Micro-Anatomy of the Brachial Plexus in a Cadaver with Ultrasound Correlation and Surface Videography in a Live Model

Objective: The aim of this paper is to report the incidences and provide a new classification of the various types of Cannieu-Riché Anastomosis (CRA).

Materials and methods: The anatomical dissections of 80 limbs from 40 fresh adult cadavers were performed in the Department of Anatomy of the Medical School of the Catholic University of São Paulo. Sixty hands were dissected from 1979 to 1983, and 20 hands were dissected from 2011 to 2015. In all subjects, both hands were studied. Careful dissections were performed under high magnification (with a surgical microscope) with special reference to the incidence of CRA

Results: CRA was found in all of the dissected hands (100%). We propose a new classification of CRA: Type I until Type XI, describing the communication between the recurrent branch of the median nerve and the deep branch of the ulnar nerve to the deep head of flexor pollicis brevis, which is the most common type of anastomosis and our others observations.

Conclusion: According to our study, CRA should be viewed as a normal anatomical neural connection and not as an anatomical variation. The knowledge of this anastomosis is essential because the presence of such neural communication can cause confusing clinical, surgical and electromyographical findings in cases of complete or incomplete median or ulnar nerve lesions or entrapment neuropathies

This report describes a long rectal duplication cyst found during routine dissection of an 82 year old male cadaver. The cyst was tubular, blind-ending and non-communicating. It emerged from the posterior rectal wall approximately 13cm superior to the anal verge and was 12cm in length. Long duplication cysts such as that described may cause complications such as perforation, bleeding and chronic pain. Hence duplication cysts should form part of the differential work up in a clinical setting.

Objectives: We sought to determine the utility of a low-cost simulator and brief educational session to help students understand midline neck anatomy and increase exposure to otolaryngology with an easily reproducible model.

Design: Pilot study including survey with lecture and hands on instructional lesson.

Methods: As part of the first-year medical student curriculum at our university, the otolaryngology department offers a workshop on head and neck anatomy and related components of the physical exam. Students participated in five 20-minute stations. One was devoted to neck anatomy with models of midline structures and a tracheostomy. Students completed a survey after the head and neck station.

Results: 182 students responded to the survey. Over 85% of participants felt the head and neck station and models helped them understand anatomy of the neck. Eighty-five percent of students responded the models helped them visualize what a tracheostomy would look like in a patient. Before the head and neck station, 16% of students agreed or strongly agreed that they had interest in ENT, Ear Nose and Throat surgery, as a career. After the station, that increased to 73% (p<0.05). Sixty-nine percent of students stated the tracheostomy models specifically increased their interest in otolaryngology

Conclusion: Simulation is a useful adjunct for teaching head and neck anatomy to medical students. Our workshop’s head and neck station, with lecture and simulation, strongly increased participant interest in otolaryngology and solidified relevant anatomy.

Introduction: The study objective was to assess lateral femoral cortex variants that may mimic prefracture findings of drug-associated atypical femoral fractures (AFF) among hip radiographs.

Materials and Methods: Bilateral hip radiographs of 1493 consecutive patients (mean age 67.7, 804 women) were reviewed. Hips were positive if localized lateral subtrochanteric femoral cortical thickening (LSFCT) was present. Positive studies were divided into a medication group if history of bisphosphonate or denosumab use was present or a variant group. The medication group was subcategorized into a prefracture group if classing beaking LSFCT or a contralateral AFF was presentor a non-prefracture group. The LSFCT width, femoral head and lesser subtrochanteric distances were measured. Analysis of Variance (ANOVA) was performed (p <0.01) to compare the three groups, with post hoc Tukey HSD evaluation. Cross-sectional imaging for each group was reviewed.

Results: Of the1493 exams, 1079 were included. In the 24 patients with LSFCT, 8 patients were assigned to the medication group and 16 to the variant group. Of the 8, 3 met criteria for the prefracture group and 5 were subcategorized to the non-prefracture group. Differences among the prefracture versus the non-prefracture and variant groups were statistically significant (p<0.01). Cross-sectional imaging of the correlated LSFCT with the third Trochanter posterolaterally in the variant group and laterally for the prefracture group

Conclusions: The third trochanter is an anatomic variant that may mimic prefracture findings of drugassociated AFF. The third trochanter can be differentiated radiographically from prefracture AFF findings with a < 3 mm width and < 3mm lesser subtrochanteric distance.

Introduction: The arteries of the posterior cervical triangle (lateral cervical region) are frequently used for flap design in plastic and reconstructive surgery. In particular, the musculocutaneous flaps, such as the flap of the lower trapezius and the dorsal scapular flap, are based on the integrity and functional availability of the dorsal scapular artery. Likewise, the cervico-dorsal and cervico-scapular flaps are based on the superficial cervical artery. We can assume that the mode of birth of these arteries - and the possibility of their origin directly from the subclavian artery - will have consequences on their vascular dynamics. These consequences can result in good or bad viability of the irrigated flaps. The objective of the present study was to highlight the birth modalities of the subclavian artery branches

Material and Methods: Dissection was performed in 58 anatomical regions from 32 non-formalin fixed cadavers. The cadavers had no history of surgery or deformity in the areas targeted for dissection (supraclavicular and dorsal regions). They were embalmed using a glycerin-rich, formalin-free solution to preserve tissue suppleness.

Results: The average age of the donors was 72.32 years (range, 34–90) and there were 21 males and 11 females. We find some similarities, with a predominance for types D (Cervico-scapular trunk from the thyrocervical trunk: 28%), A (Separate origin of superficial cervical, dorsal scapular, and suprascapular arteries: 19%), and C (Cervico-dorsal trunk from the subclavian artery: 15%).

Conclusion: There are many anatomical variations concerning the birth modalities of the collateral branches of the subclavian artery. Surgical teams should consider these variations when exploring the region of the lateral triangle of the neck.

Background: Anatomical teaching is going through several changes. Several studies observed that the students are deeming anatomy as outdated and irrelevant. The rates of lectures attendance and interest are declining. In this context, tools such as body painting, board games and team quizzes are appearing in the classroom to aid and motivate the student. Often, these complementary tools showed positive results towards their goals in the learning process of several branches of medicine. The smartphone has also been used for these purposes, although the literature lacks studies regarding anatomy. The study conducted herein aimed to create a pilot version of an anatomical application for the smartphone and disseminate its usage in nursing students

Methods: A smartphone application was self-produced with the tool known as Fábrica de Aplicativos© (https://fabricadeaplicativos.com.br) and consisted of anatomical terms and their meaning (Dictionary of Anatomy). The students had the opportunity to use this application during the semester and by the end of the period they answered a questionnaire with questions about the quality and efficacy of the app, with the option of submitting suggestions for its improvement.

Results: 100 graduation students were enrolled in this study. The overall evaluation of the dictionary was excellent/great (65%), while critics such as the lack of better images, the lack of a search resource and the lack of sections were pointed out.

Conclusion: As such, it was observed that the smartphone may have a positive effect in the learning process of anatomy, as demonstrated by our study

Multiseptate Gallbladder is a rare congenital abnormality, which can be totally asymptomatic or responsible for biliary pain in the absence of cholelithiasis or cholecystitis. In case of persistent symptomatology, cholecystectomy represents the treatment of choice

Steroid hormones and their metabolizing enzymes have previously been identified in the olfactory mucosa. Enzymes of the cytochrome P450 family that are thought to play a role in the metabolism or activation of airborne toxins have also been identified in mammalian olfactory mucosae. In the synthesis of steroid hormone, cholesterol is transported to the mitochondria where the side-chain cleavage enzyme (cytochrome P450scc) converts cholesterol into pregnenolone. Conversion of cholesterol to pregnenolone is an obligate step in steroid hormone production. The specific aim of this study is to identify cytochrome P450scc in the mammalian olfactory mucosae. Using polyclonal antibodies to cytochrome P450scc, we found immunoreactivity for cytochrome P450scc in the rat olfactory mucosa. Within the olfactory epithelium, the supranuclear region of sustentacular cells was immunoreactive for cytochrome P450scc. Olfactory neurons, basal cells, olfactory nerve axons and acinar cells of Bowman’s glands were unstained. In positive control tissue (adrenal glands), staining for cytochrome P450scc was seen in all layers of the adrenal cortex. The localization of cytochrome P450scc to sustentacular cells is consistent with a functional role for mitochondrial cytochrome P450scc in the production of olfactory mucosa-specific neurosteroids. These endogenous neurosteroids are most likely involved in the modulation of olfactory function

The glenoid cavity of the scapula shows high morphological variability that has not been clearly elucidated in the literature. Its morphological aspects knowledge can be used in the sex determination, to improve the development of more functional prostheses and in the accurate image diagnostic. The purpose of the present study was to analyze and compare sex and dominance differences in the articular surface of the human glenoid cavity. Anthropometric measurements of the glenoid cavities of scapula were taken of 200 specimens, besides we developed a morphological classification system according the shape of inferior and superior poles and the presence of the glenoid notch in the anterior margin. For all anthropometric parameters, the male scapula showed higher values than the measures in female scapula both in right and left sides, but we did not find a significant difference between the left and right scapula in either sex. On the other hand, taking into consideration the anthroposcopic aspects, 50% of male and 58% of female were classified in a different morphological group when compared to the contralateral glenoid in the same individual. The present study revealed an evident sexual dimorphism and provides information about the articular surface of normal glenoid cavities to improve the diagnosis of orthopedic lesions, to produce better prosthesis and to improve the medico-legal identification

Congestion control and red-black trees, while technical in theory, have not until recently been considered appropriate. In fact, few security experts would disagree with the construction of DHCP. Though it is regularly a practical goal, it is buffeted by previous work in the field. We introduce an analysis of IPv7, which we call Lakin.