Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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Communication between the lower thoracic paravertebral region and the celiac ganglion through the retrocrural space was investigated. After dye was injected into the endothoracic fascia in the lower thoracic paravertebral region at the T11 level, its spread to the celiac ganglion was examined in fifteen cadavers. The dye reached the celiac ganglion in nine cadavers (60%) by passing through the retrocrural space, along the greater and lesser splanchnic nerves and through the split in the crus of the diaphragm through which the splanchnic nerves traveled. ⋯ In three living subjects the spread of a radio-opaque dye injected in the same manner was studied using 3D-computed tomography. This study confirmed that the radio-opaque dye traveled toward the celiac ganglion along the crus of the diaphragm. From our results we suggest that a fluid communication may exist between the lower thoracic paravertebral region and the celiac ganglion in cadavers and in living humans and that clinicians should be aware of this possible route of spread when administering lower thoracic paravertebral anesthesia.
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Biography Historical Article
Sir Victor Alexander Haden Horsley (1857-1916): neurosurgeon and neuroscientist.
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There are inconsistencies between the descriptions of the physical connections between the spinal cervical dura and the surrounding tissues. This study was undertaken to clarify the relationship between the spinal dura, the nuchal ligament and the suboccipital muscles. Dissections were performed on embalmed cadavers: in nine the relevant structures were removed en bloc, whereas in one a sagittal section was prepared. ⋯ In addition, there was a connective tissue bridge between the deep aspect of the rectus capitis posterior minor muscle to the transverse fibers of the posterior atlanto-occipital membrane that extended laterally to blend with the perivascular tissue of the vertebral arteries. The present study is, we believe, the first to describe continuity between the nuchal ligament and the dura at the atlanto-occipital interspace, and confirms previous descriptions of similar connections at the atlanto-axial level. Knowledge of the exact attachments of the dura may contribute to understanding the biomechanics of the cervical spine and of the possible etiology of some types of cervicogenic headaches.
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Review Case Reports
Posterior dislocation of the sternoclavicular joint: a case report and review of the clinical anatomy of the region.
Posterior dislocation of the sternoclavicular joint is an uncommon injury. Since 1824, when Sir Astley Cooper described the injury, little more than 100 cases have been described, and the majority of these have been in the last decade, identified by computed tomography. The significant morbidity and mortality associated with this injury is based upon serious damage to important anatomical structures found in the vicinity of the joint. We present a case report, describe the relevant clinical anatomy of this region, and review associated complications.
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We investigated whether arteries pass superficial to veins or whether veins pass superficial to arteries at artery-vein crossings on the anterior, dorsolateral, and posterior surfaces of the human cerebrum. We examined a total of 2,266 artery-vein crossings on 40 sides of 20 cadavers. ⋯ Thus, vein (V), artery (A), and nerve (N), if we regard the cerebrum as nerve, were generally arranged in the order VAN from the superficial to the deep layers. This concept is important for a positional understanding of blood vessels on the cerebrum and it is useful for the understanding of fluid-drainage pathways from the cerebral cortex in various pathological conditions.