Cardinal ligament surgical anatomy: cardinal points at hysterectomy

Introduction and hypothesis The cardinal ligament (CL) still requires more precise anatomical mapping. We aim to elucidate the anatomy of the CL and the roles it plays in gynecological surgery. Methods Studies employed sharp dissection of 28 formalin-fixed cadaveric hemipelves and 10 unembalmed cadaveric hemipelves. Results The CL (total length averaging 10.0 cm) can be subdivided into three sections: a distal (cervical) section, on average 2.1 cm long, attached to the lateral aspect of the cervix (posteriorly, it was confluent with the attachment of the uterosacral [USL] ligament to form the cardinal–uterosacral confluence [CUSC]); an intermediate section, on average 3.4 cm long, running laterally (slightly posteriorly) from the cervix; a proximal (pelvic) section, relatively thick, triangular-shaped on cross-section, averaging 4.6 cm long, attached to the lateral pelvic sidewall, with its apex at the first branching of the internal iliac artery. Only the distal section is free of any significant neural or vascular component (ureter is in the intermediate section) and therefore safe for surgical use. The CUSC (first pedicle of a vaginal hysterectomy and later pedicle of an abdominal hysterectomy), if attached to the vaginal vault at hysterectomy has the potential for both lateral (CL) and supero-posterior (USL) surgical support. This pedicle would not be subsequently accessible for other surgeries. Conclusions Suggested cardinal points at hysterectomy are: know the CL anatomy; the distal section (as part of the CUSC) can provide vaginal vault support; the intermediate and proximal sections are surgically dangerous

Social learning by imitation in a reptile (Pogona vitticeps)

The ability to learn through imitation is thought to be the basis of cultural transmission and was long considered a distinctive characteristic of humans. There is now evidence that both mammals and birds are capable of imitation. However, nothing is known about these abilities in the third amniotic class—reptiles. Here, we use a bidirectional control procedure to show that a reptile species, the bearded dragon (Pogona vitticeps), is capable of social learning that cannot be explained by simple mechanisms such as local enhancement or goal emulation. Subjects in the experimental group opened a trap door to the side that had been demonstrated, while subjects in the ghost control group, who observed the door move without the intervention of a conspecific, were unsuccessful. This, together with differences in behaviour between experimental and control groups, provides compelling evidence that reptiles possess cognitive abilities that are comparable to those observed in mammals and birds and suggests that learning by imitation is likely to be based on ancient mechanisms