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.

Differences in body composition of upper and lower limbs in elite taekwondo athletes / Diferencias en la composición corporal de los miembros superiores e Inferiores en atletas de taekwondo de élite

In this study, we analyzed the differences in body composition among athletes during different stages of their career Forty taekwondo athletes and 10 non-athletes (20 males and 30 females) with a mean age of 18.2 years (range, 15-23 years), a mean height of 173.4 cm, and a mean body weight of 64.8 kg were studied using dual energy X-ray absorptiometry and Biodex balance system. The bone mineral density of upper and lower limbs was higher among university athletes of both sexes than in high school athletes. The lean body mass of male athletes in the university was higher than in high school male athletes. By contrast, in case of females, the opposite results were obtained for the upper and lower limbs. Elucidation of the body composition according to career and sex of taekwondo athlete is worthwhile.

En este estudio, analizamos las diferencias de la composición corporal entre los atletas durante las diferentes etapas de su carrera. Se estudiaron cuarenta atletas de taekwondo y 10 no atletas (20 hombres y 30 mujeres) edad media de 18,2 años (rango, 15-23 años), una altura media de 173,4 cm y un peso corporal medio de 64,8 kg. Se utilizaron la absorciometría de rayos X de energía dual y el sistema de equilibrio Biodex. La densidad mineral ósea de las miembros superiores e inferiores fue mayor entre los atletas universitarios de ambos sexos, que en los atletas de educación secundaria. La masa corporal magra de los atletas varones en la universidad fue mayor que en los varones de la educación secundaria. Por el contrario, en el caso de las mujeres, se obtuvieron los resultados opuestos para las miembros superiores e inferiores. En conclusión se debe considerar un análisis de la composición corporal según la carrera y el sexo del atleta de taekwondo.

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.

Aging of the bony orbit in East Asians: a three-dimensional computed tomographic study.

PURPOSE: The purpose of this study was to evaluate age-related changes of orbital rim in Koreans and construct a reference data set for the aging phenomenon in Asians. METHODS: Data were collected from computed tomography (CT) scans of orbits and facial bones obtained from 107 Korean (55 males and 52 females) at intervals of 0.60 mm. Subjects was categorized according to sex and age as follows: young group (20-35 years) and old group (60 years and above). CT scans were reconstructed via three-dimensional (3D) modeling programs. The most lateral, medial, superior and inferior points of orbital rim were used as reference points. The orbital aperture area in each 3D model was measured using an analytical software program such as 3-Matic. RESULTS: The orbital aperture height showed no overall statistically significant difference (P > 0.05) with age in either sex. Changes were irregular with a combination of decrease and increased components. The mean change did not exceed about 0.1 mm. The orbital aperture area showed no significant change with increasing age in either male or female study populations. CONCLUSIONS: In this study, there was no significant enlargement of the orbital rim with increasing age in Koreans. The measurement data in the present study differ from previous studies involving White subjects, which revealed a significant increase in orbital aperture area.

Relationship of the lobular branch of the great auricular nerve to the tympanoparotid fascia: Spatial anatomy for salvage during face and neck lift.

To enable selection of a safer suspension site to use in face and neck lifting procedures, the spatial relationship between the tympanoparotid fascia and the great auricular nerve should be clarified. In this study, we aimed to elucidate the position of the tympanoparotid fascia and the pathway of the lobular branch of the great auricular nerve traversing the tympanoparotid fascia. Twenty hemifaces from non-preserved bequeathed Korean cadavers (5 males, 7 females; mean age, 77.0 years) were dissected to determine the great auricular nerve distribution close to the tympanoparotid fascia of clinical significance for face and neck lift procedures. We observed the tympanoparotid fascia in all specimens (20 hemifaces). The tympanoparotid fascia was located anteriorly between the tragus and intertragic notch. Regarding the spatial relationship between the tympanoparotid fascia and the great auricular nerve, we found the sensory nerve entering the tympanoparotid fascia in all specimens (100%), and the depth from the skin was approximately 4.5 mm; in 65% of the specimens, the lobular branch was found to run close to the tympanoparotid fascia before going into the earlobe. Provided with relatively safer surface mapping to access the tympanoparotid fascia free of the lobular branch of the great auricular nerve, surgeons may better protect the lobular branch by anchoring the SMAS-platysma flap and thread to the deeper superior and anterior portions of the expected tympanoparotid fascia.

Clinical Anatomy for the Innervated Pattern and Boundary of the Subdeltoid Bursa.

The aim of this study was to accurately identify the distribution of sensory nerve branches running to bursa with mesoscopic dissection and boundaries following the injection of gelatin into the bursa. Eighteen shoulders of 11 Korean soft cadavers (average age, 65 years; age range, 43 - 88 years) were dissected. The most prominent point of greater tubercle of the humerus (GT) was used as a reference point. The horizontal line passing through GT was used as the x-axis while the vertical line passing through the GT was used as the y-axis. Average distances of the anterior, posterior, superior, and inferior from the GT were 1.9±0.6, 2.4±1.3, 2.1±0.7, and 3.2±1.5 cm, respectively. In 15 cases of 18 shoulders, the anterior branch of the axillary nerve was distributed to the subdeltoid bursa that was running posteriorly. The muscular branch of the anterior and middle parts of the deltoid was distributed to the branch of nerve that was running into the subdeltoid bursa. A branch of the posterior cord of brachial plexus was distributed to the subdeltoid bursa that was running anteriorly in three cases. Most of the branches of the axillary nerve were distributed into the posterolateral area. The branches of the posterior cord of brachial plexus were distributed in the anterolateral area. These results might be useful for preventing residual pain on the anterior shoulder region following an injection for the relief of shoulder pain.

The distributed pattern of the neurovascular structures around clavicle to minimize structural injury in clinical field: anatomical study.

INTRODUCTION: The aim of this study was to determine the location and distribution pattern of neurovascular structures superior and inferior to the clavicle by detailed dissection. METHODS: Fifteen adult non-embalmed cadavers with a mean age of 71.5 years were studied. For measurements, the most prominent point of the sternal end of the clavicle (SEC) on anterior view and the most prominent point of the acromial end of the clavicle (AEC) were identified and divided five equal sections before dissection. A line connecting the SEC and AEC was used as a reference line. The surrounding neurovascular structures were investigated. RESULTS: The supraclavicular nerve was mainly distributed in the second and the third sections (distribution frequency: 41.30% and 30.43%, respectively) from AEC. Branches of the thoracoacromial artery were mainly distributed in the second, third, and fourth sections (distribution frequency: 21.15%, 26.92%, and 28.85%, respectively). Branches of the subclavian vein were mainly distributed in the third and fourth sections (distribution frequency: 23.26 and 30.23%, respectively). Distribution frequency of subclavian vein, subclavian artery, and brachial plexus ranged from 31.3 to 57.5%. DISCUSSION: When the clavicle was divided into five sections, there was relatively little distribution of neurovascular damage in the first section or the fifth section. This study reveals the average location of subclavian vein with artery and brachial plexus. Results of this study could be used as reference during surgery.

Innervation of subclavius muscle: an anatomical study / Inervación del músculo subclavio: un estudio anatómico

This study was aimed to provide accurate parameters to localize the nerve endings for subclavius muscle belly and to investigate the basic information on nerve innervations on subclavius muscle. Twenty-two adult non-embalmed cadavers (7 males and 4 females) with a mean age of 68.7 years (range, 43-88 years) were enrolled for the present study. For measurements, the most prominent point of the sternal end of the clavicle (SEC) on anterior view and the most prominent point of the acromial end of the clavicle (AEC) were identified as the reference point. A line connecting the SEC and AEC was used as a reference line. Among all the measured points, 92.2 % of the points were gathered from 40 to 60 distances on the reference line. In one male specimen, both the sides of the nerve to the subclavius were merged with the phrenic nerve. It is further hypothesized that the basic anatomical results about the nerve branching pattern will be helpful in the clinical field.

El objetivo de este estudio fue proporcionar parámetros precisos para localizar las terminaciones nerviosas correspondientes al músculo subclavio e investigar la información básica sobre la inervación de los nervios en el músculo subclavio. Fueron incluidos 22 cadáveres adultos no fijados (7 hombres y 4 mujeres) con una edad media de 68,7 años (rango: 43-88 años). Para las mediciones se identificaron como punto de referencia, el punto más prominente del extremo esternal de la clavícula (SEC) en la vista anterior y el punto más prominente de la parte acromial de la clavícula (AEC). Se utilizó una línea que conecta la SEC y AEC como línea de referencia. Entre todos los puntos medidos, el 92,2 % de los puntos se obtuvieron de 40 a 60 distancias en la línea de referencia. En un espécimen masculino, a ambos lados, el nervio del músculo subclavio se presentó fusionado con el nervio frénico. Además, se plantea la hipótesis de que los resultados anatómicos básicos sobre el patrón de ramificación nerviosa serán útiles en el campo clínico.

The Distribution Pattern of the Neurovascular Structures for Anterior Ankle Arthroscopy to Minimize Structural Injury: Anatomical Study.

INTRODUCTION: The aim of this study was to investigate entry points for anterior ankle arthroscopy that would minimize the risk of neurovascular injury. METHODS: Thirty-eight specimens from 21 Korean cadavers (age range from 43 to 92 years, mean age of 62.3 years) were used for the study. For the measurements, the most prominent points of the lateral malleolus (LM) and the medial malleolus (MM) were identified before dissection. A line connecting the LM and MM, known as the intermalleolar line, was used as a reference line. We measured 14 variables passed on the reference line. RESULTS: This study found that the nerves were located at 40.0%, 50.0%, and 82.0% of the reference line from the lateral malleolus. We also found that the arteries were located at 22.0%, 35.0%, and 60% of the reference line from the lateral malleolus. DISCUSSION: If all the variables are combined (nerves, arteries, and veins), then there is no safety zone for anterior portal placement. Therefore, we recommend that surgeons concentrate primarily on the arteries and nerves in the clinical setting.

Extended treatment for cigarette smoking cessation: a randomized control trial.

AIM: To test the potential benefit of extending cognitive-behavioral therapy (CBT) relative to not extending CBT on long-term abstinence from smoking. DESIGN: Two-group parallel randomized controlled trial. Patients were randomized to receive non-extended CBT (n = 111) or extended CBT (n = 112) following a 26-week open-label treatment. SETTING: Community clinic in the United States. PARTICIPANTS: A total of 219 smokers (mean age: 43 years; mean cigarettes/day: 18). INTERVENTION: All participants received 10 weeks of combined CBT + bupropion sustained release (bupropion SR) + nicotine patch and were continued on CBT and either no medications if abstinent, continued bupropion + nicotine replacement therapy (NRT) if increased craving or depression scores, or varenicline if still smoking at 10 weeks. Half the participants were randomized at 26 weeks to extended CBT (E-CBT) to week 48 and half to non-extended CBT (no additional CBT sessions). MEASUREMENTS: The primary outcome was expired CO-confirmed, 7-day point-prevalence (PP) at 52- and 104-week follow-up. Analyses were based on intention-to-treat. FINDINGS: PP abstinence rates at the 52-week follow-up were comparable across non-extended CBT (40%) and E-CBT (39%) groups [odds ratio (OR) = 0.99; 95% confidence interval (CI) = 0.55, 1.78]. A similar pattern was observed across non-extended CBT (39%) and E-CBT (33%) groups at the 104-week follow-up (OR = 0.79; 95% CI= 0.44, 1.40). CONCLUSION: Prolonging cognitive-behavioral therapy from 26 to 48 weeks does not appear to improve long-term abstinence from smoking.

Teres minor innervation and injection site / Inervación y sitio de inyección del músculo redondo menor

The aim of this study was to elucidate the injection point on the teres minor (TM) for effective injection. Thirty-two specimens from 16 adult Korean cadavers (10 males and 6 females, age ranging from 42 to 102 years) were used in the study. The reference line between the inferior point on the inferior angle of the scapula (IA) and the most prominent point on the acromial angle of the scapula (AA) on the surface were identified. The measurements expressed the two above-mentioned parameters as X and Y coordinates in relation to the reference line. The X coordinate was located at 128.1±10.4 mm (78.1±5.7 %) and the Y coordinate was located at 25.3±7.6 mm (15.5±4.8 %). The recommended site according to this can be used for injections in patients with TM stiffness.

El objetivo fue determinar el punto de inyección en el músculo redondo menor (MRM) para llevar a cabo una correcta inyección. Se utilizaron 32 muestras correspondientes a 16 cadáveres adultos coreanos (10 hombres y 6 mujeres, entre 42 a 102 años de edad). Se identificó en la superficie la línea de referencia entre el punto inferior en el ángulo inferior de la escápula (AI) y el punto más prominente en el ángulo acromial de la escápula (AA). Las mediciones expresaron los dos parámetros mencionados anteriormente como coordenadas X e Y en relación con la línea de referencia. La coordenada X se encuentra a 128,1±10,4 mm (78,1±5,7 %) y la coordenada Y estaba situada a 25,3±7,6 mm (15,5±4,8 %). El sitio recomendado de acuerdo a estos resultados se puede usar para preparaciones inyectables en pacientes con rigidez del MRM.

Morphological study of the occipital belly of the occipitofrontalis muscle and its innervation.

PURPOSE: Occipital belly (OB) of occipitofrontalis muscle (epicranius) is a muscle which covers the occipital part of the skull. The posterior auricular nerve (PAN) is the first extracranial branch of the facial nerve, which supplies the OB. The PAN is one of the structures used to identify the facial nerve during surgeries such as parotidectomy and mastoidectomy. In the present report, we provide detailed anatomical knowledge of the OB and its innervation. METHODS: Twenty-six hemifaces from 14 Korean cadavers were dissected. The mastoid tip, external occipital protuberance (EOP), a horizontal line that is parallel to the Frankfurt horizontal plane (x-axis), and a vertical line through the EOP (y-axis) were used as reference points and lines. RESULTS: The OB demonstrated a variety of features and was mostly asymmetrical. The muscle bellies were observed to angle toward the temporoparietalis muscle laterally, with the aponeurosis angled at approximately 55°-65°. The mean width and height were 60.9 ± 8.7 and 31.7 ± 7.5 mm, respectively. Muscle bellies were located at a mean distance of 7.1 ± 2.5 mm superior to the x-axis and 29.6 ± 6.4 mm lateral to the y-axis. The mean vertical distance from the origin of the PAN at the anterior border of the mastoid process (MP) to the mastoid tip was 6.1 ± 2.1 mm. The mean nerve angle between the PAN and the x-axis was 55.7° ± 6.8°. The entry point of the PAN that innervates the OB was positioned at a mean distance of 9.0 ± 3.5 mm superior to the x-axis and 79.0 ± 8.1 mm lateral to the y-axis. CONCLUSIONS: Understanding the morphometrical characteristics of the OB and its innervation may potentially improve surgical outcomes to assist in locating the posterior auricular branch of the facial nerve.

Neurovascular distribution within the abdominal head of the pectoralis major muscle: Application to breast and flap surgery.

The abdominal head of the pectoralis major (AHPM) is important in cosmetic and flap surgeries. Few studies have reported on its neurovascular entry points and distribution patterns. We aimed to determine the entry points and distribution patterns of the neurovascular structures within the AHPM. Thirty-two hemithoraxes were dissected, and the distribution patterns of the neurovascular structures were classified into several categories. The neurovascular entry points were measured at the horizontal line passing through the jugular notch (x-axis) and the midclavicular line (y-axis). The AHPM was innervated by the communication branches of the medial pectoral nerve (MPN) and the lateral pectoral nerve (LPN) in 78.1% of the specimens and of the MPN without the communication branches in 21.9%. All the LPNs had communication branches, which could be classified as independent in 46.9% of the samples, with the MPN in 21.9%, and with the LPN in 9.3%. The blood supply of the AHPM was composed of branches from the lateral thoracic artery (LTA) in 62.5% of the specimens, the thoracoacromial artery (TA) in 15.6%, and the LTA with the TA in 21.9%. The mean distance of the entry point was 6.3 cm ± 1.3 cm lateral to the y-axis, 8.1 cm ± 3.3 cm below the x-axis in the nerves, 6.5 cm ± 1.2 cm lateral to the y-axis, and 8.6 cm ± 3.0 cm below the x-axis in the arteries. This study defined the average neurovascular entry point and distribution pattern in detail using standard lines to enable the AHPM to be better understood.