Useful Points of Geometry and Topography of the Lumbar Triangle for Transversus Abdominis Plane Block.

BACKGROUND: A new look at the topography of the lumbar triangle becomes a challenge for modern anesthesia. The aim of this study was to redefine the topography of the lumbar triangle for transverse abdominis plane block. MATERIAL AND METHODS: We explored 74 lumbar regions in 37 preserved cadavers (17 F and 20 M). RESULTS: The lumbar triangle was identified in 66 (89%) out of all explored cadavers' lumbar regions. The predominant triangle was the acute-angled shaped. It was identified in 39 (59%) out of all explored lumbar regions. The second type of dissected triangles had the obtuse-angled shaped. Most triangles of acute-angled shaped and obtuse-angled shaped (36) had medium surface (range from 3 cm2 to 6 cm2), which accounted for 55% of all dissected lumbar triangles. The mean surface of the lumbar triangle was 3.6±2.2 cm2. Based on other measurements, we demonstrated that the majority of the lumbar triangles (62 triangles) were beyond the posterior axillary line. CONCLUSIONS: According to the obtained results, the randomized searching for lumbar triangle should be limited to the area situated beyond of the posterior axillary line. The region situated anteriorly to the midaxillary line was defined in the study as the critical area for finding the lumbar triangle. Outcomes from the study revealed that the size and the location of the lumbar triangle as the gate for the transverse abdominal plane block may be responsible for difficulties encountered by anesthetists. Thus, establishing the area with the highest probability of localization of the lumbar triangle can improve both safety and efficiency of transversus abdominis plane block.

[Transverse abdominal plane - anatomical and clinical aspects]. / Przestrzen poprzeczna brzucha - aspekty anatomiczno-kliniczne.

In medicine spectacular progress can be observed at many stages, which sometimes requires the redefinition of already known anatomical structures. One of them is the transverse abdominal plane, which was the focus of anaesthetists. It was observed that anaesthetics introduced locally into this plane have similar power to a traditional epidural procedure or spinal anaesthesia. The concept of the trans- verse abdominal plane is a relatively new anatomical term which was introduced into clinical medicine by anaesthetists. Because of the potential performance of anaesthetic pro- cedures through access to the transverse abdominal plane, there has been a growing interest not only expressed by anaesthetists, but also anatomists who wish to explore new anatomical aspects of this plane. It is generally believed that anatomical studies will provide more information on this plane, which can contribute to a wider spread of this pro- cedure among anaesthetists.

[Assessment of sexual dimorphism of finger length ratio (2D:4D) ]. / Ocena dymorfizmu plciowego wskaznika dlugosci palców (2D:4D).

INTRODUCTION: Studies on many populations have shown that the length of the second finger (2D) compared to the fourth (4D), expressed as the finger length ratio (2D:4D), might be characteristic for sexual dimorphism. It was also found that the values of 2D:4D differ significantly between examined populations. It is thought that the value of 2D:4D is determined in early foetal life under the influence of genetic factors and the strong influence of sex hormones. It has been proven that the values of 2D:4D are related to, for instance, sexual orientation, and artistic and sporting ability. Recently, increasing interest in the clinical signifi- cance of finger length ratio in the diagnosis of somatic and mental disorders has been observed. For example, it was found that values of 2D:4D in individuals suffering from congenital adrenal hyperplasia or autism were significantly lower compared to healthy subjects. The aim of the study was to determine sexual dimor- phism in finger length ratio among representatives of the Polish population. MATERIALS AND METHODS: The study group comprised 115 people (57 females and 58 males). Anthropometric meas- urements were taken from the second and fourth finger of the right and left hands - from the point of dactylion (da) to pseudophalangion (pph) using analogue callipers. We calculated the significance of differences in 2D:4D between males and females separately for the right and left hands. RESULTS: In both hands mean 2D:4D values were lower in males than in females. The difference in the right hand reached the statistical significance level with p < 0.05. CONCLUSIONS: Among the subjects from the examined population the 2D:4D ratio shows trends characteristic for sexual dimorphism.