RESUMO
The frequency of injury of anterior cruciate ligament (ACL), the importance of anatomy in surgical repair and potential of the injured ACL to predispose to osteoarthritis necessitates the need for understanding its precise anatomy.Available studies have focussed on tunnel positioning and hence attachment site of the ligament. Few studies which have focussed on morphology reflect ambiguities in size, fibre bundle, number and disposition. Since a near anatomical repair of the ACL is the treatment of choice, the present study was planned to describe the morphology of ACL. Twenty-two ACL (11 right and 11 left) isolated from knee joints of collection of adult embalmed lower limbs were utilised for the study. The ACL morphology and morphometry were studied for footprints and fibre bundles. Three distinct bundles of differing lengths constitute a spiral ACL complex. These bundles are positioned as- intermediate with posteromedial and anterolateral flanking in respective positions. The tibial and femoral footprints are paw-shaped and oval respectively. Tibial footprints are approximately 2.5 times larger in area than the femoral footprints. The unique morphology of ACL vis a vis its spiralization, and its mechanical advantage of in terminal extension and conjunct rotation of knee (which are peculiarly human trait) are discussed. It is recommended to utilize the concept of spiralization and differing bundle length in ACL surgeries to achieve the favourable clinical outcome.
RESUMO
The frequency of injury of anterior cruciate ligament (ACL), the importance of anatomy in surgical repair and potential of the injured ACL to predispose to osteoarthritis necessitates the need for understanding its precise anatomy.Available studies have focussed on tunnel positioning and hence attachment site of the ligament. Few studies which have focussed on morphology reflect ambiguities in size, fibre bundle, number and disposition. Since a near anatomical repair of the ACL is the treatment of choice, the present study was planned to describe the morphology of ACL. Twenty-two ACL (11 right and 11 left) isolated from knee joints of collection of adult embalmed lower limbs were utilised for the study. The ACL morphology and morphometry were studied for footprints and fibre bundles. Three distinct bundles of differing lengths constitute a spiral ACL complex. These bundles are positioned as- intermediate with posteromedial and anterolateral flanking in respective positions. The tibial and femoral footprints are paw-shaped and oval respectively. Tibial footprints are approximately 2.5 times larger in area than the femoral footprints. The unique morphology of ACL vis a vis its spiralization, and its mechanical advantage of in terminal extension and conjunct rotation of knee (which are peculiarly human trait) are discussed. It is recommended to utilize the concept of spiralization and differing bundle length in ACL surgeries to achieve the favourable clinical outcome.
RESUMO
Advancement in imaging techniques and interventional cardiology procedures have generated renewed interest in anatomy of tricuspid valve complex. The purpose of the present study was to characterize the morphology of tricuspid valve leaflets using objective criteria. Thirty-six embalmed cadaveric hearts were utilized for the present study. Leaflet morphology was studied using newly defined criteria. Commissural zones were identified and leaflets were delineated. Presence of scallops was also recorded. Single leaflet was observed in six cases, double in 26 cases, and triple in four cases. The anterior leaflet is large with multiple scallops and frequently accrues portion of inferior leaflet. The septal leaflet is in the form of a plateau and also frequently accrues parts of inferior leaflet. The inferior leaflet rarely occurs as independent leaflet. A wide un-indented basal zone exists across the valve leaflets. The study found that the tricuspid valve is rarely tricuspid. It also generated the hypotheses that the tricuspid valve does not open completely due to presence of a wide basal zone and the valve does not close completely owing to incongruence and lack of coaptation of leaflets. The findings provide clear understanding of leaflet morphology of tricuspid valve. This will help imaging specialists for interpretation of images and cardiologists for interventional procedures. The findings also enhance our understanding of pathophysiology of conditions like functional tricuspid regurgitation.
Assuntos
Cadáver , Cardiologia , Coração , Pectinidae , Especialização , Insuficiência da Valva Tricúspide , Valva TricúspideRESUMO
During the strengthening and weakening procedures of intraocular muscles, distance of insertion from the sclerocorneal junction is an important determinant in the identification of muscles. During repositioning of the aponeurosis of the muscles, it is desired that the width should not change in order to avoid diversion of forces. Available anatomic studies on insertions of extraocular muscles are few, date back to early twentieth century and have been conducted on mostly white population. The present study is an attempt to document the insertions of recti and oblique muscles in Indian population. Forty eyeballs were removed from orbit. Insertion of recti and obliqui were cleaned and eyeballs were perfused with normal saline to regain the volume (hence shape and size) before recording observations. Insertion of recti and obliqui muscles were observed under various study parameters. The distance of insertion of recti from the limbus were found to be 7.3 mm, 8.06 mm, 8.71 mm, and 8.74 mm for medial, inferior, lateral, and superior rectus, respectively. The superior oblique was aponeurotic and found to be more variable in mode of insertion as compared to inferior oblique which had a fleshy and relatively constant insertion. The observations on insertion of recti and obliqui as obtained in present study differ from earlier studies to the tune of 1-1.5 mm. This may be attributed to adoption of method of reperfusion of eyeball before recording observations thus maintaining size close to in vivo. The observations are expected to be closer to actual.