The Distribution of the Nerves and Arteries of the Platysma for Clinical Applications.

This study aimed to provide anatomical data on the platysma for clinical procedures. The authors obtained 25 specimens from 15 adult Korean cadavers (9 men, 6 women; mean age, 72 years; range, 61-85 years). Lines connecting the gonion with the gnathion (G-GN) and the acromial end (acromial end of the clavicle) with the sternal end (sternal end of the clavicle) were used as references. Modified Sihler staining was used to trace the nerves distributed in the platysma. The superior border values of the platysma were 12.1 ± 2.7 mm, 31.5 ± 5.3 mm, 42.4 ± 5.6 mm, and 61.7 ± 6.4 mm, respectively, for sections 2 through 5 on the G-GN line. The inferior border values of the platysma were 83.6 ± 19.1 mm, 80.1 ± 14.0 mm, 74.8 ± 14.5 mm, 67.2 ± 13.7 mm, and 54.6 ± 7.1 mm, respectively, for the 5 sections on the acromial end of the clavicle-sternal end of the clavicle line. In the hyoid bone, cricoid cartilage, and jugular notch, the mean distance between the bilateral platysma was 14.4 ± 2.2 mm, 22.6 ± 10.6 mm, and 51.1 ± 15.7 mm, respectively. The mean angle at the cervical branch of the facial nerve and the anterior border of the sternocleidomastoid muscle sternal head was 28.7 ± 2.6 degrees and 53.4 ± 7.7 degrees from the G-GN line, respectively. The upper third of the platysma was supplied by branches of the facial artery and submental artery. The middle third was supplied by branches of the occipital artery and received its direct blood supply from branches of the external carotid artery. The lower third was supplied by branches of the transverse cervical artery. The authors hope that the results of this study will be helpful for rejuvenation procedures of the neck.

Thickness of the Deltoid Muscle and Location of the Anterior Branch of the Axillary Nerve and the Posterior Circumflex Humeral Artery for Deltoid Injections.

This study investigated the thickness of the deltoid muscle and the location of the anterior branch of the axillary nerve (AAN) and posterior circumflex humeral artery (PCHA), with the goal of maximizing the effectiveness of deltoid injections. Forty specimens from 22 adult Korean cadavers were used. A reference line was identified, connecting the anterior point of the deltoid muscle (AP) and the posterior point of the deltoid muscle (PP) on the surface. The midpoint between the AP and PP was used as the origin point (OP). The line connecting the OP and the lowest point of the deltoid tuberosity (DP) was used as the y-axis. The mean distance of the reference line from the AP to PP was 4.7 ± 0.7 cm. The vertical mean length of the deltoid muscle from the OP and DP was 16.1 ± 1.0 cm. At the 3, 5, and 7 cm sites, the thickness of the deltoid muscle was 0.62 ± 0.9, 0.73 ± 0.7, and 1.3 ± 1.1 cm, respectively. Most of the branches of the axillary nerve were concentrated in the third section (4-6 cm, 51%), while the branches of the PCHA were predominantly found in the fourth section (6-8 cm, 69%). The peripheral branches of the AAN entering the muscle were distributed between 2.2 and 9.8 cm from the acromion. The mean number of the peripheral branches of the AAN was 9.6 ± 3.4. In the deltoid muscle, the mean number of peripheral branches of the PCHA was 8.2 ± 2.8. Administering deltoid injections 5-6 cm below the OP is recommended to avoid axillary nerve injury.

Nerve and Arterial Supply Pattern of the Popliteus Muscle and Clinical Implications.

INTRODUCTION: The aim of this study was to investigate the nerve and artery supply and the tibial attachment of the popliteus muscle using anatomical methods. METHODS: Forty-four nonembalmed and embalmed extremities were dissected for this study. To measure the attachment area of the popliteus, the most prominent points of the medial epicondyle of the femur and the medial malleolus of the tibia were identified before dissection. A line connecting these two prominent points was used as the reference line, with the most prominent point of the medial epicondyle of the femur as the starting point. This study also investigated the area where the popliteus attaches to the bone and the points where nerves and arteries enter the popliteus muscle when it is divided into three equal parts in the coronal plane. RESULTS: The mean length of the reference line was 34.6 ± 2.1 cm. The origin of the popliteus was found to be at a distance of 16.6% to 35.2% on the tibial bone from the proximal region. The popliteus was innervated by only the tibial nerve in 90% of the cases and by the tibial and the sciatic nerves in the remaining 10% of the cases. The inferior medial genicular artery and the posterior tibial artery supplied blood to the popliteus in 90% and 65% of the cases, respectively. When the popliteus muscle was divided into three equal parts in the coronal plane, the nerve and the artery were found to enter the muscle belly in zones II and III and zones I and II in 92% and 98% of the specimens, respectively. Discussion. The anatomical investigation of the popliteus in this study will help identify patients with clinically relevant syndromes.

Relationship between the Branching Patterns of the Radial Nerve and Supinator Muscle.

The posterior interosseous nerve (PIN) innervates the posterior compartment muscle of the forearm and is a continuation of the deep branch of the radial nerve. The anatomic descriptions of PIN vary among different authors. This study investigated the distribution patterns of PIN and its relationships to the supinator muscle. This study investigated which nerves innervate the posterior compartment muscles of the forearm, the radial nerve, and the PIN, using 28 nonembalmed limbs. Also, the points where the muscle attaches to the bone were investigated. The measured variables in this study were measured from the most prominent point of the lateral epicondyle of the humerus (LEH) to the most distal point of the radius styloid process. For each specimen, the distance between the above two points was assumed to be 100%. The measurement variables were the attachment area of the supinator and branching points from the radial nerve. The attachment points of the supinator to the radius and ulna were 47.9% ± 3.6% and 31.5% ± 5.2%, respectively, from the LEH. In 67.9% of the specimens, the brachioradialis and extensor carpi radialis longus (ECRL) were innervated by the radial nerve before superficial nerve branching, and the extensor carpi radialis brevis (ECRB) innervated the deep branch of the radial nerve. In 21.4% of the limbs, the nerve innervating the ECRB branched at the same point as the superficial branch of the radial nerve, whereas it branched from the radial nerve in 7.1% of the limbs. In 3.6% of the limbs, the deep branch of the radial nerve branched to innervate the ECRL. PIN was identified as a large branch without divisions in 10.7% and as a deep branch innervating the extensor digitorum in 14.3% of the limbs. The anatomic findings of this study would aid in the diagnosis of PIN syndromes.

Morphological Boundaries of the Parotid Gland in Koreans.

ABSTRACT: This study aimed to examine the accurate location and boundary of the parotid gland in Koreans.Forty hemifaces from embalmed cadavers (mean age: 73 years) were studied. The line connecting the porion, gonion, and gnathion was used as a reference line. To measure the boundary of the parotid gland, the Frankfort horizontal line was used as the x-axis, whereas the vertical line passing through the porion was used as the y-axis. All measurements were taken from the lateral side of the face.The parotid gland has a variety of shapes: irregular, reverse triangle, and falciform. In all specimens, the boundary of the parotid gland was located 20 to 60 mm below the Frankfort horizontal line and located 10 mm anterior to the y-axis. On average, the most anterior and posterior distances of the parotid gland from the porion-gonion line were 36.4 ±â€Š13.9 mm and 20.1 ±â€Š10.5 mm, respectively, and the most inferior distance of the parotid gland from the gonion-gnathion line was 9.8 ±â€Š5.8 mm. All specimens of parotid glands were found within an area 20 to 40 mm below the Frankfort horizontal line and 10 mm to the left of the y-axis. The most anterior point of the parotid gland was observed at varying locations. The maximum value of the most anterior point was 61.26 mm; it rarely exceeded the ectocanthion. The most posterior points of the parotid gland were located between the mastoid process and sternocleidomastoid muscle.These results might be useful for preventing injury to the parotid gland during facial rejuvenation procedures.

The injection site in the tarsal tunnel to minimize neurovascular injury for heel pain: an anatomical study.

INTRODUCTION: The aim of this study was to investigate the location and distribution patterns of neurovascular structures and determine the effective injection point in the tarsal tunnel for heel pain. METHODS: Fifteen adult non-embalmed cadavers with a mean age of 71.5 years were studied. The most inferior point of the medial malleolus of the tibia (MM) and the tuberosity of the calcaneus (TC) were identified before dissection. A line connecting the MM and TC was used as a reference line. The reference point was expressed in absolute distance along the reference line using the MM as the starting point. For measurements using MRI, the depth from the skin was measured to inferior at an interval of 1 cm from the MM. RESULTS: The posterior tibial artery, lateral plantar nerve, and medial plantar nerve were located from 29.0 to 37.3% of the reference line from the MM. The distribution frequencies of the medial calcaneal nerve on the reference line from the MM were 0%, 8.60%, 37.15%, 37.15%, and 17.10%, respectively. The mean depth of the neurovascular structures was 0.3 cm. DISCUSSION: This study recommended an effective injection site from 45.0 to 80.0% of the reference line.