Surgical and radiologic anatomy : SRA
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The aim of this study was to determine the morphometric variations from various reference points to decrease risks in orbital surgery. Sixty-two orbits obtained from 31 skulls of male adult Caucasians were measured with a millimetric compass. On the medial orbital wall, the midpoint of the anterior lacrimal crest was the reference point; from this point we measured distances of 23.9+/-3.3 mm, 35.6+/-2.3 mm, 41.7+/-3.1 mm and 6.9+/-1.5 mm respectively to the anterior ethmoidal foramen, posterior ethmoidal foramen, midpoint of the medial aspect of the optic canal and posterior lacrimal crest. ⋯ Furthermore, on the same wall, the distance from the posterior ethmoidal foramen to the midpoint of the superior orbital fissure was 14.6+/-2.8 mm. Finally, on the lateral orbital wall the frontozygomatic suture was the reference point. From this point distances to the midpoints of the fossa for the lacrimal gland, superior orbital fissure, lateral aspect of the optic canal and inferior orbital fissure were 17.5+/-2.1 mm, 37.7+/-3.6 mm, 44.9+/-2.5 mm and 33.4+/-3.1 mm respectively.
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The objective of this study was to determine the level of the aortic bifurcation in relation to the lumbar spine by MRI and the effect of lumbosacral anomalies on the aortic bifurcation. A prospective study of 441 patients was performed. Sagittal MR images of the entire spine were obtained along with the standard protocol for imaging of the lumbar spine. ⋯ There was no demographic variation of the aortic bifurcation in relation to age or sex. The aorta bifurcated at L4 in two-thirds of cases and was variably located in the remaining third. The stability of this as a landmark is disturbed by the significant high incidence of lumbosacral transitional segments.
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Comparative Study
The human lumbar anterior epidural space: morphological comparison in adult and fetal specimens.
To increase our understanding of the clinical anatomy of the epidural space, the human lumbar anterior epidural space was studied morphologically and developmentally. Histological transverse sections of human lumbar spines were taken at the level of the intervertebral disc and the vertebral body in adult specimens and in fetuses aged 13, 15, 21, 32 and 39 weeks (menstrual age). At 13 weeks, connective tissue filled the epidural space. ⋯ There were many more similarities between the adult and the 39-week fetus. In conclusion, some differences in the anatomy of the epidural space exist at each fetal stage studied. The structures of the epidural space are already formed in the fetus of 13 weeks, but they differentiate progressively within the connective tissue.
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This study of 88 adrenal venograms looked at the anatomical variations in the drainage of the principal adrenal veins. These were seen with a frequency of 5% on the right and 6% on the left. On the right, we have described ectopic anastomoses with the hepatic veins. On the left, the variations were always linked to an anomaly of the renal vein.
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The subvastus region and its anatomical contents are important when performing a total knee replacement via a subvastus approach. Thirty-two human cadaver thighs were studied to provide a detailed anatomical description of the subvastus region and its contents, namely the descending genicular artery and its branches, and the saphenous nerve proximally. In 24 specimens the descending genicular artery arose from the femoral artery and divided into osteoarticular and saphenous branches, while in eight specimens it was absent. ⋯ On the basis of these distribution patterns nine variations with regard to the number and origin of the muscular, musculoarticular and saphenomusculoarticular branches arising from these vessels could be identified. The musculoarticular branch should be preserved wherever possible; however, if it must be sacrificed to improve exposure of the knee joint via a proximal extension of the incision, the passage of the saphenous nerve and the saphenous branch through the vastoadductor membrane are additional structures which must be considered. The proximal limitation for the mobilisation is the adductor hiatus, with further mobilisation increasing the risk of damaging the femoral artery and vein.