Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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We present a case of rectus sheath hematoma compounded by anterior abdominal wall haemorrhage. Its clinical and anatomical relationship is discussed.
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The application of ultrasound in the imaging of the neck has primarily focussed on anterior structures (e.g., thyroid gland). Structures located on the posterior aspect of the neck have received little attention. This study illustrates the capability of modern ultrasound equipment in visualising the musculoligamentous structures of the neck, particularly the paraspinal musculature. ⋯ Identification of key landmarks aided orientation and identification of structures. The internal architecture of the musculoligamentous structures of the cervical spine, especially the posterior neck muscles, was demonstrated well using ultrasound. Our study showed that modern ultrasound equipment is capable of producing clear images of the posterior cervical spine musculature and certain bony features.
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Determination of the safest distance the falciform ligament can be incised from its origin to the orbital apex. Measurement of the distance between the oculomotor foramen and the IV nerve in the lateral wall of the cavernous sinus. Evaluation of the optic strut as an accurate landmark between the intradural (subarachnoid) and extradural segment of the internal carotid artery (ICA). ⋯ The falciform ligament and the optic sheath should not be opened longer than 9 mm along the lateral optic nerve or injury to the IV nerve can occur. Starting at the oculomotor foramen, the opening of the cavernous sinus should be limited to 7 mm to avoid injuring the IV nerve. Finally, the optic strut can be a reliable bony landmark that separates the subarachnoid space and extradural compartments along the anterior and medial ICA.
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Citation and quotation errors are common in medical journals. We assessed the prevalence of those errors in gross anatomy journals, where articles often cite old anatomical studies. The study included 199 randomly selected references from articles published in the first 2001 issue of three major gross anatomy journals: Annals of Anatomy, Clinical Anatomy, and Surgical and Radiologic Anatomy. ⋯ Furthermore, 24% of the quotations were indirect references to a secondary, instead of original, source. There was no statistically significant difference in the rates of citation or quotation errors between the references published before or after the introduction of MEDLINE (chi2 test, P > 0.05) in 1963, and the prevalence of these errors in gross anatomy journals was similar to that found in other medical fields. A high proportion of major citation errors, a very high proportion of major quotation errors, and the substantial number of indirect quotations call for serious editorial action in anatomy journals.
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The safe and successful performance of a lumbar puncture demands a working and specific knowledge of anatomy. Misunderstanding of anatomy may result in failure or complications. This review attempts to aid understanding of the anatomical framework, pitfalls, and complications of lumbar puncture. ⋯ The procedure is by no means innocuous and anatomical pitfalls include inability to find the correct entry site and lack of awareness of structures in relation to the advancing needle. Headache is the most common complication and it is important to avoid traumatic and dry taps, herniation syndromes, and injury to the conus medullaris. With a thorough knowledge of the contraindications, regional anatomy and rationale of the technique, and adequate prior skills practice, a lumbar puncture can be carried out safely and successfully.