brachial plexus in the goat (Capra hircus)","authors":"Younes Kamali","doi":"10.1016/j.aanat.2024.152340","DOIUrl":"10.1016/j.aanat.2024.152340","url":null,"abstract":"<div><h3>Background</h3><div>The anatomy of the pectoral nerves and the two nerve loops on the course of the axillary artery was revisited to complement current general descriptions as well as to argue whether the nerves contributing to the formation of the pectoral loop are the cranial pectoral nerves. Besides, the positional relationship between the scalene muscles and the nerve roots of the brachial plexus, which contribute to the nerves aimed in this study, was also examined at the same time as the dissection.</div></div><div><h3>Methods</h3><div>Twenty brachial plexuses of 10 domestic adult goats (8 females and 2 males) were examined using gross dissection in this study.</div></div><div><h3>Results</h3><div>In many dissections (95 %), the last bundle of scalenus ventralis muscle was found to pass between the roots of C7 and C8, dividing the brachial plexus into the cranial (ventral) and caudal (dorsal) parts. Two pectoral nerves were noted to contribute to the formation of the first nerve loop around the axillary artery. The first pectoral nerve arose predominantly from the ventral branches of C6 and C7 in company with the n. musculocutaneus, while the second pectoral nerve arose directly from C8 in 70 % of the dissections or as the first branch of the n. thoracicus lateralis (C8, T1) in the remaining 30 %. After the nerve loop, the second pectoral nerve branched off to innervate the superficial surface of the m. pectoralis profundus toward its insertion. The m. subclavius was found to receive its innervation from several sources, including the ventral branches of the brachial plexus. Interestingly, in 4 of the 14 dissections a communication between the n. subclavius and the n. phrenicus heretofore not found in the animal anatomy literature was found. In 16 of the 20 dissections (60 %), the ramus muscularis proximalis of the n. musculocutaneus received the communicating branch(s) from the n. medianus at the site of the second nerve loop, <em>ansa axillaris</em>.</div></div><div><h3>Conclusion</h3><div>The second pectoral nerve contributing to the pectoral loop would be better described as the caudal pectoral nerve rather than the cranial pectoral nerve. Besides the evolutionary perspectives, understanding the findings of this study would be helpful for teaching veterinary anatomy.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152340"},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1016/j.aanat.2024.152342
George Triantafyllou , George Botis , Katerina Vassiou , Marianna Vlychou , George Tsakotos , Theodosis Kalamatianos , George Matsopoulos , Maria Piagkou
Purpose
The elongated styloid process (SP) is associated with internal carotid artery (ICA) dissection, due to its close relationship with the vessel. However, the relationship with the variable ossified stylohyoid chain (SHC) has been scarcely studied. The current study investigated the relationship between the temporal bone's SP and the external and internal carotid arteries (ECA and ICA). The hypothesis was that the morphological variants of the SP influence this relationship.
Methods
Sixty multidetector computed tomography angiographies (120 heminecks) were randomly selected and retrospectively analyzed. SP elongation and the degree of SHC ossification were assessed. The distances (mm) between the SP and the carotid arteries (CAs) were measured.
Results
Elongated SPs were present in 21 patients (35 %), while 18 patients (30 %) exhibited variable degrees of SHC ossification. The mean distance from the SP tip and ECA was 5.45 ± 3.01 mm from the ECA and 6.16 ± 3.11 mm to the ICA. The minimum distance between SP and ECA was 3.96 ± 2.74 mm, and between SP and ICA was 4.72 ± 2.73 mm. A statistically significant reduction in SP-ICA distance was observed in cases with elongated SP and SHC ossification, while the SP-ECA distance was statistically significantly shorter in cases of SP elongation. Additionally, three novel topographical patterns between the SP and surrounding vascular structures were identified.
Conclusions
SP elongation and variable SHC ossification may impact the spatial relationship between the SP and the ICA/ECA. The proximity of the SP to the carotid arteries, particularly the ICA, holds clinical significance, as a reduced distance may predispose patients to carotid artery dissection, increasing the risk of stroke.
{"title":"Τhe styloid process length and the stylohyoid chain ossification affect its relationship with the carotid arteries","authors":"George Triantafyllou , George Botis , Katerina Vassiou , Marianna Vlychou , George Tsakotos , Theodosis Kalamatianos , George Matsopoulos , Maria Piagkou","doi":"10.1016/j.aanat.2024.152342","DOIUrl":"10.1016/j.aanat.2024.152342","url":null,"abstract":"<div><h3>Purpose</h3><div>The elongated styloid process (SP) is associated with internal carotid artery (ICA) dissection, due to its close relationship with the vessel. However, the relationship with the variable ossified stylohyoid chain (SHC) has been scarcely studied. The current study investigated the relationship between the temporal bone's SP and the external and internal carotid arteries (ECA and ICA). The hypothesis was that the morphological variants of the SP influence this relationship.</div></div><div><h3>Methods</h3><div>Sixty multidetector computed tomography angiographies (120 heminecks) were randomly selected and retrospectively analyzed. SP elongation and the degree of SHC ossification were assessed. The distances (mm) between the SP and the carotid arteries (CAs) were measured.</div></div><div><h3>Results</h3><div>Elongated SPs were present in 21 patients (35 %), while 18 patients (30 %) exhibited variable degrees of SHC ossification. The mean distance from the SP tip and ECA was 5.45 ± 3.01 mm from the ECA and 6.16 ± 3.11 mm to the ICA. The minimum distance between SP and ECA was 3.96 ± 2.74 mm, and between SP and ICA was 4.72 ± 2.73 mm. A statistically significant reduction in SP-ICA distance was observed in cases with elongated SP and SHC ossification, while the SP-ECA distance was statistically significantly shorter in cases of SP elongation. Additionally, three novel topographical patterns between the SP and surrounding vascular structures were identified.</div></div><div><h3>Conclusions</h3><div>SP elongation and variable SHC ossification may impact the spatial relationship between the SP and the ICA/ECA. The proximity of the SP to the carotid arteries, particularly the ICA, holds clinical significance, as a reduced distance may predispose patients to carotid artery dissection, increasing the risk of stroke.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152342"},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142326637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent years, modern technologies have become established in most educational fields. Thus, e-learning tends to be an integral part of the learner-centered learning process, with the teacher acting as a facilitator. However, the methodologies used to study the impact of e-learning have been varied and imprecise, making comparison and meta-analysis difficult. This study attempts to overcome these obstacles with a large and homogeneous sample to compare (1) the academic outcomes obtained with face-to-face and e-learning in a blended module of human anatomy and (2) the response attempts (response index) of each student in answering questions specific to each learning modality.
Material and methods
The results of the multiple-choice exams under study were collected. All students (n=1160) were from four consecutive academic years following the same teaching program with a b-learning method: 13 topics were presented face to face by the same lecturers, and six via e-learning with the same online resources. Two variables were compared: (1) the academic grade, based on the score for correct answers and the penalty for incorrect ones, and (2) the response index, based on the number of correct and incorrect answers.
Results
(1) 73.45 % of the examinees passed the test. In the sample as a whole, results were better in face-to-face than in e-learning. In the quartiles ordered by overall academic performance, this superiority was limited to the top half of the higher-performing students. In contrast, lower-scoring students performed better in e-learning. However, these differences were modest (≤ 0.54 points). (2) In proportion, the questions on topics learned face-to-face were the most frequently answered. A strong correlation was observed between the variables in the whole sample and the students with the highest academic scores (first quartile) on the global exam and the questions on topics learned in each modality. In the remaining quartiles, the correlation was also strong in the e-learning content.
Conclusions
(1) Both modalities included in b-learning are academically effective. (2) Proportionally, students take more risks when answering content questions learned in face-to-face classes, and there is a strong correlation between response attempts and academic grades, especially, on the brightest exams and e-learning content.
{"title":"B-learning in human anatomy: Comparative analysis of academic achievement between face-to-face and e-learning modalities","authors":"Josep Nebot-Cegarra , Carlos Nebot-Bergua , Jordi Gascón-Bayarri , Enric Macarulla-Sanz , Sílvia Ricart","doi":"10.1016/j.aanat.2024.152339","DOIUrl":"10.1016/j.aanat.2024.152339","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent years, modern technologies have become established in most educational fields. Thus, e-learning tends to be an integral part of the learner-centered learning process, with the teacher acting as a facilitator. However, the methodologies used to study the impact of e-learning have been varied and imprecise, making comparison and meta-analysis difficult. This study attempts to overcome these obstacles with a large and homogeneous sample to compare (1) the academic outcomes obtained with face-to-face and e-learning in a blended module of human anatomy and (2) the response attempts (response index) of each student in answering questions specific to each learning modality.</div></div><div><h3>Material and methods</h3><div>The results of the multiple-choice exams under study were collected. All students (n=1160) were from four consecutive academic years following the same teaching program with a b-learning method: 13 topics were presented face to face by the same lecturers, and six via e-learning with the same online resources. Two variables were compared: (1) the academic grade, based on the score for correct answers and the penalty for incorrect ones, and (2) the response index, based on the number of correct and incorrect answers.</div></div><div><h3>Results</h3><div>(1) 73.45 % of the examinees passed the test. In the sample as a whole, results were better in face-to-face than in e-learning. In the quartiles ordered by overall academic performance, this superiority was limited to the top half of the higher-performing students. In contrast, lower-scoring students performed better in e-learning. However, these differences were modest (≤ 0.54 points). (2) In proportion, the questions on topics learned face-to-face were the most frequently answered. A strong correlation was observed between the variables in the whole sample and the students with the highest academic scores (first quartile) on the global exam and the questions on topics learned in each modality. In the remaining quartiles, the correlation was also strong in the e-learning content.</div></div><div><h3>Conclusions</h3><div>(1) Both modalities included in b-learning are academically effective. (2) Proportionally, students take more risks when answering content questions learned in face-to-face classes, and there is a strong correlation between response attempts and academic grades, especially, on the brightest exams and e-learning content.</div></div>","PeriodicalId":50974,"journal":{"name":"Annals of Anatomy-Anatomischer Anzeiger","volume":"257 ","pages":"Article 152339"},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号