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Les collections d'anatomie de l'universite Paris V presentent un ensemble de dissections et de cires anatomiques tres anciennes, de tres haute qualite et parfaitement conservees, ayant servi a l'enseignement de l'anatomie et classees au patrimoine des monuments historiques depuis 1992.

Arterial surgery to salvage the lower limb tends to make use of the great saphenous vein, harvested with the subject in the supine position. If this is not possible the small saphenous vein is used, harvested with the subject in the prone position, however this requires a perioperative modification of the procedure. A bypass between the popliteal and anterior tibial arteries can be performed using either a lateral or a medial and lateral approach with the patient supine. In the event of trophic disorders of the lateral compartment of the leg, these approaches are not applicable. In such cases we propose a single posterior approach. The single posterior approach was used on 10 lower limbs from 5 cadavers in the prone position. Approach to the lower part of the popliteal artery was undertaken posteriorly between the two heads of gastrocnemius. The small saphenous vein was entirely dissected 10 cm above the lateral malleolus, the Achilles tendon and short fibular vessels were retracted medially to expose the interossous fascia, which was divided over 10 cm. Medial rotation of the limb by 30 degrees exposed the anterior tibial artery. For 3 of the lower limbs an 8 cm fibular resection was necessary, whereas on the remaining 7 medial rotation enabled excellent exposure of the anterior tibial artery. The single posterior approach to the anterior tibial artery can be applied in cases requiring distal bypass, using the small saphenous vein, between the inferior part of the popliteal artery and the anterior tibial artery.

The larynx is an organ with a complex anatomic structure. MRI allows the performance of sections in the three planes of space, so that this study of the soft parts of the larynx yields results superior to those of other imaging techniques. Together with laryngoscopy, MRI is most often used in assessing the extension of malignant laryngeal tumors. This assessment is fundamental in choosing the indications for surgery, but the published reports of MRI of the larynx are sometimes discordant. The visualization of certain important anatomic structures such as the conus elasticus is uncertain. Our aim was to study the MRI radio-anatomy of the larynx based on correlations between MRI and histologic sections. Eight anatomic specimens were studied: four in the transverse plane, two in the sagittal plane, and two in the frontal plane. The MRI and histologic sections made at the same levels were compared. These comparisons allowed a description of the sectional radio-anatomy of the larynx and an assessment of the reliability and limitations of MRI. All the major anatomic structures could be identified. It was possible to demonstrate the conus elasticus. We were able to visualize the vocal process of the arytenoid cartilage, which has not to our knowledge been previously described in the literature.

The aim of this study is to describe the morphology of the normal parametrium by correlating the slices obtained with computed tomography of 12 female cadavers studied after intravascular injection of latex with the dissection findings in 6 of these patients. The upper limit, represented by the isthmus, was defined by the uterine a. and/or a superficial uterine v. and/or the coronary v. (Charpy). The lower limit corresponded to the insertion of the levator ani mm. at the junction of the middle and inferior thirds of the vagina. The paracervical and paravaginal tissues above the levator ani m. and medial to the pelvic fascia covering these muscles were perfectly visualized. The posterior limit, formed by the lateral ligament of the rectum and/or the sacrouterine ligaments, and the anterior limit determined by the umbilico-vesical fascia were more difficult to demonstrate. In this study the parametrium appeared as a highly vascular and essentially venous connective structure with a variable morphology dependent on the uterine position.

The aim of this study was to define the imaging of the retrotympanum precisely by means of high-resolution CT. Based on 66 scans of petrous bones performed in 49 patients observed in an otologic department, several retrotympanic structures were studied: the pyramidal eminence, ponticulus, subiculum, chordal ridge, tympanic sinus of Proctor, sinus tympani and recess of the facial n. The variations in morphology and depth were noted as well as the relationship between the pyramid and the facial canal. In a second phase the same anatomic structures were studied in 24 temporal bones removed from embalmed cadavers and investigated with the same radiologic technique. Anatomic correlations were made for six temporal bones to confirm the general applicability of our radiologic hypotheses. In CT the pyramidal eminence was visualised in 100% of cases, the chordal ridge in 52%, the ponticulus in 63% and the subiculum in 57%. As regards the different recesses, the sinus tympani was visualised in 95% of cases, the posterior tympanic sinus of Proctor in 38%, the fossula of Grivot in 47% and the facial recess in 80%. The mean depth of the sinus tympani was 2.7 mm and that of the tympanic sinus of Proctor was 1.65 mm; the fossula of Grivot was assessed as 2.1 mm and the facial recess as 2.2 mm. A better knowledge of these sinuses and their variations will aid the surgeon, particularly in a posterior tympanotomy or a retro-facial approach.

The aim of this study was to measure fetal ocular development and to determine a growth curve by means of measurements in utero. Fetal ocular development was recorded by analysis of the results of magnetic resonance imaging (MRI). An anatomic study allowed definition of the best contrasted MRI sequences for calculation of the ocular surface. Biometric analysis of the values of the ocular surface in the neuro-ocular plane in 35 fetuses allowed establishment of a linear model of ocular growth curve in utero. Evaluation of ocular development may allow the detection and confirmation of malformational ocular anomalies such as microphthalmia.

The aim of this study was to attempt to specify the nature of the signal modifications observed in MRI in the supraspinatus tendon apart from any pathology of the shoulder, and due, according to certain authors, to an artefact associated with MRI. Five macroscopically normal supraspinatus tendons were removed from 4 young subjects (14-28 years), 30 min after cardiac arrest, with the authorization of the ethical committee. These tendons were examined by MRI in the frontal oblique plane along the axis of the muscle with a surface coil of 4 cm diameter, using a T2-weighted spin-echo sequence, and then studied histologically using the same plane of section. 22 control subjects (18-24 years) were examined by MRI with the same T2-weighted spin echo sequence. All the tendons examined possessed a dark signal with zones of intermediate signal on the first echo of the sequence. There was a complete correlation between the MRI appearances of the 5 tendons and their histologic description. Three histologic appearances were described : fibrillary degeneration, fibrous dystrophy, and eosinophil transformation of the tendinous collagen. All the tendons examined in healthy volunteers exhibited heterogenic images at the first echo, in the second echo the hyposignal was uniform and obvious. The good correlation obtained suggests that modifications of the tendon signal from the supraspinatus m. are not related to an artefact described in MRI, but are linked with premature degeneration of this tendon, probably associated with the severity of the mechanical constraints to which it is subject.

The head and vertebral column from two human cadavers were injected with a solution of gelatin and gadolinium (Dotarem®) and imaged using magnetic resonance imaging (MRI). Comparisons between gross anatomic slices and corresponding images of the lumbar vertebral column confirmed the usefulness of a paramagnetic agent for visualising the epidural venous plexus. This technique provides accurate images of the posterior longitudinal ligament.

Acute hemorrhage during percutaneous surgery on the pelviureteric junction obstruction has been estimated to be 2-3%. Following the experience of peroperative bleeding from a vascular variation, the authors discuss the arterial anomalies of the renal pedicle which may carry the risk of hemorrhage during percutaneous surgery in this region. Arteries in front of or behind the renal pelvis are the cause of ureteropelvic function obstruction in 15-52% of cases and because of their close relationship with the upper urinary tract can complicate the procedure of endopyelotomy. Endourological techniques are inadequate for avoiding the risk of vascular damage during the necessary maneuvers. Inferior polar arteries occur in 9% of the population and their different courses are described. They are not always responsible for the vascular obstruction in the pelviureteric syndrome, and it is the exact determination of this responsibility that makes imaging essential. Arteriography performed in our case allowed embolisation of the damaged inferior polar artery and also showed the anomalous origin of the testicular artery from this polar artery; this appears to be only the second description of this anomaly. This variation is discussed in a review of the literature. In fact the testicular artery has a high or aberrant origin in 20% of cases; in 5-6% of these the origin is from a main or supernumerary renal artery. Origin from an inferior polar artery is exceptional.

Our aim was to determine the biomechanical properties of the normal human cervical spine under physiological static loads. The three-dimensional displacements under three pure moments: flexion-extension, left-right lateral bending and left-right axial torsion — were measured in 56 intact functional spinal units (FSUs) taken from between C2 and C7 in 29 human cadavers. For each mode of loading, load-displacement curves were plotted. Then we calculated each neutral zone, range of motion, neutral zone ratio, ratio of coupled motion, limit moment and secant stiffness. The effects of intervertebral disc degeneration and the disc level were also taken into account by the analysis of variance. Our results adequately demonstrated both the non-linearity of load-displacement curves and the neutral zone of the cervical spine in three-dimensional space. At the same time, we found statistically that the stiffness in the three planes are significantly different, as are the stiffnesses in lateral bending of successive different FSUs. However, significant differences of stiffness in different states of disc degeneration were only found in right lateral bending. There were significant differences between levels in ratio of coupled motion under both lateral bending and axial torsion. The loading cycle conditions and the biomechanical responses of principal motion of C1-2 are also reported.

We wanted to determine the biomechanical properties of the human cervical spine with ligamentous injuries. The three-dimensional displacements under four pure moments--flexion, extension, left-right lateral bending and left-right axial torsion--were measured in 18 functional spinal units (FSUs) taken from 9 human cadaveric cervical spines. The experimentation was first performed with intact FSUs, then a series of ligamentous injuries were artificially created. The same measurements for the same FSUs were repeated after each step of ligamentous injury. For each mode of loading and each step of injury, three-dimensional load-displacement curves were plotted. From these curves, we calculated the following parameters for the principal motion: the neutral zone, the range of motion and the flexibility coefficients. A statistical analysis of these parameters was performed between intact FSUs and different ligamentous injury situations. The analysis of ligamentous injuries shows the consequences of different ligamentous injuries and will help us to assess certain assumptions about clinical stability.

The retro vesical septum (DENONVILLIERS) can be dissected and separated of the prostate and the bladder. The neurovascular bundles bound laterally this septum and it must be removed during radial prostatectomy. The aim of this study was to know if this septum is crossed by nerves.Dissection of cadaver--histological study of recto-vesical fascia.Nerves are present coming from the neurovascular bundle to the septum and end in the prostate.These anatomical observations conduct to recommend to remove systematically the recto-vesical septum during radical prostatectomy for cancer.

To define the anatomical landmarks allowing precise vesiculectomy to be performed during radical prostatectomy for cancer.12 non-formalin-preserved anatomical subjects were dissected as during retropubic and perineal prostatectomy, with and without coloured latex vascular injection.Three anatomical landmarks were defined: 1) Denonvilliers' fascia; 2) vas deferens; 3) arteries supplying the seminal vesicles.These three anatomical landmarks ensure: complete resection, preservation of adjacent anatomical structures and elective haemostasis.

The Museum of anatomy of the University Paris V exhibits a collection of ancient and high quality dissections and waxworks, very well preserved, which were used for teaching anatomy and have been classified historic monument since 1992.

The presence of a fibrous frame within the rotator cuff has been recently emphasized. This frame may be of interest in understanding of shoulder physiology and in attempts to improve shoulders disorders treatments. We report an original method to study the fibrous frame. MRI were done in healthy volunteers. 3D reconstruction were obtained and provided a 3D image of the fibrous frame. This technic should allow to calculate, for instance, the angles between the cuff muscles and the upper end of the humerus.

A pulmonary valve autograft may be proposed to replace diseased aortic valves. The explanted pulmonary valve is replaced with a pulmonary homograft with the inherent risk of calcified degeneration. A monocusp valve using the anterior pulmonary trunk has been proposed to reconstruct the right ventricular outflow tract. The aim of this study was to determine the feasibility of this technique. In hearts from 17 adult cadavers, we measured: pulmonary trunk diameter at the leaflet tops (D1). H1 and H2 were respectively from leaflet top to lower and upper levels of the pulmonary trunk bifurcation. D2 = 1.4 D1 was calculated as the monocusp size allowing a 45 degrees opening of the valve and thus permitting good valvular efficacy. G = H1 - D2 determined the feasibility of the technique: G greater than 10 mm, appeared the most favorable, G between 0 and 10 mm, appeared possible, and G less than 0, appeared to be impossible. Mean values of D1, H1 and H2 were respectively: 20.19 mm, 37 mm and 57 mm. The technique was possible in 16 cases (94%) and impossible in 1 case (6%). Preoperative determination of these parameters, by echocardiography or magnetic resonance imaging, appears necessary before applying this new surgical technique.

To assess the morphology of the suspensory ligament of the ovary on CT scan examination, an anatomic study of the suspensory ligament of the ovary was performed to demonstrate its morphology on CT and to facilitate the visualization of the ovaries. Twelve female cadavers were studied after intravascular injection of latex (venous: 2, arterial: 6, arterio-venous: 4). We first observed all the pelvises after their transection. Six dissections were then made to obtain optimal anatomic correlations on the content and relations of the infundibulo-pelvic ligament. The arterial opacifications were poor compared with to the good quality of the venous or arteriovenous opacifications. An upright correlation between CT slices and the anatomic study was made. This radio-anatomic study emphazises the importance of the veins, which really support the suspensory ligament of the ovary, as opposed to the involution of the arteries. This study points out the link between the infundibulo-pelvic ligament above and the utero-ovarian below, then with the superficial uterine vv. All these structures were well analyzed on CT and during the anatomic studies. A very well developed periovarian venous plexus which frequently concealed the ovaries was demonstrated. Some anatomic variations which were invisible on the CT scan examinations were displayed. The visualization of the suspensory ligament of the ovary should facilitate the visualization of the ovaries and could optimize the search for lymphadenopathies originating from ovarian cancers.

T ranscatheter arterial embolization is commonly performed in the management of intractable bleeding due to various causes, including obstetric and gynecologic disorders and pelvic trauma [I, 2]. Recently, arterial embolization of the uterine arteries as a preoperative adjunct or as an alternative to surgery has been used in treating uterine leiomyoma [3]. The widespread acceptance of this technique necessitates greater knowledge of the arterial anatomy of the female genital tract so that safer embolization procedures can be performed and untargetted embolization avoided. Angiographic studies provide a comprehensive assessment of the anatomy of the internal iliac artery, especially of its patterns of division and branches. In this pictorial essay, we report the main arterial vanations in uterine vascularization.

Classically, the peripheral neural pathways for erection are proerectile, issuing from the parasympathetic sacral fibres, and antierectile from the thoracolumbar sympathetic trunk. The cavernous nerves as terminal branches of the pelvic plexus convey the parasympathetic fibres to the penis. The pudendal nerve conveys sensory fibres from the penis and somatic fibres to the bulbos-pongiosus and ischiocavernosus striated mm. In animals, it has been demonstrated that the dorsal nerve of the penis contains sympathetic fibres. These findings suggest that communicating branches exist between the cavernous nerves and the dorsal nerve. Our aim in this study was to demonstrate the presence of such connections in man. We dissected 20 fresh male cadavers. The pelvic plexus and pudendal nerves were dissected to identify their terminal branches and connections. Histologic study was performed. Our results showed evidence of communicating nervous branches between the cavernous nerves and the dorsal nerve of the penis. Several variants existed concerning the number and type of connections. The presence of such communicating branches proves that the supralevator and infralevator neural pathways communicate and suggest the possibility of a kind of plasticity of the nervous supply of penile erection. Further studies are needed to identify the nature of these communicating branches.

To study the anatomic structure and the endoscopic aspect of the lacrimal drainage system and to evaluate the efficacy of the Erbium laser with microendoscope in lacrimal obstruction.Twenty lacrimal ducts from ten fresh cadaver heads were used to lead a special rigid probe of 1.1. mm diameter (Endognost Schwind). This probe combined a flexible endoscopic probe of 500 mu, an Erbium laser fiber of 375 mu and an irrigation. The probe was introduced through the inferior canaliculus. Progressing in the lacrimal system, all the images were analysed. Then, we used the laser fiber to open the lacrimal sac mucosa and the lacrimal bone.The anatomo-endoscopic analysis was performed using endoscopic data. We appreciated essentially the walls of valves and sinuses that appeared only functional when increasing the irrigation flow. The laser could easily open the mucosa and the lacrimal bone but not the maxilla.The small size of the cannula allows to use the system for the diagnosis of lacrimal obstructions. The combined laser allows to treat at same time canalicular obstructions and lower obstructions.The endocanalicular study of the lacrimal drainage system can diagnose the type of obstruction and can treat it. A clinical study is requested to confirm these results.

The partial arthrodeses of the wrist joint are well known as a method of treatment of several articular pathologies. Although there exists controversies about the final range of motions. In the goal to compare the state of the ligaments to the final range of motions we realised some of the most popular intracarpal arthrodeses in an anatomical laboratory. For our study we used 10 fresh cadaver specimens with the mean age of 88 years (84-95). The arthrodeses were realised with Kirschner wires. Biggest range of motion (more than 70%) was obtained after scapho-lunatum, scapho-capitatum and luno-triquetrum arthrodeses, while after luno-capitatum, scapho-luno-capitatum and triquetro-hamato-luno-caitatum it was the poorest--less than 50% of the initial state. We found a correlation between the state of the ligaments and the final results--in specimens with tears of the ligaments the results were closer to the perfect-ones from the clinical series. In our opinion the measurement of radial and ulnar deviation in clinical practice is not exact and should not be considered in the elaboration of scientific databases.

Orthopedic surgery for subjects of small stature, (between 130 cm and 160 cm), after the end of the normal growth cycle, requires a definition of the individual's morphotype, according to the standard canons. There exists a "classic canon", from Mediterranean culture, which divides the human body, from the waist, into two unequal parts (in the longitudinal dimension), which can vary from excessive shortness to excessive height. These proportions are strongly hereditary. In the transversal sense, there exists also measurements which can widely vary. These, are also strongly hereditary. Thus, defining five measurements: Stature. Height from the waist to the ground. Height from the waist to the top-head. Width of the shoulders. Width of the pelvis. From these five measurements, in the longitudinal and transversal dimensions, we obtain the well defined outlines of the subject's morphotype as well as, all other variations of this morphotype. Because there are separate variations of the transversal and longitudinal canons. A canon is specific to a group or a population. There are an infinite number of canons on this earth. Before starting limb lengthening surgery, it's necessary to define the morphotype (canon) of the subject. The harmony or dysharmony of his body proportions. As well as determine, at which point of lengthening, will the patient realise a true benefit for this difficult surgery.

The aim of this study was to define precisely the imaging of the canals of the temporal bone by means of high-resolution computed tomography (HR CT). Based on 24 temporal bones removed from embalmed cadavers and investigated with HR CT, several canals were studied: the canal of the chorda tympani (CdT), the canal of the auricular branch of the vagus nerve (ABV), the canal of the tympanic nerve, the canal of the carotico-tympanic nerve and that of the lesser petrosal nerve. Anatomic correlations for six temporal bones were made to confirm the validity of our radiologic hypotheses. In CT, in axial sections OM 0 degree, the posterior canal of the CdT was visualized in 71% of cases, the ABV canal in 4%, the inferior tympanic canal in 12.5%, the carotico-tympanic canal in no cases and the canal of the lesser petrosal nerve in 50% (and in 75% with an incidence of OM + 10 degrees). In coronal incidence, the posterior canal of the CdT was seen in 20% of cases, the ABV canal in 25%, the inferior tympanic canal in 85%, the caroticotympanic canal in 65% and that of the lesser petrosal nerve in 15%. The six anatomic comparisons confirmed the radiologic hypotheses in every case. These different structures are easy to identify in HR CT and are important to define so that any lesion (tumoral or vascular) developing in their vicinity may not be overlooked.

The aim of this study was to develop a technique for injection of the vertebral venous plexuses allowing anatomic, computed tomography (CT) and magnetic resonance imaging (MRI) studies of the same anatomic specimen. It proved in practice that only a correctly adjusted mixture of different agents allowed attainment of this objective. This mixture, composed of gelatin, gadolinium and minium, enabled us to attain this end. The description of the technique of injecting the vertebral venous plexuses, the difficulties encountered and the results of the different imaging techniques are analysed in this study without entering into details of the anatomic description. The core of the study consists of 11 unembalmed subjects. Three were injected with gelatin mixed with gadolinium, one with latex mixed with minium, one with latex mixed with gadolinium, and 6 with gelatin mixed with both gadolinium and minium. Only the mixture of gelatin - gadolinium - minium allowed study of the same anatomic specimen in terms of anatomy, CT and MRI. Two different MRI sequences are described, evidence of the different properties of the injection mixture (gelatin, gadolinium). The latex-minium mixture gave good CT density but was unsuitable for MRI studies. Numerous artifacts caused interference with the radiologic images, calling for perfect injection technique. The use of several radiologic techniques for a single cadaveric injection allows better correlation of the images, and comparison and verification of results between the techniques.

The aim of this study is to describe the morphology of the normal parametrium by correlating the slices obtained with computed tomography of 12 female cadavers studies after intravascular injection of latex with the dissection findings in 6 of the these patients. the upper limit, represented by the isthmus was defined by the uterine a. and/or a superficial uterine v. and/or the coronary v. (Charpy). The lower limit corresponded to the insertion of the levator ani mm. at the junction of the middle and inferior thirds of the vagina. The paracervical and paravaginal tissues above the levator ani m. and medial to the pelvic fascia covering these muscles were perfectly visualized. The posterior limit, formed by the lateral ligament of the rectum and/or the sacrouterine ligaments, and the anterior limit determined by the umbilico-vesical fascia were more difficult to demonstrate. In this study the parametrium appeared as a highly vascular and essentially venous connective structure with a variable morphology dependent on the uterine position.

In 1963, the studies by Zacharin emphasized the importance of the suspensory apparatus of the female urethra, consisting of two non-extensible fibrous bands composed of 3 distinct ligaments. The objectives of this study were to evaluate the role of these ligaments in support of the urethra and to define the value of their preservation in cystectomy with bladder replacement in women.Five fresh female cadavres with a mean age 78 years (range: 75-82) were used for dissection of the suspensory apparatus of the urethra via a suprapubic then sagittal approach by section of the pelvis 2 cm from the midline. Histological studies of the urethra were then performed.The suspensory apparatus of the urethra was found to be a paired, symmetrical system composed of 2 paired and symmetrical fibrous bands. Dissection of these bands revealed three anterior, intermediate and posterior pubourethral ligaments. The posterior pubourethral ligament was inserted on the anterior and lateral surfaces of the urethra and vagina (underneath the bladder neck) on anatomical studies, but also on histological sections. Section of the posterior pubourethral ligament allowed great mobility of half of the urethra. Section of these ligaments totally released the urethra from the pubis.Our study confirmed the importance of this ligamentous system in suspension of the urethra and demonstrated the value of preservation of these structures in cystectomy with bladder replacement in women.

Mitral homograft replacement requires a good knowledge of the anatomy of the papillary muscles. Clinical experience with mitral homografts has revealed an as yet unexplored aspect of the morphology of the mitral subvalvular apparatus, that is correspondence between papillary muscle sub-divisions and chordal attachment to the leaflets.To further our understanding we subjected 65 normal hearts to close scrutiny which confirmed our perioperative observations.We could establish a classification based on the ways that the papillary muscles relate to the leaflets via the chordae. Four types are described. In type I the papillary muscle is single. In type II the papillary muscle has two heads, one of which sends chordae exclusively to the posterior leaflet. In type III the papillary muscle is also divided, one head supporting the commissural area exclusively. Type IV PM resembles type III but is distinguished from it in the way that the head supporting the commissure is very short. In this type the different heads also originate at different levels on the ventricular wall from the apex to the base.

Laparoscopic techniques currently constitute an alternative proposed for the repair of hernias of the inguinofemoral region. Nerve injuries have led some teams to recommend technical principles based on the anatomical relations of these nerves with the subperitoneal fascia transversalis and inguinal fossae. An anatomical study consisting of dissection of nonembalmed cadavres, allowed, after evisceration, dissection of the lumbar plexus and its terminal branches, particularly those supplying the inguinofemoral region: iliohypogastric and ilio-inguinal nerves, the genitofemoral nerve, the femoral nerve and the lateral cutaneous nerve of the thigh. Via transperitoneal laparoscopy, the posterior surface of the anterior abdominal wall is centered on the deep inguinal ring, containing testicular vessels and the vas deferens. This deep inguinal ring receives the genitofemoral nerve. Medially, the anterior parietal peritoneum describes three folds formed by the outline of the epigastric artery, umbilical artery and urachus on the midline. The outline of Hesselbach's ligament separates the deep inguinal ring from Hesselbach's triangle, the zone of weakness of direct inguinal hernia. The iliac psoas muscle pass laterally underneath the inguinal ligament, while the external iliac vessels, subsequently becoming the femoral vessels, are located medially. Pectineal ligament lies on the posterior surface of the femoral ring between the umbilical artery and the epigastric artery. Installation of an abdominal wall prosthesis, either transperitoneally or retroperitoneally, must be centered on the deep inguinal ring, and its solid sutures are located medially to the pectineal ligament and anterior abdominal wall. On the other hand, the nerves at risk of being damaged are situated laterally: the ilio-inguinal and ilio-hypogastric nerves in the plane between external oblique and internal oblique above the anterior superior iliac spine, lateral cutaneous nerve of the thigh under the inguinal ligament close to the anterior superior iliac spine, genitofemoral nerve with the spermatic cord in the deep inguinal ring and femoral nerve underneath the inguinal ligament with the psoas muscle lateral to the external iliac artery. No stapling must be performed under the plane of the inguinal ligament to avoid damage to the femoral vessels and lateral to the deep inguinal ring to avoid nerve damage.

The pterygoid venous plexuses are closely adjacent to the lateral pterygoid m. and occupy a considerable part of the infratemporal fossa (ITF). We have conducted a study after injection of colored latex in 10 unembalmed subjects in order to define the arrangement of the venous network and to assess the frequency of the different types of plexuses found. In all the subjects symmetry was noted between the right and left plexuses, with predominance of the venous layer in the upper part of the ITF. The pattern most often encountered was plexiform and complex. The development of these plexuses follows that of the masticatory muscles, whose contraction promotes drainage and represents an alternative venous pathway for drainage of the cranial cavity.

The anterior interhemispheric approach for aneurysms of the anterior communicating artery was studied in ten cadavers. This approach presents several advantages over the pterional approach widely used in neurosurgery. It allows direct access to the region of the anterior communicating artery complex with minimal retraction of the brain and preservatioin of the olfactory tract and the gyrus rectus.

The computation of eyeball growth has a wide field of applications in orbital and ocular pathology. An anatomic and MRI study to compute eyeball growth has been done. The anatomic study was made to determine the best MRI parameters to calculate the ocular surface; then this surface was computed by MRI in the neuro-ocular plane in fetuses and children aged from 0 to 13 years. The curve of eyeball growth shows rapid growth in utero and until 18 months, followed by a phase of slower growth. This method allows measurement in two dimensions, which we find complementary to ultrasound in the antenatal search for certain congenital malformations.

The computation of eyeball growth has a wide field of applications in orbital and ocular pathology. An anatomic, macroscopic, histologic and RMI study has correlated the different oculo-orbital signals with the anatomy: a study of compute eyeball growth has been done. The anatomic study was made to determine the best MRI parameters to calculate the ocular surface. The surface was computed by MRI T2 weighted in the neuro-ocular plane in children aged from 0 to 13 years. The curve of eyeball growth shows rapid growth in utero until 18 months and then a phase of slower growth. A second study with fetuses RMI of pregnant women showed the neuro-ocular plane of fetus. Application in antenatal pathology are interesting. Two cases of orbital tumor, with fetal diagnosis are analysed and histologically explained.

The orbital septum separates the intraorbital fat from the palpebral part of the orbicularis oculi m. An anatomic study after injection of colorant into the intraorbital fat allows definition of a fibroadipose layer anterior to the orbital septum. This consists of radial fibers and extraorbital fatty lobules. The septum is derived embryologically from the mesenchyme of the second arch, but the structure of the anterior layer remains controversial. The septum has an important mechanical function in containing the orbital fat and is involved in orbital movements. A knowledge of these different layers facilitates surgical approaches and helps to define the anatomic landmarks in palpebral surgery for conditions such as ptosis and in blepharoplasty.

We describe a nasolabial island flap with a proximal base. This anatomical study confirms the interest of a proximal base especially with regard to venous return. As opposed to classical naso-labial flaps with subcutaneous pedicle, it has a vascularization of musculo-cutaneous type which allows a greater degree of mobility and reliability. This flap is an effective therapeutic option in surgery for skin defects of the face.

30 MRI investigations of shoulders and 20 dissections of non embalmed cadaveric shoulders allowed us to demonstrate a particular organization of the supraspinatus muscle. In the anterior part of the muscle is an important fibrous frame with obliquely inserted muscle fibers. This organization suggests that this part of the supraspinatus muscle works as a "contractile tendon".

Reconstruction of human embryonic livers (Streeter's developmental horizons XVI, XIX and XX) showed that hepatic segmentation arises between the 35th and 45th day of intrauterine life and that the vena umbilicalis sinistra plays an important role in this developmental phenomenon. Conversely, the results of this study demonstrated the regressive and non functional nature of the vena umbilicalis dextra and vitelline vessels. Furthermore, our observations allowed to identify the embryonic period during which umbilical blood flow begins to invest the mass of hepatic cells and runs about the sinusoids. The flow pattern described in this report induces special fluid currents which are reflected by a progressive increase in the variability of the venous structures lying more and more distally to the point of entry of the vena umbilicalis sinistra in the liver. These hemodynamic phenomena could thus account for the constancy of the left part and the variability of the right part of the liver, as well as the variability of the site of origin of the right paramedian vein with respect to the bifurcation of the vena portae.

Inconstantes, les plicae sont au nombre de trois: mediale, superieure et inferieure. La plus frequente est l'inferieure, vient ensuite la plica superieure, enfin la plica mediale est la moins frequente. Sur les plans embryologique et anatomique ces formations ont la meme signification. Mais sur le plan clinique, l'interet de ces trois plicae ne sera pas le meme. La plica mediale est la plus interessante en raison de sa pathologie devenue evidente. Vient ensuite la plica superieure qui peut aussi etre responsable de derangements internes du genou, mais de facon exceptionnelle. Quant a la plica inferieure, elle tire son interet du fait que sur les cliches arthrographiques de profil, elle peut en imposer pour le ligament croise anterieur. Il est certain que cette etude gagne a etre replacee dans un cadre plus vaste anatomo-clinique [8].

At rest the uterovaginal tube presents three angles in the sagittal plane: anteflexion, anteversion and the vaginal cap. The most important, from the functional point of view, is the angle of anteversion because it places the uterus perpendicularly in relation to the vagina. This arrangement may be explained by the erect posture of the human being and commences with the toddler as she begins to stand on her feet. The uterus is tethered on each side to the pelvic wall by a bulky neurovascular pedicle composed of uterine and vaginal vessies, the hypogastric plexus and connective tissue in continuity with that of the retroperitoneal space. This pedicle, in passive fashion, maintains the position and direction of the uterus and thanks to its elasticity allows it to mould itself to the variations in volume of the bladder and rectum and take up its normal position once these organs are emptied. The histological structure of this pedicle cannot account for its effectiveness as a suspensory ligament. Support for the uterus in fact derives from the posterior part of the levator muscles of the anus. At rest the uterus lies behind the urogenital fissure. During effort it gains support by the intermediary of the rectum on the posterior part of the anal elevators and the anococcygeal ligament; it thus closes off the pouch of Douglas. The vaginal orifice, which represents a weakness in the muscular diaphragm of the pelvis, is closed during effort by abutment of the anterosuperior wall of the vagina onto the posteroinferior wall. The vagina, almost in the horizontal position, traverses the muscular diaphragm of the pelvis obliquely from above downwards and is thus situated almost perpendicular to the forces of rectal emptying. Contraction of the muscular diaphragm of the pelvis, on account of its bony attachments being diametically opposed, does not close off the urogenital fissure which in the living subject lies very anteriorly in a subpubic position. Contraction results in the anal levators becoming horizontal and displacing the pelvic viscera upwards.

Three in number, the plicae are inconstant synovial structures found within the cavity of the knee joint, and have been recognised for some time. The inferior plica in particular was described by Vesalius in 1555. Both the inferior and medial plicae are vestiges of an intermediate articular disc similar to the menisci. The superior plica derives from the wall which in the first instance, separates the bursa and quadriceps cul-de-sac.

Radiocinematographic study of the laryngo-pharyngeal area in a man showing an entirely ossified hyoid system, made during the course of chewing, swallowing, and sound utterance. Two facts seem noteworthy: 1) from the morphological point of view, we should search in organogenesis for an explanation of the ossification of the hyoid apparatus; 2) from the functional point of view, one notes considerably reduced movements of the bone, without any change in the swallowing, or in the speach functions.

This paper describes a specific prone oblique view very helpful to thoracic vertebral bone biopsy under fluoroscopic control. In this position the costal head and neck axis gives the direction of the procedure. A puncture between two ribs following this direction easily avoids both the pleura and spinal canal. This thoracic biopsy of the vertebral body and disc under fluroscopic control becomes a reliable diagnostic tool.