Clinical Anatomy最新文献

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Terminology of the growing bone: A historical study 骨骼生长术语:历史研究。
IF 2.3 4区 医学
Clinical Anatomy Pub Date : 2024-05-22 DOI: 10.1002/ca.24176
Ondřej Naňka, Jan Bartoníček
{"title":"Terminology of the growing bone: A historical study","authors":"Ondřej Naňka,&nbsp;Jan Bartoníček","doi":"10.1002/ca.24176","DOIUrl":"10.1002/ca.24176","url":null,"abstract":"<p>Division of the growing long bone into individual basic parts, that is, diaphysis, metaphysis, physes and epiphyses, has become generally accepted and used. However, the origin of these terms is almost unknown. Therefore, we have analyzed the literature in order to identify their sources. The terms epiphysis and apophysis have been used since the time of Hippokrates, although with different meanings. During the time of Galen, the term apophysis was used to describe all types of bone processes, and epiphyses denoted articular ends. The term diaphysis denoting the middle cylindrical part of the long bone was used for the first time by Heister in 1717. The first to use the term metaphysis was Theodor Kocher in his books on gunshot wounds and on bone inflammation of 1895. On the basis of Kocher's study, Lexer published a radiological study of the vascular supply to bones in which he defined metaphyseal blood vessels as a separate group supplying a particular part of the long bone. The epiphyseal growth plate had no particular name from the time of its first description in 1836. During the second half of 19th century, this structure acquired different names. The term “physis” was therefore introduced in 1964 by the American radiologist Rubin in order to label the growth structure between metaphysis and epiphysis clearly. One year later, the term physis also appeared in the radiological literature, and during the following decades it spread in the orthopedic literature.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An MRI study demonstrating consistent anatomic relation of central longitudinal artery and associated periosteal vessels with the medial femoral epicondyle and adductor tubercle-A visual landmark method for femoral tunnel placement in medial patellofemoral ligament reconstruction. 一项核磁共振成像研究显示,股骨中央纵动脉和相关骨膜血管与股骨内上髁和内收肌结节的解剖学关系一致--髌骨内侧韧带重建术中股骨隧道置入的视觉地标法。
IF 2.4 4区 医学
Clinical Anatomy Pub Date : 2024-05-15 DOI: 10.1002/ca.24173
Vipul Mandalia, Rahul Anaspure, Sharief Aboelmagd, Roy Powell, William Manning
{"title":"An MRI study demonstrating consistent anatomic relation of central longitudinal artery and associated periosteal vessels with the medial femoral epicondyle and adductor tubercle-A visual landmark method for femoral tunnel placement in medial patellofemoral ligament reconstruction.","authors":"Vipul Mandalia, Rahul Anaspure, Sharief Aboelmagd, Roy Powell, William Manning","doi":"10.1002/ca.24173","DOIUrl":"https://doi.org/10.1002/ca.24173","url":null,"abstract":"<p><p>The two most common techniques to determine femoral tunnel placement during medial patellofemoral ligament (MPFL) reconstruction are radiographic and by palpation. Their intra/interobserver reliability is widely debated. Both techniques rely on identifying bony landmarks such as the medial epicondyle (ME) and adductor tubercle (AT) during surgery. During MPFL reconstructive surgery, the central longitudinal vessels (CLVs) are seen consistently. The aim of this study was to investigate the anatomic relationship of CLV to ME and AT and to determine if CLV might be used as a landmark during MPFL reconstruction. A retrospective review of MRI scans in skeletally mature patients was undertake. There were two groups, a PFI group that consisted of patients with a diagnosis of patellofemoral instabiliy (PFI) and a non-PFI group that underwent MRI scan for an alternative diagnosis. MRIs were measured for the CLV-ME-AT anatomy and relationship. Following exclusions, 50 patients were identified in each group. The CLV passed anterior to the AT and ME in all patients. ME morphology did not differ greatly between the groups except in the tubercle height, where there was statistically significant but not a clinically important difference (larger in the non-PFI group, 2.95 vs. 2.52 mm, p = 0.002). The CLV to ME tip distance was consistent between the groups (PFI group 3.8 mm and non-PFI group 3.9 mm). The CLV-ME-AT relationship remained consistent irrespective of patients' presenting pathology. The CLV consistently courses anterior to ME and AT. The CLV could be used as a vascular landmark assisting femoral tunnel placement during MPFL reconstruction.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introducing AnatomyGPT: A customized artificial intelligence application for anatomical sciences education 介绍 AnatomyGPT:为解剖科学教育定制的人工智能应用程序。
IF 2.3 4区 医学
Clinical Anatomy Pub Date : 2024-05-09 DOI: 10.1002/ca.24178
Bradley R. Collins, Erik W. Black, Kyle E. Rarey
{"title":"Introducing AnatomyGPT: A customized artificial intelligence application for anatomical sciences education","authors":"Bradley R. Collins,&nbsp;Erik W. Black,&nbsp;Kyle E. Rarey","doi":"10.1002/ca.24178","DOIUrl":"10.1002/ca.24178","url":null,"abstract":"<p>Artificial intelligence (AI) technologies are poised to become an increasingly important part of education in the anatomical sciences. OpenAI has also introduced generative pretrained transformers (GPTs), which are customizable versions of the standard ChatGPT application. There is little research that has explored the potential of GPTs to serve as intelligent tutoring systems for learning the anatomical sciences. The objective of this study was to describe the design and explore the performance of AnatomyGPT, a customized artificial intelligence application intended for anatomical sciences education. The AnatomyGPT application was configured with GPT Builder by uploading open-source textbooks as knowledge sources and by providing pedagogical instructions for how to interact with users. The performance of AnatomyGPT was compared with ChatGPT by evaluating the responses of both applications to prompts of the National Board of Medical Examiners (NBME) sample items with respect to accuracy, rationales, and citations. AnatomyGPT achieved high scores on the NBME sample items for Gross Anatomy, Embryology, Histology, and Neuroscience and scored comparably to ChatGPT. In addition, AnatomyGPT provided several citations in the responses that it generated, while ChatGPT provided none. Both GPTs provided rationales for all sample items. The customized AnatomyGPT application demonstrated preliminary potential as an intelligent tutoring system by generating responses with increased citations as compared with the standard ChatGPT application. The findings of this study suggest that instructors and students may wish to create their own custom GPTs for teaching and learning anatomy. Future research is needed to further develop and characterize the potential of GPTs for anatomy education.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anatomical study of the relationship between the lumbar intervertebral disc, nerves, and psoas major. 腰椎间盘、神经和腰大肌之间关系的解剖学研究。
IF 2.4 4区 医学
Clinical Anatomy Pub Date : 2024-05-09 DOI: 10.1002/ca.24177
Hongqi Sun, Chaohui Fan, Xinying Zhou, Zhiyang Zheng, Zezheng Liu, Qingchu Li, Qinghao Zhao
{"title":"Anatomical study of the relationship between the lumbar intervertebral disc, nerves, and psoas major.","authors":"Hongqi Sun, Chaohui Fan, Xinying Zhou, Zhiyang Zheng, Zezheng Liu, Qingchu Li, Qinghao Zhao","doi":"10.1002/ca.24177","DOIUrl":"https://doi.org/10.1002/ca.24177","url":null,"abstract":"<p><p>Cadaveric study; To describe the characteristics of the nerve and its relationship with the lumbar intervertebral disc and psoas major muscle. Nerve injury is an understudied complication of extreme lateral interbody fusion. A detailed description of the nerve anatomy would be helpful for surgeons to minimize the risk of this complication. The lumbar plexus and lumbar sympathetic nerve of 10 embalmed male cadavers were dissected, and the distribution, number, and spatial orientation of the nerves on the L1/2 to L4/5 intervertebral discs were examined. Metal wires were applied along nerve paths through the psoas major muscle. The position of the nerves was examined on CT. In zone III at L1/2 and L4/5, no nerves were found. In zone II and zone III at L2/3, no lumbar plexus was found, and only the ramus communicans passed through. At the L1-L5 level, the density of nerves in the posterior half of the psoas major muscle was greater than that in the anterior half. The lumbar plexus was found in all of zone IV. The genitofemoral nerve emerges superficially and anteriorly from the medial border of the psoas major at the L3-4 level, but at the L1/2 level, the sympathetic trunk is located in zone II. The remaining disc-level sympathetic trunks appear in zone I. No nerves were found in zone III of the L1/2 or L4/5 disc. In zones II and III of L2/3, the lumbar plexus appears safe. The genitofemoral nerve travels through zones II and III of L3/4. The distribution density of nerves in the posterior half of the psoas major muscle was greater than that in the anterior half of that muscle at the L1-L5 level.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morphology of the dysplastic hip and the relationship with sex and acetabular version. 发育不良髋关节的形态以及与性别和髋臼形态的关系。
IF 2.4 4区 医学
Clinical Anatomy Pub Date : 2024-05-08 DOI: 10.1002/ca.24174
Inger Mechlenburg, Sepp De Raedt, Hakim C Achterberg, Maiken Stilling, Lone Rømer, Kjeld Søballe, Marleen de Bruijne
{"title":"Morphology of the dysplastic hip and the relationship with sex and acetabular version.","authors":"Inger Mechlenburg, Sepp De Raedt, Hakim C Achterberg, Maiken Stilling, Lone Rømer, Kjeld Søballe, Marleen de Bruijne","doi":"10.1002/ca.24174","DOIUrl":"https://doi.org/10.1002/ca.24174","url":null,"abstract":"<p><p>The dysplastic hip is characterized by incomplete coverage of the femoral head, resulting in increased risk of early osteoarthritis. The morphological variation of the hip joint is diverse and clear differences exist between females and males. The aim of this observational study was therefore to investigate the relationship between the morphology of the hip, sex, and hip dysplasia using a three-dimensional model. Statistical shape models of the combined femur and pelvic bones were created from bilateral hips of 75 patients. Using manual angle measurements and regression analysis, the characteristic shape differences associated with sex and hip dysplasia were determined. The model showed clear differences associated with sex and hip dysplasia. We found that the acetabular anteversion in females was significantly higher (p < 0.0001) than in males while no significant difference in acetabular anteversion was found between normal and dysplastic hips (p = 0.11). The model showed that decreased acetabular anteversion resulted in the appearance of the cross-over sign and the prominent ischial spine sign commonly associated with retroversion. Sex could be predicted with an area under the curve of 0.99 and hip dysplasia could be predicted with an area under the curve of ≥0.73. Our findings suggest that retroversion is a result of decreased anteversion of the acetabulum and is primarily associated with sex. This finding should be taken into account during the reorientation of the acetabulum in the surgical treatment of hip dysplasia.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Junior and senior students possess differential preferences towards multimodal digital anatomy resources 大三和大四学生对多模态数字解剖资源的偏好有所不同。
IF 2.3 4区 医学
Clinical Anatomy Pub Date : 2024-05-08 DOI: 10.1002/ca.24175
Sharmeen Adnan, Patrick Michael, Amanda C. Benson, Junhua Xiao
{"title":"Junior and senior students possess differential preferences towards multimodal digital anatomy resources","authors":"Sharmeen Adnan,&nbsp;Patrick Michael,&nbsp;Amanda C. Benson,&nbsp;Junhua Xiao","doi":"10.1002/ca.24175","DOIUrl":"10.1002/ca.24175","url":null,"abstract":"<p>Digital technologies are changing how anatomy is taught tremendously. However, little is known about the effective integration of multimodal digital resources when concurrently provided in an anatomy course. To address this question, an array of digital anatomy resources including Augmented Reality (AR) and Virtual Reality (VR) anatomy resources were concurrently trialed by a total of 326 undergraduate and postgraduate students across three undergraduate (systemic anatomy, neuroanatomy, and regional anatomy) and one postgraduate anatomy (applied musculoskeletal anatomy) curricula in 2022. A five-point Likert scale learning and teaching survey was conducted to evaluate students' experiences, preferences, and perceptions. Most undergraduate (81% systemic anatomy, 76% neuroanatomy, and 87% regional anatomy) and postgraduate (97%) participants across the four cohorts felt confident in studying anatomy using digital resources and the majority (&gt;80% undergraduate and &gt;90% postgraduate) found the multimodal digital anatomy resources interactive and stimulating. The response showed that undergraduate (77% systemic anatomy, 81% neuroanatomy, and 97% regional anatomy) and postgraduate students (92%) consistently enjoyed their experience of using multimodal digital anatomy resources and thought that these resources enhanced their interest in studying anatomy. However, there are significant differences in ratings of specific digital resources among the junior (first-year undergraduates) and senior (third-year undergraduates and postgraduates) students. The virtual dissection table was uniformly preferred by the four cohorts of students across the board. Interestingly, however, VR anatomy and radiographic-based digital anatomy resources received diverse ratings. VR anatomy was valued most by junior undergraduate students (84%) who studied systemic anatomy compared to their senior counterparts (73%) who studied regional anatomy, whereas radiographic-based digital anatomy resources were more valued by the postgraduate students (93%) compared to undergraduates (65% systemic anatomy, 73% neuroanatomy, and 48% regional anatomy). This study identifies that while students uniformly appreciate the value of multimodal digital anatomy teaching, there is a clear difference in their perceptions towards individual resources, likely in a course-specific manner. We conclude that the selection and adoption of digital anatomy tools must be tailored as part of course design and that digital anatomy tools should be used in combination to provide an effective learning experience for students.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ca.24175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Capturing the cervical spine shape: Angular measurements versus geometric morphometric methods. 捕捉颈椎形状:角度测量法与几何形态测量法的比较。
IF 2.4 4区 医学
Clinical Anatomy Pub Date : 2024-04-24 DOI: 10.1002/ca.24166
Einat Kedar, D. Ezra, Ruth Pelleg-Kallevag, D. Stein, Nathan Peled, H. May, Israel Hershkovitz
{"title":"Capturing the cervical spine shape: Angular measurements versus geometric morphometric methods.","authors":"Einat Kedar, D. Ezra, Ruth Pelleg-Kallevag, D. Stein, Nathan Peled, H. May, Israel Hershkovitz","doi":"10.1002/ca.24166","DOIUrl":"https://doi.org/10.1002/ca.24166","url":null,"abstract":"The cervical spine manifests a wide shape variation. However, the traditional methods to evaluate the cervical spine curve were never tested against its actual shape. The study's main aim was to determine whether the shape classification of the cervical spine, based on traditional angular measurements, coincides with each other and with the shape captured by the 2D landmark-based geometric morphometric method. The study's second aim was to reveal the associations between the cervical spine shape and the demographic parameters, the head's position, and the spine's sagittal balance. CT scans of the cervical spine of 163 individuals were evaluated to achieve these goals. The shape was assessed by measuring the C2-C7 Cobb angle (CA), the C2-C7 posterior tangent angle (PTA), the curvedness of the arch, and by a 2D landmark-based geometric morphometric method. The position of the head and the sagittal balance of the spine were evaluated by measuring the foramen magnum-C2 Cobb angle (FMCA) and the T1 slope angle (T1SA), respectively. Based on the size of the angle measured, each individual was classified into one of the three cervical 'shape groups' (lordotic, straight, and kyphotic). We found that cervical lordosis was the dominant shape regardless of the measuring methods utilized (46.6%-54.6%), followed by straight neck (28.2%-30.1%), and kyphosis (15.3%-25.2%); however, about a third of the 163 individuals were classified into a different shape group using the CA and PTA methods. The cervical spine angle was sex-independent and age-dependent. The T1SA was significantly correlated with CA and PTA (r = 0.640 and r = 0.585, respectively; p < 0.001). In conclusion, the cervical spine shape evaluation is method-dependent and varies with age.","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140661510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Research advances and trends in anatomy from 2013 to 2023: A visual analysis based on CiteSpace and VOSviewer 2013年至2023年解剖学的研究进展和趋势:基于 CiteSpace 和 VOSviewer 的可视化分析。
IF 2.3 4区 医学
Clinical Anatomy Pub Date : 2024-04-23 DOI: 10.1002/ca.24168
Yikuan Du, Xiaolin Cai, Ye Zheng, Aoxue Long, Mengting Zhang, Mianhai Chen, Weichui Zhang, Jinfeng Zhu, Jinhua Guo, Chun Yang
{"title":"Research advances and trends in anatomy from 2013 to 2023: A visual analysis based on CiteSpace and VOSviewer","authors":"Yikuan Du,&nbsp;Xiaolin Cai,&nbsp;Ye Zheng,&nbsp;Aoxue Long,&nbsp;Mengting Zhang,&nbsp;Mianhai Chen,&nbsp;Weichui Zhang,&nbsp;Jinfeng Zhu,&nbsp;Jinhua Guo,&nbsp;Chun Yang","doi":"10.1002/ca.24168","DOIUrl":"10.1002/ca.24168","url":null,"abstract":"<p>As the cornerstone of medicine, the development of anatomy is related to many disciplines and fields and has received extensive attention from researchers. How to integrate and grasp the cutting-edge information in this field quickly is a challenge for researchers, so the aim of this study is to analyze research in anatomy using CiteSpace and VOSviewer in order to identify research hotspots and future directions. To offer a fresh viewpoint for assessing the academic influences of researchers, nations, or institutions on anatomy, and to examine the development of hotspots in anatomical study and to forecast future trends. A total of 4637 anatomy-related publications from 2013 to 2023 were collected from Web of Science Core Collection databases. Their temporal distribution, spatial distribution, cited authors, co-cited journals, keywords, and disciplinary connections in the literature were analyzed using CiteSpace and VOSviewer, and a knowledge graph was constructed. The temporal distribution shows a general fluctuation in the amount of literature published from 2013 to 2023. In spatial distribution, the total number of published articles was highest in the United States, the United Kingdom, and China, the United States leading. Tubbs, Rhoton, Iwanaga, and LaPrade are important authors in anatomy. <i>Clinical Anatomy</i>, <i>Surgical and Radiologic Anatomy</i>, and <i>Journal of Anatomy</i> were the most highly cited journals. Analysis of keywords and citation emergence showed that the research hotspots and trends in anatomy focused mainly on anatomy education, digital technology, and surgical management. At the same time, anatomy showed a trend toward multidisciplinary crossover, developing closer relationships with molecular biology, immunology, and clinical medicine. Current research in anatomy focuses on innovative reform of the educational model and the application and promotion of digital technology. Also, multidisciplinary cross-fertilization is an inevitable trend for the future development of anatomy.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The importance of the palatine bone for endoscopic endonasal skull base surgery. 腭骨对内窥镜颅底手术的重要性。
IF 2.4 4区 医学
Clinical Anatomy Pub Date : 2024-04-22 DOI: 10.1002/ca.24170
N. Komune, Satoshi Matsuo, Osamu Akiyama, Yuhei Sangatsuda, Daisuke Kuga, Yusuke Miyamoto, Tomoharu Suzuki, Daisuke Murakami, Koji Yoshimoto, J. Iwanaga, R. S. Tubbs, Takashi Nakagawa
{"title":"The importance of the palatine bone for endoscopic endonasal skull base surgery.","authors":"N. Komune, Satoshi Matsuo, Osamu Akiyama, Yuhei Sangatsuda, Daisuke Kuga, Yusuke Miyamoto, Tomoharu Suzuki, Daisuke Murakami, Koji Yoshimoto, J. Iwanaga, R. S. Tubbs, Takashi Nakagawa","doi":"10.1002/ca.24170","DOIUrl":"https://doi.org/10.1002/ca.24170","url":null,"abstract":"Endoscopic endonasal skull base surgery is increasingly prevalent, with its scope expanding from pathogens in the midline region to those in the paramedian region. Maximizing anterior sphenoidectomy is important for the median approach, and lateralizing the pterygopalatine fossa is crucial for the paramedian approach. Maximizing the surgical corridor in the nasal cavity and minimizing damage to neurovascular structures are vital for establishing a surgical field with minimal bleeding, ensuring safe, precise, and gentle procedures. However, the relationship between the maxillofacial and skull base bones in endoscopic endonasal skull base surgery is difficult to understand because these bones are intricately articulated, making it challenging to visualize each bone's outline. Understanding important bones and their related neurovascular structures is essential for all skull base surgeons to maximize the surgical corridor and minimize iatrogenic injury to neurovascular structures. This study aimed to elucidate the role of the palatine bone from a microsurgical anatomical perspective. Three dry skulls were used to demonstrate the structure of the palatine bone and its relationship with surrounding bones. A formalin-perfused cadaveric head was dissected to show the related neurovascular structures. The arteries and veins of the cadaveric heads were injected with red- and blue-colored silicon. Dissection was performed using a surgical microscope and endoscope. In addition, the utilization of the palatine bone as a landmark to identify neurovascular structures, which aids in creating a wider surgical field with less bleeding, was shown in two representative cases. The palatine bone consists of unique complex structures, including the sphenoidal process, ethmoidal crest, pterygopalatine canal, and sphenopalatine notch, which are closely related to the sphenopalatine artery, maxillary nerve, and its branches. The ethmoidal crest of the palatine bone is a well-known structure that is useful for identifying the sphenopalatine foramen, controlling the sphenopalatine artery and nerve, and safely opening the pterygopalatine fossa. The sphenoidal process of the palatine bone is a valuable landmark for identifying the palatovaginal artery, which is a landmark used to safely and efficiently expose the vidian canal. The sphenoidal process is easily cracked with an osteotome and removed to expose the palatovaginal artery, which runs along the pharyngeal groove, just medial to the vidian canal. By opening the pterygopalatine canal (also known as the greater palatine canal), further lateralization of the periosteum-covered pterygopalatine fossa contents can be achieved. Overall, the sphenoidal process and ethmoidal crest can be used as important landmarks to maximize the surgical corridor and minimize unnecessary injury to neurovascular structures.","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140677987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism 通过辘轳机制直接观察和测量足弓变形过程中的足底肌腱行为
IF 2.4 4区 医学
Clinical Anatomy Pub Date : 2024-04-20 DOI: 10.1002/ca.24171
Yuka Matsumoto, Naomichi Ogihara
{"title":"Direct visualization and measurement of the plantar aponeurosis behavior in foot arch deformation via the windlass mechanism","authors":"Yuka Matsumoto, Naomichi Ogihara","doi":"10.1002/ca.24171","DOIUrl":"https://doi.org/10.1002/ca.24171","url":null,"abstract":"The plantar aponeurosis (PA) is an elastic longitudinal band that contributes to the generation of a propulsive force in the push‐off phase during walking and running through the windlass mechanism. However, the dynamic behavior of the PA remains unclear owing to the lack of direct measurement of the strain it generates. Therefore, this study aimed to visualize and quantify the PA behavior during two distinct foot postures: (i) neutral posture and (ii) windlass posture with midtarsal joint plantarflexion and metatarsophalangeal joint dorsiflexion, using computed tomography scans. Six healthy adult males participated in the experiment, and three‐dimensional reconstruction of the PA was conducted to calculate its path length, width, thickness, and cross‐sectional area. This study successfully visualized and quantified the morphological changes in the PA induced by the windlass mechanism, providing a precise reference for biomechanical modeling. This study also highlighted the interindividual variability in the PA morphology and stretching patterns. Although the windlass posture was not identical to that observed in the push‐off phase during walking, the observed PA behavior provides valuable insights into its mechanics and potential implications for foot disorders.","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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