Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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The objective of this study is to review surgical anatomy of the trigeminal nerve. We also demonstrate some pictures involving the trigeminal nerve and its surrounding connective and neurovascular structures. Ten adult cadaveric heads were studied, using a magnification ranging from 3× to 40×, after perfusion of the arteries and veins with colored latex. ⋯ Because of its size and complexity, it is essential to have thorough knowledge of the nerve before diagnoses and treatment of the pathologic processes in the orofacial, temporomandibular, infratemporal, and pterygopalatine areas. The trigeminal nerve is encountered with imaging or surgery of the skull base surgery. Thus, a comprehensive knowledge of the anatomy of the trigeminal nerve is crucial for performing the surgical procedures without significant complication.
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Comparative Study
Similarities and dissimilarities of the blood supplies of the human sciatic, tibial, and common peroneal nerves.
The aim was to investigate the arterial supply of the sciatic, tibial, and common peroneal nerves. Thirty-six lower limbs of 18 human fetuses were studied. The fetuses had been fixed in buffered formalin and the blood vessels injected with barium sulfate. ⋯ The sciatic and tibial nerves are supplied by numerous arterial branches of different origins, which provide for collateral circulation. In contrast, the common peroneal nerve is most frequently supplied only by one elongated longitudinal blood vessel, a branch of the popliteal artery. Such a vascular arrangement may make the common peroneal nerve less resistant to stretching and compression.
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The ganglion impar is often overlooked as a component of the sympathetic nervous system. Despite its obscurity, this ganglion provides a pathway for neurons by accommodating postganglionic sympathetics, visceral afferents, and somatic fibers traveling to and from the pelvis. ⋯ The aim of this review was to provide a better understanding of the anatomy of ganglion impar, accounting for variation in size, shape, and location. In addition, the clinical importance and treatment modalities associated with the ganglion impar are outlined.
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Hypertrophy of abductor hallucis muscle is one of the reported causes of compression of tibial nerve branches in foot, resulting in tarsal tunnel syndrome. In this study, we dissected the foot (including the sole) of 120 lower limbs in 60 human cadavers (45 males and 15 females), aged between 45 and 70 years to analyze the possible impact of abductor hallucis muscle in compression neuropathy of tibial nerve branches. We identified five areas in foot, where tibial nerve branches could be compressed by abductor hallucis. ⋯ We also assessed whether estimation of parameters for the muscle size could identify patients at risk of having nerve compression due to abductor hallucis muscle hypertrophy. The interclass correlation coefficient for dorso-planter thickness of abductor hallucis muscle was 0.84 (95% CI, 0.63-0.92) and that of medio-lateral width was 0.78 (95% CI, 0.62-0.88) in the imaging study, suggesting both are reliable parameters of the muscle size. Receiver operating characteristic curve analysis showed, if ultrasonographic estimation of dorso-plantar thickness is >12.8 mm and medio-lateral width > 30.66 mm in patients with symptoms of nerve compression in foot, abductor hallucis muscle hypertrophy associated compression neuropathy may be suspected.
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The mylohyoid hiatus and hernia were discovered in the nineteenth century and were considered to explain the origin of the plunging ranula from the sublingual gland. This formed the rationale for sublingual sialadenectomy for the treatment of plunging ranula. However, a more recent, extensive histological investigation reported that hernias contained submandibular gland, which supported an origin of the plunging ranula from the submandibular gland and submandibular sialadenectomy for the treatment of plunging ranula. ⋯ Sublingual gland was identified in nine hernias and fat without gland in six. This investigation supports clinical and experimental evidence that the plunging ranula originates from the sublingual gland and may enter the neck through the mylohyoid muscle. It confirms the rationale of sublingual sialadenectomy for the treatment of plunging ranula.