Variations of the origin of collateral branches emerging from the posterior aspect of the brachial plexus

<p>Abstract</p> <p>Background</p> <p>The frequency of variation found in the arrangement and distribution of the branches in the brachial plexus, make this anatomical region extremely complicated. The medical concerns involved with these variations include anesthetic blocks, surgical approaches, interpreting tumor or traumatic nervous compressions having unexplained clinical symptoms (sensory loss, pain, wakefulness and paresis), and the possibility of these structures becoming compromised. The clinical importance of these variations is discussed in the light of their differential origins.</p> <p>Methods</p> <p>The anatomy of brachial plexus structures from 46 male and 11 female cadaverous specimens were studied. The 40–80 year-old specimens were obtained from the Universidad Industrial de Santander's Medical Faculty's Anatomy Department (dissection laboratory). Parametric measures were used for calculating results.</p> <p>Results</p> <p>Almost half (47.1%) of the evaluated plexuses had collateral variations. Subscapular nerves were the most varied structure, including the presence of a novel accessory nerve. Long thoracic nerve variations were present, as were the absence of C5 or C7 involvement, and late C7 union with C5–C6.</p> <p>Conclusion</p> <p>Further studies are needed to confirm the existence of these variations in a larger sample of cadaver specimens.</p

Possible implications of an accessory abductor digiti minimi muscle: a case report

<p>Abstract</p> <p>Background</p> <p>Accessory ADM was first reported in 1868 although muscular, vascular and nervous variations of the hypothenar eminence are rare, contrary to anomalous muscles in the wrist which are relatively common.</p> <p>Case presentation</p> <p>This case report presents a bilateral variation of an accessory abductor digiti minimi muscle in a male specimen. Ulnar artery and ulnar nerves were taken into account regarding their position and trajectory related to this variation.</p> <p>Conclusion</p> <p>Muscle size may be an important factor in considering whether a variation is able to produce neurovascular compression and clinical implications.</p

Bursitis Hamular y su posible sintomatología craneofacial referida: reporte de dos casos

El diagnostico del dolor craneofacial esta condicionado al manejo interdisciplinario por lo confuso de su presentación especialmente en la ausencia de signos únicos y objetivos. La bursitis es una entidad patológica recientemente notificada en la zona hamular y que debe ser vinculada al diagnostico por exclusión en desordenes temporomandibulares (DTM) y patologías de oído, nariz y garganta, debido a la sintomatología similar a la de otras condiciones que afectan la región de cabeza y cuello. La bursitis del proceso hamular es un patología dolorosa que puede fácilmente ser confundida con neuralgia del glosofaríngeo o del trigémino que genera gran incomodidad en la orofaringe con sintomatología heterotopica referida y patrón ipsilateral a cara. Esta patología en estados crónicos puede ser responsable de la amplificación del dolor percibido por efecto de excitación central. En este reporte se presentan dos casos clínicos de Bursitis Hamular y su manejo terapéutico conservador. El reconocimiento de la inflamación de la bursa del tendón del músculo tensor del velo palatino suministra al especialista una herramienta más en el manejo del dolor craneofacial.The diagnosis of craniofacial pain is conditioned by the interdisciplinary management of its presentation especially in the absence of unique and objective signs. Bursitis is a pathological entity recently found in the hamular area and should be included in the diagnosis for exclusion of temporomandibular disorders (TMD), ear-nose-throat pathologies, due to the similar symptomatology to other head and neck conditions. The hamular process bursitis is a painful condition that can easily be confused with glosopharinge or trigeminal neuralgia that generates an uncomfortable feeling in the oropharinge with ipsilateral referred ' heteretopic - symptomatology to the head. This pathology, in chronic states, can be responsible for the amplification of the pain perceived by the central excitation effect. In this report are presented two clinical cases of hamular bursitis and its conservative therapeutic management. The recognition of the inflammation of the bursa of the tensor veli palati muscle supplies the specialist with another tool in the management of craniofacial pain

Tensor tympani muscle: strange chewing muscle

This work seeks to alert medical and odontological staff to understanding and using interdisciplinary handling for detecting different pathologies? common otic symptoms. It offers better tools for this shared symptomatology during therapy?s conservative phase. Tensor tympani muscle physiology and function in the middle ear have been veiled, even when their dysfunction and anatomical relationships may explain a group of confused otic symptoms during conventional clinical evaluation. Middle ear muscles share a common embryological and functional origin with chewing and facial muscles. This article emphasizes that these muscles share a functional neurological and anatomical dimension with the stomatognathic system; these muscles? increased tonicity ceases to be a phenomenon having no logical connections. It offers functionality and importance in understanding referred otic symptoms in common with other extra-otical symptom pathologies. Tinnitus, vertigo, otic fullness sensation, hyperacusia, hypoacusia and otalgia are not only primary hearing organ symptoms. They should be redefined and related to the neighboring pathologies which can produce them. There is a need to understand temporomandibular disorders and craniofacial referred symptomatology from neurophysiologic and muscle-skeletal angles contained in the stomatognathic system. Common symptomatology is frequently observed in otic symptoms and temporomandibular disorders during daily practice; this should be understood by each discipline from a broad, anatomical and clinical perspective

Hamular Bursitis and its possible craniofacial referred symptomatology : two case reports

The diagnosis of craniofacial pain is conditioned by the interdisciplinary management of its presentation especially in the absence of unique and objective signs. Bursitis is a pathological entity recently found in the hamular area and should be included in the diagnosis for exclusion of temporomandibular disorders (TMD), ear-nose-throat pathologies, due to the similar symptomatology to other head and neck conditions. The hamular process bursitis is a painful condition that can easily be confused with glosopharinge or trigeminal neuralgia that generates an uncomfortable feeling in the oropharinge with ipsilateral referred ? heteretopic - symptomatology to the head. This pathology, in chronic states, can be responsible for the amplification of the pain perceived by the central excitation effect. In this report are presented two clinical cases of hamular bursitis and its conservative therapeutic management. The recognition of the inflammation of the bursa of the tensor veli palati muscle supplies the specialist with another tool in the management of craniofacial pain

Differential distribution patterns in cerebellar irrigation. A study with autopsy material

Aim: The aim of this investigation was characterize morphologically the cerebellar artery and its branches in a specimen of autopsy material. Methods: This descriptive cross-sectional study evaluated the anatomical characteristics of the cerebellar arteries and their branches in 93 brain stem and cerebellum blocks obtained from fresh cadavers. The specimens were perfused bilaterally channeling the proximal segments of the internal carotid and vertebral arteries with a semi-synthetic resin (Palatal GP40L 85%; styrene 15%) impregnated with mineral red dye. We evaluated the distribution patterns of the cerebellar artery and its branches. Results: The calibers of the superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) were 1.46 ± 0.2 mm, 1.02 ± 0.35 mm and 1.45 ± 0.37 mm, respectively. Agenesis of the SCA was observed in six specimens (3.2%), AICA in 30 (16.1%), and PICA in 14 (7.5%) specimens. Usual irrigation was observed in 44 (47.3%) cerebellar blocks, whereas 49 (52.7%) specimens showed irrigation variants, 23 (46.9%) of which appeared bilaterally. The dominant distribution of the cerebellar arteries corresponded to SCA in 9 (12.5%) cases, AICA in 46 (63.9%) and PICA in 7 (9.7%) specimens; shared dominance was found in 10 (13.9%) specimens. Conclusion: The high variability of the cerebellar arteries observed in the present study is consistent with previous reports. The diverse anatomic expressions of the cerebellar arteries were typified in relation to their dominance and territories irrigated, useful for the diagnosis and clinical-surgical management of the cerebellum blood supply

The digastric muscle?s anterior accessory belly : case report

Digastric muscle is characterized by presenting occasional variations. The suprahyoid region of an 83 year-old male cadaver was dissected and an anatomic variation of the digastric muscle was observed in its anterior belly. It consisted of an accessory bilateral anterior belly originating in the intermediate tendon and inserted into the mylohyoid raphe. The implications of this variation are discussed from a diagnostic and functional perspective

Frecuencia del músculo Palmar Longo. Un estudio con población de Bucaramanga

RESUMEN El propósito de este estudio fue determinar la presencia del Músculo Palmar Longo (MPL) considerando el sexo y el componente étnico en una población de Bucaramanga. Materiales y métodos: se evaluó la presencia del MPL, mediante la visualización directa de su tendón, en los antebrazos de 1214 individuos mayores de 10 años, de sexo masculino y femenino y de raza blanca y mestiza. La expresión del tendón del MPL requiere de una maniobra específica de oposición de los pulgares y flexión de las articulaciones radiocarpianas. Resultados; se observó agenesia global de 20,3%, correspondiendo a los blancos 21.5% y a los mestizos 19%. Considerando el sexo, la agenesia del palmar fue mayor en mujeres (22.2%) que en los hombres (17,2%), siendo la diferencia significativa (chi cuadrado yates corrected x2= 4,07, p< 0.04). Predominó la ausencia muscular bilateral (10.3%) sobre la unilateral izquierda (5.8%) y derecha (4.2%). Conclusiones: la incidencia de la agenesia observada del palmar longo se ubica en un rango intermedio a lo señalado para las poblaciones étnicas: caucasoides, negroides y mongoloides. Existe concordancia con la mayoría de estudios que señalan mayor agenesia del palmar en mujeres que en hombres y en el lado izquierdo. Salud UIS 2002; 34: 12-17Palabras Clave: Anatomía, Sistema muscular, Palmar longo, Agenesia.  ABSTRACT The purpose of this study was to determine the presence of the Palmaris Longus Muscle (PLM) considering the sex and the ethnic component in a population of Bucaramanga. Materials and methods: the presence of the PLM was evaluated, by means of the direct visualization of its tendon, in the forearms of 1214 individuals bigger than 10 years old, of males and females and of white and half-breed race. The expression of the tendon of the PLM requires of a specific maneuver of opposition of the thumbs and flexion of the radiocarpian articulations. Results: global absence of 20.3% was observed, corresponding to the white race 21.5% and to the half-breed race 19%. Considering the sex, the absence of the palmaris longus was bigger in women (22.2%) that in the men (17.2%), being the significant difference {squared Chi: Yates corrected x1 = 4.07,

Superficial palmar arch: anatomy and clinical implications

Introduction: The palmar irrigation has been the subject of research in different population groups using direct anatomical dissection. However, there is no standardized classification of superficial palmar arches, which leads the different authors to design own classifications.Objective: to determine the different patterns of superficial palmar arch, and the clinical and surgical revelance of the various anatomical variants associated with this structure. Research methodology: A literature search was performed in data bases Medline, Ovid, Proquest, Cochrane, Scielo, Lilacs and Hinary, besides classical texts of anatomy and surgery. Retrospective and cross-sectional studies were selected in cadaveric specimens made in different population groups between 1987 to 2014. Results: It was used the superficial palmar arch classification established by Lippert and Pabst, that presented the complete superficial palmar arch as the most common vascular pattern, with a prevalence of 56.7%, in which was the most common subtype the classic radio-ulnar (64%). The prevalence of incomplete surperficial palmar arch was 48.8%, with a subtype of ulnar pattern reported in 24.7% of the samples tested. Conclusions: Adequate knowledge of the different patterns of palmar Irrigation is essential for successful approaches in hand surgery, and for understanding the pathophysiology of diseases related to employment as hypothenar hammer syndrome. MÉD UIS. 2015;28(3):363-9.Keywords: Anatomical Variation. Superficial Palmar Arch. Radial Artery. Ulnar Artery.Introducción: La irrigación palmar ha sido investigada en diferentes grupos poblacionales mediante la disección anatómica directa. Sin embargo, no existe una clasificación estandarizada de arcos palmares superficiales, lo cual conduce a que diferentes autores diseñen clasificaciones propias. Objetivo: Determinar los diferentes patrones del arco palmar superficial y la relevancia tanto clínica como quirúrgica de las diversas variantes anatómicas asociadas a esta estructura. Metodología de búsqueda: Se realizó una búsqueda de literatura en las bases de datos Medline, Ovid, Proquest, Cochrane, SciELO, Lilacs y Hinary, además de textos clásicos de anatomía y cirugía. Se seleccionaron estudios retrospectivos y transversales en especímenes cadavéricos realizados en diferentes grupos poblacionales entre 1987 hasta 2014. Resultados: Se utilizó la clasificación de arco palmar superficial establecida por Lippert y Pabst, que presentó el arco palmar superficial completo como el patrón vascular más común, con una prevalencia del 56,7%, en la que el subtipo más frecuente fue el radio-ulnar clásico con un 64%. La prevalencia del arco palmar superficial incompleto fue de 48,8%, con un subtipo de patrón ulnar reportado en el 24,7% de las muestras evaluadas. Conclusiones: El adecuado conocimiento de los diferentes patrones de la irrigación palmar es esencial para realizar abordajes exitosos en cirugías de mano y para la comprensión de la fisiopatología de enfermedades de carácter laboral como el síndrome de martillo hipotenar. MÉD UIS. 2015;28(3):363-9.Palabras clave: Variación Anatómica. Arco Palmar Superficial. Arteria Radial. Arteria Ulnar.

Estandarización de una técnica de inyección de resinas poliéster para el estudio de la vasculatura cerebral

RESUMEN INTRODUCCIÓN: La enfermedad cerebrovascular en nuestro medio tiene una alta tasa de morbimortalidad. Dentro de las técnicas anatómicas utilizadas para el estudio de la irrigación de diversas estructuras y órganos se destaca la inyección de látex neopreno, acetato de vinilo y de diferentes polímeros tipo silicona, seguida de corrosión parcial o total de las estructuras anatómicas. Para poder establecer el patrón de irrigación de una muestra de población colombiana se desarrolló una técnica de inyección de resinas tipo poliéster. MATERIALES Y MÉTODOS: Para la implementación de la técnica se analizaron 122 encéfalos de sujetos mestizos de sexo masculino provenientes de la ciudad de Bucaramanga, Colombia. Las edades de los sujetos variaron entre los 15 y 65 años que no presentaban ninguna patología que comprometiera el sistema nervioso. El procedimiento incluyó la cateterización de las arterias carótida interna (ACI) y vertebral en forma bilateral, lavado y prefijado del lecho vascular con 100 ce de formaldehído al 10% y la posterior inyección de 100 cc de resina de poliéster impregnada de color rojo mineral. CONCLUSIONES: Esta técnica económica permite por medio de la fácil manipulación de las muestras, conservar las características anatómicas de los vasos sanguíneos, su apariencia, relaciones estructurales externas, lo cual es de gran relevancia en la evaluación de las diferentes alteraciones. Palabras Clave: Compuestos de silicona; vasos sanguíneos, resinas acrílicas, sistema nervioso central, circulación sanguíneaABSTRACT INTRODUCTION: The Vascular-Brain disease in our media has a high rate of morbidity and mortality Among the anatomical techniques used for the study of the irrigation of diverse structures and organs, there is highlighted the injection of neoprene latex, vinyl acetate and different silicone-like polymers, followed by partial or total corrosion of the anatomical structures. In order to establish the pattern of irrigation of a sample of Colombian population, a technique of injection of polyester-like resins was developed. MATERIALS AND METHODS: For the implementation of the technique 122 brains were analyzed belonging to male crossbred subjects, natives from Bucaramanga, Colombia. The age of the subjects ranged between 15 and 65 years who did not show any pathology that jeopardize the nervous system. The procedure included the catheterization of the internal carotid artery (ICA) and vertebral artery bilaterally, washing and default of vascular bed with 100 cc Formaldehyde 10%, and the subsequent injection of 100 cc Polyester resin impregnated with red ore. CONCLUSIONS: This economic technique allows through the easy manipulation of the samples, to keep the anatomical characteristics of the blood vessels, its appearance, structural external relations, which is very relevant in the evaluation of different alterations. Keywords: Silicon compounds, blood vessels, acrylic resins, central nervous system, blood circulation