Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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The common peroneal nerve (CPN) lies on the neck of the fibula, which forms the floor of the so-called 'fibular tunnel.' The tunnel entrance is a musculo-aponeurotic arch derived from the soleus and peroneus longus muscles and it is here that the CPN is commonly compressed in cases of peroneal nerve palsy. This study aims to define the relationship of the CPN and its branches to the apex of the head of the fibula and to the tunnel, with special regard to possible sites of entrapment. The distances from the apex of the fibula to the opening of the fibular tunnel, the CPN bifurcation, and the exit point of the deep peroneal nerve (DPN) from the tunnel, were measured in 30 legs to ascertain possible sites of entrapment. ⋯ The mean (+/-SD) distance from the apex of the head of the fibula to the opening of the fibular tunnel was 3.2 +/- 1.0 cm, to the CPN bifurcation was 3.8 +/- 0.9 cm, and to the DPN exit point was 7.0 +/- 1.5 cm. The mean angle subtended anteriorly from the long axis of the fibula by the CPN was 18.9 +/- 9.0 degrees. We recommend further study of the mean distances and reference angle in relation to fibular landmarks, for use in possible minimally invasive surgical procedures to decompress the fibular tunnel.
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The present article surveys the changes in the time allocated for the four disciplines in the anatomical sciences in the medical curricula of allopathic medical schools in the United States from 1967-2001. The results indicate that there was a great reduction in the laboratory portions, but not in the lecture portions of Gross Anatomy, Histology, Neuroanatomy, and Embryology. The greatest time reduction overall for the disciplines occurred between 1967-1973 (502 to 387 hr), followed by the time reduction between 1982-1995 (380 to 329 hr).
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A workshop in the clinical anatomy of the female pelvic viscera has been part of the training program for the first year residents in Gynecology and Obstetrics at the University of Padova since the 1999-2000 academic year. The purpose of the workshop is to offer a direct experience of practical anatomy despite a shortage of cadavers. It is designed for six residents who work in three teams on three specimens. ⋯ The unfixed viscera preserves the natural characteristics of the different tissues that exhibit the aspects of living organs, such as color, softness, and pliability, enhancing the knowledge of anatomy. The worksheet is structured as a guide to the anatomical basis of physical examination through inspection and palpation of the viscera. It also introduces the residents to the surgical anatomy of the female pelvis through a brief and selective dissection focused on the relationship between the different regional systems.
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A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. ⋯ Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases.