Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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Biography Historical Article
Charles Estienne (Carolus Stephanus) (ca.1504-1564): physician and anatomist.
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Regional anesthesia around the ankle joint is well suited to a large number of surgical procedures of the foot. Previous studies have alluded to the variable nerve distribution of the foot, which may result in incomplete blocks. The aim of the study was to determine the position of the nerves in relation to the ankle joint to easily identifiable bony and prominent soft tissue landmarks to aid more accurate targeting of these nerves. ⋯ The saphenous nerve was measured (gamma) from its medial border to the most anterior aspect of the medial malleolus on a horizontal plane. Factors such as sex, length, and ankle side were also analyzed concerning their influence on the position of the nerves. This study suggests that a greater degree of certainty may possibly be attained when palpable and easy to find bony landmarks are used to determine the position of the nerves around the ankle and ensure a simple to perform, predictable, and selectively targeted block.
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Chest drains are normally inserted in the fifth intercostal space in the mid-axillary line. The classical technique for chest drain insertion involves locating the drain in an interspace just superior to the inferior rib, so as to avoid the neurovascular bundle. ⋯ The idea that the neurovascular bundle is safely protected in the subcostal groove should be dispelled, as should the concept that there is nothing to damage in the zone immediately superior to the inferior rib. Clinicians should be aware that the Safe Zone is narrower than hitherto appreciated and should be between 50-70% of the way down an interspace to avoid the variably positioned superior intercostal neurovascular bundle and the inferior collateral artery.
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The pudendal nerve (S3-S5) is a major branch of the sacral plexus. After branching from the sacral plexus, the pudendal nerve travels through three main regions: the gluteal region, the pudendal canal, and the perineum. In the gluteal region, the pudendal nerve lies posterior to the sacrospinous ligament. ⋯ We also measured the average length of the pudendal nerve trunks before terminal branching to be 25.14 +/- 10.29 mm. There was no significant statistical difference in the average length, average diameter, number of trunks, and pudendal nerve variations between male and female or right or left sides of the pelves. A detailed study of pudendal nerve trunking in relationship to the sacrospinous ligament would be useful for instruction in basic anatomy courses and in relevant clinical settings as well.
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The purpose of this study was to quantify the spatial resolution of microscopic arteries on magnetic resonance images acquired at 8 Tesla (T). Techniques similar to those used for standard MRI of the human brain in vivo at 8 T were utilized to generate high-resolution gradient echo (GE) images of a whole postmortem human brain whose common carotid arterial system had been injected with an epoxy-resin. ⋯ There was excellent MR visualization of the microscopic cerebral arteries down to a spatial resolution of 200 microm. Through the use of an 8 T whole-body MRI scanner and standard GE imaging sequences, microscopic arterial structures can be clearly resolved down to a dimension of 200 microm.