Aortic arch origin of the left vertebral artery: An Anatomical and Radiological Study with Significance for Avoiding Complications with Anterior Approaches to the Cervical Spine.

Complications from anterior approaches to the cervical spine are uncommon with normal anatomy. However, variant anatomy might predispose one to an increased incidence of injury during such procedures. We hypothesized that left vertebral arteries that arise from the aortic arch instead of the subclavian artery might take a more medial path in their ascent making them more susceptible to iatrogenic injury. Fifty human adult cadavers were examined for left vertebral arteries having an aortic arch origin and these were dissected along their entire cervical course. Additionally, two radiological databases of CTA and arteriography procedures were retrospectively examined for cases of aberrant left vertebral artery origin from the aortic arch over a two-year period. Two cadaveric specimens (4%) were found to have a left vertebral artery arising from the aortic arch. The retrospective radiological database analysis identified 13 cases (0.87%) of left vertebral artery origin from the aortic arch. Of all cases, vertebral arteries that arose from the aortic arch were much more likely to not only have a more medial course (especially their preforaminal segment) over the cervical vertebral bodies but also to enter a transverse foramen that was more cranially located than the normal C6 entrance of the vertebral artery. Spine surgeons who approach the anterior cervical spine should be aware that an aortic origin of the left vertebral artery is likely to be closer to the midline and less protected above the C6 vertebral level. Clin. Anat. 30:811-816, 2017. © 2017Wiley Periodicals, Inc.

Formaldehyde exposure and its effects during pregnancy: Recommendations for laboratory attendance based on available data.

Formalin is commonly used in fixation of cadaveric specimens. Exposure to formaldehyde, a component of formalin and a known carcinogen, during gross anatomy laboratory dissection is a continuing concern for pregnant students and instructors. Since there is little literature on this specific topic, the current review was compiled in the hope of offering recommendations to pregnant students and instructors who are engaged in human anatomical dissection where formalin is used. Relevant articles were obtained through searches of PubMed and Google Scholar for the terms "formaldehyde," "pregnant," "formalin," and "exposure." A literature search was conducted for chemical information and articles about exposure as issued by government regulatory agencies and chemical companies that produce formaldehyde. This led to the compilation of 29 articles each of which included references to previous, relevant, human research. The reviewed literature contains data strongly suggesting that pregnancy can be affected by formaldehyde exposure. Therefore, on the basis our analysis, female students who might be pregnant should avoid formaldehyde exposure, including that in a gross anatomy laboratory. Instructors should find other means of ensuring anatomical competence for these students.

Humphrey Ridley (1653-1708): forgotten neuroanatomist and neurophysiologist.

Humphrey Ridley is a little known character in the history of anatomy and physiology. Born in 1653, Ridley was a physician and anatomist who followed the research done by Willis, Vieussens, and Galen. Outside of a cursory knowledge of his birth and death, readers have only two remnants of his contributions to science: The Anatomy of the Brain, containing its Mechanism and Physiology and Observationes Quaedam Medico-Practicae et Physiologicae de Asthmate et Hydrophobia. The former text was the first book in the English language written on the human brain. Ridley's studies using cadavers executed by hanging provided him with a novel view of the venous drainage and lymphatic system not seen as accurately by those before him. Since the study of the brain was still largely in its infancy, he was not without his errors of deduction as to the purpose of parts of the brain and its pathologies. With his dissections, however, Ridley was able to build on the collective knowledge of neuroanatomy and provided new insight into brain structure and function. The current paper reviews what is known of Ridley's life and contributions to neuroanatomy and neurophysiology.

The intramuscular course of the greater occipital nerve: novel findings with potential implications for operative interventions and occipital neuralgia.

BACKGROUND: A better understanding of the etiologies of occipital neuralgia would help the clinician treat patients with this debilitating condition. Since few studies have examined the muscular course of the greater occipital nerve (GON), this study was performed. METHODS: Thirty adult cadaveric sides underwent dissection of the posterior occiput with special attention to the intramuscular course of the GON. Nerves were typed based on their muscular course. RESULTS: The GON traveled through the trapezius (type I; n = 5, 16.7%) or its aponeurosis (type II; n = 15, 83.3%) to become subcutaneous. Variations in the subtrapezius muscular course were found in 10 (33%) sides. In two (6.7%) sides, the GON traveled through the lower edge of the inferior capitis oblique muscle (subtype a). On five (16.7%) sides, the GON coursed through a tendinous band of the semispinalis capitis, not through its muscular fibers (subtype b). On three (10%) sides the GON bypassed the semispinalis capitis muscle to travel between its most medial fibers and the nuchal ligament (subtype c). For subtypes, eight were type II courses (through the aponeurosis of the trapezius), and two were type I courses (through the trapezius muscle). The authors identified two type IIa courses, four type IIb courses, and two type IIc courses. Type I courses included one type Ib and one type Ic courses. CONCLUSIONS: Variations in the muscular course of the GON were common. Future studies correlating these findings with the anatomy in patients with occipital neuralgia may elucidate nerve courses vulnerable to nerve compression. This enhanced classification scheme describes the morphology in this region and allows more specific communications about GON variations.

Guillaume Rondelet (1507-1566): Cardinal physician and anatomist who dissected his own son.

The 16th century French anatomist Guillaume Rondelet will be remembered as a great naturalist and a founder of ichthyology. Little known to most is that Rondelet was a proficient anatomist and contemporary to Vesalius and in fact, both studied anatomy under Johannes Guinter. Even less known is that he established the first dissecting theatre at Montpellier and it was here that he would dissect his infant son in an attempt to identify the cause of death. In this article, we review the life and contributions to anatomy of Rondelet.

Robert Liston (1794-1847): surgical anatomist and resurrectionist with an interest in hydrocephalus.

INTRODUCTION: The Scottish surgeon Robert Liston was an accomplished anatomist of the nineteenth century. The study of anatomy during this day was often overshadowed by the so-called resurrectionists. CONCLUSIONS: The present historic paper reviews the life and contributions of Robert Liston and discusses his fascination with childhood hydrocephalus.