Surgical and radiologic anatomy : SRA
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The authors measured the superior vena cava in the newborn by radiologic, anatomic and histologic methods and analysed the correlations between cross-sectional area and the biometric data. This method makes it possible to select the size of catheter for parenteral nutrition via the superior vena cava in relation to body-weight.
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In order to define the technical modalities of the so-called transgluteal approach to the hip, the authors studied the structure and topography of the anatomic features encountered in this approach. The gluteus medius, gluteus minimus and vastus lateralis muscles are anatomically continuous by way of their tendinous fibers. ⋯ The caudal neurovascular trunk of the space between the gluteus medius and vastus lateralis is situated at a distance of 3 to 5 cm from the greater trochanter. The practical surgical implications are discussed, particularly as regards the methods of dissecting the anterior margin of the transgluteal incision, exposure of the capsule and preservation of the neurovascular pedicle, with reference to concepts published previously in studies elsewhere.
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Ten normal human volunteers and 44 patients with pathology of the brainstem or cranial nerves were scanned using a. 3 Tesla permanent MR imaging system. MR images were obtained of the cranial nerves and brainstem using various spin-echo pulse sequences and scanning planes. 4 mm thick sections with .75 mm pixels on a 256 display matrix were used whenever possible. The normal MR images were correlated with thin section cryodissection specimens of fresh human cadavers. ⋯ Unlike CT, there is no beam hardening artifact from bone. T1 weighted images maximize brainstem-CSF contrast and are useful for demonstrating the external anatomy of the brainstem and cranial nerves. The T2 weighted images show internal brainstem anatomy, CSF within neural foramina, and highlight many pathological conditions.
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On the supposition that some "pseudocoxalgias" might be due to a neuralgia of the lateral rami leaving the subcostal and iliohypogastric nerves above the lateral edge of the iliac crest, the authors undertook an anatomic study of their pathways and pattern of distribution. These rami supplying the skin below the iliac crest, which they cross close together, the ramus arising from the subcostal nerve by perforating the internal and external oblique abdominal muscles, that arising from the iliohypogastric nerve a little lower, creating a bony groove palpable in thin subjects and transformed into an osseomembranous tunnel by the aponeurosis of these muscles. This arrangement may give rise to an entrapment syndrome. ⋯ That arising from the iliohypogastric nerve descends further, passing 3 to 5 cm anterior to the great trochanter. It ends either at this level or 8 to 10 cm below. This accounts for the distribution of the pain felt when there is irritation of this ramus.