Diagnostics

Editorial

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3 pages, 175 KiB

Open AccessEditorial

Anatomical Variation and Clinical Diagnosis

by Heather F. Smith

Diagnostics 2021, 11(2), 247; https://doi.org/10.3390/diagnostics11020247 - 5 Feb 2021

Cited by 5 | Viewed by 2235

Abstract

In the anatomical sciences, it has long been recognized that the human body displays a range of morphological patterns and arrangements, often termed “anatomical variation” [...] Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

Research

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12 pages, 2050 KiB

Open AccessArticle

Midline and Mediolateral Episiotomy: Risk Assessment Based on Clinical Anatomy

by Danielle K. Garner, Akash B. Patel, Jun Hung, Monica Castro, Tamar G. Segev, Jeffrey H. Plochocki and Margaret I. Hall

Diagnostics 2021, 11(2), 221; https://doi.org/10.3390/diagnostics11020221 - 2 Feb 2021

Cited by 7 | Viewed by 13143

Abstract

Episiotomy is the surgical incision of the vaginal orifice and perineum to ease the passage of an infant’s head while crowning during vaginal delivery. Although episiotomy remains one of the most frequently performed surgeries around the world, short- and long-term complications from the [...] Read more.

Episiotomy is the surgical incision of the vaginal orifice and perineum to ease the passage of an infant’s head while crowning during vaginal delivery. Although episiotomy remains one of the most frequently performed surgeries around the world, short- and long-term complications from the procedure are not uncommon. We performed midline and mediolateral episiotomies with the aim of correlating commonly diagnosed postepisiotomy complications with risk of injury to perineal neuromuscular and erectile structures. We performed 61 incisions on 47 female cadavers and dissected around the incision site. Dissections revealed that midline incisions did not bisect any major neuromuscular structures, although they did increase the risk of direct and indirect injury to the subcutaneous portion of the external anal sphincter. Mediolateral incisions posed greater risk of iatrogenic injury to ipsilateral nerve, muscle, erectile, and gland tissues. Clinician discretion is advised when weighing the potential risks to maternal perineal anatomy during vaginal delivery when episiotomy is indicated. If episiotomy is warranted, an understanding of perineal anatomy may benefit diagnosis of postsurgical complications. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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10 pages, 2612 KiB

Open AccessArticle

Anatomographic Variants of Sphenoid Sinus in Ethiopian Population

by Tizita K. Degaga, Abay M. Zenebe, Amenu T. Wirtu, Tequam D. Woldehawariat, Seife T. Dellie and Jickssa M. Gemechu

Diagnostics 2020, 10(11), 970; https://doi.org/10.3390/diagnostics10110970 - 19 Nov 2020

Cited by 14 | Viewed by 11823

Abstract

Neurosurgeons often neglect the sphenoid sinus due to its deep location and difficulties in accessing during surgical interventions. Disease of the sphenoid sinus is difficult to diagnose since its presenting symptoms are difficult to recognize. Moreover, compared with other paranasal sinuses, the sphenoid [...] Read more.

Neurosurgeons often neglect the sphenoid sinus due to its deep location and difficulties in accessing during surgical interventions. Disease of the sphenoid sinus is difficult to diagnose since its presenting symptoms are difficult to recognize. Moreover, compared with other paranasal sinuses, the sphenoid sinus is considered the most variable air sinus in terms of its degree of pneumatization, number and position of inter-sinus septa, and its relationship with the surrounding anatomical structures. Anatomical variations of the sphenoid sinus are significant from a neurosurgical point of view. Understanding of these variations and its relationships with surrounding structures such as the internal carotid artery, optic nerve, and pituitary gland are clinically relevant to minimize injuries associated with surgical procedures that involve sphenoid sinus. We implemented principles of imaging using computed tomography to elucidate any anatomical variations of the sphenoid sinus in the Ethiopian population. We conducted a prospective study in 200 patients with ages 18–79, who underwent scans of the sphenoid sinus at the Tikur Anbessa Referral Teaching Hospital in 2017–2018. Our findings revealed an incidence of anatomographical variations in terms of pneumatization that varied between 2–50%. These variants include 2% conchal, 25.5% presellar, 50% sellar, and 22.5% postsellar pneumatization. We also demonstrated anatomographic variants in terms of septation, 77.5% single complete septa, 11.5% single incomplete, 10% double septa, and 1% absence of septa. In summary, the sellar pneumatization was found to be the most clinically relevant anatomographic variant among Ethiopians participating in the study, of which 90% were tomographically single septated. These variants must be taken into consideration during trans-sphenoidal surgery and knowledge of the variations has clinical implication in minimizing injuries during invasive surgical procedures involving the sphenoid sinus. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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13 pages, 2171 KiB

Open AccessArticle

Longitudinal Observation of Changes in the Ankle Alignment and Tibiofibular Relationships in Hereditary Multiple Exostoses

by Jae Hoo Lee, Chasanal Mohan Rathod, Hoon Park, Hye Sun Lee, Isaac Rhee and Hyun Woo Kim

Diagnostics 2020, 10(10), 752; https://doi.org/10.3390/diagnostics10100752 - 25 Sep 2020

Cited by 6 | Viewed by 2398

Abstract

The longitudinal changes in the tibiofibular relationship as the ankle valgus deformity progresses in patients with hereditary multiple exostoses (HME) are not well-known. We investigated the longitudinal changes and associating factors in the tibiofibular relationship during the growing period. A total of 33 [...] Read more.

The longitudinal changes in the tibiofibular relationship as the ankle valgus deformity progresses in patients with hereditary multiple exostoses (HME) are not well-known. We investigated the longitudinal changes and associating factors in the tibiofibular relationship during the growing period. A total of 33 patients (63 legs) with HME underwent two or more standing full-length anteroposterior radiographs. Based on the change in ankle alignments, thirty-five patients with an increase in tibiotalar angle were grouped into group V, and 28 patients with a decreased angle into group N. In terms of the change in radiographic parameters, significant differences were noted in the tibial length, the fibular/tibial ratio, and the proximal and distal epiphyseal gap. However, age, sex, initial ankle alignment, location of osteochondroma, and presence of tibiofibular synostosis did not affect the tibiofibular alignment. The tibial growth was relatively greater than the fibular growth and was accompanied by significant relative fibular shortening in the proximal and distal portions. In pediatric patients with HME, age, sex, initial ankle alignment, location of the osteochondroma, and synostosis did not predict the progression of the ankle valgus deformity. However, when valgus angulation progressed, relative fibular shortening was observed as the tibia grew significantly in comparison to the fibula. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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11 pages, 2425 KiB

Open AccessArticle

Relationship between Cortical Bone Thickness and Cancellous Bone Density at Dental Implant Sites in the Jawbone

by Shiuan-Hui Wang, Yen-Wen Shen, Lih-Jyh Fuh, Shin-Lei Peng, Ming-Tzu Tsai, Heng-Li Huang and Jui-Ting Hsu

Diagnostics 2020, 10(9), 710; https://doi.org/10.3390/diagnostics10090710 - 17 Sep 2020

Cited by 27 | Viewed by 8582

Abstract

Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to [...] Read more.

Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe’s posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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7 pages, 859 KiB

Open AccessArticle

Anatomical Variations of the Recurrent Laryngeal Nerve and Implications for Injury Prevention during Surgical Procedures of the Neck

by Alison M. Thomas, Daniel K. Fahim and Jickssa M. Gemechu

Diagnostics 2020, 10(9), 670; https://doi.org/10.3390/diagnostics10090670 - 4 Sep 2020

Cited by 16 | Viewed by 6362

Abstract

Accurate knowledge of anatomical variations of the recurrent laryngeal nerve (RLN) provides information to prevent inadvertent intraoperative injury and ultimately guide best clinical and surgical practices. The present study aims to assess the potential anatomical variability of RLN pertaining to its course, branching [...] Read more.

Accurate knowledge of anatomical variations of the recurrent laryngeal nerve (RLN) provides information to prevent inadvertent intraoperative injury and ultimately guide best clinical and surgical practices. The present study aims to assess the potential anatomical variability of RLN pertaining to its course, branching pattern, and relationship to the inferior thyroid artery, which makes it vulnerable during surgical procedures of the neck. Fifty-five formalin-fixed cadavers were carefully dissected and examined, with the course of the RLN carefully evaluated and documented bilaterally. Our findings indicate that extra-laryngeal branches coming off the RLN on both the right and left side innervate the esophagus, trachea, and mainly intrinsic laryngeal muscles. On the right side, 89.1% of the cadavers demonstrated 2–5 extra-laryngeal branches. On the left, 74.6% of the cadavers demonstrated 2–3 extra-laryngeal branches. In relation to the inferior thyroid artery (ITA), 67.9% of right RLNs were located anteriorly, while 32.1% were located posteriorly. On the other hand, 32.1% of left RLNs were anterior to the ITA, while 67.9% were related posteriorly. On both sides, 3–5% of RLN crossed in between the branches of the ITA. Anatomical consideration of the variations in the course, branching pattern, and relationship of the RLNs is essential to minimize complications associated with surgical procedures of the neck, especially thyroidectomy and anterior cervical discectomy and fusion (ACDF) surgery. The information gained in this study emphasizes the need to preferentially utilize left-sided approaches for ACDF surgery whenever possible. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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10 pages, 1106 KiB

Open AccessArticle

Anatomic Investigation of Two Cases of Aberrant Right Subclavian Artery Syndrome, Including the Effects on External Vascular Dimensions

by Mitchell H. Mirande, Madelyn R. Durhman and Heather F. Smith

Diagnostics 2020, 10(8), 592; https://doi.org/10.3390/diagnostics10080592 - 14 Aug 2020

Cited by 3 | Viewed by 4175

Abstract

The retroesophageal aberrant right subclavian artery (ARSA) is a variation of the aortic arch that occurs asymptomatically in most patients. However, when symptomatic, it is most commonly associated with dysphagia. ARSA has also been noted as a location of potentially severe aneurysms in [...] Read more.

The retroesophageal aberrant right subclavian artery (ARSA) is a variation of the aortic arch that occurs asymptomatically in most patients. However, when symptomatic, it is most commonly associated with dysphagia. ARSA has also been noted as a location of potentially severe aneurysms in some patients, as well as posing a risk during surgical interventions in the esophageal region. This case study analyzes two individuals with ARSA morphology in comparison to a normal sample in order to gain a better anatomical understanding of this anomaly, potentially leading to better risk assessment of ARSA patients going forward. The diameter of the ARSA vessel was found to be substantially larger than both the right subclavian artery and brachiocephalic trunk of the subjects with classic aortic arch anatomy. As many ARSA individuals are asymptomatic, we hypothesize that the relative size of the ARSA may dictate its contribution to the presence and/or severity of associated symptomatology. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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9 pages, 769 KiB

Open AccessArticle

Radiographic Analysis on the Distortion of the Anatomy of First Metatarsal Head in Dorsoplantar Projection

by Jessica Grande-del-Arco, Ricardo Becerro-de-Bengoa-Vallejo, Patricia Palomo-López, Daniel López-López, César Calvo-Lobo, Eduardo Pérez-Boal, Marta Elena Losa-Iglesias, Carlos Martin-Villa and David Rodriguez-Sanz

Diagnostics 2020, 10(8), 552; https://doi.org/10.3390/diagnostics10080552 - 2 Aug 2020

Cited by 6 | Viewed by 4277

Abstract

Background: The diagnostic of flat and crest-shaped of first metatarsal heads has been associated as an important risk factor for hallux deformities, such as hallux valgus and hallux rigidus. The rounded form of the first metatarsal head on the dorsoplantar radiograph of the [...] Read more.

Background: The diagnostic of flat and crest-shaped of first metatarsal heads has been associated as an important risk factor for hallux deformities, such as hallux valgus and hallux rigidus. The rounded form of the first metatarsal head on the dorsoplantar radiograph of the foot has been believed to be associated with the development of hallux valgus. Purpose: The aim of this study was to clarify the effect of tube angulation on the distortion of first metatarsal head shape, and verify the real shape of the metatarsal head in anatomical dissection after an X-ray has been taken. Materials and Methods: In this prospective study at Universidad Complutense de Madrid, from December 2016 to June 2019, 103 feet from embalmed cadavers were included. We performed dorsoplantar radiograph tube angulation from 0° until 30° every 5° on all specimens; then, two observers verified the shape of the first metatarsal head in the radiographs and after its anatomic dissection. Kappa statistics and McNemar Bowker tests were used to assess and test for intra and interobserver agreement of metatarsal shape. Results: We calculated the intraobserver agreement, and the results showed that the first metatarsal head is distorted and crested only when the angle of the X-ray beam is at 20° of inclination (p < 0.001). The interobserver agreement showed good agreement at 0°, 5°, 10°, 20°, and 25° and was excellent at 30° (p < 0.001). Conclusion: All of the studies that we identified in the literature state that there are three types of shapes of the first metatarsal head and relate each type of head to the diagnosis of a foot pathology, such as hallux valgus or hallux rigidus. This study demonstrates that there is only the round-shaped form, and not three types of metatarsal head shape. Therefore, no diagnoses related to the shape of the first metatarsal head can be made. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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9 pages, 1410 KiB

Open AccessArticle

The Branching and Innervation Pattern of the Radial Nerve in the Forearm: Clarifying the Literature and Understanding Variations and Their Clinical Implications

by F. Kip Sawyer, Joshua J. Stefanik and Rebecca S. Lufler

Diagnostics 2020, 10(6), 366; https://doi.org/10.3390/diagnostics10060366 - 2 Jun 2020

Cited by 11 | Viewed by 6563

Abstract

Background: This study attempted to clarify the innervation pattern of the muscles of the distal arm and posterior forearm through cadaveric dissection. Methods: Thirty-five cadavers were dissected to expose the radial nerve in the forearm. Each muscular branch of the nerve was identified [...] Read more.

Background: This study attempted to clarify the innervation pattern of the muscles of the distal arm and posterior forearm through cadaveric dissection. Methods: Thirty-five cadavers were dissected to expose the radial nerve in the forearm. Each muscular branch of the nerve was identified and their length and distance along the nerve were recorded. These values were used to determine the typical branching and motor entry orders. Results: The typical branching order was brachialis, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, supinator, extensor digitorum, extensor carpi ulnaris, abductor pollicis longus, extensor digiti minimi, extensor pollicis brevis, extensor pollicis longus and extensor indicis. Notably, the radial nerve often innervated brachialis (60%), and its superficial branch often innervated extensor carpi radialis brevis (25.7%). Conclusions: The radial nerve exhibits significant variability in the posterior forearm. However, there is enough consistency to identify an archetypal pattern and order of innervation. These findings may also need to be considered when planning surgical approaches to the distal arm, elbow and proximal forearm to prevent an undue loss of motor function. The review of the literature yielded multiple studies employing inconsistent metrics and terminology to define order or innervation. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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9 pages, 1529 KiB

Open AccessArticle

Anatomic and Histological Features of the Extensor Digitorum Longus Tendon Insertion in the Proximal Nail Matrix of the Second Toe

by Patricia Palomo-López, Marta Elena Losa-Iglesias, Ricardo Becerro-de-Bengoa-Vallejo, David Rodríguez-Sanz, Cesar Calvo-Lobo, Jorge Murillo-González and Daniel López-López

Diagnostics 2020, 10(3), 147; https://doi.org/10.3390/diagnostics10030147 - 7 Mar 2020

Cited by 3 | Viewed by 3178

Abstract

Background: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities. Objective: The main purpose was to determine the anatomic and histological [...] Read more.

Background: Anatomic and histological landmarks of the extensor digitorum longus (EDL) tendon insertion in the proximal nail matrix may be key aspects during surgery exposure in order to avoid permanent nail deformities. Objective: The main purpose was to determine the anatomic and histological features of the EDL’s insertion to the proximal nail matrix of the second toe. Methods: A sample of fifty second toes from fresh-frozen human cadavers was included in this study. Using X25-magnification, the proximal nail matrix limits and distal EDL tendon bony insertions were anatomically and histologically detailed. Results: The second toes’ EDLs were deeply located with respect to the nail matrix and extended superficially and dorsally to the distal phalanx in all human cadavers. The second toe distal nail matrix was not attached to the dorsal part of the distal phalanx base periosteum. Conclusions: The EDL is located plantar and directly underneath to the proximal nail matrix as well as dorsally to the bone. The proximal edge of the nail matrix and bed in human cadaver second toes are placed dorsally and overlap the distal EDL insertion. These anatomic and histological features should be used as reference landmarks during digital surgery and invasive procedures. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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10 pages, 2610 KiB

Open AccessArticle

The Roles of Celiac Trunk Angle and Vertebral Origin in Median Arcuate Ligament Syndrome

by Ryan P. Dyches, Kelsey J. Eaton and Heather F. Smith

Diagnostics 2020, 10(2), 76; https://doi.org/10.3390/diagnostics10020076 - 31 Jan 2020

Cited by 16 | Viewed by 10348

Abstract

Median arcuate ligament syndrome (MALS) is a rarely diagnosed condition resulting from compression of the celiac trunk (CT) by the median arcuate ligament (MAL) of the diaphragm. Ischemia due to reduced blood flow through the CT and/or neuropathic pain resulting from celiac ganglion [...] Read more.

Median arcuate ligament syndrome (MALS) is a rarely diagnosed condition resulting from compression of the celiac trunk (CT) by the median arcuate ligament (MAL) of the diaphragm. Ischemia due to reduced blood flow through the CT and/or neuropathic pain resulting from celiac ganglion compression may result in a range of gastrointestinal symptoms, including nausea, postprandial discomfort, and weight loss. However, the mechanism of compression and its anatomical correlates have been incompletely delineated. It has been hypothesized that CT angle of origination may be more acute in individuals with MALS. Here, frequency of anatomical variation in the MAL and CT were assessed in 35 cadaveric subjects (17M/18F), including the vertebral level of origin of CT and superior mesenteric artery (SMA), the distance between CT and MAL and SMA, the angles of origination of CT and SMA, the diameter at the CT base, and MAL/CT overlap. Females exhibited significantly higher rates of inferred MAL/CT overlap than males. Significant correlations were revealed between MAL/CT overlap and angles of origination of the CT and SMA. Vertebral level of origin of the CT in individuals with MAL/CT overlap was not significantly more superior than in those without. This study also revealed a significant relationship between MAL/CT overlap and angle of origination of the CT, which has clinical implications for understanding the anatomy associated with MALS. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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Review

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27 pages, 10937 KiB

Open AccessReview

Pelvic Lymphadenectomy in Gynecologic Oncology—Significance of Anatomical Variations

by Stoyan Kostov, Yavor Kornovski, Stanislav Slavchev, Yonka Ivanova, Deyan Dzhenkov, Nikolay Dimitrov and Angel Yordanov

Diagnostics 2021, 11(1), 89; https://doi.org/10.3390/diagnostics11010089 - 7 Jan 2021

Cited by 9 | Viewed by 6220

Abstract

Pelvic lymphadenectomy is a common surgical procedure in gynecologic oncology. Pelvic lymph node dissection is performed for all types of gynecological malignancies to evaluate the extent of a disease and facilitate further treatment planning. Most studies examine the lymphatic spread, the prognostic, and [...] Read more.

Pelvic lymphadenectomy is a common surgical procedure in gynecologic oncology. Pelvic lymph node dissection is performed for all types of gynecological malignancies to evaluate the extent of a disease and facilitate further treatment planning. Most studies examine the lymphatic spread, the prognostic, and therapeutic significance of the lymph nodes. However, there are very few studies describing the possible surgical approaches and the anatomical variations. Moreover, a correlation between anatomical variations and lymphadenectomy in the pelvic region has never been discussed in medical literature. The present article aims to expand the limited knowledge of the anatomical variations in the pelvis. Anatomical variations of the ureters, pelvic vessels, and nerves and their significance to pelvic lymphadenectomy are summarized, explained, and illustrated. Surgeons should be familiar with pelvic anatomy and its variations to safely perform a pelvic lymphadenectomy. Learning the proper lymphadenectomy technique relating to anatomical landmarks and variations may decrease morbidity and mortality. Furthermore, accurate description and analysis of the majority of pelvic anatomical variations may impact not only gynecological surgery, but also spinal surgery, urology, and orthopedics. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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Other

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20 pages, 6240 KiB

Open AccessCase Report

Frequency and Clinical Review of the Aberrant Obturator Artery: A Cadaveric Study

by Guinevere Granite, Keiko Meshida and Gary Wind

Diagnostics 2020, 10(8), 546; https://doi.org/10.3390/diagnostics10080546 - 30 Jul 2020

Cited by 12 | Viewed by 9723

Abstract

The occurrence of an aberrant obturator artery is common in human anatomy. Detailed knowledge of this anatomical variation is important for the outcome of pelvic and groin surgeries requiring appropriate ligation. Familiarity with the occurrence of an aberrant obturator artery is equally important [...] Read more.

The occurrence of an aberrant obturator artery is common in human anatomy. Detailed knowledge of this anatomical variation is important for the outcome of pelvic and groin surgeries requiring appropriate ligation. Familiarity with the occurrence of an aberrant obturator artery is equally important for instructors teaching pelvic anatomy to students. Case studies highlighting this vascular variation provide anatomical instructors and surgeons with accurate information on how to identify such variants and their prevalence. Seven out of eighteen individuals studied (38.9%) exhibited an aberrant obturator artery, with two of those individuals presenting with bilateral aberrant obturator arteries (11.1%). Six of these individuals had an aberrant obturator artery that originated from the deep inferior epigastric artery (33.3%). One individual had an aberrant obturator artery that originated directly from the external iliac artery (5.6%). Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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17 pages, 1612 KiB

Open AccessPerspective

Exploring Anatomic Variants to Enhance Anatomy Teaching: Musculus Sternalis

by Andrew J. Petto, David E. Zimmerman, Elizabeth K. Johnson, Lucas Gauthier, James T. Menor and Nicholas Wohkittel

Diagnostics 2020, 10(8), 508; https://doi.org/10.3390/diagnostics10080508 - 22 Jul 2020

Cited by 5 | Viewed by 5128

Abstract

The opportunity to encounter and appreciate the range of human variation in anatomic structures—and its potential impact on related structures, function, and treatment—is one of the chief benefits of cadaveric dissection for students in clinical preprofessional programs. The dissection lab is also where [...] Read more.

The opportunity to encounter and appreciate the range of human variation in anatomic structures—and its potential impact on related structures, function, and treatment—is one of the chief benefits of cadaveric dissection for students in clinical preprofessional programs. The dissection lab is also where students can examine unusual anatomic variants that may not be included in their textbooks, lab manuals, or other course materials. For students specializing in physical medicine, awareness and understanding of muscle variants has a practical relevance to their preparations for clinical practice. In a routine dissection of the superficial chest muscles, graduate students in a human gross anatomy class exposed a large, well-developed sternalis muscle. The exposure of this muscle generated many student questions about M sternalis: its prevalence and appearance, its function, its development, and its evolutionary roots. Students used an inquiry protocol to guide their searches through relevant literature to gather this information. Instructors developed a decision tree to assist students in their inquiries, both by helping them to make analytic inferences and by highlighting areas of interest needing further investigation. Answering these questions enriches the understanding and promotes “habits of mind” for exploring musculoskeletal anatomy beyond simple descriptions of function and structure. Full article

(This article belongs to the Special Issue Anatomical Variation and Clinical Diagnosis)

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