Morfología del conducto torácico y su importancia clínica

Desde su descubrimiento, el conducto torácico ha sido de poco interés para los anatomistas y los cirujanos. Se le estudian porciones: abdominal, torácica y cervical. Cada una de ellas muestra variaciones que tienen importancia clínico-quirúrgica. El conocimiento de su morfología permite a los cirujanos evitar su lesión

Morphometric characteristics of the asterion and the posterolateral surface of the skull: relationship with dural venous sinuses and neurosurgical importance

abstract Background: Knowledge of the location and morphometry of the lateral venous sinus (transverse and sigmoid) and their relationship with the asterion and other surface anatomic landmarks is imperative for posterolateral approaches to the posterior cranial fossa to avoid vascular structure injury and surgical complications. We undertook this study to determine a secure anatomic area for drilling that allows entry into the posterior cranial fossa without damaging adjacent structures and study the morphometric characteristics of the asterion, the lateral sinus and bony landmarks of the posterolateral surface of the skull. methods: Using a 1.3-mm drill, both sides of 88 dry skulls (176 hemicranias) were drilled. The anatomic landmarks studied were the asterion, apex of the mastoid process, suprameatal spine, Frankfurt horizontal plane, posterior root of the zygomatic arch, external occipital protuberance and its relationship with the transverse sinus. results: Type I asterion is prevalent in 74.4%. In 82.4% of the specimens, the lateral venous sinus can be found lower than the asterion in 12.5% and higher in 5.1%. Conclusions: Using the data from this and other studies, the initial drill must be placed 15 mm below the asterion and 15 mm posterior to it to reduce the risk of injury to the lateral venous sinus

La anatomía en México: un vistazo a la historia

La anatomía es una de las ciencias médicas más antiguas, y en su evolución histórica ha pasado por diversos periodos. En México ha permanecido en los currículos de las escuelas de medicina en forma bastante discreta y sin grandes cambios, conservando su formato y técnicas de enseñanza. En nuestros días son necesarios algunos cambios para actualizar los contenidos y, sobre todo, empatarlos con las tendencias curriculares actuales. Este artículo muestra una revisión general de los periodos por las que ha pasado la anatomía en nuestro país, precolonial (a.C.-1521), poscolonial (1521-1910), moderna (1910-2000) y actual (2000-presente)

A Morphometric Study of the Extraocular Muscles

Extraocular muscles are important references in strabismus surgery and in placement of intraorbital devices. We analyzed extraocular muscles morphometry and possible anatomical variances of 20 orbits. We report the length, width, and points of insertion of the extraocular muscles. No anatomical variations in length, width and points of insertion were found. With regard to the rectus muscles, it was found that the superior rectus and lateral rectus are the longest muscles and that the width difference between the superior and inferior rectus is greater than that between the medial and lateral rectus and that the point of insertion of the rectus muscles has a variable morphology. The superior oblique muscle was smaller in caliber than the inferior oblique, as consistent with previous anatomical studies. Knowledge of the detailed morphology of extraocular muscles is fundamental in strabismus surgery and represents a key factor for the innovation of surgical techniques and orbital procedures

Comments on: Implications of structural variations in the human sacrum: why is an anatomical classification crucial?

We sincerely appreciate the work done by Mahato [1] in which a qualitative classification of the sacrum is done to determine the number of segments, position of auricular surfaces, symmetry and abnormalities. This work is of the utmost importance since it is crucial for several surgical interventions and at the same time correlates certain pathologies with the morphology, mostly low back pai

New arthroscopic portal for performing tenotomy/tenodesis procedures on the long head of the biceps brachii tendon

AbstractBackgroundShoulder arthroscopy is the standard technique for performing procedures involving the intertubercular groove. Current techniques continue to produce excessive soft tissue manipulation and neurovascular injury.Materials and methodsA cross-sectional, observational and descriptive study was conducted on a cohort of 24 shoulders following the standard surgical protocol and using punch dissection. The neurovascular structures with risk of damage by the standard lateral portal were evaluated during the study to establish a secure area for a new arthroscopic portal. Finally, the safety of the new proposed site was evaluated.ResultsThe presence of 24 venous structures, with a mean diameter was 1.05mm (SD: 0.71) was documented. A tendency was observed in locating these structures in the lower half of the dissecting field for the left shoulders and a hypovascular area between the 7 and 10h circle dissected relative to the right shoulder. The new site was determined at a point 1.5cm anterolateral to the anterolateral border of the acromion at an angle of 60° to the horizontal axis of the acromion and towards the intertubercular groove of the humerus.ConclusionsThe methodology used in this study is innovative, reproducible and applicable for the study of all existing shoulder arthroscopic portals procedures, as well as any joint. The results provided by this study will be helpful for clinicians to improve tenotomy/tendon tenodesis procedures of the long head of the biceps brachii tendon

Anatomical Variants of Anterior Cerebral Arterial Circle: A Study by Multidetector Computerized 3D Tomographic Angiography

SUMMARY: One of the most common causes of stroke is rupture of aneurysms whose approach requires knowledge of anatomical variants. The aim of this study was to determine the prevalence of anatomical variants of the anterior cerebral artery (ACA) and the anterior communicating artery (AComA) by 3D computed tomography angiography (3D CTA) in Mexican individuals. A retrospective, observational, cross-sectional descriptive study of 283 patients, independent of sex or age, in which morphometric measurements of cerebral vessels were evaluated using contrasted 3D CTA from a period of two years was performed. We found at least one "atypical" variant in a third of the study population (33.93 %). The most common "atypical" variant was the absence of the AComA (14.1 %). A significant association between the hypoplastic variant of the right A1 segment and hypoplasia of the left A1 and the right A2 was found, while hypoplasia of the left A1 was associated with hypoplasia of the right A2. There is a difference in the prevalence of anatomical variants of the ACA-AComA complex in Mexican population in relation to other populations. The typical variant is the most prevalent form in the study population. However, the presence of atypical variants represents an important number that should be taken into account in clinical and surgical procedures. KEY WORDS: Anterior cerebral artery; Anatomical variant; Anterior communicating artery; Cerebral arterial circle; Subarachnoid hemorrhage; Cerebral endovascular surgery

Conduits for myocardial revascularization grafts: the importance of morphology and imaging

The therapeutic options for patients with multivessel coronary artery disease, consist of pharmacological treatment, percutaneous coronary intervention and coronary artery bypass graft surgery. The ultimate goal of this surgery is to achieve complete revascularization with conduits that remain permeable for the remainder of the life of the patient. Some of the conduits used in this type of surgery, are the great saphenous vein, the internal thoracic artery, the radial artery and the ulnar artery. For a vascular conduit to be selected as a coronary revascularization graft, it must exhibit the following characteristics: sufficient length, lumen diameter and thickness of the vessel wall. It must also have minimal in situ ischemic consequences and an acceptable permeability over time of the conduit. Recent literatures of these conduits, as well as the importance of morphological and imaging studies are reviewed in this article