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1.
Int. j. morphol ; 40(3): 851-854, jun. 2022. ilus
Article in English | LILACS-Express | LILACS | ID: biblio-1385663

ABSTRACT

SUMMARY: The plantaris muscle is located between the soleus and gastrocnemius muscles, within the posterior calf group. Due to degeneration and its loss of plantar-flexion function, the muscle is vestigial in human beings, but it retains clinical significance. Few cases of variation in the plantaris muscle have been reported, and this, therefore, appears to be rare. Nonetheless, absence of this muscle was identified via the dissection of a left lower limb (male), which also indicated the absence of an attachment in the usual position. The present report, which addresses such variation, may provide both inspiration and reference points for the clinical treatment of so-called "tennis leg", and for the use of plantaris muscle for the purposes of clinical, autologous graft repair.


RESUMEN: El músculo plantar se ubica entre los músculos sóleo y gastrocnemio, dentro del grupo posterior de la pierna. Debido a la degeneración y la pérdida de la función de flexión plantar, el músculo es un vestigio en los seres humanos, pero conserva su importancia clínica. Se han informado pocos casos de variación en el músculo plantar y, por lo tanto, esto parece ser raro. No obstante, se observó la ausencia de este músculo durante la disección de un miembro inferior izquierdo (masculino). El presente informe, que aborda dicha variación, puede proporcionar puntos de referencia para el tratamiento clínico de la llamada "pierna de tenista" y para el uso del músculo plantar con fines de reparación clínica con injerto autólogo.


Subject(s)
Humans , Male , Adult , Muscle, Skeletal/anatomy & histology , Anatomic Variation
2.
Int. j. morphol ; 40(1)feb. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1385570

ABSTRACT

SUMMARY: The superior vena cava is usually located only on the right side, but persistence of the left superior vena cavais observed in about 0.3 to 0.5 % of adults. A routine dissection of the cadaver of a 91-year-old Japanese female, whose cause of death was sepsis due to cholecystitis, was performed at Nagasaki University and revealed a double-sided superior vena cava. On the right side, the superior vena cava opened to the right atrium, while on the left, it opened into the extended coronary sinus. Veins in the left head, neck and upper limb regions joined to form the persistent left superior vena cava, with eventual drainage into the expanded coronary vein. An anastomosing branch occurred between each superior vena cava, and two thymic veins opened to the anastomosing branch. The azygos vein in the azygos venous system opened into the right superior vena cava, whereas a hemi-azygos vein opened into the azygos vein. The accessory hemi-azygos vein also opened into the azygos vein and opened cranially into the left superior vena cava. The left supreme intercostal vein also opened into the left superior vena cava. Several studies have reported a persistent left superior vena cava and the various considerations for its occurrence. Here, we propose a new hypothesis for the embryonic development of the persistent left superior vena cava with the thymic vein. This hypothesis essentially states that the left brachiocephalic vein fails to mature due to inadequate venous return from the thymic vein during the embryonic period, and the left superior vena cava then remains to maintain venous return from the left head, neck and upper limb. We also discuss the clinical significance of the persistent left superior vena cava.


RESUMEN: Usualmente la vena cava superior se localiza solo en el lado derecho, sin embargo en aproximadamente 0,3 a 0,5 % de los adultos se observa la persistencia de la vena cava superior izquierda. En la Universidad de Nagasaki se realizó una disección de rutina del cadáver de una mujer japonesa de 91 años, cuya causa de muerte fue sepsis debido a una colecistitis. El cuerpo presentaba una vena cava superior doble. En el lado derecho, la vena cava superior llegaba al atrio derecho, mientras que en el lado izquierdo drenaba al seno coronario. Las venas de las regiones de la cabeza, el cuello y del miembro superior izquierdo formaban la vena cava superior izquierda persistente, con drenaje hacia la vena coronaria. Se observó una rama anastomótica entre cada vena cava superior y dos venas tímicas drenaban a la rama anastomótica. La vena ácigos drenaba a la vena cava superior derecha, mientras que una vena hemiácigos drenaba a la vena ácigos. La vena hemiácigos accesoria también drnaba en la vena ácigos y cranealmente lo hacia la vena cava superior izquierda. La vena intercostal suprema izquierda drenaba en la vena cava superior izquierda. Varios estudios han informado una vena cava superior izquierda persistente y las diversas consideraciones para su aparición. Aquí, proponemos una nueva hipótesis para el desarrollo embrionario de la vena cava superior izquierda persistente con la vena tímica, que esencialmente establece que la vena braquiocefálica izquierda no se dearrolla debido a un retorno venoso inadecuado de la vena tímica durante el período embrionario, y se mantiene la vena cava superior izquierda para el retorno venoso de la cabeza, el cuello y el miembro superior izquierdo. Además se informa de la importancia clínica de la persistencia de la vena cava superior izquierda.

3.
Int. j. morphol ; 40(1)feb. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1385576

ABSTRACT

SUMMARY: The dorsalis pedis artery (DPA) is a vital artery that supplies the foot and ankle area which is clinically important for palpating when taking the pulse. This research was performed on fresh cadaveric dissection of 40 legs by injecting paint into popliteal artery for tracking the dorsalis pedis artery and its branches. The present research revealed that the Thai population has an anatomical variation and different location of the DPA and exact location of DPA for estimating the location of the DPA and may have clinical implications. The statistically descriptive analysis elucidated the distances of the DPA to the lateral malleolus and medial malleolus which were 51.48 ± 7.27 mm and 42.62 ± 11.40 mm, respectively. The distance of the extensor hallucis longus (EHL) to the DPA was 14.29 ± 4.11 mm. The length of the dorsalis pedis artery which measured from artery on intermalleolar line to its dipping in 1st intermetatarsal space to be 122.03 ± 21.07 mm. The arcuate loop which is anastomosis U-loop of lateral tarsal arteries of the DPA was found 55 % in Thais population. There were no statistically significant differences of all parameters between the side and sex in DPA consideration. An understanding of the variations of the anatomical vasculature of DPA is essential for precise clinical assessment because exact anatomical knowledge and location can contribute to the pulse taking and be applied in surgical procedure.


RESUMEN: La arteria dorsal del pie (ADP) es una arteria vital que irriga eldorso del pie y el tobillo, y es clínicamente importante para la toma del pulso. Esta investigación se realizó en disección cadavérica de 40 piernas inyectando látex coloreado en la arteria poplítea para rastrear la ADP y sus ramas. La presente investigación reveló que en la población tailandesa la ADP tiene una variación anatómica y una ubicación diferente. Por tanto, determinar la ubicación exacta del ADP será útil para las implicaciones clínicas. El análisis estadísticamente descriptivo determinó que las distancias del ADP al maléolo lateral y al maléolo medial eran 51,48 ± 7,27 mm y 42,62 ± 11,40 mm, respectivamente. La distancia del tendón del músculo extensor largo del halux (ELH) al ADP era de 14,29 ± 4,11 mm. La longitud de la ADP, desde la línea intermaleolar hasta su entrada al primer espacio intermetatarsiano, era de 122,03 ± 21,07 mm. El asa arqueada, que es una anastomosis U-loop de las arterias tarsales laterales de la ADP, se encontró en un 55 % de la población tailandesa. No hubo diferencias estadísticamente significativas en todos los parámetros de la ADP entre el lado y el sexo. La comprensión de las variaciones de la variaciones anatómicas de la ADP es esencial para una evaluación clínica precisa. El conocimiento anatómico exacto y la ubicación pueden contribuir a la toma del pulso y ser útil en el procedimiento quirúrgico.

4.
Int. j. morphol ; 40(1)feb. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1385594

ABSTRACT

SUMMARY: The aim of this study was to study the anatomical landmarks and variations of supraorbital, infraorbital, and mental foramina. One hundred and sixty Thai dry skulls were randomly selected from the Forensic Osteology Research Center. The distances of the parameters were measured by using Vernier caliper. The supraorbital foramen could be found in a notch form 13.8 %, single supraorbital foramen accounted for 82.5 %, and supraorbital foramen with an accessory foramen represented 3.8 %. Single infraorbital foramen was found 90.0 %, and infraorbital foramen with an accessory foramen represented 10.0 %. Single mental foramen was observed 96.6 %, and the frequency of mental foramen with an accessory foramen was determined 3.4%. The majority of infraorbital foramina (48.0 %) was detected above the second premolar area. 19.0 % of the infraorbital foramina was seen in the region between the first premolar and the second premolar, and 22.8 % of the infraorbital foramina was located between the second premolar and the first molar. The infraorbital foramen is anatomically positioned above the first molar (10.2 %). The majority of mental foramina (53.5 %) can be identified below second premolar area. The region between the first premolar and the second premolar is the site for the mental foramen 26.0 % of the total variations. The region between the second premolar and the first molar is the site for the mental foramen 16.9 % of the total variations. The mental foramen is approximately situated below the first molar (3.6 %). The present study of anatomical variations of various foramina demonstrates a useful application in cosmetic and ophthalmic plastic surgery. The findings could improve the efficacy of the surgeons and accuracy for the indicated localization of these foramina during maxillofacial operations and local anesthetic procedures.


RESUMEN: El objetivo de este estudio fue estudiar los puntos de referencia anatómicos y las variaciones de los forámenes supraorbitario, infraorbitario y mental. Ciento sesenta cráneos secos tailandeses fueron seleccionados al azar del Centro de Investigación de Osteología Forense. Las distancias de los parámetros se midieron utilizando un calibre Vernier. El foramen supraorbitario se pudo encontrar en forma de muesca el 13,8 %, el foramen supraorbitario único representó el 82,5 % y el foramen supraorbitario con un foramen accesorio representó el 3,8 %. El foramen infraorbitario único se encontró en un 90,0 % y el foramen infraorbitario con un foramen accesorio representó el 10,0 %. Se observó foramen mental único 96,6 % y se determinó la frecuencia de foramen mental con foramen accesorio 3,4 %. La mayoría de los forámenes infraorbitarios (48,0 %) se detectaron por encima del área del segundo premolar. El 19,0 % de los forámenes infraorbitarios se observó en la región entre el primer premolar y el segundo premolar, y el 22,8 % de los forámenes infraorbitarios se ubicó entre el segundo premolar y el primer molar. El foramen infraorbitario se ubica anatómicamente por encima del primer molar (10,2 %). La mayoría de los forámenes mentales (53,5 %) se pudieron identificar inferior al área del segundo premolar. La región entre el primer premolar y el segundo premolar es el sitio del foramen mental 26,0 % de las variaciones totales. La región entre el segundo premolar y el primer molar es el sitio del foramen mental 16,9 % del total de variaciones. El foramen mental se sitúa aproximadamente por debajo del primer molar (3,6 %). El presente estudio de variaciones anatómicas de estos forámenes demuestra una aplicación útil en la cirugía plástica y oftálmica. Los hallazgos podrían mejorar la eficacia de los cirujanos y la precisión para la localización de estos forámenes durante las operaciones maxilofaciales y los procedimientos anestésicos locales.

5.
Int. j. morphol ; 40(4): 880-882, 2022. ilus
Article in English | LILACS-Express | LILACS | ID: biblio-1405257

ABSTRACT

SUMMARY: The variations in the serratus anterior (SA) muscle are common. Here, we report a rare variation of the muscle origin with a potentially great clinical implication. We found an aberrant SA variation in an 81-year-old Korean male cadaver during a routine dissection for medical students. Additional slip (AS) of the SA originated from the clavipectoral fascia and the pectoralis minor. It traveled inferiorly and merged to the typical SA part. Precise knowledge about SA variations is clinically valuable; therefore, clinicians should be aware of the possible variation.


RESUMEN: Las variaciones en el músculo serrato anterior (MSA) son comunes. En este trabajo informamos una variación rara del origen muscular con una implicación clínica potencialmente importante. Encontramos una variación aberrante del MSA en un cadáver masculino, coreano de 81 años, durante una disección de rutina para estudiantes de medicina, con un fascículo adicional del MSA originado en la fascia clavipectoral y el músculo pectoral menor. Este fascículo se dirigió inferiormente y se fu- sionó con la parte común de MSA. El conocimiento preciso sobre las variaciones de MSA es útil clínicamente; por lo tanto, los médicos deben ser conscientes de esta posible variación.


Subject(s)
Humans , Male , Aged, 80 and over , Muscle, Skeletal/anatomy & histology , Anatomic Variation , Cadaver , Fascia
6.
Article in Chinese | WPRIM | ID: wpr-934242

ABSTRACT

Objective:To investigate the anatomical variation of the T3 sympathetic ganglia and its relationship with surgical outcomes in primary palmar hyperhidrosis.Methods:A total of 86 patients with primary palmar hyperhidrosiswho underwent R4 sympathicotomy from November 2017 to September 2018 were prospectively enrolled. The anatomical variation of T3 sympathetic ganglia was observed by fluorescence thoracoscopy. The therapeutic effect and side effect were followed up after operation.The relationship between T3 anatomical variation and postoperative effect was analyzed.Results:82.6% of T3 ganglion had no anatomic variation, 17.4% of T3 ganglion shifted down to the surface of the fourth rib or intercostal space. After 1 month of follow-up, the therapeutic effect was: overly dry 2.1%, dry 39.4%, mild moist 57.0%, moist 1.4% innormalside, and 13.3%, 53.3%, 33.3%, 0 in the variation side respectively. Mann- Whitney U test showed statistically significant difference between the two groups( P=0.004). After 1 year of follow-up, the effect was 0, 36.5%, 56.9%, 6.6% in normal side, and 0, 33.3%, 63.0%, 3.7% in the variation side respectively. There was no significant difference between the two groups by Mann- Whitney U test( P=0.869). Conclusion:Fluorescence thoracoscopy showed that the variation rate of the position of T3 sympathetic ganglion was 17.4%. Postoperatively, patients with the downshift variation of T3 sympathetic ganglion have drier hands in short-term follow-up.

7.
Int. j. morphol ; 40(2)2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1385619

ABSTRACT

SUMMARY: Azygos lobe is one of the most common pulmonary variations. Although numerous studies discuss to the clinical and surgical implications of anatomical variations, there are few investigations about this topic. The aim of this study was to discuss the anatomy of the pulmonary azygos lobe and its possible clinical and surgical correlations. In this systematic review, a total of 48 results were found between 1968 and 2020. After application of eligibility criteria, 16 articles were included to analysis. Our results showed there were no reports of surgery complications in azygos lobe presence. In all articles that described the anatomical variation, the pulmonary azygos lobe received tertiary segmental branches. Among the surgical implications in the presence of the azygos lobe, complications are of low complexity. It is necessary to teach about this anatomical variation in medical schools in cadavers. Emphasizing the obvious morphological modifications in the superior mediastinum.


RESUMEN: El lóbulo ácigos es una de las variaciones pulmonares más comunes. Aunque numerosos estudios discuten las implicaciones clínicas y quirúrgicas de las variaciones anatómicas, existen pocas investigaciones sobre este tema. El objetivo de este estudio fue discutir la anatomía del lóbulo ácigos pulmonar y sus posibles correlaciones clínicas y quirúrgicas. En esta revisión sistemática se encontraron un total de 48 resultados entre los años 1968 y 2020. Después de la aplicación de los criterios de elegibilidad, 16 artículos fueron incluidos para análisis. Nuestros resultados mostraron que no hubo informes de complicaciones quirúrgicas en presencia del lóbulo ácigos. En todos los artículos que describieron la variación anatómica, el lóbulo ácigos pulmonar recibió ramas segmentarias terciarias. Dentro de las implicaciones quirúrgicas en presencia del lóbulo ácigos, las complicaciones son de baja complejidad. En las escuelas de medicina es necesaria la enseñanza en cadáveres de esta variación anatómica, destacando las evidentes modificaciones morfológicas en el mediastino superior.

8.
Int. j. morphol ; 39(4)ago. 2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1385452

ABSTRACT

SUMMARY: The objective of this study was to consider the type of variation and to estimate the landmarks for localizing the pterion. One hundred twenty Thai dry skulls were selected randomly from the Forensic Osteology Research Center, Faculty of Medicine, Chiang Mai University. The distances of the parameters were measured via Vernier caliper. The sphenoparietal type is the most dominant in the Thai population with 88.75 %. In the male, the distance of the midglabella to the pterion was 9.94?0.64 mm The distance of the frontozygomatic suture to the pterion was 35.41?4.38 mm The distance of the zygomatic arch to the pterion was 39.39?4.69 mm and the distance of the mastoid process tip to the pterion was 86.88?4.44 mm In the female, the distance of the midglabella to the pterion was 9.27?0.63 mm The distance of the frontozygomatic suture to the pterion was 33.08?4.12 mm The distance of the zygomatic arch to the pterion was 33.08?4.12 mm and the distance of the mastoid process tip to the pterion was 83.62?5.16 mm. The pterion approach is the most popular method for neurosurgical procedures, and it provides anatomical variations in the pattern. The sphenoparietal type of pterion is the most common form and the stellate type of pterion is the least common form in Thai skulls. Sex influences the location of the pterion. These findings will be of importance to predict the pterion type in Thai skull and estimate the localization of pterion by using a bony landmark. Knowledge of the precise location of the pterion is an important landmark in the neurosurgical approach.


RESUMEN: El objetivo de este estudio fue considerar el tipo de variación del pterion y estimar los puntos de referencia para localizarlo. Se seleccionaron al azar 120 cráneos secos de individuos tailandeses del Centro de Investigación de Osteología Forense de la Facultad de Medicina de la Universidad de Chiang Mai. Las distancias de los parámetros se midieron mediante un caliper Vernier. El tipo esfenoparietal es el más dominante en la población tailandesa con 88,75 %. En el hombre, la distancia de la glabella al pterion fue de 9,94 ? 0,64 mm. La distancia de la sutura frontocigomática fue de 35,41 ? 4,38 mm La distancia del arco cigomático fue de 39,39 ? 4,69 mm y la distancia del ápice del proceso mastoideo al pterion fue de 86,88 ? 4,44 mm. En la mujer, la distancia de la glabella al pterion fue de 9,27 ? 0,63 mm. La distancia de la sutura frontocigomática al pterion fue de 33,08 ? 4,12 mm. La distancia del arco cigomático al pterion fue de 33,08 ? 4,12 mm y la distancia del ápice proceso mastoideo al pterion fue de 83,62 ? 5,16 mm. El abordaje del pterion es el método más utilizado para procedimientos neuroquirúrgicos y proporciona variaciones anatómicas en el patrón. El tipo esfenoparietal del pterion es la forma más común y el tipo estrellado del pterion es la forma menos común en los cráneos tailandeses. El sexo influye en la ubicación del pterion. Estos hallazgos serán importantes para predecir el tipo de pterion del cráneo en tailandeses y a la vez estimar su localización mediante el uso de un punto de referencia óseo. El conocimiento de la ubicación precisa del pterion es un hito impor- tante en el abordaje neuroquirúrgico.

9.
Article in Chinese | WPRIM | ID: wpr-942935

ABSTRACT

Objective: Due to its various anatomical variations and numerous branches, the gastrocolic vein trunk (Henle trunk) is the most common site to develop bleeding and other complications in laparoscopic right hemicolectomy for colon cancer. This study aims to investigate the role of ileocolic vein (ICV) joining with Henle trunk, a rare anatomical variation. Methods: A rare case whose ICV was newly found to involve in the formation of Henle trunk during laparoscopic resection of right hemicolon cancer was reported as right gastroepiploic vein+ right colic vein+superior right colic vein+ICV. This anatomical variation was confirmed by multi-slice spiral CT coronal two-dimensional reconstruction of right hemicolon angiography. The literatures about ICV participating in formation of Henle trunk were systematically searched from PubMed, The Cochran Library, CNKI net and Wanfang database, and the occurrence probability and composition of its anatomical variation were analyzed. Results: This was a 47-year-old female patient who underwent laparoscopic right hemicolectomy. When the vessels were dissected during operation, it was found that ICV did not accompany the ileocolic artery, but directly flowed into Henle trunk. Two-dimensional reconstructed CT images of right hemicolon vessels showed that the composition of Henle trunk was rarely varied, which was composed of right gastroepiploic vein, right colonic vein, superior right colonic vein and ICV. Five literatures were enrolled from literature retrieval. A total of 12 cases with ICV participating in the construction of Henle trunk were reported, with a probability of 0.27%-6.31% and 6 forms of the formation of Henle trunk. In this case, Henle trunk was made up of right gastroepiploic vein, right colonic vein, upper right colonic vein and ICV, which was reported for the first time. Conclusions: ICV involving in Henle trunk is a rare vascular variation, and this type of variation should be fully recognized. Careful dissection during operation is necessary to prevent intraoperative bleeding caused by improper operation.


Subject(s)
Anatomic Variation , Colectomy , Colonic Neoplasms/surgery , Female , Humans , Laparoscopy , Mesenteric Veins , Middle Aged
10.
Chinese Journal of Lung Cancer ; (12): 99-107, 2021.
Article in Chinese | WPRIM | ID: wpr-880245

ABSTRACT

BACKGROUND@#Lobectomy is the main treatment strategy for early lung cancer. However, there are many anatomical variations in the lungs, especially some pulmonary veins will deviate from the normal position, and even cross the border of lob to enter the adjacent lobes, which increases the difficulty and risk of lobectomy. This study aims to analyze the variation types and frequency of pulmonary translobar veins, and further investigate its clinical significance in lobectomy.@*METHODS@#This study retrospectively included 916 patients who underwent lung resection in our center from December 2018 to November 2019, and selected 310 patients who underwent enhanced chest computed tomography (CT) examination before surgery. Enhanced chest CT and three-dimensional computed tomography bronchography and angiography (3D-CTBA) of these patients were applied to analyze the types and frequency of translobar veins. Further, 48 cases of lobectomy whose operation areas involved translobar veins were further screened out of 916 surgical cases (Among them, the translobar veins of 36 subjects were cut off and the other 12 patients were reserved). The effect of two different treatments on remaining lung was observed by surgical video.@*RESULTS@#A total of 26 translobar veins patterns were identified with an overall incidence of 82.26%, much greater in the right than in the left lung (80.65% vs 11.94%). The major types (frequency >5%) in the right lung include: the VX2 (5.48%) that flows into the inferior pulmonary vein behind the intermediate bronchus, the V3b (58.39%) that converges the venous branches of the upper and middle lobe, the VX4 that flows into the V2 (13.23%) or V3 (12.58%) in the horizontal fissure, the VX4 (8.71%) or VX5 (7.42%) that flows into the left atrium beneath the middle lobe bronchus, and the VX6 that flows into V2 in the Oblique fissure. The major types in the left lung include the common trunk (9.36%) of the superior and inferior pulmonary vein, of which 4.84% are greater than 1 cm in length. Compared to the preserved group, circulatory function of the remaining lung was impaired in the severed group, with the impaired area failing to collapse long after ventilation is stopped, the incidence of postoperative hemoptysis (13.89% vs 0.00%) and pulmonary air leakage (19.44% vs 8.33%) increased, the postoperative hospital stay [(4.72±1.86) d vs (3.92±1.62) d] was longer, and the total drainage during 3 days after operation [(705.42±265.02) mL vs (604.92±229.64) mL] was more, but the difference is not statistically significant.@*CONCLUSIONS@#There are a variety of types of translobar pulmonary veins and some of them have a high incidence; However, most of the translobar veins were neglected in surgery, which could adversely affect the safety of surgery and the recovery of patients after surgery.

11.
Radiol. bras ; 53(6): 413-418, Nov.-Dec. 2020. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1136110

ABSTRACT

Abstract As they are asymptomatic or have a nonspecific, anatomical variations of the ribs are usually detected as incidental findings on imaging studies. They may be isolated changes or can be related to anomalies or clinical syndromes. Such variations are easily overlooked on conventional radiography and computed tomography if they are not actively investigated, mainly because most indications for a chest X-ray studies aim to evaluate the lung parenchyma and mediastinal structures. The objective of this pictorial essay was to use multislice computed tomography images to illustrate the imaging aspects of the main anatomical variations and congenital anomalies of the ribs.


Resumo As variantes anatômicas dos arcos costais são, geralmente, achados incidentais nos exames de imagem, em razão do seu comportamento assintomático ou quadro inespecífico, podendo constituir alterações isoladas ou relacionadas a anomalias e síndromes clínicas. Essas alterações são facilmente negligenciadas na radiografia convencional e na tomografia computadorizada se não forem investigadas ativamente, principalmente quando a maioria das indicações do estudo radiológico do tórax tem como objetivo a avaliação do parênquima pulmonar e das estruturas mediastinais. O objetivo deste artigo é demonstrar, por meio da tomografia computadorizada multidetectores, os aspectos de imagem das principais variantes anatômicas e anomalias congênitas dos arcos costais.

12.
Rev. bras. ortop ; 55(6): 764-770, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156206

ABSTRACT

Abstract Objective To analyze the anatomical variations of the motor branches of the radial nerve in the elbow region. The origin, course, length, branches, motor points and relationships with neighboring structures were evaluated. Materials and Methods Thirty limbs from15 adult cadavers were dissected and prepared by intra-arterial injection of a 10% glycerin and formaldehyde solution. Results The first branch of the radial nerve in the forearm went to the brachioradialis muscle (BR), originating proximally to the division of the radial nerve into superficial branch of the radial nerve (SBRN) and posterior interosseous nerve (PIN) in all limbs. The branches to the extensor carpi radialis longus muscle (ECRL) detached from the proximal radial nerve to its division into 26 limbs, in 2, at the dividing points, in other 2, from the PIN. In six limbs, the branches to the BR and ECRL muscles originated from a common trunk. We identified the origin of the branch to the extensor carpi radialis brevis muscle (ECRB) in the PIN in 14 limbs, in the SBRN in 12, and in the radial nerve in only 4. The branch to the supinator muscle originated from the PIN in all limbs. Conclusion Knowledge of the anatomy of the motor branches of the radial nerve is important when performing surgical procedures in the region (such as the approach of the proximal third and the head of the radius, release of compressive syndromes of the posterior interosseous nerve and radial tunnel, and distal nerve transfers) in order to understand the order of recovery of muscle function after a nerve injury.


Resumo Objetivo Analisar as variações anatômicas dos ramos motores do nervo radial na região do cotovelo. Foram avaliadas a origem, curso, comprimento, ramificações, pontos motores e relações com estruturas vizinhas. Materiais e Métodos Foram dissecados 30 membros de 15 cadáveres adultos, preparados por injeção intra-arterial de uma solução de glicerina e formol a 10%. Resultados O primeiro ramo do nervo radial no antebraço foi para o músculo braquiorradial (BR), que se origina proximalmente à divisão do nervo radial em ramo superficial do nervo radial (RSNR) e nervo interósseo posterior (NIP) em todos os membros. Os ramos para o músculo extensor radial longo do carpo (ERLC) se desprenderam do nervo radial proximalmente à sua divisão em 26 membros, em 2, nos pontos de divisão, em outros 2, do NIP. Em seis, os ramos para os músculos BR e ERLC originavam-se de um tronco comum. Identificamos a origem do ramo para o músculo extensor radial curto do carpo (ERCC) no NIP em 14 membros, no RSNR em 12, e no nervo radial em apenas 4. O ramo para o músculo supinador originou-se do NIP em todos os membros. Conclusão O conhecimento da anatomia dos ramos motores do nervo radial é importante quando se realizam procedimentos cirúrgicos na região, como a abordagem do terço proximal e da cabeça do rádio, a liberação das síndromes compressivas do nervo interósseo posterior e do túnel radial, as transferências nervosas distais, e para entender a ordem de recuperação da função muscular após uma lesão nervosa.


Subject(s)
Radial Nerve , Radius , Surgical Procedures, Operative , Wrist , Cadaver , Nerve Transfer , In Situ Nick-End Labeling , Elbow , Extremities , Forearm , Forearm Injuries , Glycerol , Head , Anatomy , Injections, Intra-Arterial
13.
Int. j. morphol ; 38(5): 1208-1211, oct. 2020. graf
Article in English | LILACS | ID: biblio-1134426

ABSTRACT

SUMMARY: Facial muscles are known to have a variable anatomy. Such anatomical variations can affect facial expressions. A natural smile is produced by contracting several muscles of facial expression, including the muscles invested in the superficial musculoaponeurotic system. Change in the width of the mouth on smiling is a known iatrogenic complication affecting the risorius muscle when using Botulinum Neurotoxin as a non-invasive treatment for masseteric hypertrophy. Also damage to the risorius muscle, with consequent clinical deficits, is a common surgical complication in facial aesthetic, oncologic and other head and neck procedures such as parotidectomy and rhytidectomy. Hence, a thorough knowledge of muscle anatomy, particularly its potential variations, is critical in reducing the associated operative morbidity. Accordingly, we report an unusual variation of the transversus nuchal muscle fused with the risorius muscle noted in an 83-year-old female body cadaver.


RESUMEN: Los músculos faciales tienen una anatomía variable. Tales variaciones anatómicas pueden afectar las expresiones faciales. Una sonrisa natural se produce al contraer varios músculos de la expresión facial, incluidos los músculos invertidos en el sistema musculoaponeurótico superficial. El cambio en el ancho de la boca al sonreír es una complicación iatrogénica conocida, que afecta el músculo risorio cuando se usa la neurotoxina botulínica como un tratamiento no invasivo para la hipertrofia masterérica. Además, el daño al músculo risorio, con los consecuentes déficits clínicos, es una complicación quirúrgica común en la estética facial, oncológica y otros procedimientos de cabeza y cuello, como la parotidectomía y la ritidectomía. Por lo tanto, un conocimiento profundo de la anatomía muscular, particularmente sus posibles variaciones, es crítico para reducir la morbilidad operativa asociada. En consecuencia, informamos una variación inusual del músculo transverso de la nuca fusionado con el músculo risorio, observado en un cadáver de cuerpo femenino de 83 años.


Subject(s)
Humans , Male , Aged, 80 and over , Facial Expression , Facial Muscles/anatomy & histology , Anatomic Variation , Cadaver
14.
Int. j. morphol ; 38(4): 845-852, Aug. 2020. graf
Article in English | LILACS | ID: biblio-1124864

ABSTRACT

Anatomical variations of the scalene muscles are frequent, as are those of the brachial plexus and its terminal nerves. Nonetheless, these variations are reported separately in the literature. The aim of this work is to present a variation of scalene muscles, concomitant with an abnormal path of the musculocutaneous nerve. During a routine dissection of the cervical region, axilla and right anterior brachial region in an adult male cadaver, a supernumerary muscle fascicle was located in the anterior scalene muscle, altering the anatomical relations of C5 and C6 ventral branches of the brachial plexus. This variation was related to an anomalous path of the musculocutaneous nerve that did not cross the coracobrachialis muscle. It passed through the brachial canal along with the median nerve. It then sent off muscular branches to the anterior brachial region and likewise, communicating branches to the median nerve. The concomitant variations of the brachial plexus and scalene muscles they are not described frequently. Knowledge of these variations improves diagnosis, enhancing therapeutic and surgical approaches by reducing the possibility of iatrogenesis during cervical, axillary and brachial region interventions.


Las variaciones anatómicas de los músculos escalenos son frecuentes, así como también las del plexo braquial y sus nervios terminales. Sin embargo la literatura científica las presenta por separado. El propósito de este trabajo es presentar una variación de los músculos escalenos concomitante con un trayecto anómalo del nervio musculocutáneo. Disección de rutina de región cervical, axila y región braquial anterior derechas realizada en un cadáver adulto de sexo masculino. Se encontró un fascículo muscular supernumerario para el músculo escaleno anterior que alteraba las relaciones anatómicas de los ramos ventrales C5 y C6 del plexo braquial. Esta variación estaba acompañada por un trayecto anómalo del nervio musculocutáneo, el cual no atravesaba al músculo coracobraquial y transitaba por el conducto braquial acompañando al nervio mediano. Desde allí enviaba a la región braquial anterior ramos musculares y al nervio mediano ramos comunicantes. Las variaciones conjuntas del plexo braquial y los músculos escalenos no se presentan con frecuencia. Conocerlas enriquece la capacidad diagnóstica, terapéutica y quirúrgica. Reduciendo la posibilidad de iatrogenia al intervenir en las regiones cervical, axilar y braquial.


Subject(s)
Humans , Female , Aged, 80 and over , Brachial Plexus/anatomy & histology , Musculocutaneous Nerve/anatomy & histology , Neck Muscles/anatomy & histology , Brachial Plexus/abnormalities , Cadaver , Dissection , Anatomic Variation , Musculocutaneous Nerve/abnormalities , Neck Muscles/abnormalities
15.
Rev. MVZ Córdoba ; 25(1): 98-102, ene.-abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1279660

ABSTRACT

RESUMEN Objetivo. El propósito de este estudio fue explorar la duplicidad de la arteria renal en un espécimen de Cerdocyon thous, centrándose en las posibilidades de la implicación clínico-quirúrgica de esta variación anatómica. Materiales y Métodos. Fueron disecados 32 especímenes de Cerdocyon thous, obtenidos de las colecciones del Laboratorio de Enseñanza e Investigación en Morfología de los Animales Domésticos y Salvajes del Departamento de Anatomía Animal y Humana, de la Universidad Federal Rural del Rio de Janeiro y del Laboratorio de Anatomía Animal de la Universidad Federal del Pampa. Resultados. Fue observada una variación numérica en la arteria renal izquierda en un cadáver hembra adulto. El riñón izquierdo tenía dos arterias renales, una craneal y otra caudal. La primera arteria renal del riñón izquierdo, midiendo 2,25 cm de longitud, se ha originado lateralmente desde la aorta abdominal a nivel de la tercera vértebra lumbar. Además, emanaba dos ramas prehiliares, una dorsal y otra ventral, con la rama ventral suministrando también a la glándula suprarrenal. La segunda arteria renal también se ha originado lateralmente desde la aorta abdominal a nivel de la tercera vértebra lumbar, midiendo 2,36 cm de longitud. También ha emitido dos ramas prehiliares, una craneal y otra caudal, las cuales emitieron la rama uretral. Conclusiones. Las variaciones numéricas de las arterias renales deben ser consideradas en la ejecución de procedimientos quirúrgicos, radiológicos y experimentales, con los fines de evitar errores ocasionados por la falta de conocimiento de la posibilidad de estas variaciones tanto en animales domésticos como salvajes.


ABSTRACT Objective. The aim of this study was explored the duplicity of renal artery in a specimen of Cerdocyon thous, focusing on the possibilities of clinical-surgical implication of this anatomical variation. Materials and methods. Were dissected 32 specimens of Cerdocyon thous, obtained from the collections of the Laboratório de Ensino e Pesquisa em Morfologia dos Animais Domésticos e Selvagens do Departamento de Anatomia Animal e Humana, da Universidade Federal Rural do Rio de Janeiro e Laboratório de Anatomia Animal da Universidade Federal do Pampa. Results. Were observed a numerical variation in the left renal artery in an adult female cadaver. The left kidney had two renal arteries, one cranial and another caudal. The first renal artery of the left kidney, measuring 2.25 cm in length, originated laterally from the abdominal aorta at the level of the third lumbar vertebra. Moreover, it emanated two pre-hilar branches, one dorsal and one ventral, with the ventral branch supplying also to the adrenal gland. The second renal artery also originated laterally from the abdominal aorta at the level of the third lumbar vertebra and measured 2.36 cm in length. It also emitted two pre-hilar branches, one cranial and another caudal, which emitted the ureteral branch. Conclusions. Numerical variations of the renal arteries should be considered in the execution of surgical, radiological and experimental procedures in order to avoid mistakes made due to lack of knowledge of the possibility these variations both in domestic and wild animals.


Subject(s)
Animals , Swine , Renal Artery , Urogenital System
16.
Rev. bras. ciênc. vet ; 27(1): 3-6, jan./mar. 2020. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1379086

ABSTRACT

O interesse pelo estudo de animais silvestres vem crescendo consideravelmente nos últimos anos, seja em decorrência do risco de extinção ou visando o controle de doenças, especialmente as zoonoses. A ordem Rodentia apresenta o maior número de espécies da classe Mammalia. Apesar de ampla distribuição e importância, dados sobre sua anatomia vascular renal são escassos na literatura. O objetivo deste artigo é relatar o aparecimento de variação numérica na artéria renal esquerda em Sphiggurusvillosus com enfoque nas possibilidades de implicações clínico-cirúrgicas, como, anastomoses cirúrgicas, estudos imaginológicos, nefrectomias e planejamento pré-operatório para redução de riscos e complicações como hemorragia. O cadáver foi devidamente formolizado no Laboratório de Ensino e Pesquisa em Morfologia de Animais Domésticos e Selvagens e posteriormente dissecado. O rim esquerdo apresentou três artérias renais, uma cranial, uma intermediaria e outra caudal, ambas posicionadas em nível de L2 emergindo de forma impar lateralmente da aorta abdominal. A primeira artéria, mais cranial, apresentou 10,52 mm de comprimento e se dirigiu diretamente para o hilo renal, emitindo ramo para adrenal, diafragma e musculatura sublombar. A segunda artéria, intermediária, mediu 7,77 mm, emitiu ramo cranial e caudal para o hilo renal e ramo ureteral. A terceira artéria, caudal, mediu 10,11 mm e se dirigiu para o hilo renal. A veia renal esquerda era única e apresentou 9,25 mm de comprimento, posicionada em nível de L1. Este é o primeiro relato de artéria renal tripla em mamífero silvestre.


Interest in the study of wild animals has grown considerably in recent years, either due to the risk of extinction or to control diseases, especially zoonoses. The order Rodentia has the largest number of species in the Mammalia class. Despite its wide distribution and importance, data on its renal vascular anatomy are scarce in the literature. The aim of this paper is to report the appearance of numerical variation in the left renal artery in porcupine focusing on the possibilities of clinical and surgical implications, such as surgical anastomoses, imaging studies, nephrectomies and preoperative planning to reduce risks and complications such as bleeding. The animal was duly formalized in the Laboratory of Teaching and Research in Morphology of Domestic and Wild Animals and subsequently dissected. The left kidney had three renal arteries, one cranial, one intermediate, and one caudal, both positioned at L2 level, emerging unevenly laterally from the abdominal aorta. The first more cranial artery was 10.52 mm long and directed directly into the renal hilum, emitting a branch to the adrenal, diaphragm and sub lumbar muscles. The second intermediate artery measured 7.77 mm, emitting a cranial and caudal branch to the renal hilum and ureteral branch. The third caudal artery measured 10.11 mm and headed straight for the renal hilum. The left renal vein was unique, measured 9.25 mm long, and positioned at L1 level. This is the first report of triple renal artery in wild mammals.


Subject(s)
Animals , Renal Artery/anatomy & histology , Renal Veins/anatomy & histology , Porcupines/anatomy & histology , Dissection/veterinary , Anatomic Variation , Kidney/anatomy & histology , Aorta, Abdominal/anatomy & histology , Animals, Wild/anatomy & histology
17.
Clinics ; 75: e1623, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133402

ABSTRACT

OBJECTIVES: To verify the pyramidalis muscle's frequency (bilaterality, unilaterality, or absence) and morphometry (length of the medial border and width of its origin/base) in a sample of the Brazilian population and the anthropometric influence. METHODS: Dissection of 30 cadavers, up to 24h post-mortem. RESULTS: The pyramidalis muscle was present bilaterally and unilaterally in 83.33% and 3.33% of the cadavers, respectively, and absent in 13.33%. The muscles on the right and left sides were symmetrical in length but not in width; the pyramidalis muscles of men were longer, while those of the women were wider. We also found that there was greater variation in the dimensions (length and width) of the men's muscles. Finally, in this sample of the Brazilian population, the pyramidalis muscle's unilaterality was more prevalent than in other populations, and its complete absence was less prevalent. CONCLUSIONS: There were no cases of muscle duplication in one or both sides, as described in some studies. Despite all of its morphometric variation, the pyramidalis muscle maintained its triangular shape with longitudinal fibers in every case. Furthermore, no statistically significant correlation was noted between the muscles' dimensions and person's age, height, weight, or gender.


Subject(s)
Humans , Male , Female , Adult , Abdominal Muscles , Brazil , Cadaver
18.
Clin. biomed. res ; 40(2): 144-145, 2020.
Article in English | LILACS | ID: biblio-1147984

ABSTRACT

Gallbladder duplication results from a rare abnormality of embriogenesis and is twice as common in women as in men. The signs and symptoms of double gallbladder cholecystitis are the same as those of single gallbladder cholecystitis: strong pain in the epigastric region and right hypochondrium, which may irradiate to the back and be accompanied by nausea and/or vomiting, Murphy positive sign, and pain on palpation of these regions; plastron may also be present. For this reason, many cases are still diagnosed intraoperatively, making surgery difficult and increasing the possibility of biliary tract injury. We report the case of a female patient with epigastric and dorsal pain for 4 days, which worsened with the ingestion of salty and fatty foods and was accompanied by nausea and vomiting. Physical examination showed a positive Murphy sign. A complete abdominal ultrasound examination showed gallbladder duplication, both lithiasic. Magnetic resonance cholangiography confirmed the duplication of the gallbladder and cystic ducts, with a single main biliary tract and acute lithiasic cholecystitis in both gallbladders. A laparoscopic cholecystectomy of both vesicles was performed without complications, and the patient was discharged 3 days after the procedure. (AU)


Subject(s)
Humans , Female , Adolescent , Gallbladder/abnormalities , Gallbladder Diseases/surgery , Gallbladder Diseases/diagnostic imaging
19.
Int. j. morphol ; 37(4): 1342-1346, Dec. 2019. graf
Article in English | LILACS | ID: biblio-1040135

ABSTRACT

The musculus sternalis is an anatomical variant that occurs in 3-8 % of the world population and its incidence is higher in women. It can be found unilaterally or bilaterally and is located in the anterior wall of the thorax, where its fibers run parallel to the sternum and superficial to the medial part of the pectoralis major muscle. The main objective of this study was to quantify the incidence of musculus sternalis in the population of Caldas (Colombia) and, therefore, 68 cadavers of adult individuals were used during a period of twenty years to determine the incidence of this muscle and describe its anatomical characteristics. Two cadavers had this muscle, which was equivalent to 2.94 % of the sample, where one was located unilaterally and in other bilaterally. In the case of unilateral presence, the muscle presented an oblique direction thatdoes not coincide with any subtype of the classification given for these muscles. In bilateral presentation, both muscles were continuous at their upper ends with the respective sternocleidomastoid muscle. In addition, the right musculus sternalis had a digastric shape, which also does not coincide with any subtype of the classification.


El músculo esternal es una variante anatómica que se presenta entre el 3 % y 8 % de la población mundial y su incidencia es mayor en mujeres. Puede hallarse de manera unilateral o bilateral y se localiza en la pared anterior del tórax, donde sus fibras corren paralelas al esternón y superficial a la región medial del músculo pectoral mayor. El objetivo del presente estudio fue cuantificar la incidencia del músculo esternal en la población de Caldas (Colombia). Fueron revisados 68 cadáveres de individuos adultos durante un lapso de doce años, con el fin de determinar el grado de presencialidad del músculo y sus características anatómicas. Dos cadáveres, que equivale al 2,94 % de la muestra, presentaron el músculo esternal, uno de manera unilateral y el otro bilateral, a los cuales se les hizo una descripción anatómica detallada. En la presentación unilateral, el músculo presentó una dirección oblicua que no coincide con ningún subtipo de la clasificación dada para estos músculos. En la presentación bilateral, ambos músculos se continúan por su extremo superior con el respectivo músculo esternocleidomastoideo. Además, el músculo esternal derecho tiene una configuración digástrica, que tampoco coincide con ningún subtipo de la clasificación.


Subject(s)
Humans , Male , Female , Pectoralis Muscles/anatomy & histology , Sternum/anatomy & histology , Cadaver , Colombia , Anatomic Variation
20.
Int. j. morphol ; 37(4): 1504-1508, Dec. 2019. graf
Article in English | LILACS | ID: biblio-1040161

ABSTRACT

A routine dissection of the digastric muscle reflected that it originated by two muscle bellies namely. the anterior and posterior belly which are connected by an intermediate tendon (IT). These bellies originated from the mastoid process of the temporal bone and the digastric fossa of the mandible respectively. The digastric muscle serves as an important surgical landmark in surgical interventions involving the submental area however, accessory bellies may interfere with surgical intervention in this area. Therefore, this study aimed to document the occurrence of the anatomical variations in the anterior belly of the digastric muscle (ABDM) in a selected number of cadaveric samples. Ten bilateral adult cadaveric head and neck specimens (n = 20) were macro-dissected in order to document the morphology of the digastric muscle. The accessory bellies in the ABDM was observed in 60 % of the specimens. Unilateral and bilateral variations were observed in 20 % and 30 % of the specimens, respectively. These accessory bellies originated in the digastric fossa, ABDM, IT and hyoid bone, and inserted into the mylohyoid raphe, mylohyoid muscle and hyoid bone. In addition, an anomalous main ABDM was observed in 10 % of the specimens inserting through a transverse tendon into the hyoid bone. Variations in the digastric muscle are common especially the accessory bellies, therefore, a comprehensive understanding of these anatomical variations could be of clinical importance to the surgeons during head and neck radiological diagnosis and surgical interventions.


Una disección de rutina del músculo digástrico refleja que se éste originaba por dos vientres musculares, anterior y posterior conectados por un tendón intermedio (IT). Estos vientres se originaban a partir del proceso mastoide del hueso temporal y de la fosa digástrica de la mandíbula, respectivamente. El músculo digástrico sirve como un hito quirúrgico importante en las intervenciones que involucran el área submental. Sin embargo, los vientres accesorios pueden obstaculizar la intervención quirúrgica en esta área. Por lo anterior, este estudio tuvo como objetivo documentar observaciones de las variaciones anatómicas en el vientre anterior del músculo digástrico (VAMD) en un número seleccionado de cadáveres. Las muestras consistieron en 10 cabezas y cuellos cadavéricos de individuos adultos, estudiadas bilateralmente (n = 20). Estas muestras fueron disecadas para documentar la morfología del músculo digástrico. Los vientres accesorios en el VAMD se observaron en el 60 % de los casos. Se observaron variaciones unilaterales y bilaterales en el 20 % y el 30 % de las muestras, respectivamente. Estos vientres accesorios se originaban en la fosa digástrica, VAMD, IT y hueso hioides, y se insertaban en el rafe milohioideo, el músculo milohioideo y el hueso hioides. Además, se observó un VAMD principal anómalo en el 10 % de las muestras que se insertaban a través de un tendón transversal en el hueso hioides. Las variaciones en el músculo digástrico son comunes, especialmente los vientres accesorios, por lo tanto, un conocimiento completo de estas variaciones anatómicas podría ser de importancia clínica durante el diagnóstico radiológico de cabeza y cuello y en las intervenciones quirúrgicas de la región.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Anatomic Variation , Neck Muscles/abnormalities , Cadaver , Neck Muscles/anatomy & histology
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