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PURPOSE To determine the association between coracoacromial ligament (CAL) morphology and rotator cuff tears. MATERIALS AND METHODS The present study is a prospective cohort study based on the dissection of 172 shoulders from 86 (46 female, 40 male) formalin embalmed European Caucasian cadavers, with a median age of 82 years. The anatomy of CAL was examined, including its morphology and parametric measurements, while the rotator cuff tendons were inspected for the presence of tears. RESULTS Gross examination of the CAL in 155 shoulders revealed a variable number of bands as follows: 28 (18%) had one band, 56 (36%) two bands and 71 (46%) three or more bands. Inspection of the rotator cuff tendons showed the presence of tears in 77 (50%) shoulders, of which 37 (24%) were partial and 40 (26%) were full-thickness tears. Statistical analysis showed a significant association (P

Objectives: This study aims to describe variations of the third part of the axillary artery branches with respect to their diameter, origin, subsequent branches, and gender. Methods: One-hundred and forty cadaveric shoulders were examined bilaterally in the Centre for Anatomy and Human Identification, University of Dundee, which is regulated by Human Tissue Act (Scotland) 2006. Branches arising from the third part of the axillary artery were dissected and the diameter, origin, subsequent branching patterns of each branch were documented, as well as gender. T-tests and chi-square tests were used to determine the association between the variables. Results: The most common variations were associated with the posterior circumflex humeral artery (48.3%), followed by the anterior circumflex humeral (25%) and subscapular arteries (16.7%). Variations of the anterior circumflex humeral artery were more common in females than males (p

Objectives: Although the glenoid labrum is linked to glenohumeral joint stability, its anatomy remains controversial. This study aimed to investigate the shape, consistency of the glenoid labrum, and whether these and its thickness and depth are age related. Methods: A total of 140 shoulders were dissected to expose the glenoid labrum. the shape and consistency of the glenoid labrum were assessed at a gross level. Measurements were taken of the labrum depth and thickness, using callipers, in the superior, anterior, inferior and posterior regions. ANOVA and chi-square tests were conducted to determine statistical significance, which was set at p

Cadaver preservation methods impact their utilization in anatomical research and teaching. Thiel-embalmed cadavers show flexibility, however, the cause remains poorly understood. This study aimed to (1) describe qualitative and quantitative histological differences between Thiel-embalmed and formalin-fixed skeletal muscle and tendon tissue; (2) investigate whether boric acid in Thiel solution is solely responsible for modification of tissues; and (3) explore whether the modifications observed could potentially explain the mechanisms underpinning flexibility of Thiel cadavers. Skeletal muscle and tendon samples were harvested from mice preserved using formalin, Thiel solution, or modified-Thiel solution (without boric acid). Using standard HE formalin-fixed samples remained substantially more intact while Thiel-embalmed samples showed fiber fragmentation and lack of nuclei. The mean cell diameter of Thiel-embalmed muscle (24.4 μm) was significantly smaller (P < 0.005) than formalin-fixed muscle (40.7 μm). There was significantly greater (P < 0.005) fragmentation in Thiel-embalmed muscle (631.5 per 1 mm2 ) compared to formalin-fixed muscle (75.4 per 1 mm2 ). Samples embalmed using modified-Thiel showed a severe lack of integrity within internal tissue structure. This suggests that Thiel solution significantly alters tissue structure at cellular level, with quantitative data demonstrating measurable differences between Thiel and formalin-fixed specimens. While the precise mechanism for these alterations remains unknown, it is shown that boric acid is not the only component of Thiel responsible for degradation of internal tissue structure. Clin. Anat., 33:696-704, 2020. © 2019 Wiley Periodicals, Inc.

The key management of glenohumeral osteoarthritis is shoulder arthroplasty which aims to reduce pain and restore full shoulder function: it has increased in recent years. A detailed understanding of the anatomy of the glenoid and humeral head, as well as morphological changes of the glenoid in osteoarthritis, are important factors to consider when deciding on replacement components. This review begins with a brief introduction of the glenohumeral joint itself, and then considers the detailed anatomy of the glenoid fossa and humeral head, both of which are reported to have variable morphology. Several studies have been undertaken to assess various parameters, especially of the glenoid fossa including its shape, height, width, and articular surface area, version and inclination, in an attempt to define a standard classification that can be applied to surgical intervention. Nevertheless, no definitive consensus concerning the classification of these morphologies has been forthcoming, hence the need for this review. Following a consideration of these morphologies, the current state of knowledge regarding glenoid deformity in osteoarthritis, as well as its surgical management, is considered.

WOS: 000454335600026 The current study was undertaken to assess the incidence of different types of suprascapular notch, acromion dimensions and the lower and upper scapular angles. The suprascapular notch and variations of the acromion are clinically important in suprascapular nerve compression and subacromial impingement. Measurements were taken from 73 Anatolian dry scapulae of unknown age or sex. The suprascapuar notch was classified according to that of Rengachary et al. (1979). Its width and depth, the distance between supraglenoid tubercle and the deepest point of notch, as well as the upper and lower scapular angles were also determine measured. The type of acromion was assessed according to shape (type I (cobra), type II (square), type III (intermediate)) and tilt (type I (flat), type II (curve). Acromion length and the distance between acromion and coracoid process were also measured. The frequency of different types of suprascapular notch were type I (28.8 %), type II (23.3 %), type III (13.7 %), type IV (20.5 %), type V (2.7 %), type VI (5.5 %)and absence (5.5 %). Acromion type were type I (45.5 %), type II (7.5 %) and type III (47.0 %), acromion tilt type I (15.2 %), and type II (84.8 %). An understanding of the association between the anatomical structures of the scapula and morphometric measurements is clinically important.

The coracoacromial ligament (CAL) presents with variable morphology and plays a significant role in the development of subacromial impingement syndrome. Sectioning the CAL has been suggested to relieve impingement of the rotator cuff. The aim of the current study was to investigate the CAL attachment in relation with ligament morphology. The CAL was investigated in 220 cadaveric shoulders from 58 males and 59 females, with a median age of 82 years (range 53–102 years). CALs were classified according to three factors: (1) number of bands present; (2) shape; and (3) attachment to the acromial and coracoid processes. 35 (16%) CALs had a single band, 84 (38%) two bands, and 101 (46%) three or more bands. CAL shape was either broadband (14: 6%), quadrangular (21: 10%), Y-shaped (84: 38%), or multiple-banded (101: 46%). More ligaments were attached to the medial aspect of the acromion (60%) and medial end of the coracoid (75%) than those restricted to the anterior edge of the acromion (40%) and posterior aspect of the coracoid (25%). Multiple-banded ligaments attached significantly more medially at the acromion and coracoid processes, while single band ligament attachments were restricted to the anterior edge of the acromion and posterior aspect of the coracoid process. The CAL has variable morphology and attachments with interconnections to different structures around the shoulder. CALs with a medial acromial attachment may narrow the subacromial space leading to further shoulder impingement.

To compare the projectional surface anatomy of healthy individuals in an adult population with those with a thyroid mass, using computed tomography (CT). Sixteen slice CT images of 101 individuals were analyzed using a 32-bit Radiant DICOM viewer to establish the relationships among major anatomical landmarks in the neck and their vertebral levels. The structures investigated included: hard palate (HP), hyoid bone (HB) including body and lesser horns, soft palate (SP), thyroid gland (TG) (both superior and inferior poles), thyroid gland anteroposterior (APD) and superoinferior (SID) diameters, thyroid isthmus (TI) superoinferior dimension, epiglottis, vertebral arteries (right and left), and both right and left parotid glands (superior and inferior extents). The vertebral levels noted most frequently were: body of hyoid bone (C4, 42.71%); lesser horns of hyoid bone (C3, 36.46%); thyroid gland superior pole (C6, 31.25%); and thyroid gland inferior pole (T2, 30.2%). TG-ID, TG-APD, and TG-SID were not significantly different between males and females in the healthy group; however, there was a significant gender difference in thyroid gland inferior diameter in the pathology group [males 2.16(±1.16) vs. females 3.37(±1.30), P = 0.01, paired sample t-test]. Further studies are needed to determine whether neck pathology in those with a thyroid mass affects the dimensions of the thyroid gland. Moreover, the surface anatomy of the neck should be revisited using modern imaging techniques to address inconsistencies in anatomy and clinical reference texts. Clin. Anat. 30:781-787, 2017. © 2017Wiley Periodicals, Inc.

To compare key thoracic anatomical surface landmarks between healthy and patient adult populations using Computed Tomography (CT). Sixteen slice CT images of 250 age and gender matched healthy individuals and 99 patients with lung parenchymal disease were analyzed to determine the relationship of 17 thoracic structures and their vertebral levels using a 32-bit Radiant DICOM viewer. The structures studied were: aortic hiatus, azygos vein, brachiocephalic artery, gastroesophageal junction (GEJ), left and right common carotid arteries, left and right subclavian arteries, pulmonary trunk bifurcation, superior vena cava junction with the right atrium, carina, cardiac apex, manubriosternal junction, xiphisternal joint, inferior vena cava (IVC) crossing the diaphragm, aortic arch and junction of brachiocephalic veins. The surface anatomy of all structures varied among individuals with no significant effect of age. Binary logistic regression analysis showed a significant association between individual health status and vertebral level for brachiocephalic artery (P = 0.049), GEJ (P = 0.020), right common carotid (P = 0.009) and subclavian arteries (P = 0.009), pulmonary trunk bifurcation (P = 0.049), carina (P = 0.004), and IVC crossing the diaphragm (P = 0.025). These observations differ from those reported in a healthy white Caucasian population and from the vertebral levels of the IVC, esophagus, and aorta crossing the diaphragm in an Iranian population. The differences observed in this study provide insight into the effect of lung pathology on specific thoracic structures and their vertebral levels. Further studies are needed to determine whether these are general changes or pathology-specific. Clin. Anat. 30:227-236, 2017. © 2017 Wiley Periodicals, Inc.

Knowledge of variations in MF location, size and shape is important when anesthetizing nerves of the mandibular region in dental procedures. The location, shape and position of the MF were determined in 119 human mandibles of unknown age and sex from different KP medical institutions. Parameters determined were: MF length and width; accessory mental foramen (AMF) width; MF and AMF to midline (MF-ML) (AMF-ML), upper (MF-UM) (AMF-UM) and lower mandibular margins (MF-LM) (AMF-LM) and posterior border of the mandibular ramus (MF-PRM) (AMF-PRM). AMF position in relation to the MF was also noted. MF were mainly oval and situated below the second premolar. MF mean length and width were: 2.4 ± 0.89 (right) and 2.4 ± 0.727 mm (left), and 3.0 ± 0.80 (right) and 2.9 ± 0.94 mm (left) respectively. MF-ML, MF-UM, MF-LM and MF-PRM distances on the right and left sides were: 29.1 ± 2.19 mm and 28.1 ± 2.12 mm; 11.0 ± 3.99 mm and 11.2 ± 3.98 mm; 13.1 ± 1.83 mm and 12.8 ± 1.74 mm; and 69.3 ± 5.52 mm and 68.7 ± 5.02 mm, respectively. Double mental foramen (DMF) were observed on both sides (10.9 % right, 12.6 % left) with length and width 0.7 ± 0.42 mm and 0.9 ± 0.34 mm (right) and 0.8 ± 0.32 mm and 1.0 ± 0.47 mm (left): they were mainly oval (5.8 % right, 7.56 % left). DMF-MF distance was 8.9 ± 4.58 mm on the right and 6.6 ± 4.11 mm on the left. An oval accessory mental foramen was observed in one mandible. There was no difference between right and left MF; however differences in the parameters measured were observed in relation to other populations indicating the need to be aware of such differences when undertaking surgical procedures around the MF.

WOS: 000395669600033 Anatomical variations in terms of ligamentous attachments, articulations and bony morphology are common in the subtalar region. The shape of the articular facets of the talus and calcaneus and their relationship to each other are important for joint function and surgical procedures. In this study an assessment of the morphology of the articular facets of the talus and calcaneus, in an Anatolian population, was undertaken. 49 tali and 57 calcanei from Anatolian adults of unknown gender were examined. The types of articular facets on the talus and calcaneus were determined using the following classification: Type A1, the distance between the anterior and middle facets was less than 2 mm; Type A2, the distance between the anterior and middle facets was 2-5 mm; Type A3, the distance between the anterior and middle facets was more than 5 mm; Type A4, there was only one articular facet; Type B1, the separation between the anterior and middle facets was not complete; Type B2, separation of the anterior and middle facets was present; Type C, no separation between the anterior, middle and posterior facets was present, i.e. there was one articular facet. In addition, the anteroposterior length and width of the talus and calcaneus, together with the width, length and depth of sulcus tali and sulcus calcanei were determined. Left and right tali, respectively, displayed the folowing types of articular facet: A1, 0 %, 0 %; A2, 0 %, 3,4 %; A3, 0 %, 0 %; A4, 0 %, 0 %; B1, 60 %, 51,8 %; and B2, 40 %, 44.8 %. Articular facets on left and right calcanei, respectively, were: A1, 10 %, 7.4 %; A2, 10 %, 14.8 %; A3, 16.7 %, 11.1 %; A4, 3.3 %, 3.7 %; B1, 30 %, 22.2 %; B2, 30 %, 40.8 %. The length and width of left and right tali were 50.5 +/- 3.81 mm and 39.5 +/- 2.97 mm, and 53.1 +/- 4.38 mm and 39.3 +/- 3.66 mm, respectively. The width, length and depth of left and right sulcus tali were: 5.2 +/- 1.09 mm, 21.7 +/- 2.73 mm and 5.7 +/- 0.84 mm, and 6.1 +/- 2.05 mm, 21.1 +/- 3.66 mm and 5.7 +/- 1.52 mm, respectively. For left and right calcanei length and width were; 76.1 +/- 5.44 mm 44.0 +/- 3.97 mm, and 75.7 +/- 6.76 mm and 45.9 +/- 4.21 mm, respectively. The width, length and depth of left and right sulcus calcanei were: 6.4 +/- 1.19 mm, 31.9 +/- 2.76 mm and 4.0 +/- 0.81 mm, and 5.5 +/- 1.00 mm, 32.4 +/- 3.23 mm and 4.4 +/- 1.05 mm, respectively. The articular facets on both the talus and calcaneus in the Anatolian population studied was predominantly type B. This observations is similar to previous reports conducted in America, India and Africa, but differ from those undertaken in Europe. A knowledge of variations of the articular facets of the talus and calcaneus provides a valuable road map for orthopaedic surgeons, as well as others involved in foot rehabilitation.

To understand the geometry of the proximal humerus and glenoid fossa to facilitate the design of components used in shoulder arthroplasty. The aim is to evaluate the geometry of the proximal humerus and glenoid fossa and their relationship using a MicroScribe 3D digitizer. Scans and measurements were obtained from 20 pairs of dry proximal humeri and scapulae [10 female and 10 male cadavers: median age 81 years (range 70–94 years)] using a MicroScribe 3D digitizer and Rhinoceros software. Means (±SD) of humeral inclination, medial wall angle of the bicipital groove, and radius of the humeral head values were 135 ± 11°, 39 ± 19°, and 14 ± 3 mm, respectively. Means (±SD) of glenoid height and width were 35 ± 4 and 26 ± 4 mm, while the means (±SD) of the angles of glenoid inclination, retroversion, and rotation were 87 ± 32°, 96 ± 10°, and 9 ± 6°, respectively. A significant difference in glenoid height (P ≤ 0.002) and width (P ≤ 0.0001) was observed between males and females, despite them having almost an identical radius of the humeral head, glenoid inclination, retroversion, and angle of rotation. There was also a significant difference (P ≤ 0.01) in the angle of glenoid retroversion between the right and left sides. Using a MicroScribe 3D digitizer, the glenoid fossa was observed to be significantly smaller in females than males; furthermore, there was a difference in glenoid retroversion between the right and left sides.

Background: The height and width of the glenoid fossa is important in total shoulder replacement. Previous studies, using different methods, have reported differences in glenoid fossa height and width. The current study aims to provide the morphometric parameters of the glenoid fossa with the labrum attached. Material and Methods: One hundred and forty shoulders from 30 males and 40 females were dissected and measurements taken. Exposure of the glenoid fossa with the labrum attached was undertaken, followed by direct measurement of glenoid height, width and level of maximum width using digital calipers. Data were double-entered into the Statistical Package for Social Sciences (SPSS, version 21). Kruskal-Wallis and One Way Analysis of Variance on Ranks tests were used. Statistical significance was defined as p

Given the degree of variation in clavicular morphology, 4 clavicle plating systems were examined for their congruity as superior, midshaft, anatomic clavicle (SMAC) plates in a cadaveric study.SMAC plates from 4 manufacturers were applied to 79 dry right human clavicles. Two systems offered multiple (4) variations of plates (MP), 1 offered two variations (TP), and 1 had a single plate (SP). Two examiners applied and clamped the best-fitting plate from each system onto each of the 79 clavicles and then graded them: 1, poor fit; 2, good fit; and 3, anatomic fit. Each examiner repeated the process to assess intraobserver and interobserver reliability. The scores were averaged to produce a final score for each system for each clavicle.The MP systems scored the highest (32%-37% anatomic, 54%-63% good, 5%-8% poor), followed by the TP system (30% anatomic, 53% good, 17% poor), and finally the SP system (9% anatomic, 59% good, 32% poor). Of note, clavicular length significantly correlated with a higher degree of conformity in all plating systems (Spearman rank correlation P .05 for each system). In clavicles longer than 150 mm, the MP and TP systems performed identically, with the SP system close behind. Contouring of the plate is needed in 73% of cases overall.Plating systems with multiple plate shape variations are more advantageous when dealing with smaller-sized clavicles, typically in females. However, when dealing with larger clavicles, there was no real difference.

El objetivo de este estudio fue determinar la morfología del paladar duro para proporcionar directrices a los profesionales. Para dichos propósitos se midió el paladar duro de 63 cráneos de sexo y edad desconocidos, provenientes de una población del subcontinente Indio. Las medias y las desviaciones estándar de los siguientes parámetros fueron: anchura máxima del foramen palatino mayor, 2,3 ± 0,5 mm; anchura máxima del foramen palatino menor, de 0,9 ± 0,4 mm; anchura máxima del foramen incisivo, 4,08 ± 0,99 mm; distancia inter-alveolar de canino a canino, 23,5 ± 2,2 mm; distancia entre los forámenes palatinos mayores izquierdo y derecho, 27,6 ± 2,77 mm; anchura del paladar, 37,97 ± 3,32 mm; longitud palatal, 52,2 ± 3,2 mm; altura del paladar, 11,54 ± 2,4 mm; distancia entre el orificio palatino mayor a la base del hamulus pterigoideo, 8,7 ± 2,2 mm; distancia del foramen palatino mayor a la sutura maxilar mediana, 13,8 ± 1,5 mm; ángulo entre la línea media y la línea entre el foramen oral y el foramen palatino mayor, 16,45 ± 1,600. En esta investigación, los tipos más frecuentes de índice palatino e índice de altura paladar fueron el leptoestafilino y el ortoestafilino. Los Índices de asimetría oscilaron entre el 4,3 al 18,3%. El presente estudio proporciona datos morfométricos y cualitativos del paladar duro derivado de cráneos indios. El conocimiento de la posición y el diámetro de los forámenes palatinos es esencial para la aplicación de la anestesia localizada antes de realizar los procedimientos quirúrgicos. Además, los datos pueden ser útiles en la determinación de ascendencia del paladar duro. The purpose of this study was to determine hard palate morphology to provide guidelines for practitioners. This study measured the hard palate of 63 skulls of unsexed and unknown age from Indian subcontinent. The means and standard deviations of the following parameters were: greater palatine foramen maximum width, 2.3 ± 0.5 mm; lesser palatine foramen maximum width, 0.9 ± 0.4 mm; incisive foramen maximum width, 4.08 ± 0.99 mm; canine to canine intersocket distance, 23.5 ± 2.2 mm; distance between right and left greater palatine foramen, 27.6 ± 2.77 mm; palatal breadth, 37.97 ± 3.32 mm; palatal length, 52.2 ± 3.2 mm; palatal height, 11.54 ± 2.4 mm; greater palatine foramen to the base of medial pterygoid hamulus distance, 8.7 ± 2.2 mm; distance from greater palatine foramen to median maxillary suture, 13.8 ± 1.5 mm; angle between the midline and a line between the orale and the greater palatine foramen, 16.45 ± 1.600. The leptostaphyline and orthostaphyline were the most prevalent types of palatine index and palate height index in this study. Asymmetry indices ranged between 4.3 - 18.3%. The present study provides morphometric and qualitative data of the hard palate derived from Indian skulls. Knowledge of the position and diameter of the palatine foramina is essential in performing localized anaesthesia before surgical procedures. In addition, the data may be useful in ancestry determination using the hard palate.

En varios estudios se ha relacionado la vena safena magna doble con dilataciones varicosas. Durante una clase de disección de pre-grado de la extremidad inferior se encontró una doble vena safena magna unilateral en el miembro inferior izquierdo de un cadáver masculino. La incidencia de esta variación fue del 1,3% de todos los especímenes muestra. En este trabajo se reporta la variabilidad del drenaje venoso de las extremidades inferiores para mejorar la conciencia para los radiólogos vasculares y proporcionar además una opción adicional en la cirugía de bypass de la arteria coronaria para evitar las várices iatrogénicas. A double great saphenous vein has been associated with varicosity in a number of studies. During routine undergraduate dissection of the lower limb a unilateral double great saphenous was found in the left lower limb of a male cadaver. The incidence of this variation was 1.3% of all specimens. This paper reports the variability of lower limb venous drainage to increase the awareness for vascular radiologists and provide further an additional option in coronary artery bypass surgery to avoid iatrogenic varicosity.

Background The definition of the bare spot and tubercle of Assaki is controversial, with studies reporting different incidences, locations, and clinical significance. The aims of this study were to evaluate the incidence of the bare spot, to determine the length and width of the bare spot, and to assess the relationship between the bare spot and tubercle of Assaki. Materials and methods A total of 140 shoulders from 30 men and 40 women were dissected and examined. After exposure of the glenoid fossa with the glenoid labrum attached, direct measurement of the length and width of the bare spot was undertaken using digital calipers. The repeatability and reliability of the measurements was assessed using Kruskal-Wallis one way analysis of variance on ranks, with statistical significance set at P Results A bare spot was observed in 80.7% (n = 113) of shoulders, being more common in men than in women, with an overall mean length and width of 7.2 mm and 6.2 mm. It was significantly longer ( P = .002) and wider ( P = .018) in men. Conclusion A bare spot exists within the glenoid fossa and differs from the tubercle of Assaki. It is a characteristic round to oval lesion in the central or eccentric cartilage. It should not be misdiagnosed as a pathologic lesion.

Thiel embalming has been gaining a great deal of worldwide attention. Its long-lasting life-like quality enables multiple applications in surgical training programs. The standard process of Thiel embalming, which involves perfusion of embalming fluid in fresh cadavers through cannulation of the arterial and venous systems could be difficult in some areas of the world where fresh body donation rates are low or banned. This study will assess the ability to Thiel embalm fresh frozen mice as an animal model as a solution for the lack of fresh cadavers. The ability of Thiel embalming frozen tissue would enable areas in the world where they do not have access to recently diseased donated cadavers. The study was ethically approved King Fahad Medical City Institutional Review Board. The 20 Mice cadavers were ethically gained from the university of Dundee animal house. They were euthanized ethically by carbon dioxide. They were handled by following the university’s ethical code. The mice were split into 4 groups with 5 mice for each group, where group 1 is fresh unfixed. Group 2 standard Theil embalmed. Group 3 defrosted one-week frozen mice then standard embalmed. group 4 perfused with Theil fluid, frozen, defrosted then set in the embalming tank. The embalming validation tests were made by visual gross and histological changes in the gastric, renal and muscular tissue. These tissues were chosen to test the penetration of the embalming solution. The results show similarity in all groups with difference of internal gross changes in the pre-frozen cadavers. Histological changes were similar in all embalmed groups meaning that the embalming method has been successful from a histological point of view.

Although acromial morphology is classified as flat, curved, and hooked, whether the morphology is primary or acquired is debated. There have been no investigations on the effect of acromial spurs on acromial morphology. This study therefore aimed to evaluate acromial morphology in relation to spur formation at the anterior edge of the acromion. Acromial morphology was investigated in 40 scapulae taken from 20 cadavers (10 male and 10 female), with a median age of 82 years (range 62–97 years). Ink prints of the anteroposterior aspect of the acromion were used to evaluate acromial slope angle and curvature height in relation to spur incidence, length, and shape at the anterior edge of the acromion. Differences were observed in acromial morphology and acromial curvature in relation to acromial spurs (incidence, size, and shape). A hooked acromion was observed as a primary structure in 25% of specimens, which increased to 43% when acromial spurs were involved. No differences were observed in relation to sex or side, while a significant correlation was observed between acromial curvature and the age of the specimens. Acromial spurs increase acromial curvature and therefore change acromion morphology. Nevertheless, it is concluded that a hooked acromion occurs as a primary formed structure. Basic science study, anatomy, cadaver dissection.

Background:Although the glenoid labrum has an important role in shoulder stability, little is known about its composition, vascularity and innervation. The aims of this study were therefore to evaluate the histology, vascularity and innervation of the glenoid labrum.Materials and methods:Ten glenoid labrum specimens (three male, two female: mean age 81.2 years, range 76–90 years) were detached at the glenoid neck. Following decalcification, sections were cut through the whole thickness of each specimen perpendicular to the glenoid labrum at 12 radii corresponding to a clock face superimposed on the glenoid fossa. Then they were stained using haematoxylin and eosin, a silver nitrate protocol or subjected to immunohistochemistry using anti-protein gene protein 9.5 to demonstrate neuronal processes.Results:The labrum was fibrocartilaginous, being more fibrous in its free margin. There was a variable distribution of blood vessels, being more vascular in its periphery, with many originating from the fibrous capsule and piercing the glenoid labrum. Immunohistochemistry revealed positive staining of nerve fibres within the glenoid labrum.Conclusion:The glenoid labrum is fibrocartilaginous, being more fibrous in its periphery, and is vascularized, with the anterosuperior aspect having a rich blood supply. Free sensory nerve fibres were also present; no encapsulated mechanoreceptors were observed. The presence of sensory nerve fibres in the glenoid labrum could explain why tears induce pain. It is postulated that these sensory fibres could play a role in glenohumeral joint proprioception.

The ulnar nerve (UN) was classically described as supplying most of the intrinsic muscles of the hand, and the cutaneous innervation of the ulnar one and half digits, by dividing into superficial sensory and deep motor branches in Guyon's canal. Variations of this pattern have been reported in the literature. This study investigated the cutaneous distribution of the UN in the palm following the dissection of 144 cadaveric hands. The UN was examined and the distances from branching points of the superficial branch to the proximal edge of the pisiform were measured. The UN bifurcated (80.4%) into one deep trunk and one superficial trunk, which further divided distally into the proper digital (PDN) and common digital (CDN) nerves or trifurcated (19.6%) into one deep trunk, a PDN and a CDN in Guyon's canal. It received fibers from the median nerve in four cases and from the dorsal branch of the UN in six cases. A classification scheme based on the nerves contributing to the sensory innervation of the ulnar side of the palm was suggested. Understanding the cutaneous distribution of the UN in the palm and appreciating possible communicating branches can help clinicians to assess hand pathologies better and avoid injuries during surgical interventions.

Introduction: The present study is to provide comprehensive data concerning the morphology of brachial artery which has a clinical significance for clinicians, orthopedics, vascular surgeons and anatomists. Materials and Methods: Routine dissections of the right and left upper limb of 34 adult cadavers (20 male and 14 female: mean age 78.9 year) were undertaken. It investigates the characteristics of the brachial artery such as the internal diameter, external diameter, wall thickness and distance of bifurcation of brachial artery. Results: The mean of the external and internal diameters of the brachial artery from proximal to distal ranged from 6.87-5.35 mm respectively. The bifurcation of the brachial artery from the head of radius into its terminal branch radial and ulnar artery ranged from 13.49-13.79 mm, while the distance of bifurcation of common interosseous from origin of the ulnar artery ranged from 33.11-33.45 mm. The angle of bifurcation ofthe radial and ulnar arteries from the brachial artery ranged from 5.79-7.33° and 18.640-19.36° respectively. Due to variability of the brachial artery in the upper limb, the surgical and invasive procedures are performed in the region such as artiicial arterial-venous fistula become more difficult and may result in iatrogenic injury. Conclusion: Therefore, it is a clinical significant for surgeons to known the variable morphology and course of brachial artery to minimize surgical complication prior to operation.

The palmar communicating branch between the median and ulnar nerves was investigated in 98 hands with the aim of outlining its most common branching patterns and describing its relationship to well-defined anatomical landmarks, including the bistyloid line, wrist crease and flexor retinaculum. Five branching patterns were identified and classified based on their proximal and distal attachments. The palmar communicating branch was found to lie between 26%–79% of the total distance between the metacarpophalangeal joint of the long finger and the wrist crease, and 35%–75% of the total distance between the metacarpophalangeal joint of the long finger and the middle of the bistyloid line. With the aid of the morphometric indices obtained from this study, a risk area where the palmar communicating branch is most likely to be found is outlined. Knowledge of the branching patterns and location of the palmar communicating branch can help clinicians to better assess variations in the patterns of sensation, preserve the nerve during surgical interventions to the palm and better assess post-operative complications involving the branch.

WOS: 000438815300031 The aim of this study was to reveal the clinical importance of measurements taken from the pharyngeal tubercle (PT) to various anatomical structures around the extracranial clivus. Twenty-six adult dry Anatolian skulls were examined. The extracranial clivus and PT were used as landmarks from which various distances were measured using a digital caliper accurate to 0.01 mm. The following mean distances from the PT were observed; foramen lacerum (PL) (L: 17.15 mm, R: 17.4 mm): medial external margin of the carotid canal (CC) (L: 26.7 mm, R: 27.5 mm); anterior tip of occipital condyle (OC) (L: 16.4 mm, R: 16.3 mm); anterior margin of foramen magnum (FM) (10.8 mm); foramen ovale (FO) (L: 25.9 mm, R: 29.1); medial margin of the jugular fossa (JF) (L: 25.4 mm, R: 25.7 mm); medial external margin of the hypoglossal canal (HC) (L: 20.0 mm, R: 19.9 mm). Mean bilateral distances were: LFO-RFO: 45.34 mm; LFL-RFL: 20.1 mm: LCC-RCC: 52.1 mm; LOG-ROC: 17.6 mm: LJF-RJF: 45.2 mm: LHC-RHC: 33.5 mm. The following mean distances were observed from the FM: FM-OC (L: 8.3 mm. R: 9.3 mm); FM-HC (L: 17.8 mm, R: 17.4 mm). Also the mean distance of OC-HC were observed (L: 11.7 mm, R: 11.4 mm). Present measurements suggest that the PT can be used as an anatomical landmark during surgery involving clival pathology. However, the anatomy and variations of the extracranial clivus and surrounding structures must be taken into consideration.

Due to the close association between the superior thyroid arteries (STA) and external laryngeal nerve (ELN) one potential complication of thyroidectomy is trauma to the ELN. The aim of the current study was to evaluate variations in the origin of the STA and its relation to the ELN in 44 hemisections from 22 Thiel embalmed cadavers (9 male, 13 female: mean age 79 years). The STA arose from the external carotid artery in 31/44 (71%) specimens, the common carotid artery in 12/44 (27%) and was absent in 1/44 (2%) specimens. The ELN crossed the STA within 10 mm superior to the superior pole of the thyroid gland in 21/44 (48%) specimens, between 10 and 15 mm superiorly in 10/44 (23%) and more than 15 mm superiorly in 7/44 (16%) in 6/44 (13%) specimens the ELN did not cross the STA. A modified classification of the relationship between the STA and ELN is proposed in which a crossing point between 10 and 15 mm superior to the superior pole of the thyroid gland in introduced.

The sensory distribution in the dorsum of the hand was investigated in 150 formalin-fixed hands with the aim of outlining the most common innervation pattern of the superficial branch of the radial nerve (SBRN), dorsal branch of the ulnar nerve (DBUN) and the lateral antebrachial cutaneous nerve (LABCN). Although variable, the most common pattern found was SBRN innervation to the dorsal surface of the lateral 2½ digits and DBUN innervation to the dorsal surface of the medial 2½ digits. Dual innervation due to communicating branches or nerves overlapping was found in 41 cases. All-radial supply to the dorsum of the hand was found in ten cases. The LABCN was closely associated, and occasionally overlapped, with the SBRN. There were significant differences in the sensory distribution of the dorsum of the right and left hands of the same cadaver. The sensory distribution in the dorsum of the hand is variable; however, understanding the most common innervation pattern and appreciating the possible variations to this pattern is important to avoid errors in interpretation of conduction velocity studies, misdiagnosis of nerve pathology signs and symptoms and inappropriate treatments.

The lateral sacral artery usually originates from the posterior trunk of the internal iliac artery. The current study of 342 specimens from 171 cadavers (79 male, 92 female) investigated the origin and course of the lateral sacral artery. It was observed to arise from the posterior trunk in 79.1%. Occasionally it originated from the anterior trunk that occurred in 1%. It arose from the sciatic artery in 8.8%, from the superior gluteal artery in 16.8%, and from the inferior gluteal artery in 5.4%. Conversely, the lateral sacral artery is congenital absence in 0.3%. In addition, the lateral sacral artery was single, double, triple, and quadruple in 77.2%, 19.8%, 2.3%, and 0.3%, respectively. Consequently, variability of the lateral sacral artery origin is due to vascular demand as the lateral sacral artery plexus does arise from the earlier trunk development. With variability of the lateral sacral artery origin, there is a variability of the sciatic nerve supply. Knowing the variability of origins, surgeons have to avoid prolonged ligation of the internal iliac artery or its posterior trunk during surgical procedures which may lead to sciatic neuropathy. Therefore, the lateral sacral artery origin, course, and branches are important for clinicians to improve their knowledge and patient management.

Despite the major anatomical importance of the human ilium in medicine and forensic investigations, little is understood about its pattern of growth. This study was conducted to investigate the changes in the surface area of the human ilium from birth through to adolescence in 80 human ilia. A photographic image of the pelvic surface of each bone was taken and examined using an image quantification package. The surface areas of four regions of interest were quantified: the auricular, post-auricular (PA), iliac fossa, and whole pelvic surface of the ilium. The results highlight a rapid increase in surface area for all regions in the first few years after birth which continues, albeit at a slower rate, until ∼4 years of age when the rate of growth is further reduced. Although the ilium and its various components continue to grow between 5 years and puberty, the rate of growth is markedly reduced until puberty when growth of the pelvis again increases. Interestingly, analysis of the differential growth of the auricular region compared with the PA region throughout development suggests that the PA region exhibits more advanced growth. This may indicate that its role in structural development for the purposes of preparation and maintenance of bipedal stance and locomotion may have been previously poorly understood.

Respiration-related movement of organs is a complication in a range of diagnostic and interventional procedures. The development and validation of techniques to compensate for such movement requires appropriate models. Human cadavers embalmed with the Thiel method remain flexible and could provide a suitable model. In this study liver displacement during ventilation was assessed in eight Thiel embalmed cadavers, all of which showed thoracic and abdominal motion. Four cadavers displayed realistic lung behaviour, one showed some signs of pneumothorax after prolonged ventilation, one had limited filling of the lungs, and two displayed significant leakage of air into the thorax. A coronal slice containing the largest section through the liver was imaged with a real-time Fast Gradient Echo (FGR) MRI sequence: Craniocaudal displacement of the liver was then determined from a time-series of slices. The maximum liver displacement observed in the cadavers ranged from 7 to 35 mm. The ventilation applied was comparable to tidal breathing at rest and the results found for liver displacement are similar to values in the literature for respiratory motion of the liver under similar conditions. This indicates that Thiel embalmed cadavers have potential as a model for research and training in minimally invasive procedures.

In 2009, the Centre for Anatomy and Human Identification started Thiel embalming on a small scale to assess (i) the suitability for our current teaching in which long-lasting dissection courses are key, (ii) the potential for new collaborations and activities, and (iii) the practical implications of changing our embalming method from formalin to Thiel. Twenty six Thiel-embalmed cadavers have been used for dissection by staff and students on a taught MSc course, as a model for clinical and surgical training, and increasingly as a model for evaluation of new medical devices and procedures. Our experiences with dissection were mostly positive especially for teaching the musculoskeletal system. Internal organs handle differently from formalin-fixed organs and dissection manuals need to be adjusted to reflect this. Durability of the cadavers was not an issue, though changes are seen over time due to gradual fluid loss. We have started new collaborations related to postgraduate anatomy teaching and advanced training in surgical and clinical skills. In general, feedback is very positive and demand for cadavers outstrips our current limited supply. Thiel-embalmed cadavers were found to provide a unique opportunity for evaluation of medical products especially in areas where no suitable alternative model is available, and without the complications associated with clinical testing. This has resulted in new collaborations and research projects. As a result Thiel-embalmed cadavers are used for longer and for more activities than formalin cadavers: this requires changes in our procedures and staff roles.

Although later isolated injuries cruciate of the ligament (PCL) are managed through non-operative rehabilitation, reconstruction is becoming ITS anatomic increasingly important. This study Provides Information Regarding the position and variability of Its tibial attachment sites, dimensions of the femoral insertions, Between These Comparing males and females, and Between right and left knees. Thirty one cadaveric knees (15 right, 16 left) from nine female and seven male cadavers ( mean age 77 years) Were Examined. The PCL footprint Which was Identified from the mean length and width of the tibial anterolateral (AL) and posteromedial (PM) 8.7 and 10.9 mm Were bundles, and 7.3 and 13.44mm respectively. The mean length and width of the tibial footprint in males and females 10.2 and 10.3 mm Were, and 7.7 and 11.4 mm for the AL bundle and 8.2 and 14.2 mm and 12.9 mm and 6.7 for the PM bundle respectively. The mean anatomical position of the AL and 51.0% Were PM bundles and 50.0% of the mediolateral diameter of the tibial plateau. The mean lengths and widths of the PCL femoral attachment Were 9.4 mm and 12.8 for the AL bundle and 7.5 and 11.4 mm for the PM bundle, with the AL bundle attachment being Significantly larger (P = 0.034) in evils. No Difference between right and left knees Were Observed . The data presented here will aid in making decisions to Achieve Appropriate anatomic PCL reconstruction. , Although isolated lesions of the posterior cruciate ligament (PCL) are Treated by non-operative rehabilitation, anatomical reconstruction've Become increasingly important. This study Provides information on the position and variability of the binding sites of the tibia, the dimensions of the femoral insertions, Comparing them Between the sexes, and Between the right and left knee. They Were Examined thirty-one (15 right and 16 left knees) of 9 women and 7 dead bodies of males (mean age 77 years). Brand LCP was Identified from the length and width anterolateral and posteromedial (PM) of the tibia (AL) Were the results 8.7 and 10.9 mm, and 7.3 and 13.44mm respectively. The average length and width of the mark of the tibia in the male and female Were 10.2 and 10.3 mm and 7.7 mm and 11.4 for fiber AL, 8.2 and 14.2 mm and 6.7 mm and 12.9 for PM, respectively fiber. The average anatomical position of the tendons AL and PM Were 51.0% and 50.0% of the mediolateral diameter of the tibial plateau. Half lengths and widths of the PCL femoral insertion Were 9.4 and 12.8 mm for the tendon AL and 7.5 and 11.4 mm for the PM tendon, tendon insertion site AL was Significantly higher (P = 0.034) in men. no Difference Between the right and left Knees Were Observed. The data presented here will help in the decision-PCL suitable for anatomical reconstruction decisions.

The azygos venous system is highly variable in terms of its origin, course, communications, tributaries and termination of the associated veins: this study aimed to classify these anatomical variations. Thirty Thiel-embalmed cadavers aged 48­98 years (18 female, 12 male) were examined. The vertebral level of termination and diameter of the azygos, hemiazygos, accessory hemiazygos and the left superior intercostal veins were determined, as well as the termination level of the right superior intercostal vein. The azygos system was classified into 3 types; primitive (type 1), transitional (type 2) and unicolumnar (type 3). Type 2 was further divided into 5 subgroups (A to E) according to the number of retroaortic communications. Type one was observed in 3 % (n=1), type 2 in 87 % (n=26) and type 3 in 10 % (n=3) of specimens. The vertebral level of termination of the azygos, hemiazygos, accessory hemiazygos, right superior intercostal and left superior intercostal veins were between T2 and T3, T6 and T10, T5 and T9, T2 and T4, and T2 and T4 respectively. Identification and understanding these variations are important during preoperative radiological investigations and surgical procedures, especially spinal surgery between T7 and T12 using a left thoracotomy approach, to avoid injuries which may lead to postoperative hematomas.

This study investigated the haptic 'dissection' of a digital model of the hand and wrist in anatomy education at both undergraduate (UG) and postgraduate (PG) levels. The study ran over five successive years and was split into three discreet phases. Phase one compared the results of PG students across control, non-haptic and haptic groups. Phase two compared the results of UG students between control and haptic groups. Phase three compared the results of UG students across control, non-haptic and haptic groups. Results for all phases indicate that use of the model, both through haptic and non-haptic interfaces produced some significantly improved test results. The non-haptic group performing the strongest overall indicating that the addition of haptic feedback may not be beneficial to student learning.

Objetivo: El propósito del presente estudio es evaluar la geometría del acromion en relación con las ruptura del manguito de los rotadores. Materiales y métodos: Se utilizaron 30 pares de escápulas, 20 del sexo femenino y 10 del sexo masculino, con una edad promedio de 82 años (con intervalo de 62 a 101 años). Las escápulas fueron escaneadas y las mediciones se realizaron con un digitalizador Microscribe 3D y el software de rinoceronte. Principales Resultados: La media encontrada para el ángulo de inclinación acromial y la vertiente fueron 38,70 ± 5,91° y 48,87 ± 9,94° respectivamente. La media de los ángulos acromial lateral y acromio-glenoideo fueron 81,13 ± 8,72° y 182,80 ± 12,09°, respectivamente. Las distancias entre el acromial (la extremidad anterior y posterior) y el glenoideo fueron 28,7 ± 3,77 mm y 20,75 ± 4,45 mm, respectivamente. Los ángulos entre el acromion y la glena son más grandes en el lado izquierdo en comparación con el lado derecho, 186.49° y 179,16° (P

La estructura de las venas de la cavidad torácica varía significativamente en función de sus conexiones. Treinta cadáveres embalsamados con la técnica de Thiel fueron disecados (18 mujeres, 12 hombres), con edades comprendidas entre 48 y 98 años (media 81.3±12.40). Los pulmones, el corazón, la aorta torácica, el esófago y la pleura parietal fueron cuidadosamente retirados para permitir la visualización de las venas ácigos, hemiácigos y hemiácigos accesoria así como el conducto torácico. En la mayoría de los especímenes (21) se encontró que las venas intervertebrales estaban directamente conectadas con el sistema venoso ácigos en vez de con la parte terminal proximal de las venas intercostales posteriores. Se observó también que dicha distribución es más común en el lado derecho, pero no en todos los niveles vertebrales. Estas conexiones podrían jugar un rol en la regulación del volúmen de sangre entre los sistemas venosos ácigos y vertebral: también podrían actuar como vías metastásicas entre las regiones torácica y abdominal. Dado que su aspecto es bastante similar al de los vasos intercostales posteriores, es importante que los cirujanos sean conscientes de esta variación para evitar lesiones que induzcan hematomas postoperatorios. Veins in the thoracic cavity are highly variable in terms of their communications. Thirty Thiel-embalmed cadavers were dissected (18 females and 12 males), ranging in age from 48 to 98 years old (mean 81.3±12.40). The lungs, heart, thoracic aorta, oesophagus and parietal pleura were removed carefully to expose the azygos, hemiazygos, accessory hemiazygos veins and thoracic duct. In most specimens (21) intervertebral veins were connected directly to the azygos venous systems rather than the proximal end of the posterior intercostal veins. This presentation was observed to be more common on the right side, but not at all vertebral levels. These communications could play a role in regulating blood volume between the azygos and vertebral venous systems; they may also act as metastatic pathways between the thoracic and abdominal regions. As they mimic posterior intercostal vessels, it is important for surgeons to be aware of this variation to avoid injuries leading to postoperative hematomas.

Durante la disección de la región cervical de diez cadáveres (5 varones y 5 mujeres, con edad media de 81,66 años) de una población de Escocia, se observaron dos especímenes con canales bilaterales de las arterias vertebrales y otro ejemplar con un canal vertebral unilateral en el arco posterior del atlas (C1). En estas muestras, se observó que la tercera parte de las arterias vertebrales pasan a través del foramen accesorio ubicado en el arco posterior del atlas. Anomalías del atlas y la arteria vertebral no son comúnmente reportadas en la literatura; sin embargo, son importantes debido a su importancia en el diagnóstico y tratamiento clínico. Forámenes bilate-rales en el arco posterior de C1 no se han informado anteriormente en una población escocesa. Para los neurocirujanos y radiólogos la presencia de este rasgo no métrico es importante a la hora de realizar operaciones o en la interpretación de esta zona de la anatomía. During dissection of the cervical region of ten cadavers (5 males, 5 females: mean age 81.66 years) from a Scottish population, two specimens were observed to have bilateral vertebral artery canals and a further specimen had a unilateral vertebral canal on the posterior arch of the atlas (C1): in these specimens the third part of the vertebral artery passed through the accessory foramen. Anomalies of the atlas and vertebral artery are not commonly reported in the literature; however they are important due to their significance in clinical diagnosis and treatment. Bilateral foramina in the posterior arch of C1 have not been previously reported in a Scottish population. The presence of this non-metric trait is important for neurosurgeons and radiologists who may be operating on or interpreting this area of anatomy.

Incidence of anterior cruciate ligament (ACL) rupture and its consequent reconstruction is on the rise. In contributing to the achievement of anatomic reconstruction this study seek to provide information regarding the position and variability of the tibial attachment sites, dimensions of femoral insertions and compare these measurements in males and females, and in right and left knees. Thirty one cadaveric knees (15 right and 16 left from 9 females and 7 males, mean age 77 years) were dissected. Various ACL footprint dimensions were taken. The mean length and width of the tibial anteromedial (AM) bundle footprint were 8.9 and 9.8 mm while that of the posterolateral (PL) bundle were 9.3 and 8.0 mm respectively. The mean length and width of the tibial AM and PL bundles in males were 8.5 and 9.8 mm, and 9.1 and 8.3 mm while corresponding values in females were and 9.2 and 9.7 mm, and 9.4 and 7.8 mm respectively. Males had larger femoral footprints (P=0.020) and tibial plateau (P

Las venas del tronco venoso de ácigos son altamente variables en lo que se refiere a orígenes, trayecto, afluentes y terminaciones. Las comunicaciones linfovenosas entre el conducto torácico y el sistema venoso de ácigos, fueron halladas en una disección de un cadáver embalsamado de 92 años de edad. El conducto linfático estaba dividido en dos pequeños vasos linfáticos los cuales, drenaban la vena hemiciácigos accesoria en los niveles de T9 y T8. Estas comunicaciones son clínicamente importantes debido a que pueden actuar como vías metastásicas desde la parte más inferior del cuerpo hasta los pulmones. Veins of the azygos venous system are highly variable in terms of their origins, course, communications, tributaries and termination. Lymphovenous communic-ations between the thoracic duct and the azygos venous system were revealed during dissection of a 92-year-old female Thiel-embalmed cadaver. The thoracic duct branched into two small lymph vessels which drained into the accessory hemiazygos vein at the levels of T9 and T8. These communications are clinically important as they might act as metastatic pathways from the lower part of the body to the lungs

BackgroundPrevious studies have demonstrated that the glenoid fossa can be anteverted or retroverted with respect to the scapular spine and that this may affect the propensity to dislocate, although clinical studies have provided conflicting evidence.MethodsWe have used a highly accurate, noncontact laser morphometric method of analysis to determine the precise shape of 59 glenoid fossae from shoulders, with no evidence of instability, arthritis or rotator cuff disease.ResultsWe have shown that, at the mid-glenoid level, most fossae are retroverted, although some are anteverted. Furthermore, below this level, the glenoid can either twist into greater anteversion or retroversion. This forms the basis of a classification system that describes how much static restraint to dislocation is provided by the bony glenoid, and we have repeated the work to identify any contribution from variations in the thickness of overlying articular cartilage. Of 59 fossae, five were of type 1A, comprising an anteverted glenoid that becomes increasingly anteverted below its equator and provides least bony restraint to anterior dislocation.ConclusionsWe propose that this classification system is used to study the effect of glenoid shape on shoulder stability and options for reconstruction.

Human cadaveric tissue is the fundamental substrate for basic anatomic and surgical skills training. A qualitative assessment of the use of human cadavers preserved by Thiel's method for a British Association of Urological Surgeons-approved, advanced laparoscopic renal resection skills training course is described in the present study. Four trainees and four experienced laparoscopic surgeons participated in the course. All participants completed a five-point Likert scale satisfaction questionnaire after their training sessions. The quality of cadaveric tissue and the training session were assessed with particular emphasis placed on the ease of patient positioning, the ease of trocar placement, the preservation of tissue planes, the ease of renal pedicle dissection, and the quality of tissue preservation. All of the participants highly rated the quality of the cadaveric tissue embalmed by Thiel's method (mean scores for quality on the five-point Likert scale were 4.5 and 4.3 by the trainees and experienced laparoscopic surgeons, respectively). All of the steps of laparoscopic renal resection were rated 4.0 or more on the Likert scale by both trainees and faculty members. The initial response rates for using a human cadaver embalmed by Thiel's method as a training tool for laparoscopic nephrectomy showed encouraging results. The performance of a laparoscopic nephrectomy on a human cadaver embalmed by Thiel's method bears close resemblance to real laparoscopic nephrectomy procedures, and thus demonstrates added advantages to the previously reported models.

Preservation of piriformis during exposure of the hip joint via a posterior approach may result in a lower rate of dislocation following total hip arthroplasty. The aim of this study was to identify anatomical variations in the tendons of piriformis and obturator internus which could inform piriformis sparing approaches to the hip. Twenty-nine proximal femora from 15 cadavers, 5 male and 10 female aged 65–79 years, were examined. Tendon crossing angles, location and mode of insertion to the greater trochanter and the extent of fusion between tendons prior to insertion were noted. The mean (and associated standard deviation) of the vertical and horizontal widths of the piriformis tendon were 4.78 ± 1.31 mm and 7.35 ± 1.74 mm, respectively. The mean (and associated standard deviation) of the vertical and horizontal widths of the obturator internus tendon were 6.87 ± 1.61 mm and 5.72 ± 1.38 mm, respectively. The mean distances of the anterior and posterior margins of the piriformis tendon insertion from the posterior limit of the greater trochanter, defined as a percentage of the anteroposterior length of the greater trochanter, were 63.3% ± 9.4% and 43.0% ± 9.4%, respectively. Equivalent mean distances for the obturator internus insertion were 73.0% ± 6.6% and 55.9% ± 7.0%, respectively. On the basis of the relationship between the piriformis and obturator internus tendons in terms of the angle and point at which they cross, in addition to any degree of tendon fusion, four classifications were identified. This study shows that the most posterior margins of the piriformis and obturator internus attachments are located more than one-third of the way along the greater trochanter, suggesting that current osteotomies would not include these external rotators in the majority of cases. Clin. Anat. 24:70–76, 2011. © 2010 Wiley-Liss, Inc.

The present study was undertaken to determine the morphometric relationships between specific aspects of the cranial anterior and middle fossae because of their importance as landmarks in surgical approaches to the skull base. Bilateral and midline measurements were made between specific anatomic landmarks. The mean midline anteroposterior width of the lesser wing of the sphenoid and distance from the crista galli to the tuberculum sellae were 20 and 35.6 mm, respectively. Significant differences (P

PubMedID: 17319614 Nutrient arteries, the main blood supply to long bones, are particularly important during the active growth period, as well as during the early phases of ossification. In the present study, 569 adult human long bones of the upper (101 humeri, 93 radii, 102 ulnae) and lower (100 femora, 100 tibiae, 73 fibulae) limbs were investigated to determine the number and location of their nutrient foramina. For each bone, a foraminal index was calculated giving the location of the nutrient foramen in relation to its proximal end. In the upper limb, foramina were located on the diaphysis 15-69% of the overall length of the humerus, 22-46% for the radius and 27-54% for the ulna. In the lower limb, foramina were located on the diaphysis 29-69% of the overall length of the femur, 27-63% for the tibia and 26-83% for the fibula. In addition, the number and the distribution of the foramina in relation to specific regions/surfaces of the diaphysis were identified. This study provides additional and important information on the location and number of nutrient foramina in the long bones of the upper and lower limbs in the Turkish Caucasian population. © 2006 Elsevier GmbH. All rights reserved.