Sample records for endonasal anatomy relevance

  1. Variations of endonasal anatomy: relevance for the endoscopic endonasal transsphenoidal approach.

    NARCIS (Netherlands)

    Lindert, E.J. van; Ingels, K.J.A.O.; Mylanus, E.A.M.; Grotenhuis, J.A.


    BACKGROUND: The endoscopic endonasal transsphenoidal approach (EETA) to the pituitary is performed by ear, nose, and throat (ENT) surgeons in collaboration with neurosurgeons but also by neurosurgeons alone even though neurosurgeons have not been trained in rhinological surgery. PURPOSE: To register

  2. Nasal and skull base anatomy of endoscopic endonasal transsphenoidal surgery with multi-detector computed tomography

    International Nuclear Information System (INIS)

    Hasegawa, Yuzo; Saeki, Naokatsu; Murai, Hisayuki; Horiguchi, Kentaro; Hanazawa, Toyoyuki; Okamoto, Miyoshi; Yanagawa, Noriyuki


    The endoscope is a new and highly useful instrument for transphenoidal surgery (TSS), and is generally used because of its minimally invasiveness. In addition, endoscopic transsphenoidal surgey (eTSS) has a potential for more radical tumor removal at the pituitary and the parasellar regions by wider visualization and more powerful illumination. To operate these regions safely, we need to know nasal and skull base anatomy under the endoscope which looks different from images under a microscope. In this paper, we demonstrated nasal and skull base anatomy with multi-detector computed tomography, which was performed in 23 recent patients with pituitary and parasellar legions. In the nasal legion, deviation of nasal septum and deviation of sphenoid ostium are important for endonasal approach of eTSS, and often determine the difficulty of surgery in the nasal cavity. Our study showed that deviation of nasal septum was seen in 26% of patients. Deviation of sphenoid ostium was 5.5±1.5 mm from the midline. The anatomy of sphenoid sinus plays a key role in our determination of the safety of a bony opening of the sella. In addition to sellar, presellar, and concha types, carotid prominence and optic prominence are important to determine the midline orientation. Development of carotid prominence was significantly related to the extent of lateral pneumatization of sphenoid sinus (P=0.0016). Reconstructed 3D-image of sphenoid sinus was very useful in visual understanding skull base anatomy. (author)

  3. Three-Hand Endoscopic Endonasal Transsphenoidal Surgery: Experience With an Anatomy-Preserving Mononostril Approach Technique. (United States)

    Eseonu, Chikezie I; ReFaey, Karim; Pamias-Portalatin, Eva; Asensio, Javier; Garcia, Oscar; Boahene, Kofi D; Quiñones-Hinojosa, Alfredo


    Variations on the endoscopic transsphenoidal approach present unique surgical techniques that have unique effects on surgical outcomes, extent of resection (EOR), and anatomical complications. To analyze the learning curve and perioperative outcomes of the 3-hand endoscopic endonasal mononostril transsphenoidal technique. Prospective case series and retrospective data analysis of patients who were treated with the 3-hand transsphenoidal technique between January 2007 and May 2015 by a single neurosurgeon. Patient characteristics, preoperative presentation, tumor characteristics, operative times, learning curve, and postoperative outcomes were analyzed. Volumetric EOR was evaluated, and a logistic regression analysis was used to assess predictors of EOR. Two hundred seventy-five patients underwent an endoscopic transsphenoidal surgery using the 3-hand technique. One hundred eighteen patients in the early group had surgery between 2007 and 2010, while 157 patients in the late group had surgery between 2011 and 2015. Operative time was significantly shorter in the late group (161.6 min) compared to the early group (211.3 min, P = .001). Both cohorts had similar EOR (early group 84.6% vs late group 85.5%, P = .846) and postoperative outcomes. The learning curve showed that it took 54 cases to achieve operative proficiency with the 3-handed technique. Multivariate modeling suggested that prior resections and preoperative tumor size are important predictors for EOR. We describe a 3-hand, mononostril endoscopic transsphenoidal technique performed by a single neurosurgeon that has minimal anatomic distortion and postoperative complications. During the learning curve of this technique, operative time can significantly decrease, while EOR, postoperative outcomes, and complications are not jeopardized. Copyright © 2017 by the Congress of Neurological Surgeons

  4. Endoscopic endonasal anatomy of superior orbital fissure and orbital apex regions: critical considerations for clinical applications. (United States)

    Dallan, Iacopo; Castelnuovo, Paolo; de Notaris, Matteo; Sellari-Franceschini, Stefano; Lenzi, Riccardo; Turri-Zanoni, Mario; Battaglia, Paolo; Prats-Galino, Alberto


    The superior orbital fissure is a critical three-dimensional space connecting the middle cranial fossa and the orbit. From an endoscopic viewpoint, only the medial aspect has a clinical significance. It presents a critical relationship with the lateral sellar compartment, the pterygopalatine fossa and the middle cranial fossa. The connective tissue layers and neural and vascular structures of this region are described. The role of Muller's muscle is confirmed, and the utility of the maxillary and optic strut is outlined. Muller's muscle extends for the whole length of the inferior orbital fissure, passes over the maxillary strut and enters the superior orbital fissure, representing a critical surgical landmark. Dividing the tendon between the medial and inferior rectus muscle allows the identification of the main trunk of the oculomotor nerve, and a little laterally, it is usually possible to visualize the first part of the ophthalmic artery. Based on a better knowledge of anatomy, we trust that this area could be readily addressed in clinical situations requiring an extended approach in proximity of the orbital apex.

  5. Relevance of human anatomy in daily clinical practice. (United States)

    Arráez-Aybar, Luis-Alfonso; Sánchez-Montesinos, Indalecio; Mirapeix, Rosa-M; Mompeo-Corredera, Blanca; Sañudo-Tejero, Jose-Ramón


    the aim of this study has been to evaluate the relevance of gross human anatomy in daily clinical practice and to compare it to that of other basic sciences (biochemistry, bioethics, cytohistology, microbiology, pharmacology, physiology, psychology). a total of 1250 questionnaires were distributed among 38 different medical speciality professionals. Answers were analyzed taking into account speciality (medical, surgery and others), professional status (training physician or staff member) and professional experience. the response rate was 42.9% (n=536). Gross human anatomy was considered the most relevant basic discipline for surgical specialists, while pharmacology and physiology were most relevant for medical specialists. Knowledge of anatomy was also considered fundamental for understanding neurological or musculoskeletal disorders. In undergraduate programmes, the most important focuses in teaching anatomy were radiological, topographical and functional anatomy followed by systematic anatomy. In daily medical practice anatomy was considered basic for physical examination, symptom interpretation and interpretation of radiological images. When professional status or professional experience was considered, small variations were shown and there were no significant differences related to gender or community. our results underline the relevance of basic sciences (gross anatomy, physiology, and pharmacology) in daily professional activity. Evidence-based studies such as ours, lend greater credibility and objectivity to the role of gross anatomy in the undergraduate training of health professionals and should help to establish a more appropriate curriculum for future professionals. 2010 Elsevier GmbH. All rights reserved.

  6. The brain's default network: anatomy, function, and relevance to disease. (United States)

    Buckner, Randy L; Andrews-Hanna, Jessica R; Schacter, Daniel L


    Thirty years of brain imaging research has converged to define the brain's default network-a novel and only recently appreciated brain system that participates in internal modes of cognition. Here we synthesize past observations to provide strong evidence that the default network is a specific, anatomically defined brain system preferentially active when individuals are not focused on the external environment. Analysis of connectional anatomy in the monkey supports the presence of an interconnected brain system. Providing insight into function, the default network is active when individuals are engaged in internally focused tasks including autobiographical memory retrieval, envisioning the future, and conceiving the perspectives of others. Probing the functional anatomy of the network in detail reveals that it is best understood as multiple interacting subsystems. The medial temporal lobe subsystem provides information from prior experiences in the form of memories and associations that are the building blocks of mental simulation. The medial prefrontal subsystem facilitates the flexible use of this information during the construction of self-relevant mental simulations. These two subsystems converge on important nodes of integration including the posterior cingulate cortex. The implications of these functional and anatomical observations are discussed in relation to possible adaptive roles of the default network for using past experiences to plan for the future, navigate social interactions, and maximize the utility of moments when we are not otherwise engaged by the external world. We conclude by discussing the relevance of the default network for understanding mental disorders including autism, schizophrenia, and Alzheimer's disease.

  7. The maxillae: integrated and applied anatomy relevant to dentistry. (United States)

    Du Tolt, D F; Nortjé, Curly


    The union of the two paired maxillae form the whole upper jaw. Individual components of the maxilla contribute to the formation of the face, nose, mouth and orbit. The bony surfaces are in relation to the infratemporal and pterygopalatine fossae. Grooves, openings and foramina lend passage to structures such as the infra-orbital, posterior superior alveolar, nasopalatine and greater palatine nerves. These nerves are of great importance for regional anaesthesia in dentistry. The maxillary antrum of Highmore is frequently affected by pathological processes such as accidental tooth root impaction during an extraction procedure, sinusitis, cysts, fractures (LeFort) and tumours. Fast-growing maxillary sinus tumours often breach the thin walls of this cavity and encroach upon adjacent structures such as the orbit, nose, cheek, infratemporal fossa and mouth. 'Blow-out' fractures through the orbital component may result in nerve and muscle entrapment. Alveolar processes form an arcade for the two incisors, one canine, two premolars and three molars on each side. Knowledge of regional and applied anatomy, relevant to the maxillae, is essential when considering diagnostic imaging by X-rays, CT, and MRI.

  8. Clinical relevance of distal biceps insertional and footprint anatomy

    NARCIS (Netherlands)

    van den Bekerom, Michel P J; Kodde, Izaäk F.; Aster, Asir; Bleys, Ronald L A W; Eygendaal, Denise


    Purpose: The aim of this review was to present an overview, based on a literature search, of surgical anatomy for distal biceps tendon repairs, based on the current literature. Methods: A narrative review was performed using Pubmed/Medline using key words: Search terms were distal biceps,

  9. Uterine Artery Anatomy Relevant to Uterine Leiomyomata Embolization

    International Nuclear Information System (INIS)

    Gomez-Jorge, Jackeline; Keyoung, Andrew; Levy, Elliot B.; Spies, James B.


    To categorize the anatomic variants of uterine arteries, and determine the incidence of menopausal symptoms where the tubo-ovarian branches were seen prior to embolization. Between July 1997 and June 2000, 257 (n = 257) uterine fibroid embolizations were performed at our institution. Arteriograms were retrospectively evaluated. Uterine arteries were classified into groups: type I (the uterine artery as first branch of the inferior gluteal artery), type II (the uterine artery as second or third branch of the inferior gluteal artery), type III (the uterine artery, the inferior gluteal and the superior gluteal arteries arising as a trifurcation), type IV (the uterine artery as first branch of the hypogastric artery), inconclusive, or not studied. Tubo-ovarian branches were recorded if visualized prior to and/or after embolization. Menopausal symptoms were recorded (n = 175 at 3 months, n = 139 at 6 months, n = 98 at 1 year, n = 22 at 2 years) using written questionnaires. Five hundred and fourteen uterine arteries (n = 514) were evaluated. There were 38% classifiable types, 23% inconclusive, and 39% not studied. Classification was as follows: type I, 45%; type II, 6%; type III, 43%; type IV, 6%. Among 256 patients, tubo-ovarian arteries were seen in 36 prior to embolization, but not afterwards. In this group, 25 patients reported transient menopausal symptoms (hot flashes, amenorrhea). Five patients did not report any menopausal symptoms. Six patients did not answer the questionnaires. Type I is the most common type of anatomy, followed by type III. The tubo-ovarian arteries may be visualized prior to and/or after embolization. The embolization was monitored to avoid embolization of the tubo-ovarian branches. Menopausal symptoms were transient all patients when the tubo-ovarian branches were seen prior to embolization

  10. Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

    Directory of Open Access Journals (Sweden)

    Jan Plzák

    Full Text Available OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.

  11. Endoscopic endonasal approach for mass resection of the pterygopalatine fossa (United States)

    Plzák, Jan; Kratochvil, Vít; Kešner, Adam; Šurda, Pavol; Vlasák, Aleš; Zvěřina, Eduard


    OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas) and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma) that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa. PMID:29069259

  12. Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches. (United States)

    Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo


    Recent advances in endonasal endoscopy have facilitated the surgical access to the lateral skull base including areas such as Meckel's cave. This approach has been well documented, however, few studies have outlined transantral specific access to Meckel's. A transantral approach provides a direct pathway to this region obviating the need for extensive endonasal and transsphenoidal resection. Our aim in this study is to compare the anatomical perspectives obtained in endonasal and transantral approaches. We prepared 14 cadaveric specimens with intravascular injections of colored latex. Eight cadavers underwent endoscopic endonasal transpterygoid approaches to Meckel's cave. Six additional specimens underwent an endoscopic transantral approach to the same region. Photographic evidence was obtained for review. 30 CT scans were analyzed to measure comparative distances to Meckel's cave for both approaches. The endoscopic approaches provided a direct access to the anterior and inferior portions of Meckel's cave. However, the transantral approach required shorter instrumentation, and did not require clearing of the endonasal corridor. This approach gave an anterior view of Meckel's cave making posterior dissection more difficult. A transantral approach to Meckel's cave provides access similar to the endonasal approach with minimal invasiveness. Some of the morbidity associated with extensive endonasal resection could possibly be avoided. Better understanding of the complex skull base anatomy, from different perspectives, helps to improve current endoscopic skull base surgery and to develop new alternatives, consequently, leading to improvements in safety and efficacy.

  13. Endoscopic Endonasal Management of Craniopharyngioma. (United States)

    Zacharia, Brad E; Amine, Muhamad; Anand, Vijay; Schwartz, Theodore H


    Craniopharyngioma is a rare clinical entity that poses a significant management challenge given their location and propensity to recur. As part of a minimally disruptive treatment paradigm, the expanded endonasal approach has the potential to improve rates of resection, improve postoperative visual recovery, and minimize surgical morbidity. This article updates the otolaryngologic community on the basic principles and techniques regarding the incorporation of the endoscopic, endonasal approach in the management paradigm of craniopharyngioma. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Nasal Anatomy (United States)

    ... Caregivers Contact ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... Size + - Home > ANATOMY > Nasal Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

  15. Sinus Anatomy (United States)

    ... Caregivers Contact ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... Size + - Home > ANATOMY > Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

  16. Stability of the elbow joint: relevant anatomy and clinical implications of in vitro biomechanical studies

    NARCIS (Netherlands)

    de Haan, J.; Schep, N. W. L.; Eygendaal, D.; Kleinrensink, G.-J.; Tuinebreijer, W. E.; den Hartog, D.


    The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed

  17. Stability of the Elbow Joint: Relevant Anatomy and Clinical Implications of In Vitro Biomechanical Studies

    NARCIS (Netherlands)

    J. de Haan (Jeroen); D. Eygendaal (Denise); N.W.L. Schep (Niels); G.J. Kleinrensink (Gert Jan); W.E. Tuinebreijer (Wim); D. den Hartog (Dennis)


    textabstractAbstract: The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint

  18. Relevant radiological anatomy of the pig as a training model in interventional radiology

    International Nuclear Information System (INIS)

    Dondelinger, R.F.; Ghysels, M.P.; Brisbois, D.; Donkers, E.; Snaps, F.R.; Saunders, J.; Deviere, J.


    The use of swine for teaching purposes in medicine and surgery has largely increased in recent years. Detailed knowledge of the porcine anatomy and physiology is a prerequisite for proper use of pigs as a teaching or an experimental model in interventional radiology. A systematic study of the radiological anatomy was undertaken in more than 100 female pigs aged 6-8 weeks. All studies were performed under general anesthesia in a single session. Animals were sacrificed at the end of the study. Selective angiographies were systematically obtained in all anatomical territories. In other animals CT and MRI examinations were performed and were correlated to anatomical sections and acrylic casts of the vascular structures. Endoscopical examinations of the upper gastrointestinal tract, including retrograde opacification of the biliary and pancreatic ducts, were added in selected animals. The main angiographic aspects of the brain, head and neck, thorax, abdomen, and pelvis were recorded. Similarities and differences in comparison with human anatomy are stressed. Potential applications in interventional radiology are indicated. (orig.)

  19. Porcine Tricuspid Valve Anatomy and Human Compatibility: Relevance for Preclinical Validation of Novel Valve Interventions. (United States)

    Waziri, Farhad; Lyager Nielsen, Sten; Michael Hasenkam, John


    Tricuspid regurgitation may be a precursor for heart failure, reduced functional capacity, and poor survival. A human compatible experimental model is required to understand the pathophysiology of the tricuspid valve disease as a basis for validating novel tricuspid valve interventions before clinical use. The study aim was to evaluate and compare the tricuspid valve anatomy of porcine and human hearts. The anatomy of the tricuspid valve and the surrounding structures that affect the valve during a cardiac cycle were examined in detail in 100 fresh and 19 formalin-fixed porcine hearts obtained from Danish Landrace pigs (body weight 80 kg). All valvular dimensions were compared with human data acquired from literature sources. No difference was seen in the tricuspid annulus circumference between porcine and human hearts (13.0 ± 1.2 cm versus 13.5 ± 1.5 cm; p = NS), or in valve area (5.7 ± 1.6 cm2 versus 5.6 ± 1.0 cm2; p = NS). The majority of chordae types exhibited a larger chordal length and thickness in human hearts compared to porcine hearts. In both species, the anterior papillary muscle (PM) was larger than other PMs in the right ventricle, but muscle length varied greatly (range: 5.2-40.3 mm) and was significantly different in pigs and in humans (12.2 ± 3.2 mm versus 19.2 mm; p human hearts.

  20. Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

    Directory of Open Access Journals (Sweden)

    Bhalaghuru Chokkalingam Mani, MD


    Full Text Available More than half a century has passed since the concept of dual atrioventricular (AV nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.

  1. Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification

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    Assis, André Moreira de, E-mail:; Moreira, Airton Mota, E-mail:; Paula Rodrigues, Vanessa Cristina de, E-mail: [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil); Harward, Sardis Honoria, E-mail: [The Dartmouth Center for Health Care Delivery Science (United States); Antunes, Alberto Azoubel, E-mail:; Srougi, Miguel, E-mail: [University of Sao Paulo Medical School, Urology Department (Brazil); Carnevale, Francisco Cesar, E-mail: [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil)


    PurposeTo describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure.MethodsAngiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage.ResultsTwo hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I–IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %).ConclusionsDespite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure.

  2. Is endoscopic endonasal transsphenoidal surgery increases the susceptibility to rhinosinusitis. (United States)

    Topuz, Muhammet Fatih; Sarı, Murat; Binnetoglu, Adem; Dogrul, Ramazan; Bugdaycı, Onur; Şeker, Aşkın


    The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis. It was a retrospective clinical study. Forty-five cases, between 2013 and 2015, planned for endoscopic endonasal transsphenoidal surgery due to hypophyseal pathology at the Neurosurgery Departments of Marmara University Hospital were evaluated retrospectively. The patients were evaluated for the changes in the anatomy of the middle concha and the effects of these changes to paranasal sinuses by paranasal computed tomographies were studied at the preoperative second week and postoperative 12 month. The Lund-Mackay scoring system was used for the evaluation of opacification in the five major paranasal sinuses and occlusion of the osteomeatal complex in the pre- and postoperative period. The Lund-Mackay scoring system was used to analyze the paranasal computed tomography of the patients at the preoperative 2 weeks and postoperative first year. According to the Lund-Mackay scoring system, no significant difference was detected between the preoperative and postoperative opacification of paranasal sinuses (p > 0.05). Besides, there was also no significant difference between the preoperative and postoperative osteomeatal complex occlusion (p > 0.05). Considering the distance between middle concha and lamina papyracea following the out-fracture of the middle concha, a significant lateralization of 0.5 mm between the preoperative and postoperative period was observed (p transsphenoidal surgery causes some variations in the structures of

  3. Surgical Anatomy and Microvascular Surgical Technique Relevant to Experimental Renal Transplant in Rat Employing Aortic and Inferior Venacaval Conduits. (United States)

    Shrestha, Badri Man; Haylor, John


    Rat models of renal transplant are used to investigate immunologic processes and responses to therapeutic agents before their translation into routine clinical practice. In this study, we have described details of rat surgical anatomy and our experiences with the microvascular surgical technique relevant to renal transplant by employing donor inferior vena cava and aortic conduits. For this study, 175 rats (151 Lewis and 24 Fisher) were used to establish the Fisher-Lewis rat model of chronic allograft injury at our institution. Anatomic and technical details were recorded during the period of training and establishment of the model. A final group of 12 transplanted rats were studied for an average duration of 51 weeks for the Lewis-to-Lewis isografts (5 rats) and 42 weeks for the Fisher-to-Lewis allografts (7 rats). Functional measurements and histology confirmed the diagnosis of chronic allograft injury. Mastering the anatomic details and microvascular surgical techniques can lead to the successful establishment of an experimental renal transplant model.

  4. Facial anatomy. (United States)

    Marur, Tania; Tuna, Yakup; Demirci, Selman


    Dermatologic problems of the face affect both function and aesthetics, which are based on complex anatomical features. Treating dermatologic problems while preserving the aesthetics and functions of the face requires knowledge of normal anatomy. When performing successfully invasive procedures of the face, it is essential to understand its underlying topographic anatomy. This chapter presents the anatomy of the facial musculature and neurovascular structures in a systematic way with some clinically important aspects. We describe the attachments of the mimetic and masticatory muscles and emphasize their functions and nerve supply. We highlight clinically relevant facial topographic anatomy by explaining the course and location of the sensory and motor nerves of the face and facial vasculature with their relations. Additionally, this chapter reviews the recent nomenclature of the branching pattern of the facial artery. © 2013 Elsevier Inc. All rights reserved.

  5. Comprehensive review on endonasal endoscopic sinus surgery (United States)

    Weber, Rainer K.; Hosemann, Werner


    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  6. Expanded Endoscopic Endonasal Resection of Retrochiasmatic Craniopharyngioma. (United States)

    Davanzo, Justin R; Goyal, Neerav; Zacharia, Brad E


    This video abstract demonstrates the use of the expanded endoscopic endonasal approach for the resection of a retrochiasmatic craniopharyngioma. These tumors are notoriously difficult to treat, and many approaches have been tried to facilitate safe and effective resection. The endoscopic endonasal approach has been increasingly utilized for selected sellar/suprasellar pathology. We present the case of a 39-year-old man who was found to have a cystic, partially calcified suprasellar mass consistent with a craniopharyngioma. To facilitate robust skull base repair, a vascularized nasoseptal flap was harvested. A wide sphenoidotomy was performed and the sella and tuberculum were exposed. After the dural opening and arachnoid dissection, the stalk was identified, merging seamlessly with the tumor capsule. The lesion was then internally debulked with the use of an ultrasonic aspirator. The capsule was then dissected off of the optic chiasm, thalamus, and hypothalamus. The cavity was inspected with an angled endoscope to ensure complete resection. A multilayered reconstruction was performed using autologous fascia lata, the previously harvested nasoseptal flap, and dural sealant. Postoperatively, the patient did have expected panhypopituitarism but remained neurologically intact and had improvement in his vision. In conclusion, this video demonstrates how an expanded endonasal approach can be used to safely resect a craniopharyngioma, even when in close proximity to delicate structures such as the optic chiasm. The link to the video can be found at: .

  7. Investigation of effectiveness of surgical treatment of chronic dacryocystitis - endonasal dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Borodulya V.L.


    Full Text Available Prolonged and conti­nuous lacrimation (symptom of epiphora causes discomfort, inclination to conjunctiva infect, reduces visual acuity and ultimately the quality of life of the patient. Despite the fact that there is a large number of various surgical interventions to restore tearing in patients with chronic dacryocystitis, the problem of lacrimation remains relevant. We have studied the operation of endonasal dacryocystorhinostomy and its long-term consequences. Surgical intervention in endonasal dacryocystorhinostomy is aimed at eliminating lacrimation by eliminating stenosis and forming a new combination of the cavity of the laryngeal canal with the nasal cavity, as well as the sanation of purulent foci of infection in the throat. There were 8 surgical interventions. Period of observation of patients in the postoperative period by ophthalmologist and ENT-doctor is from 1.5 to 2 years. The evaluation of the result was carried out in 6 months or more after the operation. A complete recovery with the recovery of the tear excretion in the nasal cavity has been achieved in all patients. The formed rhinostoma was wide, well functioning. Thus, endonasal dacryocystorhinostomy is a highly effective and should be a method of choice for inflammation of the lacrimal sac at any stage of development.

  8. First Application of 7T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors (United States)

    Barrett, Thomas F; Dyvorne, Hadrien A; Padormo, Francesco; Pawha, Puneet S; Delman, Bradley N; Shrivastava, Raj K; Balchandani, Priti


    Background Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. Methods Images were acquired at 7T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5T, 3T, and 7T scans for detection of intracavernous cranial nerves and ICA branches. Detection rates were compared. Images were utilized for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. Results Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7T. 7T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. Conclusion Our study represents the first application of 7T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7T MRI compared to 3T and 1.5 T, and found that integration of 7T into surgical planning and guidance was feasible. These results suggest a potential for 7T MRI to reduce surgical complications. Future studies comparing standardized 7T, 3T, and 1.5 T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7T MRI for endonasal endoscopic surgical efficacy. PMID:28359922

  9. First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors. (United States)

    Barrett, Thomas F; Dyvorne, Hadrien A; Padormo, Francesco; Pawha, Puneet S; Delman, Bradley N; Shrivastava, Raj K; Balchandani, Priti


    Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7-T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of the skull base. In this study, we apply a 7-T imaging protocol to patients with skull base tumors and compare the images with clinical standard of care. Images were acquired at 7 T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5-, 3-, and 7-T scans for detection of intracavernous cranial nerves and internal carotid artery (ICA) branches. Detection rates were compared. Images were used for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7 T. The 7-T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. Our study represents the first application of 7-T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7-T MRI compared with 3- and 1.5-T MRI, and found that integration of 7 T into surgical planning and guidance was feasible. These results suggest a potential for 7-T MRI to reduce surgical complications. Future studies comparing standardized 7-, 3-, and 1.5-T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7-T MRI for endonasal endoscopic surgical efficacy. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Endoscopic Endonasal Approach for a Suprasellar Craniopharyngioma. (United States)

    Zenonos, Georgios A; Snyderman, Carl H; Gardner, Paul A


    Objectives  The current video presents the nuances of an endoscopic endonasal approach to a suprasellar craniopharyngioma. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon, at a teaching academic institution. Participants  The case refers to a 67-year-old man who presented with vision loss and headaches, and was found to have a suprasellar mass, with imaging characteristics consistent with a craniopharyngioma. Main Outcome Measures  The main outcome measures consistent of the reversal of the patient symptoms (vision loss and headaches), the recurrence-free survival based on imaging, as well as the absence of any complications. Results  The patient's vision improved after the surgery; at his last follow-up there was no evidence of recurrence on imaging. Conclusions  The endoscopic endonasal approach is safe and effective in treating suprasellar craniopharyngiomas. The link to the video can be found at: .

  11. Medical Student Dissection of CadaversImproves Performance on Practical Exams, but not Dissection-Relevant Questions in the NBME Gross Anatomy and Embryology Final Exam

    Directory of Open Access Journals (Sweden)

    Leslie Sargent Jones


    Full Text Available We have examined whether cadaver dissection by first year medical students (MIs affected their performance in two test measures: the NBME Gross Anatomy and Embryology Subject Exam (dissection-relevant questions only, and practical exams given at the end of each major section within the course. The dissections for the entire course were divided into 18 regional dissection units and each student was assigned to dissect one third of the regional units; the other two-thirds of the material was learned from the partner-prosected cadavers. Performance for each student on the exams was then assessed as a function of the regions those students actually dissected. While the results indicated a small performance advantage for MIs answering questions on material they had dissected on the NBME Subject Exam questions relevant to dissection (78-88% of total exam, the results were not statistically significant. However, a similar, small performance advantage on the course practical exams was highly significant.

  12. [Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess]. (United States)

    Yu, Huanxin; Liu, Gang


    To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess. Eighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded. All patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach. Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.

  13. Larynx Anatomy (United States)

    ... e.g. -historical Searches are case-insensitive Larynx Anatomy Add to My Pictures View /Download : Small: 648x576 ... View Download Large: 2700x2400 View Download Title: Larynx Anatomy Description: Anatomy of the larynx; drawing shows the ...

  14. Vulva Anatomy (United States)

    ... e.g. -historical Searches are case-insensitive Vulva Anatomy Add to My Pictures View /Download : Small: 720x634 ... View Download Large: 3000x2640 View Download Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

  15. Pharynx Anatomy (United States)

    ... e.g. -historical Searches are case-insensitive Pharynx Anatomy Add to My Pictures View /Download : Small: 720x576 ... View Download Large: 3000x2400 View Download Title: Pharynx Anatomy Description: Anatomy of the pharynx; drawing shows the ...

  16. [Endoscopic endonasal detection of cerebrospinal fluid leakage with topical fluorescein]. (United States)

    Sato, Taku; Kishida, Yugo; Watanabe, Tadashi; Tani, Akiko; Tada, Yasuhiro; Tamura, Takamitsu; Ichikawa, Masahiro; Sakuma, Jun; Omori, Koichi; Saito, Kiyoshi


    We evaluated the effectiveness of intraoperative topical application of fluorescein to detect the leakage point of cerebrospinal fluid(CSF)rhinorrhea. Three patients with CSF rhinorrhea were treated with an endoscopic endonasal technique. Ten percent fluorescein was topically used for intraoperative localization of the leak site. A change of the fluorescein color from brown to green due to dilation of CSF were recognized as evidence of CSF rhinorrhea. We repeated the procedure to detect any small defects. All CSF rhinorrheas were successfully repaired by this endoscopic endonasal approach. Topical application of fluorescein is simple and sensitive for identifying intraoperative CSF rhinorrhea.

  17. Non-endoscopic Mechanical Endonasal Dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Mohammad Etezad Razavi


    Full Text Available To circumvent the disadvantages of endoscopic dacryocystorhinostomy such as small rhinostomy size, high failure rate and expensive equipment, we hereby introduce a modified technique of non-endoscopic mechanical endonasal dacryocystorhinostomy (NE-MEDCR. Surgery is performed under general anesthesia with local decongestion of the nasal mucosa. A 20-gauge vitrectomy light probe is introduced through the upper canaliculus until it touches the bony medial wall of the lacrimal sac. While directly viewing the transilluminated target area, a nasal speculum with a fiber optic light carrier is inserted. An incision is made vertically or in a curvilinear fashion on the nasal mucosa in the lacrimal sac down to the bone using a Freer periosteum elevator. Approximately 1 to 1.5 cm of nasal mucosa is removed with Blakesley forceps. Using a lacrimal punch, the thick bone of the frontal process of the maxilla is removed and the inferior half of the sac is uncovered. The lacrimal sac is tented into the surgical site with the light probe and its medial wall is incised using a 3.2 mm keratome and then excised using the Blakesley forceps. The procedure is completed by silicone intubation. The NE-MEDCR technique does not require expensive instrumentation and is feasible in any standard ophthalmic surgical setting.

  18. Microsurgical anatomy of the ventral callosal radiations: new destination, correlations with diffusion tensor imaging fiber-tracking, and clinical relevance. (United States)

    Peltier, Johann; Verclytte, Sébastien; Delmaire, Christine; Deramond, Hervé; Pruvo, Jean-Pierre; Le Gars, Daniel; Godefroy, Olivier


    In the current literature, there is a lack of a detailed map of the origin, course, and connections of the ventral callosal radiations of the human brain. The authors used an older dissection technique based on a freezing process as well as diffusion tensor imaging to investigate this area of the human brain. The authors demonstrated interconnections between areas 11, 12, and 25 for the callosal radiations of the trunk and rostrum of the corpus callosum; between areas 9, 10, and 32 for the genu; and between areas 6, 8, and 9 for the ventral third of the body. The authors identified new ventral callosal connections crossing the rostrum between both temporal poles and coursing within the temporal stem, and they named these connections the "callosal radiations of Peltier." They found that the breadth of the callosal radiations slightly increases along their course from the rostrum to the first third of the body of the corpus callosum. The fiber dissection and diffusion tensor imaging techniques are complementary not only in their application to the study of the commissural system in the human brain, but also in their practical use for diagnosis and surgical planning. Further investigations, neurocognitive tests, and other contributions will permit elucidation of the functional relevance of the newly identified callosal radiations in patients with disease involving the ventral corpus callosum.

  19. Extended Endoscopic Endonasal Approaches for Cerebral Aneurysms: Anatomical, Virtual Reality and Morphometric Study

    Directory of Open Access Journals (Sweden)

    Alberto Di Somma


    Full Text Available Introduction. The purpose of the present contribution is to perform a detailed anatomic and virtual reality three-dimensional stereoscopic study in order to test the effectiveness of the extended endoscopic endonasal approaches for selected anterior and posterior circulation aneurysms. Methods. The study was divided in two main steps: (1 simulation step, using a dedicated Virtual Reality System (Dextroscope, Volume Interactions; (2 dissection step, in which the feasibility to reach specific vascular territory via the nose was verified in the anatomical laboratory. Results. Good visualization and proximal and distal vascular control of the main midline anterior and posterior circulation territory were achieved during the simulation step as well as in the dissection step (anterior communicating complex, internal carotid, ophthalmic, superior hypophyseal, posterior cerebral and posterior communicating, basilar, superior cerebellar, anterior inferior cerebellar, vertebral, and posterior inferior cerebellar arteries. Conclusion. The present contribution is intended as strictly anatomic study in which we highlighted some specific anterior and posterior circulation aneurysms that can be reached via the nose. For clinical applications of these approaches, some relevant complications, mainly related to the endonasal route, such as proximal and distal vascular control, major arterial bleeding, postoperative cerebrospinal fluid leak, and olfactory disturbances must be considered.

  20. Extended Endoscopic Endonasal Approach for Suprasellar Craniopharyngioma. (United States)

    Locatelli, D; Pozzi, F; Agresta, G; Padovan, S; Karligkiotis, A; Castelnuovo, P


    Objectives  We illustrate a suprasellar craniopharyngiomas treated with an extended endoscopic endonasal approach (EEEA). Design  Case report of a 43-year-old male affected by cerebral lesion located in suprasellar region involving the third ventricle and compressing the neurovascular structures, causing an anterosuperior dislocation of the chiasma. There is a complete disruption of the pituitary stalk that can explain the clinical finding of partial anterior hypopituitarism and hyperprolactinemia. The lesion is characterized by a solid and cystic component. Considering the absence of lateral extension and the suprasellar location of the lesion, an EEEA is preferred. Setting  University Hospital "Ospedale di Circolo," Department of Neurosurgery, Varese, Italy. Participants  Neurosurgical and ENT Skull Base Team. Main Outcome Measures  A bilateral parasagittal approach is performed using a four-hand technique. The first step of the surgery is the preparation of the Hadad's flap. The approach is extended to the planum sphenoidalis to expose the suprasellar region. The lesion is completely removed employing also an ultrasound aspirator. Skull base reconstruction is performed with three-layer technique: graft of fat tissue, fascia lata, and nasoseptal flap. Results  No postoperative complications occurred. In the post-op, the patient presents a panhypopituitarism and an improvement in neurological status. The visual deficit remains stable. Post-op magnetic resonance imaging at 1 year documents the complete absence of pathological contrast enhancement. Conclusions  EEEA is a feasible approach in treating craniopharyngioma with suprasellar extension. The advantages include optimal visualization, good resection rate, and absence of brain retraction. The link to the video can be found at: .

  1. Endoscopic Endonasal Approach to a Suprasellar Craniopharyngioma. (United States)

    Todeschini, Alexandre B; Montaser, Alaa S; Shahein, Mostafa; Revuelta, Juan Manuel; Otto, Bradley A; Carrau, Ricardo L; Prevedello, Daniel M


    We present the case of a 57-year-old male who presented with progressive right side vision loss whose workup revealed a large suprasellar lesion with invasion of the third ventricle. The pituitary stalk was not visible. Hormonal panel showed no hormonal deficits. The initial diagnosis was of a type II transinfundibular craniopharyngioma (as classified by Kassam et al). An endoscopic endonasal transplanum transtuberculum approach was done using a standard binostril four-hand technique, with the patient positioned supine with the head turned to the right side and tilted to the left, fixed in a three-pin head clamp, under imaging guidance. The tumor was carefully dissected away from the optic apparatus while preserving the vessels, mainly the superior hypophyseal artery. The stalk was identified around the tumor and preserved. The third ventricle was entered and inspected at the end of the procedure and a near-total resection (a small residual in the right hypothalamus) with decompression of the optic apparatus was achieved. Reconstruction was done in a multilayered fashion, using collagen matrix and a nasoseptal flap. Patient had an uneventful postoperative stay and was discharged on POD 4, neurologically stable with no hormonal deficits. Pathology confirmed an adamantinomatous craniopharyngioma. Due to a small growth of the residual, patient underwent fractionated stereotactic radiation (50.4Gy in 28 sessions). He presented with panhypopituitarism 2 years after radiation therapy. At 3-month follow-up, his vision was back to normal and 6-year postoperative magnetic resonance imaging showed no signs of recurrence. The link to the video can be found at: .

  2. Studies on Colombian Cryptogams VII. Culture studies on the taxonomic relevance of costal anatomy in the Campylopus leucognodes-subconcolor complex and in Campylopus pittieri

    NARCIS (Netherlands)

    Florschütz-de Waard, J.; Worrell-Schets, M.


    Observations on costal anatomy in Colombian material of the Campylopus leucognodessubconcolor complex revealed a correlation between habitat humidity and degree of cell wall thickness. Cultivation experiments confirmed the assumption that the presence or absence of pseudostereids in this group is

  3. Applied peritoneal anatomy

    International Nuclear Information System (INIS)

    Patel, R.R.; Planche, K.


    The peritoneal cavity is a complex anatomical structure with multiple attachments and connections. These are better understood with reference to the embryological development of this region. Armed with this knowledge, the diagnosis and assessment of a wide range of common intra-abdominal diseases becomes straightforward. This article will review and simplify the terminology, complex embryological development, and anatomy of the peritoneum, peritoneal attachments, and the reflections forming the peritoneal boundaries. Normal anatomy will be described using schematic diagrams with corresponding computed tomography (CT) and magnetic resonance imaging (MRI) images, including CT peritoneograms. The relevance of intra- and extra-peritoneal anatomy to common pathological processes will be demonstrated

  4. A method for safely resecting anterior butterfly gliomas: the surgical anatomy of the default mode network and the relevance of its preservation. (United States)

    Burks, Joshua D; Bonney, Phillip A; Conner, Andrew K; Glenn, Chad A; Briggs, Robert G; Battiste, James D; McCoy, Tressie; O'Donoghue, Daniel L; Wu, Dee H; Sughrue, Michael E


    OBJECTIVE Gliomas invading the anterior corpus callosum are commonly deemed unresectable due to an unacceptable risk/benefit ratio, including the risk of abulia. In this study, the authors investigated the anatomy of the cingulum and its connectivity within the default mode network (DMN). A technique is described involving awake subcortical mapping with higher attention tasks to preserve the cingulum and reduce the incidence of postoperative abulia for patients with so-called butterfly gliomas. METHODS The authors reviewed clinical data on all patients undergoing glioma surgery performed by the senior author during a 4-year period at the University of Oklahoma Health Sciences Center. Forty patients were identified who underwent surgery for butterfly gliomas. Each patient was designated as having undergone surgery either with or without the use of awake subcortical mapping and preservation of the cingulum. Data recorded on these patients included the incidence of abulia/akinetic mutism. In the context of the study findings, the authors conducted a detailed anatomical study of the cingulum and its role within the DMN using postmortem fiber tract dissections of 10 cerebral hemispheres and in vivo diffusion tractography of 10 healthy subjects. RESULTS Forty patients with butterfly gliomas were treated, 25 (62%) with standard surgical methods and 15 (38%) with awake subcortical mapping and preservation of the cingulum. One patient (1/15, 7%) experienced postoperative abulia following surgery with the cingulum-sparing technique. Greater than 90% resection was achieved in 13/15 (87%) of these patients. CONCLUSIONS This study presents evidence that anterior butterfly gliomas can be safely removed using a novel, attention-task based, awake brain surgery technique that focuses on preserving the anatomical connectivity of the cingulum and relevant aspects of the cingulate gyrus.

  5. Hepatic Arterial Configuration in Relation to the Segmental Anatomy of the Liver; Observations on MDCT and DSA Relevant to Radioembolization Treatment

    International Nuclear Information System (INIS)

    Hoven, Andor F. van den; Leeuwen, Maarten S. van; Lam, Marnix G. E. H.; Bosch, Maurice A. A. J. van den


    PurposeCurrent anatomical classifications do not include all variants relevant for radioembolization (RE). The purpose of this study was to assess the individual hepatic arterial configuration and segmental vascularization pattern and to develop an individualized RE treatment strategy based on an extended classification.MethodsThe hepatic vascular anatomy was assessed on MDCT and DSA in patients who received a workup for RE between February 2009 and November 2012. Reconstructed MDCT studies were assessed to determine the hepatic arterial configuration (origin of every hepatic arterial branch, branching pattern and anatomical course) and the hepatic segmental vascularization territory of all branches. Aberrant hepatic arteries were defined as hepatic arterial branches that did not originate from the celiac axis/CHA/PHA. Early branching patterns were defined as hepatic arterial branches originating from the celiac axis/CHA.ResultsThe hepatic arterial configuration and segmental vascularization pattern could be assessed in 110 of 133 patients. In 59 patients (54 %), no aberrant hepatic arteries or early branching was observed. Fourteen patients without aberrant hepatic arteries (13 %) had an early branching pattern. In the 37 patients (34 %) with aberrant hepatic arteries, five also had an early branching pattern. Sixteen different hepatic arterial segmental vascularization patterns were identified and described, differing by the presence of aberrant hepatic arteries, their respective vascular territory, and origin of the artery vascularizing segment four.ConclusionsThe hepatic arterial configuration and segmental vascularization pattern show marked individual variability beyond well-known classifications of anatomical variants. We developed an individualized RE treatment strategy based on an extended anatomical classification

  6. Eye Anatomy (United States)

    ... News About Us Donate In This Section Eye Anatomy en Español email Send this article to a ... You at Risk For Glaucoma? Childhood Glaucoma Eye Anatomy Five Common Glaucoma Tests Glaucoma Facts and Stats ...

  7. Paraganglioma Anatomy (United States)

    ... e.g. -historical Searches are case-insensitive Paraganglioma Anatomy Add to My Pictures View /Download : Small: 648x576 ... View Download Large: 2700x2400 View Download Title: Paraganglioma Anatomy Description: Paraganglioma of the head and neck; drawing ...

  8. Hand Anatomy (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is ... Hand Therapist? Media Find a Hand Surgeon Home Anatomy Bones Joints Muscles Nerves Vessels Tendons Anatomy The upper extremity is ...

  9. Expanded Endonasal Endoscopic Approach for Resection of an Infrasellar Craniopharyngioma. (United States)

    Abou-Al-Shaar, Hussam; Blitz, Ari M; Rodriguez, Fausto J; Ishii, Masaru; Gallia, Gary L


    Craniopharyngiomas are uncommon benign locally aggressive epithelial tumors mostly located in the sellar and suprasellar regions. An infrasellar origin of these tumors is rare. The authors report a 22-year-old male patient with a purely infrasellar adamantinomatous craniopharyngioma centered in the nasopharynx with extension into the posterior nasal septum, sphenoid sinus, and clivus. Gross total resection was achieved using an expanded endonasal endoscopic transethmoidal, transsphenoidal, transpterygoid, and transclival approach. Follow-up at one year demonstrated no evidence of disease recurrence. Infrasellar craniopharyngioma should be included in the differential diagnosis of sinonasal masses even in the absence of sellar extension. Expanded endonasal endoscopic approaches provide excellent access to and visualization of such lesions and may obviate the need for postoperative radiotherapy when gross total resection is achieved. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Clival chordomas: considerations after 16 years of endoscopic endonasal surgery. (United States)

    Zoli, Matteo; Milanese, Laura; Bonfatti, Rocco; Faustini-Fustini, Marco; Marucci, Gianluca; Tallini, Giovanni; Zenesini, Corrado; Sturiale, Carmelo; Frank, Giorgio; Pasquini, Ernesto; Mazzatenta, Diego


    OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter. Postoperative adjuvant therapies were considered. RESULTS Sixty-five patients (male/female ratio 1:0.9) were included in this study. The median age was 48 years (range 9-80 years). Gross-total resection (GTR) was achieved in 47 cases (58.7%). On univariate analysis, primary procedures (p = 0.001), location in the superior or middle third of the clivus (p = 0.043), extradural location (p = 0.035), and histology of conventional chordomas (p = 0.013) were associated with a higher rate of GTR. The complication rate was 15.1%, and there were no perioperative deaths. Most complications did not result in permanent sequelae and included 2 CSF leaks (2.5%), 5 transient cranial nerve VI palsies (6.2%), and 2 internal carotid artery injuries (2.5%), which were treated with coil occlusion of the internal carotid artery without neurological deficits. Three patients (3.8%) presented with complications resulting in permanent neurological deficits due to a postoperative hematoma (1.2%) causing a hemiparesis, and 2 permanent ophthalmoplegias (2.5%). Seventeen patients (26.2%) have died of tumor progression over the course of follow-up (median 52 months, range 7-159 months). Based on Kaplan-Meier analysis, the survival rate was 77% at 5 years and 57% at 10

  11. Effectiveness of caudal septal extension graft application in endonasal septoplasty

    Directory of Open Access Journals (Sweden)

    Yunus Karadavut

    Full Text Available Abstract Introduction Septal deviation is a common disease seen in daily otorhinolaryngology practice and septoplasty is a commonly performed surgical procedure. Caudal septum deviation is also a challenging pathology for ear, nose, and throat specialists. Many techniques are defined for caudal septal deviation. Objective To evaluate the effectiveness of caudal septal extension graft (CSEG application in patients who underwent endonasal septoplasty for a short and deviated nasal septum. Methods Forty patients with nasal septal deviation, short nasal septum, and weak nasal tip support who underwent endonasal septoplasty with or without CSEG placement between August 2012 and June 2013 were enrolled in this study. Twenty patients underwent endonasal septoplasty with CSEG placement. The rest of the group, who rejected auricular or costal cartilage harvest for CSEG placement, underwent only endonasal septoplasty without any additional intervention. Using the Nasal Obstruction Symptom Evaluation (NOSE and Rhinoplasty Outcome Evaluation (ROE questionnaires, pre- and post-operative acoustic rhinometer measurements were evaluated to assess the effect of CESG placement on nasal obstruction. Results In the control group, preoperative and postoperative minimal cross-sectional areas (MCA1 were 0.44 ± 0.10 cm2 and 0.60 ± 0.11 cm2, respectively (p < 0.001. In the study group, pre- and postoperative MCA1 values were 0.45 ± 0.16 cm2 and 0.67 ± 0.16 cm2, respectively (p < 0.01. In the control group, the nasal cavity volume (VOL1 value was 1.71 ± 0.21 mL preoperatively and 1.94 ± 0.17 mL postoperatively (p < 0.001. In the study group, pre- and postoperative VOL1s were 1.72 ± 0.15 mL and 1.97 ± 0.12 mL, respectively (p < 0.001. Statistical analysis of postoperative MCA1 and VOL1 values in the study and the control groups could not detect any significant intergroup difference (p = 0.093 and 0.432, respectively. In the study group, mean nasolabial angles were

  12. Endoscopic endonasal repair of spontaneous sphenoid sinus lateral wall meningocele presenting with cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Ali Erdem Yildirim


    Full Text Available Spontaneous sphenoid sinus lateral wall meningoceles are rare lesions with an unknown etiology. Endoscopic endonasal technique is a considerable route in the treatment of this condition. The aim of this paper is to report the etiology, surgical technique, and outcome in a patient repaired via endoscopic endonasal approach. A 51-year-old male patient applied with rhinorrhea started three months ago after an upper respiratory infection. There were no history of trauma or sinus operation. Biochemical analysis of the fluid was positive for beta-2-transferrin. This asypthomatic patient had undergone for repairment of lateral sphenoid sinus meningocele with endoscopic endonasal transsphenoidal approach. After endoscopic endonasal meningocele closure procedure no complications occured and a quick recovery was observed. Endoscopic endonasal approach is an effective and safe treatment modality of spontaneous lateral sphenoid sinus meningoceles and efficient in anterior skull base reconstruction.

  13. Two- versus four-handed techniques for endonasal resection of orbital apex tumors. (United States)

    Craig, John R; Lee, John Y K; Petrov, Dmitriy; Mehta, Sonul; Palmer, James N; Adappa, Nithin D


    Open versus endonasal resection of orbital apex (OA) tumors is generally based on tumor size, location, and pathology. For endonasal resection, two- and four-handed techniques have been reported, but whether one technique is more optimal based on these tumor features has not been evaluated. To determine whether two- versus four-handed techniques result in better outcomes after endoscopic resection of OA tumors, and whether either technique is better suited for intra- versus extraconal location and for benign versus malignant pathology. A retrospective review of all expanded endonasal approaches for OA tumors was performed at a single institution from 2009 to 2013. A PubMed database search was also performed to review series published on endonasal OA tumor resection. Across all the cases reviewed, the following data were recorded: two- versus four-handed techniques, intra- versus extraconal tumor location, and benign versus malignant pathology. The relationship between these variables and resection extent was analyzed by the Fisher exact test. Postoperative visual status and complications were also reviewed. Ten cases from the institution and 94 cases from 17 publications were reviewed. Both two- and four-handed techniques were used to resect extra- and intraconal OA tumors, for both benign and malignant pathology. Four-handed techniques included a purely endonasal approach and a combined endonasal-orbital approach. On univariate analysis, the strongest predictor of complete resection was benign pathology (p = 0.005). No significant difference was found between the extent of resection and a two- versus a four-handed technique. Visual status was improved or unchanged in 94% of cases, and other complications were rare. Benign tumors that involve the medial extraconal and posterior inferomedial intraconal OA can be treated by either two- or four-handed endonasal techniques. Selecting two- versus four-handed techniques and endonasal versus endonasal-orbital four

  14. Integer anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Doolittle, R. [ONR, Arlington, VA (United States)


    The title integer anatomy is intended to convey the idea of a systematic method for displaying the prime decomposition of the integers. Just as the biological study of anatomy does not teach us all things about behavior of species neither would we expect to learn everything about the number theory from a study of its anatomy. But, some number-theoretic theorems are illustrated by inspection of integer anatomy, which tend to validate the underlying structure and the form as developed and displayed in this treatise. The first statement to be made in this development is: the way structure of the natural numbers is displayed depends upon the allowed operations.

  15. Transsphenoidal Approach in Endoscopic Endonasal Surgery for Skull Base Lesions: What Radiologists and Surgeons Need to Know. (United States)

    García-Garrigós, Elena; Arenas-Jiménez, Juan José; Monjas-Cánovas, Irene; Abarca-Olivas, Javier; Cortés-Vela, Jesús Julián; De La Hoz-Rosa, Javier; Guirau-Rubio, Maria Dolores


    In the last 2 decades, endoscopic endonasal transsphenoidal surgery has become the most popular choice of neurosurgeons and otolaryngologists to treat lesions of the skull base, with minimal invasiveness, lower incidence of complications, and lower morbidity and mortality rates compared with traditional approaches. The transsphenoidal route is the surgical approach of choice for most sellar tumors because of the relationship of the sphenoid bone to the nasal cavity below and the pituitary gland above. More recently, extended approaches have expanded the indications for transsphenoidal surgery by using different corridors leading to specific target areas, from the crista galli to the spinomedullary junction. Computer-assisted surgery is an evolving technology that allows real-time anatomic navigation during endoscopic surgery by linking preoperative triplanar radiologic images and intraoperative endoscopic views, thus helping the surgeon avoid damage to vital structures. Preoperative computed tomography is the preferred modality to show bone landmarks and vascular structures. Radiologists play an important role in surgical planning by reporting extension of sphenoid pneumatization, recesses and septations of the sinus, and other relevant anatomic variants. Radiologists should understand the relationships of the sphenoid bone and skull base structures, anatomic variants, and image-guided neuronavigation techniques to prevent surgical complications and allow effective treatment of skull base lesions with the endoscopic endonasal transsphenoidal approach. ©RSNA, 2015.

  16. Pontine encephalocele and abnormalities of the posterior fossa following transclival endoscopic endonasal surgery. (United States)

    Koutourousiou, Maria; Filho, Francisco Vaz Guimaraes; Costacou, Tina; Fernandez-Miranda, Juan C; Wang, Eric W; Snyderman, Carl H; Rothfus, William E; Gardner, Paul A


    Transclival endoscopic endonasal surgery (EES) has recently been used for the treatment of posterior fossa tumors. The optimal method of reconstruction of large clival defects following EES has not been established. A morphometric analysis of the posterior fossa was performed in patients who underwent transclival EES to compare those with observed postoperative anatomical changes (study group) to 50 normal individuals (anatomical control group) and 41 matched transclival cases with preserved posterior fossa anatomy (case-control group) using the same parameters. Given the absence of clival bone following transclival EES, the authors used the line between the anterior commissure and the basion as an equivalent to the clival plane to evaluate the location of the pons. Four parameters were studied and compared in the two populations: the pontine location/displacement, the maximum anteroposterior (AP) diameter of the pons, the maximum AP diameter of the fourth ventricle, and the cervicomedullary angle (CMA). All measurements were performed on midsagittal 3-month postoperative MR images in the study group. Among 103 posterior fossa tumors treated with transclival EES, 14 cases (13.6%) with postoperative posterior fossa anatomy changes were identified. The most significant change was anterior displacement of the pons (transclival pontine encephalocele) compared with the normal location in the anatomical control group (p 50% of the clivus) and dura. Nine (64.3%) of the 14 patients were overweight (body mass index [BMI] > 25 kg/m(2)). An association between BMI and the degree of pontine encephalocele was observed, but did not reach statistical significance. The use of a fat graft as part of the reconstruction technique following transclival EES with dural opening was the single significant factor that prevented pontine displacement (p = 0.02), associated with 91% lower odds of pontine encephalocele (OR = 0.09, 95% CI 0.01-0.77). The effect of fat graft reconstruction was

  17. Extended Endoscopic Endonasal Approach for Craniopharyngioma Removal. (United States)

    Messerer, Mahmoud; Maduri, Rodolfo; Daniel, Roy Thomas


    Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig. 1 , panels A and B). Surgical Procedure  The head is rotated 10 degrees toward the surgeons. The nasal step is started through the left nostril with a middle turbinectomy. A nasoseptal flap is harvested and positioned in the left choana. The binostril approach allows a large sphenoidotomy to expose the key anatomic landmarks. The craniotomy boundaries are the planum sphenoidale superiorly, the median opticocarotid recesses, the internal carotid artery laterally and the clival recess inferiorly. After dural opening and superior intercavernous sinus coagulation, the tumor is entirely removed ( Fig. 2 , panels A and B). Skull base reconstruction is ensured by fascia lata grafting and nasoseptal flap positioning. Results  Postoperative MRI showed the complete tumor resection ( Fig. 1 , panels C and D). At 3 months postoperatively, the bitemporal hemianopia regressed and the visual acuity improved. A novel left homonymous hemianopia developed secondary to optic tract manipulation. Conclusions  The extended EEA is a valid surgical approach for craniopharyngioma resection. A comprehensive knowledge of the sellar and parasellar anatomy is mandatory for safe tumor removal with decreased morbidity and satisfactory oncologic results. The link to the video can be found at: .

  18. Outcomes following Purely Endoscopic Endonasal Resection of Pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Rezaul Amin


    Full Text Available Background: The use of endoscope for the management of pituitary adenoma is not new. The better magnification and illumination provided by the endoscope gives better outcome than microscopic pituitary surgery. Objective: To find out the benefits of endoscope in relation to microscopic surgery. Materials and Methods: We performed 45 cases of pituitary adenoma surgery by endoscopic endonasal approach from July 2008 to July 2010. Results: Forty five cases underwent endoscopic transsphenoidal approach. Gross total removal was done in 35 cases and subtotal removal was done in 10 cases. Residual tumours were seen in 10 cases (22% in postoperative follow-up MRI scan. Visual improvement was satisfactory, and hormonal improvement of functional adenoma was nice. Postoperative visual acuity and visual field were improved in 75% cases. There were 37% cases of temporary diabetes insipidus and about 4.5% cases of permanent diabetes insipidus. The average duration of follow-up was 20 months. One patient required reexploration to correct visual deterioration in the immediate postoperative period. There were 4.5% cases of CSF leak and 6.6% mortality. Mortality was due to electrolyte imbalance and improper management of infection and hydrocephalus. Conclusion: Endoscopic endonasal pituitary surgery now has become a gold standard surgery for most of the pituitary adenomas because of its better advantages in relation to microscopic surgery and less complications and less hospital stay.

  19. Transforming Anatomy


    Hall, Anndee


    Abstract: Transforming Anatomy Studying historic books allows people to witness the transformation of the world right before their very eyes. The Bruxellensis Icones Anatomicae[1] by Andreas Vesalius is a vital piece of evidence in the movement from a more rudimentary understanding of the human body into the more complex and accurate development of modern anatomy. Vesalius’ research worked to both refute and confirm findings of his predecessor, the great historical Greek philosopher, Galen...

  20. Intraoperative Neurophysiological Monitoring for Endoscopic Endonasal Approaches to the Skull Base: A Technical Guide

    Directory of Open Access Journals (Sweden)

    Harminder Singh


    Full Text Available Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base. The modalities employed include electroencephalography, somatosensory evoked potentials, free-running and electrically triggered electromyography, transcranial electric motor evoked potentials, and auditory evoked potentials. Methodological considerations as well as benefits and limitations are discussed. The authors argue that, while individual modalities have their limitations, multimodality neuromonitoring provides a real-time, comprehensive assessment of nervous system function and allows for safer, more aggressive management of skull base tumors via the endonasal route.

  1. [Endonasal Dacryocystorhinostomy (DCR) with Transcanalicular Endoillumination (TCE) of the Saccus Lacrimalis]. (United States)

    Hefner, J; Klask, J; Gerding, H


    Endonasal dacryocystorhinostomy (DCR) has been established as a standard procedure of lacrimal surgery, since it causes much less tissue damage than ab externo procedures. Diffiulties in visualization of the target area has been a limitation to the transnasal approach. An improvement of the classical endonasal DCR was achieved by the introduction of a transcanalicular endoillumination (TCE) of the lacrimal sac using a 23-Gauge vitreoretinal light probe, which can easily be intubated into the cannaliculi and advanced into the the lacrimal sac. Illumination of the lacrimal sac guides the endonasal approach and facilitates the creation of a lacrimal bypass. In our standard procedure a bicanalicular silicone intubation through the osteotomy is finally placed. Due to the introduction of TCE of the lacrimal sac, the surgical procedure of endonasal DCR became less traumatic and needed a significantly reduced operating time. Georg Thieme Verlag KG Stuttgart · New York.

  2. The "suprasellar notch," or the tuberculum sellae as seen from below: definition, features, and clinical implications from an endoscopic endonasal perspective. (United States)

    de Notaris, Matteo; Solari, Domenico; Cavallo, Luigi M; D'Enza, Alfonso Iodice; Enseñat, Joaquim; Berenguer, Joan; Ferrer, Enrique; Prats-Galino, Alberto; Cappabianca, Paolo


    The tuberculum sellae is a bony elevation ridge that lines up the anterior aspect of the sella, dividing it from the chiasmatic groove. The recent use of the endoscopic endonasal transtuberculum approach has provided surgeons with a method to reach the suprasellar area, offering a new surgical point of view somehow "opposite" of this area. The authors of this study aimed to define the tuberculum sellae as seen from the endoscopic endonasal view while also providing CT-based systematic measurements to objectively detail the anatomical features of such a structure, which was renamed the "suprasellar notch." The authors analyzed routine skull CT scans from 24 patients with no brain pathology or fractures and measured the interoptic distance at the level of the limbus sphenoidale, the chiasmatic groove sulcal length and width, and the angle of the suprasellar notch. Indeed, the suprasellar notch was defined as the angle between 2 lines, the first passing through the tuberculum sellae midpoint and perpendicular to the cribriform plate, and a second line passing between 2 points, the midpoints of the limbus sphenoidale and the tuberculum sellae. Moreover, the authors performed on 15 cadaveric heads an endoscopic endonasal transplanum transtuberculum approach with the aid of a neuronavigator to achieve a step-by-step comparison with the radiological data. The whole CT scanning set was statistically analyzed to determine the statistical interdependency of the suprasellar notch angle with the other 3 measurements, that is, the sulcal length at the midline, the interoptic distance at the optic canal entrance, and the interoptic distance at the limbus. Based on the endoscopic endonasal view and CT imaging analysis, the authors identified a certain anatomical variability and thus introduced a new classification of the suprasellar notch: Type I, angle 138°. They then analyzed the surgical implications of the endoscopic endonasal approach to the suprasellar area, which could be

  3. A checklist for endonasal transsphenoidal anterior skull base surgery. (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul


    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  4. Human ocular anatomy. (United States)

    Kels, Barry D; Grzybowski, Andrzej; Grant-Kels, Jane M


    We review the normal anatomy of the human globe, eyelids, and lacrimal system. This contribution explores both the form and function of numerous anatomic features of the human ocular system, which are vital to a comprehensive understanding of the pathophysiology of many oculocutaneous diseases. The review concludes with a reference glossary of selective ophthalmologic terms that are relevant to a thorough understanding of many oculocutaneous disease processes. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Anomalous origin of the coronary artery from the wrong coronary sinus evaluated with computed tomography: ''High-risk'' anatomy and its clinical relevance

    International Nuclear Information System (INIS)

    Krupinski, Maciej; Urbanczyk-Zawadzka, Malgorzata; Laskowicz, Bartosz; Irzyk, Malgorzata; Banys, Robert; Klimeczek, Piotr; Gruszczynska, Katarzyna; Baron, Jan


    The aim of the study was to assess coronary arteries arising from the wrong coronary sinus, including CT-evaluated high-risk anatomic features, clinical symptoms and cardiac events during follow-up. A total of 7,115 patients scheduled for 64-slice or dual-source cardiac CT were screened for the presence of isolated anomalous origin of the coronary artery from the wrong coronary sinus. Anomalous origin of the coronary artery was found in 54 (0.76 %) patients (29 men, 25 women, mean age 60.9 ± 11.6 years). Sixteen (30 %) patients with abnormal right coronary origin (ARCA) more commonly had a slit-like orifice (15 vs. 3; p < 0.001), intramural course (15 vs. 3; p < 0.001) and interarterial course (11 vs. 0; p < 0.001) than 22 (41 %) and 13 (24 %) individuals with abnormal circumflex artery (ALCx) and left coronary artery (ALCA) origin, respectively. Patients with ALCA presented less frequently with chest pain than subjects with ARCA and ALCx (25 vs. 3; p = 0.03). Patients with ARCA tended to show higher occurrence of cardiac events in the follow-up than individuals with ALCA and ALCx (5 vs. 4; p = NS). High-risk anatomy features are most common in patients with ARCA and these patients also have higher prevalence of chest pain and cardiac events in the follow-up than individuals with ALCA and ALCx. (orig.)

  6. Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations. (United States)

    Koutourousiou, Maria; Gardner, Paul A; Fernandez-Miranda, Juan C; Paluzzi, Alessandro; Wang, Eric W; Snyderman, Carl H


    Giant pituitary adenomas (> 4 cm in maximum diameter) represent a significant surgical challenge. Endoscopic endonasal surgery (EES) has recently been introduced as a treatment option for these tumors. The authors present the results of EES for giant adenomas and analyze the advantages and limitations of this technique. The authors retrospectively reviewed the medical files and imaging studies of 54 patients with giant pituitary adenomas who underwent EES and studied the factors affecting surgical outcome. Preoperative visual impairment was present in 45 patients (83%) and partial or complete pituitary deficiency in 28 cases (52%), and 7 patients (13%) presented with apoplexy. Near-total resection (> 90%) was achieved in 36 patients (66.7%). Vision was improved or normalized in 36 cases (80%) and worsened in 2 cases due to apoplexy of residual tumor. Significant factors that limited the degree of resection were a multilobular configuration of the adenoma (p = 0.002) and extension to the middle fossa (p = 0.045). Cavernous sinus invasion, tumor size, and intraventricular or posterior fossa extension did not influence the surgical outcome. Complications included apoplexy of residual adenoma (3.7%), permanent diabetes insipidus (9.6%), new pituitary insufficiency (16.7%), and CSF leak (16.7%, which was reduced to 7.4% in recent years). Fourteen patients underwent radiation therapy after EES for residual mass or, in a later stage, for recurrence, and 10 with functional pituitary adenomas received medical treatment. During a mean follow-up of 37.9 months (range 1-114 months), 7 patients were reoperated on for tumor recurrence. Three patients were lost to follow-up. Endoscopic endonasal surgery provides effective initial management of giant pituitary adenomas with favorable results compared with traditional microscopic transsphenoidal and transcranial approaches.

  7. Outcomes of endonasal endoscopic dacryocystorhinostomy after maxillectomy in patients with paranasal sinus and skull base tumors. (United States)

    Abu-Ghanem, Sara; Ben-Cnaan, Ran; Leibovitch, Igal; Horowitz, Gilad; Fishman, Gadi; Fliss, Dan M; Abergel, Avraham


    Maxillectomy followed by radiotherapy and/or chemotherapy can result in lacrimal blockage and the need for subsequent dacryocystorhinostomy (DCR). Endonasal endoscopic DCR, as opposed to external DCR, allows better accuracy and leaves no scar. To date no report was published regarding the results of endoscopic DCR in these patients. The current study presents a retrospective review of all patients with paranasal and skull base tumors who developed nasolacrimal duct blockage after ablative maxillectomy with or without radiotherapy and/or chemotherapy and underwent endonasal endoscopic DCR between January 2006 and October 2012 in a tertiary reference medical center. According to our results, ten patients underwent 11 subsequent endonasal endoscopic DCR. There were 6 men and 4 women with a median age of 55 years (range, 19-81 years); four suffered from benign tumors and six had malignant tumors. All underwent maxillectomy. Six received high-dose radiotherapy. Time interval between primary ablative surgery and endonasal endoscopic DCR was 18 months (range, 7-118 months). Silicone stents were removed after median period of 11 weeks (range, 1-57 weeks). Nine out of ten patients experienced symptomatic improvement following one endonasal endoscopic DCR. One patient had recurrent epiphora and underwent a successful endonasal endoscopic revision DCR. In conclusion, endonasal endoscopic DCR in patients with paranasal and skull base tumors, who previously underwent maxillectomy, is generally successful and not associated with a high rate of complications or failure. Moreover, our findings may suggest that silicone stents can be removed shortly after the operation with high success rate.

  8. Regulatory Anatomy

    DEFF Research Database (Denmark)

    Hoeyer, Klaus


    This article proposes the term “safety logics” to understand attempts within the European Union (EU) to harmonize member state legislation to ensure a safe and stable supply of human biological material for transplants and transfusions. With safety logics, I refer to assemblages of discourses, le...... they arise. In short, I expose the regulatory anatomy of the policy landscape....

  9. Stedets Anatomi

    DEFF Research Database (Denmark)

    Larsen, Lasse Juel

    Titlen på denne ph.d.-afhandling, Stedets Anatomi – en teoretisk undersøgelse af stedets og rumlighedens betydning for leg, computerspil og læring, skitserer ikke kun afhandlingens teoretiske dimensionering, men også dens analytiske bliks tematik i forbindelse med undersøgelsen af fænomenerne leg...

  10. Panorama of Reconstruction of Skull Base Defects: From Traditional Open to Endonasal Endoscopic Approaches, from Free Grafts to Microvascular Flaps (United States)

    Reyes, Camilo; Mason, Eric; Solares, C. Arturo


    Introduction A substantial body of literature has been devoted to the distinct characteristics and surgical options to repair the skull base. However, the skull base is an anatomically challenging location that requires a three-dimensional reconstruction approach. Furthermore, advances in endoscopic skull base surgery encompass a wide range of surgical pathology, from benign tumors to sinonasal cancer. This has resulted in the creation of wide defects that yield a new challenge in skull base reconstruction. Progress in technology and imaging has made this approach an internationally accepted method to repair these defects. Objectives Discuss historical developments and flaps available for skull base reconstruction. Data Synthesis Free grafts in skull base reconstruction are a viable option in small defects and low-flow leaks. Vascularized flaps pose a distinct advantage in large defects and high-flow leaks. When open techniques are used, free flap reconstruction techniques are often necessary to repair large entry wound defects. Conclusions Reconstruction of skull base defects requires a thorough knowledge of surgical anatomy, disease, and patient risk factors associated with high-flow cerebrospinal fluid leaks. Various reconstruction techniques are available, from free tissue grafting to vascularized flaps. Possible complications that can befall after these procedures need to be considered. Although endonasal techniques are being used with increasing frequency, open techniques are still necessary in selected cases. PMID:25992142

  11. The Anatomy of Learning Anatomy (United States)

    Wilhelmsson, Niklas; Dahlgren, Lars Owe; Hult, Hakan; Scheja, Max; Lonka, Kirsti; Josephson, Anna


    The experience of clinical teachers as well as research results about senior medical students' understanding of basic science concepts has much been debated. To gain a better understanding about how this knowledge-transformation is managed by medical students, this work aims at investigating their ways of setting about learning anatomy.…

  12. Thymus Gland Anatomy (United States)

    ... historical Searches are case-insensitive Thymus Gland, Adult, Anatomy Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Thymus Gland, Adult, Anatomy Description: Anatomy of the thymus gland; drawing shows ...

  13. Normal Female Reproductive Anatomy (United States)

    ... historical Searches are case-insensitive Reproductive System, Female, Anatomy Add to My Pictures View /Download : Small: 720x756 ... Large: 3000x3150 View Download Title: Reproductive System, Female, Anatomy Description: Anatomy of the female reproductive system; drawing ...

  14. Normal Pancreas Anatomy (United States)

    ... hyphen, e.g. -historical Searches are case-insensitive Pancreas Anatomy Add to My Pictures View /Download : Small: ... 1586x1534 View Download Large: 3172x3068 View Download Title: Pancreas Anatomy Description: Anatomy of the pancreas; drawing shows ...

  15. Clinical outcome of endonasal KTP laser assisted dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Carrie Sean


    Full Text Available Abstract Background To evaluate the clinical outcome of primary endonasal laser assisted dacryocystorhinostomy (ENL-DCR using the potassium-titanyl-phosphate laser. Methods We retrospectively reviewed all primary ENL-DCRs performed within a period of twelve months by the same combined Ophthalmology and Otorhinolaringology team in Freeman Hospital, Newcastle upon Tyne, UK. The main outcome measure for success was resolution or significant improvement of epiphora. Details of surgery, intraoperative and postoperative complications, as well as pathology associated with failure were also studied. Patients were followed up for at least 12 months. Results A total of 41 consecutive ENL-DCRs on 29 patients (22 females, 7 males, mean age 75 years were analysed. All patients had bicanalicular silicone intubation for at least 4 months. The success rate at 12 months postoperatively was 78.1%. Pathology associated with failure included: intranasal pathology (12.2%, mucocele (7.3%, and systemic sarcoidosis (2.4%. No significant intra-operative complications were recorded. Conclusion The ENL-DCR with potassium-titanyl-phosphate laser can be considered as a safe and efficient primary procedure for the treatment of nasolacrimal duct obstruction.

  16. Improving gross anatomy learning using reciprocal peer teaching


    Manyama, Mange; Stafford, Renae; Mazyala, Erick; Lukanima, Anthony; Magele, Ndulu; Kidenya, Benson R.; Kimwaga, Emmanuel; Msuya, Sifael; Kauki, Julius


    Background The use of cadavers in human anatomy teaching requires adequate number of anatomy instructors who can provide close supervision of the students. Most medical schools are facing challenges of lack of trained individuals to teach anatomy. Innovative techniques are therefore needed to impart adequate and relevant anatomical knowledge and skills. This study was conducted in order to evaluate the traditional teaching method and reciprocal peer teaching (RPT) method during anatomy dissec...

  17. Endoscopic endonasal transsphenoidal surgery: implementation of an operative and perioperative checklist. (United States)

    Christian, Eisha; Harris, Brianna; Wrobel, Bozena; Zada, Gabriel


    Endoscopic endonasal surgery relies heavily on specialized operative instrumentation and optimization of endocrinological and other critical adjunctive intraoperative factors. Several studies and worldwide initiatives have previously established that intraoperative and perioperative surgical checklists can minimize the incidence of and prevent adverse events. The aim of this article was to outline some of the most common considerations in the perioperative and intraoperative preparation for endoscopic endonasal transsphenoidal surgery. The authors implemented and prospectively evaluated a customized checklist at their institution in 25 endoscopic endonasal operations for a variety of sellar and skull base pathological entities. Although no major errors were detected, near misses pertaining primarily to missing components of surgical equipment or instruments were identified in 9 cases (36%). The considerations in the checklist provided in this article can serve as a basic template for further customization by centers performing endoscopic endonasal surgery, where their application may reduce the incidence of adverse or preventable errors associated with surgical treatment of sellar and skull base lesions.

  18. Analyses and treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (United States)

    Cheng, You; Xue, Fei; Wang, Tian-You; Ji, Jun-Feng; Chen, Wei; Wang, Zhi-Yi; Xu, Li; Hang, Chun-Hua; Liu, Xin-Feng


    Abstract In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1.6%), olfactory disorder (1.6%), perforation of nasal septum (0.8%), and nasal adhesion (2.3%). All patients clinically recovered after therapy, which included treatment of the cavity through nasal endoscopy, intranasal corticosteroids, and nasal irrigation. We propose that regular nasal endoscopic review, specific nasal medications, and regular nasal irrigation can effectively clear nasal mucosal hyperemia-induced edema and nasal/nasoantral secretions, as well as promote regeneration of nasal mucosa, prevent nasal adhesion, maintain the sinus cavity drainage, and accelerate the recovery of the physiological function of the paranasal sinus. Timely treatment of patients with nasal complications after endonasal transsphenoidal resections of PNs could greatly relieve the clinical symptoms. Nasal cleaning is very beneficial to patients after surgery recovery. PMID:28403108

  19. Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance. (United States)

    Ari, Seyhmus; Kürşat Cingü, Abdullah; Sahin, Alparslan; Gün, Ramazan; Kiniş, Vefa; Caça, Ihsan


    To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocystorhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance. Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success. Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28). Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates.

  20. Extended Transsphenoidal Endoscopic Endonasal Surgery of Suprasellar Craniopharyngiomas. (United States)

    Fomichev, Dmitry; Kalinin, Pavel; Kutin, Maxim; Sharipov, Oleg


    The endoscopic extended transsphenoidal approach for suprasellar craniopharyngiomas may be a really alternative to the transcranial approach in many cases. The authors present their experience with this technique in 136 patients with craniopharyngiomas. From the past 7 years 204 patients with different purely supradiaphragmatic tumors underwent removal by extended endoscopic transsphenoidal transtuberculum transplanum approach. Most of the patients (136) had craniopharyngiomas (suprasellar, intra-extraventricular). The patients were analyzed according to age, sex, tumor size, growth and tumor structure, and clinical symptoms. Twenty-five patients had undergone a previous surgery. The mean follow-up was 42 months (range, 4-120 months). The operation is always performed with the bilateral endoscopic endonasal anterior extended transsphenoidal approach. A gross-total removal was completed in 72%. Improvement of vision or absence of visual deterioration after operation was observed in 89% of patients; 11% had worsening vision after surgery. Endocrine dysfunction did not improve after surgery, new hypotalamopituitary dysfunction (anterior pituitary dysfunction or diabetes insipidus) or worsening of it was observed in 42.6%. Other main complications included transient new mental disorder in 11%, temporary neurological postoperative deficits in 3.7%, bacterial meningitis in 16%, cerebrospinal fluid leaks in 8.8%. The recurrence rate was 20% and the lethality was 5.8%. Resection of suprasellar craniopharyngiomas using the extended endoscopic approach is a more effective and less traumatic technology, able to provide resection of the tumor along with high quality of life after surgery, and relatively rare postoperative complications and mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Endoscopic endonasal trans-sphenoid surgery of pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Y R Yadav


    Full Text Available Endoscopic endonasal trans-sphenoid surgery (EETS is increasingly used for pituitary lesions. Pre-operative CT and MRI scans and peroperative endoscopic visualization can provide useful anatomical information. EETS is indicated in sellar, suprasellar, intraventricular, retro-infundibular, and invasive tumors. Recurrent and residual lesions, pituitary apoplexy and empty sella syndrome can be managed by EETS. Modern neuronavigation techniques, ultrasonic aspirators, ultrasonic bone curette can add to the safety. The binostril approach provides a wider working area. High definition camera is much superior to three-chip camera. Most of the recent reports favor EETS in terms of safety, quality of life and tumor resection, hospital stay, better endocrinological, and visual outcome as compared to the microscopic technique. Nasal symptoms, blood loss, operating time are less in EETS. Various naso-septal flaps and other techniques of CSF leak repair could help reduce complications. Complications can be further reduced after achieving the learning curve, good understanding of limitations with proper patient selection. Use of neuronavigation, proper post-operative care of endocrine function, establishing pituitary center of excellence and more focused residency and endoscopic fellowship training could improve results. The faster and safe transition from microscopic to EETS can be done by the team concept of neurosurgeon/otolaryngologist, attending hands on cadaveric dissection, practice on models, and observation of live surgeries. Conversion to a microscopic or endoscopic-assisted approach may be required in selected patients. Multi-modality treatment could be required in giant and invasive tumors. EETS appears to be a better surgical option in most pituitary adenoma.

  2. Endoscopic Endonasal Approach in the Management of Rathke's Cleft Cysts.

    Directory of Open Access Journals (Sweden)

    Domenico Solari

    Full Text Available Rathke's cleft cysts (RCCs are quite uncommon sellar lesions that can extend or even arise in the suprasellar area. The purpose of this study is to evaluate the effectiveness of both standard and extended endoscopic endonasal approaches in the management of different located RCCs.We retrospectively analyzed a series of 29 patients (9 males, 20 females complaining of a RCC, who underwent a standard or an extended endoscopic transsphenoidal approach at the Division of Neurosurgery, Department of Neurosciences and Reproductive and Odontostomatological Sciences, of the Università degli Studi di Napoli "Federico II". Data regarding patients' demographics, clinical evaluation, cyst characteristics, surgical treatments, complications and outcomes were extracted from our electronic database (Filemaker Pro 11, File Maker Inc., Santa Clara, California, USA.A standard transsphenoidal approach was used in 19 cases, while the extended variation of the approach in 10 cases (5 purely suprasellar and 5 intra-suprasellar RCC. Cysts contents was fully drained in all the 29 cases, whilst a gross total removal, that accounts on the complete cyst wall removal, was achieved in an overall 55,1% of patients (16/29, specifically 36,8% (7/19 that received standard approach and 90% (9/10 of those that underwent to extended approach. We reported a 56.2% of recovery from headache, 38.5% of complete recovery and 53.8% of improvement from visual field defect and an overall 46.7% of improvement of the endocrine functions. Postoperative permanent DI rate was 10.3%, overall post-operative CSF leak rate 6.9%; recurrence/regrowth occurred in 4 patients (4/29, 13.8%, but only one required a second surgery.The endoscopic transsphenoidal approach for the removal of a symptomatic RCC offers several advantages in terms of visualization of the surgical field during both the exposure and removal of the lesion. The "extended" variation of the endoscopic approach provides a direct access

  3. [Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery: a case report]. (United States)

    Oka, Tetsuo; Sugiu, Kenji; Ishida, Joji; Hishikawa, Tomohito; Ono, Shigeki; Tokunaga, Koji; Date, Isao


    We report here a case of massive nasal bleeding from the sphenopalatine artery three weeks after endonasal transsphenoidal surgery. This 66-year-old male suffered from massive nasal bleeding with the status of hypovolemic shock. Under general anesthesia, an emergent angiography revealed an extravasation from the sphenopalatine artery. Trans-arterial embolization using coil and n-butyl-cyanoacrylate (NBCA) was performed following the diagnostic angiography. Complete occlusion of the injured artery was achieved. The patient showed good recovery from general anesthesia. Delayed nasal bleeding after endonasal transsphenoidal surgery is a rare but important complication. The sphenopalatine artery and its branch are located in the hidden inferior lateral corner of the sphenoid sinus and may be injured during enlargement of the sphenoid opening. When massive delayed nasal bleeding follows transsphenoidal surgery and damage of the internal carotid artery has been ruled out, endovascular treatment of the external carotid artery should be considered.

  4. Endoscopic Endonasal Approach in Skull Base Chondrosarcoma Associated with Maffucci Syndrome: Case Series and Literature Review. (United States)

    Beer-Furlan, André; Balsalobre, Leonardo; Vellutini, Eduardo A S; Stamm, Aldo C


    Maffucci syndrome is a nonhereditary disorder in which patients develop multiple enchondromas and cutaneous, visceral, or soft tissue hemangiomas. The potential malignant progression of enchondroma into a secondary chondrosarcoma is a well-known fact. Nevertheless, chondrosarcoma located at the skull base in patients with Maffuci syndrome is a very rare condition, with only 18 cases reported in the literature. We report 2 other cases successfully treated through an expanded endoscopic endonasal approach and discuss the condition based on the literature review. Skull base chondrosarcoma associated with Maffucci syndrome is a rare condition. The disease cannot be cured, therefore surgical treatment should be performed in symptomatic patients aiming for maximal tumor resection with function preservation. The endoscopic endonasal approach is a safe and reliable alternative for the management of these tumors. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Endonasal versus trans-canalicular endoscopic dacriocystorhinostomy using diode laser. Surgical techniques and outcomes]. (United States)

    Piédrola Maroto, David; Franco Sánchez, Javier; Reyes Eldblom, Robin; Monje Vega, Elena; Conde Jiménez, Manuel; Ortiz Rueda, Manuel


    To evaluate the benefits and disadvantages of the endoscopic endonasal versus transcanalicular approaches using diode laser, and to compare their clinical outcomes. A total of 127 patients were operated on, 80 of them with the endonasal approach (Group I) and 47 with the transcanalicular technique (Group II). Epiphora improved completely in 67 patients in Group I (83.7 %) while the other 13 (16.2 %) continued to present the same symptoms. In Group II, a successful result was achieved in 39 patients (82.9 %) and 8 (17 %) of them had to be re-operated because of the persistence of epiphora. The surgical outcomes are similar with both laser techniques. The main advantages of using diode laser are that it does not require general anaesthesia, the lower intra- and peri-operative morbidity, the lack of nasal packing and the greater ease of performing additional interventions if it fails. The only real disadvantage of laser procedures is the high cost.

  6. Anatomy Journal of Africa

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... Anatomy Journal of Africa is the Official Journal for the Association of Anatomical Societies of Africa. ... Applied anatomy - Clinical anatomy - Morphology, - Embryology ...

  7. Clinical Pearls in Anaesthesia for Endoscopic Endonasal Transsphenoid Pituitary Macroadenoma Surgery

    Directory of Open Access Journals (Sweden)

    Shah Shagun B


    Full Text Available Endoscopic Endonasal Trans-sphenoid Surgery (EETS aided by avant-garde neuro-navigation techniques, ultrasonic aspirators and bone curettes has come of age. Endoscopic surgery supersedes conventional microscopic approach due to better visualization, avoidance of craniotomy, brain retraction and undue neurovascular manipulation with less morbidity, blood loss and improved safety. Anaesthetic techniques must be tailored to cater for such advances in surgery.

  8. Utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. (United States)

    Jayarao, Mayur; Devaiah, Anand K; Chin, Lawrence S


    This study sought to report on the utility and safety of the flexible-fiber CO2 laser in endoscopic endonasal transsphenoidal surgery. A retrospective chart review identified 16 patients who underwent laser-assisted transsphenoidal surgery. All tumor pathology types were considered. Results were assessed based on hormone status, tumor size, pathology, complications, and resection rates. Sixteen pituitary lesions (pituitary adenomas, 12; Rathke cleft cyst, 2; pituitary cyst and craniopharyngioma, 1 each) with an average size of 22.7 mm were identified by radiographic and pathologic criteria. All patients underwent flexible-fiber CO2 laser-assisted endoscopic endonasal transsphenoidal surgery. Of the adenomas, 8 were nonsecreting and 4 were secreting (3 prolactinomas and 1 ACTH secreting). Gross total resection was achieved in 7 of 16 patients (43.75%) with hormone remission in all patients (100%) after a mean follow-up of 19.3 months. Postoperative complications occurred in 3 patients (18.75%): 2 patients developed transient diabetes insipidus (DI) and 1 developed a CSF leak requiring surgical repair. Five patients (31.25%) underwent postoperative radiation to the residual lesions. We found that CO2-laser-assisted endoscopic endonasal transsphenoidal surgery for sellar tumors is a minimally invasive approach using a tool that is quick and effective at cutting and coagulation. The surgery has a low rate of complication, and no laser-related complications were encountered. The laser fiber allows the surgeon to safely cut and coagulate without the line-of-sight problems encountered with conventional CO2 lasers. Further studies are recommended to further define its role in endoscopic endonasal sellar surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. [Neurophysiological identification of the cranial nerves in endoscopic endonasal surgery of skull base tumors]. (United States)

    Shkarubo, A N; Ogurtsova, A A; Moshchev, D A; Lubnin, A Yu; Andreev, D N; Koval', K V; Chernov, I V


    Intraoperative identification of the cranial nerves is a useful technique in removal of skull base tumors through the endoscopic endonasal approach. Searching through the scientific literature found one pilot study on the use of triggered electromyography (t-EMG) for identification of the VIth nerve in endonasal endoscopic surgery of skull base tumors (D. San-Juan, et al, 2014). The study objective was to prevent iatrogenic injuries to the cranial nerves without reducing the completeness of tumor tissue resection. In 2014, 5 patients were operated on using the endoscopic endonasal approach. Surgeries were performed for large skull base chordomas (2 cases) and trigeminal nerve neurinomas located in the cavernous sinus (3). Intraoperatively, identification of the cranial nerves was performed by triggered electromyography using a bipolar electrode (except 1 case of chordoma where a monopolar electrode was used). Evaluation of the functional activity of the cranial nerves was carried out both preoperatively and postoperatively. Tumor resection was total in 4 out of 5 cases and subtotal (chordoma) in 1 case. Intraoperatively, the IIIrd (2 patients), Vth (2), and VIth (4) cranial nerves were identified. No deterioration in the function of the intraoperatively identified nerves was observed in the postoperative period. In one case, no responses from the VIth nerve on the right (in the cavernous sinus region) were intraoperatively obtained, and deep paresis (up to plegia) of the nerve-innervated muscles developed in the postoperative period. The nerve function was not impaired before surgery. The t-EMG technique is promising and requires further research.

  10. Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note. (United States)

    Dolci, Ricardo Landini Lutaif; Todeschini, Alexandre Bossi; Santos, Américo Rubens Leite Dos; Lazarini, Paulo Roberto


    One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base. Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy. Step by step description of the endoscopic double flap technique (nasoseptal and pericranial vascularized flaps and fascia lata free graft) as used and illustrated in two patients with an olfactory groove meningioma who underwent an endoscopic approach. Both patients achieved a gross total resection: subsequent reconstruction of the anterior skull base was performed with the nasoseptal and pericranial flaps onlay and a fascia lata free graft inlay. Both patients showed an excellent recovery, no signs of cerebrospinal fluid leak, meningitis, flap necrosis, chronic meningeal or sinonasal inflammation or cerebral herniation having developed. This endoscopic double flap technique we have described is a viable, versatile and safe option for anterior skull base reconstructions, decreasing the incidence of complications in endoscopic endonasal approaches. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  11. Anatomic comparison of the endonasal and transpetrosal approaches for interpeduncular fossa access. (United States)

    Oyama, Kenichi; Prevedello, Daniel M; Ditzel Filho, Leo F S; Muto, Jun; Gun, Ramazan; Kerr, Edward E; Otto, Bradley A; Carrau, Ricardo L


    The interpeduncular cistern, including the retrochiasmatic area, is one of the most challenging regions to approach surgically. Various conventional approaches to this region have been described; however, only the endoscopic endonasal approach via the dorsum sellae and the transpetrosal approach provide ideal exposure with a caudal-cranial view. The authors compared these 2 approaches to clarify their limitations and intrinsic advantages for access to the interpeduncular cistern. Four fresh cadaver heads were studied. An endoscopic endonasal approach via the dorsum sellae with pituitary transposition was performed to expose the interpeduncular cistern. A transpetrosal approach was performed bilaterally, combining a retrolabyrinthine presigmoid and a subtemporal transtentorium approach. Water balloons were used to simulate space-occupying lesions. "Water balloon tumors" (WBTs), inflated to 2 different volumes (0.5 and 1.0 ml), were placed in the interpeduncular cistern to compare visualization using the 2 approaches. The distances between cranial nerve (CN) III and the posterior communicating artery (PCoA) and between CN III and the edge of the tentorium were measured through a transpetrosal approach to determine the width of surgical corridors using 0- to 6-ml WBTs in the interpeduncular cistern (n = 8). Both approaches provided adequate exposure of the interpeduncular cistern. The endoscopic endonasal approach yielded a good visualization of both CN III and the PCoA when a WBT was in the interpeduncular cistern. Visualization of the contralateral anatomical structures was impaired in the transpetrosal approach. The surgical corridor to the interpeduncular cistern via the transpetrosal approach was narrow when the WBT volume was small, but its width increased as the WBT volume increased. There was a statistically significant increase in the maximum distance between CN III and the PCoA (p = 0.047) and between CN III and the tentorium (p = 0.029) when the WBT volume

  12. Student Perspectives of Imaging Anatomy in Undergraduate Medical Education (United States)

    Machado, Jorge Americo Dinis; Barbosa, Joselina Maria Pinto; Ferreira, Maria Amelia Duarte


    Radiological imaging is gaining relevance in the acquisition of competencies in clinical anatomy. The aim of this study was to evaluate the perceptions of medical students on teaching/learning of imaging anatomy as an integrated part of anatomical education. A questionnaire was designed to evaluate the perceptions of second-year students…

  13. Endoscopic Endonasal Transplanum Transtuberculum Approach for the Resection of a Large Suprasellar Craniopharyngioma. (United States)

    Mangussi-Gomes, João; Vellutini, Eduardo A; Truong, Huy Q; Pahl, Felix H; Stamm, Aldo C


    Objectives  To demonstrate an endoscopic endonasal transplanum transtuberculum approach for the resection of a large suprasellar craniopharyngioma. Design  Single-case-based operative video. Setting  Tertiary center with dedicated skull base team. Participants  A 72-year-old male patient diagnosed with a suprasellar craniopharyngioma. Main Outcomes Measured  Surgical resection of the tumor and preservation of the normal surrounding neurovascular structures. Results  A 72-year-old male patient presented with a 1-year history of progressive bitemporal visual loss. He also referred symptoms suggestive of hypogonadism. Neurological examination was unremarkable and endocrine workup demonstrated mildly elevated prolactin levels. Magnetic resonance images demonstrated a large solid-cystic suprasellar lesion, consistent with the diagnosis of craniopharyngioma. The lesion was retrochiasmatic, compressed the optic chiasm, and extended into the interpeduncular cistern ( Fig. 1 ). Because of that, the patient underwent an endoscopic endonasal transplanum transtuberculum approach. 1 2 3 The nasal stage consisted of a transnasal transseptal approach, with complete preservation of the patient's left nasal cavity. 4 The cystic component of the tumor was decompressed and its solid part was resected. It was possible to preserve the surrounding normal neurovascular structures ( Fig. 2 ). Skull base reconstruction was performed with a dural substitute, a fascia lata graft, and a right nasoseptal flap ( Video 1 ). The patient did well after surgery and referred complete visual improvement. However, he also presented pan-hypopituitarism on long-term follow-up. Conclusions  The endoscopic endonasal route is a good alternative for the resection of suprasellar lesions. It permits tumor resection and preservation of the surrounding neurovascular structures while avoiding external incisions and brain retraction. The link to the video can be found at: .

  14. Teaching Anatomy: need or taste?


    Farrokhi, Ahmad; Nejad, Masoume Soleymani


    Abstract Background: Anatomy is one of the core sections of Basic Medical Sciences. Given the central role of anatomy, the development of medical knowledge and reach new horizons in science is not possible without relying on anatomy. Since in the anatomy science, students are familiar with the basic terms of medical language, the anatomy's hard to know and have a negative attitude towards this course. With these conditions, anatomy professors have an important role in providing incentives...

  15. Ligadura endoscópica endonasal da artéria esfenopalatina para epistaxe severa

    Directory of Open Access Journals (Sweden)

    Santos Rodrigo P.


    Full Text Available Introdução: A epistaxe severa, geralmente associada a fatores predisponentes como hipertensão arterial sistêmica e coagulopatia, é uma doença desafiadora, e pode necessitar de uma abordagem cirúrgica nos casos que não respondem ao tratamento conservador, como cauterização e tamponamento nasal. Objetivo: avaliar os resultados da ligadura endoscópica endonasal da artéria esfenopalatina no tratamento da epistaxe severa refratária à abordagem terapêutica conservadora. Forma de estudo: Clínico prospectivo. Material e Método: foram avaliados doze casos de pacientes submetidos à ligadura endoscópica endonasal da artéria esfenopalatina no tratamento da epistaxe severa não responsiva ao tratamento conservador, observando-se a história clínica, os fatores predisponentes, a evolução e as complicações deste procedimento. Resultados: a idade média foi de 50,9 anos, e a distribuição por sexo foi de 33% do sexo feminino e 67% do sexo masculino; 33% apresentaram HAS e 16,6% coagulopatia (hepatopatia como fatores predisponentes. Um paciente (8,3% apresentou ressangramento após o procedimento cirúrgico. Discussão: a ligadura endoscópica endonasal da artéria esfenopalatina representa uma abordagem segura e garante um controle satisfatório do sangramento, com índice de ressangramento de 8,3% entre os nossos casos. Conclusão: a ligadura endoscópica endonasal da artéria esfenopalatina representa uma opção cirúrgica adequada, pois não apresenta as complicações das técnicas anteriores, atinge um controle satisfatório do sangramento e pode ser realizada por otorrinolaringologistas habituados à cirurgia endoscópica nasal.

  16. Endoscopic Endonasal Infrapetrous Transpterygoid Approach to the Petroclival Junction for Petrous Apex Chondrosarcoma: Technical Report. (United States)

    Maurer, Adrian J; Bonney, Phillip A; Iser, Courtney R; Ali, Rohaid; Sanclement, Jose A; Sughrue, Michael E


    Chondrosarcomas of the skull base are rare tumors that present difficult management considerations due to the pathoanatomical relationships of the tumor to adjacent structures. We present the case of a 25-year-old female patient presenting with a chondrosarcoma of the right petrous apex extending inferiorly, medial to the cranial nerves. The tumor was resected via an endoscopic endonasal infrapetrous transpterygoid approach that achieved complete resection and an excellent long-term outcome with no complications. Technical nuances and potential pitfalls of the case are discussed in depth including measures to protect the carotid artery while performing the required drilling of the skull base to access the lesion.

  17. Gigant Transethmoidal Meningoencephalocele Operated by Full Endonasal Endoscopic Approach: Case Report

    Directory of Open Access Journals (Sweden)

    Omar Lopez Arbolay


    Full Text Available Intranasal meningoencephaloceles have historically been managed by neurosurgeons, although their main clinical manifestations are rhinological. Recent advances in endoscopic skull base surgery has significantly improved the treatment of these lesions and consequently diminished appreciable surgical morbidity. We report an ethmoidal meningoencephalocele case operated on by endonasal endoscopic approach for removal of the lesion and reconstructing the associated skull base. From this experience, we conclude that removal of the lesion and watertight closure of the skull base irrespective of the size of the mass and anterior skull base defect are the operation’s most important aspects.

  18. Neuromodulators: available agents, physiology, and anatomy. (United States)

    Nettar, Kartik; Maas, Corey


    Neuromodulators have risen to the forefront of aesthetic medicine. By reversibly relaxing target muscles, neuromodulators exhibit their effect by softening hyperfunctional lines. An understanding of their physiology, relevant facial anatomy, and current agents is imperative for a successful aesthetic practice. © Thieme Medical Publishers.

  19. A Review of the Comparative Anatomy, Histology, Physiology and Pathology of the Nasal Cavity of Rats, Mice, Dogs and Non-human Primates. Relevance to Inhalation Toxicology and Human Health Risk Assessment. (United States)

    Chamanza, R; Wright, J A


    There are many significant differences in the structural and functional anatomy of the nasal cavity of man and laboratory animals. Some of the differences may be responsible for the species-specific nasal lesions that are often observed in response to inhaled toxicants. This paper reviews the comparative anatomy, physiology and pathology of the nasal cavity of the rat, mouse, dog, monkey and man, highlighting factors that may influence the distribution of nasal lesions. Gross anatomical variations such as turbinate structure, folds or grooves on nasal walls, or presence or absence of accessory structures, may influence nasal airflow and species-specific uptake and deposition of inhaled material. In addition, interspecies variations in the morphological and biochemical composition and distribution of the nasal epithelium may affect the local tissue susceptibility and play a role in the development of species-specific nasal lesions. It is concluded that, while the nasal cavity of the monkey might be more similar to that of man, each laboratory animal species provides a model that responds in a characteristic and species-specific manner. Therefore for human risk assessment, careful consideration must be given to the anatomical differences between a given animal model and man. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Anatomy Comic Strips (United States)

    Park, Jin Seo; Kim, Dae Hyun; Chung, Min Suk


    Comics are powerful visual messages that convey immediate visceral meaning in ways that conventional texts often cannot. This article's authors created comic strips to teach anatomy more interestingly and effectively. Four-frame comic strips were conceptualized from a set of anatomy-related humorous stories gathered from the authors' collective…

  1. Meningitis caused by Enterococcus casseliflavus with refractory cerebrospinai fluid leakage following endoscopic endonasal removal of skull base chondrosarcoma

    Institute of Scientific and Technical Information of China (English)


    To the Editor:Meningitis caused by Enterococcus casseliflavus (E.casseliflavus) is extremely rare.Here we report an unusual case of meningitis caused by E.casseliflavus coexisting with refractory cerebrospinal fluid (CSF) leakage following endoscopic endonasal resection of skull base chondrosarcoma.

  2. Teaching medical anatomy: what is the role of imaging today? (United States)

    Grignon, Bruno; Oldrini, Guillaume; Walter, Frédéric


    Medical anatomy instruction has been an important issue of debate for many years and imaging anatomy has become an increasingly important component in the field, the role of which has not yet been clearly defined. The aim of the paper was to assess the current deployment of medical imaging in the teaching of anatomy by means of a review of the literature. A systematic search was performed using the electronic database PubMed, ScienceDirect and various publisher databases, with combinations of the relevant MeSH terms. A manual research was added. In most academic curricula, imaging anatomy has been integrated as a part of anatomical education, taught using a very wide variety of strategies. Considerable variation in the time allocation, content and delivery of medical imaging in teaching human anatomy was identified. Given this considerable variation, an objective assessment remains quite difficult. In most publications, students' perceptions regarding anatomical courses including imaging anatomy were investigated by means of questionnaires and, regardless of the method of teaching, it was globally concluded that imaging anatomy enhanced the quality and efficiency of instruction in human anatomy. More objective evaluation based on an increase in students' performance on course examinations or on specific tests performed before and after teaching sessions showed positive results in numerous cases, while mixed results were also indicated by other studies. A relative standardization could be useful in improving the teaching of imaging anatomy, to facilitate its assessment and reinforce its effectiveness.

  3. A prospective qualitative study on patients' perceptions of endoscopic endonasal transsphenoidal surgery. (United States)

    Edem, Idara J; Banton, Beverly; Bernstein, Mark; Lwu, Shelly; Vescan, Allan; Gentilli, Fred; Zadeh, Gelareh


    Endoscopic transsphenoidal surgery has been shown to be a safe and effective treatment option for patients with pituitary tumours, but no study has explored patients' perceptions before and after this surgery. The authors in this study aim to explore patients' perceptions on endoscopic transsphenoidal surgery. Using qualitative research methodology, two semi-structured interviews were conducted with 30 participants who were adults aged > 18 undergoing endoscopic transsphenoidal surgery for the resection of a pituitary tumour between December 2008 and June 2011. The interviews were audiotaped and transcribed. The resulting data was analyzed using a modified thematic analysis. Seven overarching themes were identified: (1) Patients had a positive surgical experience; (2) patients were satisfied with the results of the procedure; (3) patients were initially surprised that neurosurgery could be performed endonasally; (4) patients expected a cure and to feel better after the surgery; (5) many patients feared that something might go wrong during the surgery; (6) patients were psychologically prepared for the surgery; (7) most patients reported receiving adequate pre-op and post-op information. This is the first qualitative study reporting on patients' perceptions before and after an endoscopic endonasal transsphenoidal pituitary surgery, which is increasingly used as a standard surgical approach for patients with pituitary tumours. Patients report a positive perception and general satisfaction with the endoscopic transsphenoidal surgical experience. However, there is still room for improvement in post-surgical care. Overall, patients' perceptions can help improve the delivery of comprehensive care to future patients undergoing pituitary tumour surgery.

  4. [The extended endoscopic endonasal transsphenoidal approach in surgery for epidermoid cysts of the chiasmatic region]. (United States)

    Fomichev, D V; Kalinin, P L; Kutin, M A; Sharipov, O I; Chernov, I V

    Surgical treatment for epidermoid cysts of the chiasmatic region is a challenge because of the tendency to a massive spread of epidermoid masses through the cerebrospinal fluid pathways and a significant lesion deviation from the midline. To analyze capabilities of the extended endoscopic endonasal transsphenoidal approach in surgery for epidermoid cysts. The study included 6 patients with epidermoid cysts of the chiasmatic region who were operated on using the extended anterior endoscopic endonasal transsphenoidal approach at the Burdenko Neurosurgical Institute in the past 5 years. Epidermoid masses were completely removed in 5 patients; in none of the cases, complete removal of the epidermoid cyst capsule was achieved. There were no cases of vision deterioration and the development of new focal neurological symptoms. One female patient developed hypopituitary disorders in the postoperative period. There was no recurrence of epidermoid cysts during follow-up. Removal of epidermoid cysts of the chiasmatic region using the extended anterior endoscopic transsphenoidal approach may be an alternative to transcranial microsurgery.

  5. Olfactory function and quality of life following microscopic endonasal transsphenoidal pituitary surgery. (United States)

    Wang, Shousen; Chen, Yehuang; Li, Jianzhong; Wei, Liangfeng; Wang, Rumi


    Olfactory outcomes as well as oronasal postoperative complications of transsphenoidal pituitary surgery have not been well studied. The objective of this study was to investigate nasal symptoms including olfactory function as well as quality of life following transsphenoidal pituitary surgery. The study is designed as a prospective cohort study set in a single tertiary hospital. A total of 53 patients with pituitary adenomas were included. All patients underwent pituitary surgery with the right-sided endonasal transsphenoidal approach. Outcomes were assessed with the Chinese version of the Medical Outcomes Study Short Form-36 (SF-36) to survey patient health, the Chinese version of the 22-item Sinonasal Outcome Test (SNOT-22), and a Toyota and Takagi (T&T) olfactometer. Assessments were carried out before surgery and at 1 week, and 1 and 4 months after surgery. The overall SF-36 scores were significantly lower, but the SNOT-22 scores were higher at 1 week and 1 month postoperatively compared with baseline (all P surgery were independent risk factors for a higher SNOT-22 score at 1 week after surgery. The findings show that microscopic endonasal transsphenoidal pituitary surgery impairs olfactory function in most patients for at least 4 months after surgery.

  6. Successful endonasal dacryocystorhinostomy in a patient with Wegener’s granulomatosis

    Directory of Open Access Journals (Sweden)

    P Eloy


    Full Text Available P Eloy, E Leruth, B Bertrand, Ph RombauxENT and HNS department, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, 5530, Yvoir, BelgiumAbstract: Wegener’s granulomatosis (WG is one form of idiopathic autoimmune vasculitis. The disease has a predilection for the upper and lower respiratory tracts (lungs, nose, sinus, and kidneys. WG may be systemic, severe, and potentially lethal, but it may also be limited to the otolaryngological area or to the eyes and the orbits. Obstruction of the lacrimal pathway is a possible complication of the disease that affects approximately 7% of patients with WG. It usually occurs as a direct extension of sinonasal disease and typically is a late manifestation. Management of such a condition is generally viewed as difficult. We report the case of a patient with a quiescent WG limited to the otolaryngological area. This patient presented a bilateral obstruction of the nasolacrimal ducts caused by bilateral extensive adhesions in the nasal cavity. Because she had several episodes of left-side acute dacryocystitis which necessitated several courses of broad-spectrum antibiotics, she successfully underwent an endonasal endoscopic dacryocystorhinostomy using a diode laser and powered instrumentation. The authors describe the clinical case, the surgical technique, and review the literature.Keywords: Wegener’s granulomatosis, recurrent dacryocystitis, endonasal DCR, diode, laser, powered instrumentation

  7. Resident simulation training in endoscopic endonasal surgery utilizing haptic feedback technology. (United States)

    Thawani, Jayesh P; Ramayya, Ashwin G; Abdullah, Kalil G; Hudgins, Eric; Vaughan, Kerry; Piazza, Matthew; Madsen, Peter J; Buch, Vivek; Sean Grady, M


    Simulated practice may improve resident performance in endoscopic endonasal surgery. Using the NeuroTouch haptic simulation platform, we evaluated resident performance and assessed the effect of simulation training on performance in the operating room. First- (N=3) and second- (N=3) year residents were assessed using six measures of proficiency. Using a visual analog scale, the senior author scored subjects. After the first session, subjects with lower scores were provided with simulation training. A second simulation served as a task-learning control. Residents were evaluated in the operating room over six months by the senior author-who was blinded to the trained/untrained identities-using the same parameters. A nonparametric bootstrap testing method was used for the analysis (Matlab v. 2014a). Simulation training was associated with an increase in performance scores in the operating room averaged over all measures (p=0.0045). This is the first study to evaluate the training utility of an endoscopic endonasal surgical task using a virtual reality haptic simulator. The data suggest that haptic simulation training in endoscopic neurosurgery may contribute to improvements in operative performance. Limitations include a small number of subjects and adjudication bias-although the trained/untrained identity of subjects was blinded. Further study using the proposed methods may better describe the relationship between simulated training and operative performance in endoscopic Neurosurgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Anatomy of Sarcocaulon

    Directory of Open Access Journals (Sweden)

    R. L. Verhoeven


    Full Text Available The anatomy of the leaf blade, petiole, stem and root of the genus Sarcocaulon (DC. Sweet is discussed. On the basis of the leaf anatomy, the four sections recognized by Moffett (1979 can be identified: section Denticulati (dorsiventral leaves, section Multifidi (isobilateral leaves and adaxial and abaxial palisade continuous at midvein, section Crenati (isobilateral leaves, short curved trichomes and glandular hairs, section Sarcocaulon (isobilateral leaves and glandular hairs only. The anatomy of the stem is typically that of a herbaceous dicotyledon with a thick periderm. The root structure shows that the function of the root is not food storage.

  9. Comparison of a Gross Anatomy Laboratory to Online Anatomy Software for Teaching Anatomy (United States)

    Mathiowetz, Virgil; Yu, Chih-Huang; Quake-Rapp, Cindee


    This study was designed to assess the grades, self-perceived learning, and satisfaction between occupational therapy students who used a gross anatomy laboratory versus online anatomy software (AnatomyTV) as tools to learn anatomy at a large public university and a satellite campus in the mid-western United States. The goal was to determine if…

  10. Anatomy of Memory


    J Gordon Millichap


    Studies of the anatomy and function of the brain system for memory in humans and animal models are reviewed from the Veterans Affairs Medical Center, San Diego and the Department of Psychiatry, University of California, San Diego, La Jolla, CA.

  11. Endoscopic endonasal transsphenoidal approach for pituitary adenomas: technical aspects and report of casuistic Abordagem endoscópica endonasal para adenomas de hipófise: aspectos técnicos e relato de casuística

    Directory of Open Access Journals (Sweden)

    Américo Rubens Leite dos Santos


    Full Text Available OBJECTIVE: Analyse technical aspects, effectiveness and morbidity of the endoscopic endonasal transphenoidal approach for pituitary adenomas. METHOD: From January 2005 to September 2008, 30 consecutive patients underwent endoscopic endonasal resection of pituitary adenomas with a follow up from 3 to 36 months. Their medical charts were retrospectively analysed. RESULTS: There were 18 women and 12 men, mean age 44 years (range 17-65 yr. Among the 30 patients, 23 had macroadenomas and 7 microadenomas. Twelve patients had non-functioning tumors, 9 had ACTH-secreting tumors, 8 had GH-secreting tumors and 1 prolactinoma. Complete resection and hormonal control was achieved in all microadenomas. Macroadenomas were completely removed in 6 patients, subtotal resection in 6 and partial resection in 11. Three patients had diabetes insipidus and 5 had CSF leaks treated with lumbar drainage. CONCLUSION: The endonasal endoscopic approach for pituitary tumors is effective and has low morbidity.OBJETIVO: Analisar aspectos técnicos, eficácia e morbidade do acesso transesfenoidal endonasal endoscópico para adenomas hipofisários. MÉTODO: Estudo retrospectivo de trinta pacientes consecutivos submetidos à ressecção endoscópica endonasal de adenomas hipofisários, entre janeiro de 2005 e setembro de 2008, com seguimento pós-operatório entre três e 36 meses. RESULTADOS: Foram operados 18 mulheres e 12 homens com idades variando entre 17 e 65 anos (média 44 anos. Entre os 30 casos operados, 23 eram macroadenomas e sete microadenomas. Doze pacientes apresentavam adenomas não-funcionantes, nove tumores secretores de ACTH, oito tumores secretores de GH e um prolactinoma. Ressecção macroscópica completa e controle endócrino foram conseguidos em todos microadenomas. Ressecção dos macroadenomas foi completa em seis pacientes, subtotal em seis e parcial em seis casos. Três pacientes desenvolveram diabetes insipidus e cinco tiveram fístula liqüórica p

  12. Endoscopic endonasal transsphenoidal surgery: surgical results of 228 pituitary adenomas treated in a pituitary center. (United States)

    Gondim, Jackson A; Schops, Michele; de Almeida, João Paulo C; de Albuquerque, Lucas Alverne F; Gomes, Erika; Ferraz, Tânia; Barroso, Francisca Andréa C


    Pituitary tumors are challenging tumors in the sellar region. Surgical approaches to the pituitary have undergone numerous refinements over the last 100 years. The introduction of the endoscope have revolutionized pituitary surgery. The aim of this study is to report the results of a consecutive series of patients undergoing pituitary surgery using a pure endoscopic endonasal approach and to evaluate the efficacy and safety of this procedure. We reviewed the data of 228 consecutive patients who underwent endonasal transsphenoidal adenoma removal over an 10-year period. Pre- and post-operative hormonal status (at least 3 months after surgery) were analyzed and compared with clinical parameters presented by the patients. Tumor removal rate, endocrinological outcomes, and complications were retrospectively assessed in 228 patients with pituitary adenomas who underwent 251 procedures between December 1998 and December 2007. There were 93 nonfunctioning adenomas, 58 growth hormone-secreting, 41 prolactin-secreting, 28 adrenocorticotropin hormone secreting, 7 FSH-LH secreting and 1 thyroid-stimulating hormone-secreting adenomas. Gross total removal was achieved in 79.3% of the cases after a median follow-up of 61.5 months. The remission results for patients with nonfunctioning adenomas was 83% and for functioning adenomas were 76.3% (70.6% for GH hormone-secreting, 85.3% for prolactin hormone-secreting, 71.4% for ACTH hormone-secreting, 85.7% for FSH-LH hormone-secreting and 100% for TSH hormone-secreting), with no recurrence at the time of the last follow-up. Post-operative complications were present in 35 (13.9%) cases. The most frequent complications were temporary and permanent diabetes insipidus (six and two cases, respectively), syndrome of inappropriate antidiuretic hormone secretion (two cases) and CSF leaks (eight cases). There was no death related to the procedure in this series. The endoscopic endonasal approach for resection of pituitary adenomas, provides

  13. Anatomy of the Corrugator Muscle. (United States)

    Hwang, Kun; Lee, Jung Hun; Lim, Hee Joong


    The aim of this article is to systematically review the anatomy and action of the corrugator muscle. PubMed and Scopus were searched using the terms "corrugator" AND "anatomy." Among the 60 full texts from the 145 relevant abstracts, 34 articles without sufficient content were excluded and 4 articles drawn from the reference lists were added. Among the 30 articles analyzed (721 hemifaces), 28% classified by oblique head and transverse head, and 72% did not. Corrugator originated mostly from the medial supraorbital rim (45%), followed by the medial frontal bone (31%), the medial infraorbital rim (17%), and the upper nasal process (7%). Corrugator extended through the frontalis and orbicularis oculi (41%), only the frontalis (41%), or only the orbicularis oculi (18%). Corrugator ran superolaterally (59%), or laterally (41%). Corrugators inserted mostly to the middle of the eyebrow (57%), or the medial half of the eyebrow (36%), but also to the glabella region (7%). The length of the corrugator ranged 38 to 53 mm. The transverse head (23.38 mm) was longer than the oblique head (19.75 mm). Corrugator was thicker at the medial canthus than at the midpupillary line. Corrugator was innervated by the temporal branch of the facial nerve (66%), the zygomatic branch (17%), or the angular nerve (zygomatic branch and buccal branch, 17%). Supraorbital nerve (60%) or supratrochlear nerve (40%) penetrated the corrugator. The action was depressing, pulling the eyebrow medially (91%), or with medial eyebrow elevation and lateral eyebrow depression (9%). Surgeons must keep this anatomy in mind during surgical procedures.

  14. Teaching Anatomy in the XXI Century: New Aspects and Pitfalls

    Directory of Open Access Journals (Sweden)

    Veronica Papa


    Full Text Available Anatomy has historically been a cornerstone in medical education regardless of nation, racial background, or medical school system. By learning gross anatomy, medical students get a first “impression” about the structure of the human body which is the basis for understanding pathologic and clinical problems. Although the importance of teaching anatomy to both undergraduate and postgraduate students remains undisputed, there is currently a relevant debate concerning methods of anatomy teaching. In the past century, dissection and lectures were its sole pedagogy worldwide. Recently, the time allocated for anatomy teaching was dramatically reduced to such an extent that some suggest that it has fallen below an adequate standard. Traditional anatomy education based on topographical structural anatomy taught in lectures and gross dissection classes has been replaced by a multiple range of study modules, including problem-based learning, plastic models or computer-assisted learning, and curricula integration. “Does the anatomical theatre still have a place in medical education?” And “what is the problem with anatomic specimens?” We endeavor to answer both of these questions and to contribute to the debate on the current situation in undergraduate and graduate anatomy education.

  15. Recent Evolution of Endoscopic Endonasal Surgery for Treatment of Pituitary Adenomas (United States)

    NISHIOKA, Hiroshi


    For the treatment of pituitary tumors, microscopic transsphenoidal surgery has been considered the “gold standard” since the late 1960s. Over the last two decades, however, a worldwide shift towards endoscopic endonasal surgery is in progress for many reasons. These include a wide panoramic view, improved illumination, an ability to look around anatomical corners using angled tip and, in addition, application to the extended approaches for parasellar tumors. Both endoscopic and microscopic approaches appear equally effective for nonfunctioning adenomas without significant suprasellar or lateral extensions, whereas the endoscopic approach may improve outcomes associated with the extent of resection and postoperative complications for larger tumors. Despite many theoretical benefits in the endoscopic surgery, remission rates of functioning adenomas do not substantially differ between the approaches in experienced hands. The endoscopic approach is a valid alternative to the microscopic approach for adenomas. The benefits will be more appreciated in the extended surgery for parasellar tumors. PMID:28239067

  16. Surgical treatment of non-functioning pituitary macroadenomas by the endoscopic endonasal approach in the elderly

    Directory of Open Access Journals (Sweden)

    Horacio Armando Marenco


    Full Text Available Over the past three decades, surgical series of elderly patients treated for pituitary adenomas have been published, all of which used the microscopic transsphenoidal or transcranial approach. The objective of this study was to retrospectively analyze the surgical results of our first 25 elderly patients with non-functioning pituitary macroadenoma (NFPM operated by the endoscopic endonasal approach (EEA. Preoperative visual loss was found in 92.8% of the cases, and 70.8% experienced visual improvement following surgery. Preoperative pituitary dysfunction was found in 69.2% of the cases and postoperative pituitary recovery occurred in 22.2% of them. Mean hospital stay was 6.7 days. The results of this study suggest that surgery remains the first line of treatment for NFPM in the elderly. Because age alone is not a barrier for surgery, patients should be selected for surgical treatment based on their symptoms and clinical condition, as defined by comorbidities.

  17. Initial Experiments with the Leap Motion as a User Interface in Robotic Endonasal Surgery. (United States)

    Travaglini, T A; Swaney, P J; Weaver, Kyle D; Webster, R J

    The Leap Motion controller is a low-cost, optically-based hand tracking system that has recently been introduced on the consumer market. Prior studies have investigated its precision and accuracy, toward evaluating its usefulness as a surgical robot master interface. Yet due to the diversity of potential slave robots and surgical procedures, as well as the dynamic nature of surgery, it is challenging to make general conclusions from published accuracy and precision data. Thus, our goal in this paper is to explore the use of the Leap in the specific scenario of endonasal pituitary surgery. We use it to control a concentric tube continuum robot in a phantom study, and compare user performance using the Leap to previously published results using the Phantom Omni. We find that the users were able to achieve nearly identical average resection percentage and overall surgical duration with the Leap.

  18. Limitations of the endonasal endoscopic approach in treating olfactory groove meningiomas. A systematic review. (United States)

    Shetty, Sathwik Raviraj; Ruiz-Treviño, Armando S; Omay, Sacit Bulent; Almeida, Joao Paulo; Liang, Buqing; Chen, Yu-Ning; Singh, Harminder; Schwartz, Theodore H


    To review current management strategies for olfactory groove meningioma (OGM)s and the recent literature comparing endoscopic endonasal (EEA) with traditional transcranial (TCA) approaches. A PubMed search of the recent literature (2011-2016) was performed to examine outcomes following EEA and TCA for OGM. The extent of resection, visual outcome, postoperative complications and recurrence rates were analyzed using percentages and proportions, the Fischer exact test and the Student's t-test using Graphpad PRISM 7.0Aa (San Diego, CA) software. There were 444 patients in the TCA group with a mean diameter of 4.61 (±1.17) cm and 101 patients in the EEA group with a mean diameter of 3.55 (± 0.58) cm (p = 0.0589). GTR was achieved in 90.9% (404/444) in the TCA group and 70.2% (71/101) in the EEA group (p OGMs.

  19. Initial Experiments with the Leap Motion as a User Interface in Robotic Endonasal Surgery (United States)

    Travaglini, T. A.; Swaney, P. J.; Weaver, Kyle D.; Webster, R. J.


    The Leap Motion controller is a low-cost, optically-based hand tracking system that has recently been introduced on the consumer market. Prior studies have investigated its precision and accuracy, toward evaluating its usefulness as a surgical robot master interface. Yet due to the diversity of potential slave robots and surgical procedures, as well as the dynamic nature of surgery, it is challenging to make general conclusions from published accuracy and precision data. Thus, our goal in this paper is to explore the use of the Leap in the specific scenario of endonasal pituitary surgery. We use it to control a concentric tube continuum robot in a phantom study, and compare user performance using the Leap to previously published results using the Phantom Omni. We find that the users were able to achieve nearly identical average resection percentage and overall surgical duration with the Leap. PMID:26752501

  20. Outcome of functional endonasal sinus surgery with and without CT-navigation. (United States)

    Tschopp, Kurt P; Thomaser, Esther G


    Computer-assisted surgery (CAS) has found widespread use in functional endonasal sinus surgery (FESS) over the past few years. The present study investigates if CAS leads to a better outcome in FESS. All patients who underwent endonasal sphenoethmoidectomy were enrolled in a prospective, non-randomized case-control study. The procedures were done without CAS (group A) in 2003 and with CAS (group B) in 2004, using a Stryker navigation unit. Sixty-two patients (113 sphenoidectomies) were included in group A and 61 patients (109 sphenoidectomies) in group B. The underlying disease was recurrent chronic sinusitis or polyposis nasi in all patients except for inverted papilloma in one patient from group A and in two patients from group B. The follow-up period was 12 months. Symptom scores were assessed preoperatively and at 12 months postoperatively, using a questionnaire. A CT-scan was obtained in all patients preoperatively and at 6 months postoperatively. No significant difference was found between group A and B, neither with respect to symptom scores at 12 months postoperatively, nor in postoperative CT-scans. The operation strategy did not change by the introduction of CAS. The frontal sinuses were entered in group A and B in 59% and 64% of the patients, respectively. All parameters improved significantly postoperatively, compared to the preoperative values. As far as complications are concerned, two anterior orbital injuries and one retrobulbar haematoma occurred in group A and one postoperative lacrimal stenosis in group B. CAS does not lead to a better clinical outcome in FESS. Our data suggest that the rate of complications may be reduced using CAS. However, studies with a much larger number of patients would be necessary in order to definitely answer the question of whether CAS reduce complications in FESS.

  1. [Does CT-navigation improve the outcome of functional endonasal sinus surgery?]. (United States)

    Thomaser, E G; Tschopp, K


    Computer-assisted surgery (CAS) has found widespread use in functional endonasal sinus surgery (FESS) over the past few years. The present study investigates if CAS leads to a better outcome in FESS. All patients who underwent endonasal sphenoethmoidectomy were enrolled in a prospective, non-randomized study. The procedures were done without CAS (group A) in 2003 and in 2004 with CAS (group B), using a Stryker navigation unit. 62 patients (113 sphenoidectomies) were included in group A and 61 patients (109 sphenoidectomies) in group B. The underlying disease was recurrent chronic sinusitis or polyposis nasi in all patients except for inverted papilloma in one patient of group A and in two patients of group B. The follow-up period was 6 months. Preoperatively and at 6 months postoperatively, a CT-scan was obtained and symptom scores were assessed using a questionnaire. No significant difference was found between group A and B with respect to symptom scores, and CT-scans preoperatively and at 6 months postoperatively. The operation strategy did not change by the introduction of CAS. The frontal sinus was entered in group A and B in 59% and 64%, respectively. All parameters significantly improved postoperatively, compared to the preoperative values. As far as complications are concerned, two anterior orbital injuries and one retrobulbar haematoma occurred in group A and one postoperative lacrimal stenosis in group B. CAS does not lead to a better clinical outcome in FESS. Our data suggest that the rate of complications may be reduced using CAS. However, studies with a much larger number of patients would be necessary for a definite answer to this issue.

  2. Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction. (United States)

    Lee, J K; Kim, T H


    We attempted to compare the cytokine composition of tears between primary acquired nasolacrimal duct (NLD) obstruction and normal controls. We investigated the changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy (DCR). Eighteen patients underwent endonasal DCR, with seven patients undergoing bilateral DCR, resulting in twenty-five DCRs in total. Eleven contralateral un-operated eyes were used as normal controls. Silicone stents were removed 3 months after surgery. Tear samples were collected from all eyes before surgery, and at 1 month, 2 months, 3 months, and 4 months after surgery. The level of interleukin (IL)-1β, IL-2, IL-6, IL-10, transforming growth factor (TGF)-β2, fibroblast growth factor (FGF)-2, and vascular endothelial growth factor (VEGF) in the tears was measured. The concentrations of IL-2, IL-6, IL-10, VEGF, and FGF-2 were significantly higher in eyes with NLD obstruction than controls before surgery (P=0.006, 0.018, 0.002, 0.048, and 0.039, respectively). Most inflammatory cytokines (IL-1β, IL-2, IL-6, VEGF, and FGF-2) were higher in the tears of the DCR group compared with the controls during the postoperative follow-up, but then rapidly decreased to the level of the controls after removal of the silicone stent. The recurred eyes showed a higher level of TGF-β2 and FGF-2 in tears compared with the eyes that showed good surgical results (Ptear levels of inflammatory cytokines were higher in eyes with NLD obstruction than controls. The changes in cytokine level during the postoperative period showed the importance of cytokine analysis in understanding wound healing after DCR.

  3. Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series. (United States)

    Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J


    Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these

  4. Transcanalicular Laser-Assisted Dacryocystorhinostomy With Endonasal Augmentation in Primary Nasolacrimal Duct Obstruction: Our Experience. (United States)

    Goel, Ruchi; Nagpal, Smriti; Kumar, Sushil; Meher, Ravi; Kamal, Saurabh; Garg, Sonam

    To evaluate and compare the success rate of transcanalicular laser-assisted dacryocystorhinostomy with endonasal augmentation, with and without intubation, in patients suffering from primary acquired nasolacrimal duct obstruction, at 1 year of follow up. A prospective, randomized interventional pilot study was conducted at a tertiary care center, in accordance with the guidelines of Declaration of Helsinki. Sixty eyes of 60 adult patients with primary acquired nasolacrimal duct obstruction were included. The participants were divided randomly into 2 equal groups (A and B-without and with bicanalicular intubation, respectively). An osteotomy was first created using 980 nm diode laser (set at 8W continuous mode) transcanalicularly and then enlarged intranasally using Blakesley's nasal forceps, followed by bicanalicular silicon intubation in group B patients. The tubes were removed at the end of 8 weeks. The ostium size was assessed endoscopically at 8 weeks and again at the end of follow up, at 1 year. A successful outcome was defined in terms of ostium patency at the end of 1 year. The results were analyzed at the end of a follow up of 1 year, using various statistical tests (p < 0.05). The mean age of the patients was 35.3 ± 15.89 years, with 23 male and 37 female patients, the 2 groups having a similar male:female ratio. An overall success rate of 90% was achieved at the end of 1 year with no statistically significant difference between the groups. Postoperative complications like tube displacement and punctal, canalicular injury were more in the intubated group. The average osteotomy size was 8.06 ± 5.4 mm at the end of 1 year. Transcanalicular laser-assisted dacryocysto rhinostomy, with endonasal augmentation, is a scarless, effective, daycare procedure, for treatment of primary acquired nasolacrimal duct obstruction with no additional advantage offered by silicone intubation.

  5. The Usefulness of the Endonasal Incisional Approach for the Treatment of Nasal Bone Fracture

    Directory of Open Access Journals (Sweden)

    Hyo Seong Kim


    Full Text Available BackgroundAmong all facial fractures, nasal bone fractures are the most common, and they have been reduced by closed reduction (CR for a long time. But several authors have reported suboptimal results when using CR, and the best method of nasal bone reduction is still being debated. We have found that indirect open reduction (IOR through an endonasal incisional approach is a useful method for more accurate reduction of the nasal bone.MethodsA retrospective chart review was performed of 356 patients who underwent reduction of a nasal bone fracture in our department from January, 2006, to July, 2011. We treated 263 patients with IOR. We assessed patients' and doctors' satisfaction with surgical outcomes after IOR or CR. We evaluated the frequency of nasal bleeding owing to mucosal injury, and followed the surgical outcomes of patients who had simultaneous dorsal augmentation rhinoplasty.ResultsAccording to the analysis of the satisfaction scores, both patients and doctors were significantly more satisfied in the IOR group than the CR group (P<0.05. Mucosal injury with nasal bleeding occurred much less in the IOR group (5.3% than the CR group (12.9%. Dorsal augmentation rhinoplasty with IOR was performed simultaneously in 34 cases. Most of them (31/34 showed satisfaction with the outcomes.ConclusionsIOR enables surgeons to manipulate the bony fragment directly through the endonasal incisional approach. However, we propose that CR is the proper technique for patients under 16 and for those with comminuted nasal bone fractures because submucosal dissection in IOR can damage the growth or circulation of nasal bone.

  6. [Laurentius on anatomy]. (United States)

    Sawai, Tadashi; Sakai, Tatsuo


    Andreas Laurentius wrote Opera anatomica (1593) and Historia anatomica (1600). These books were composed of two types of chapters; 'historia' and 'quaestio'. His description is not original, but take from other anatomists. 'Historia' describes the structure, action and usefulness of the body parts clarified after dissection. 'Quaestio' treats those questions which could not be solved only by dissection. Laurentius cited many previous contradicting interpretations to these questions and choose a best interpretation for the individual questions. In most cases, Laurentius preferred Galen's view. Historia anatomica retained almost all the 'historia' and 'quaestio' from Opera anatomica, and added some new 'historia' and 'quaestio', especially in regard to the components of the body, such as ligaments, membranes, vessels, nerves and glands. Other new 'historia' and 'quaestio' in Historia anatomica concerned several topics on anatomy in general to comprehensively analyze the history of anatomy, methods of anatomy, and usefulness of anatomy. Historia anatomica reviewed what was anatomy by describing in 'historia' what was known and in 'quaestio' what was unresolved. Till now Laurentius's anatomical works have attracted little attention because his description contained few original findings and depended on previous books. However, the important fact that Historia anatomica was very popular in the 17th century tells us that people needed non-original and handbook style of this textbook. Historia anatomica is important for further research on the propagation of anatomical knowledge from professional anatomists to non-professionals in the 17th century.

  7. The functional anatomy of forearm rotation


    Lees, Vivien C.


    The elbow, forearm and wrist act as a unified structure to provide a stable, strong and highly mobile strut for positioning the hand in space and for conducting load-bearing tasks. An understanding of the relevant anatomy and biomechanics is important for the surgeon assessing and treating disorders of forearm function. This paper is concerned with illuminating the principles and concepts governing forearm rotation and load-bearing functions.

  8. Variation in root wood anatomy

    NARCIS (Netherlands)

    Cutler, D.F.


    Variability in the anatomy of root wood of selected specimens particularly Fraxinus excelsior L. and Acer pseudoplatanus L. in the Kew reference microscope slide collection is discussed in relation to generalised statements in the literature on root wood anatomy.

  9. Synopsis of radiologic anatomy

    International Nuclear Information System (INIS)

    Meschan, I.


    The book is a compact version of earlier publications that appeared in 1975 as a one- and a two-volume issue under the title 'Atlas of Radiologic Anatomy'. A chapter on computed tomography has been added as this novel technique requires a new approach to radiologic anatomy. The radiologist will find all the information on the anatomic conditions he needs for analysing radiographs and CT pictures. More than 600 radiographs and CT pictures are given that illustrate typical and rare findings. The book also is useful as a source of reference for making good radiographs and evaluating the quality of radiographs or CT pictures. With 1413 figs., 18 tabs [de

  10. Henry Gray's Anatomy. (United States)

    Pearce, J M S


    Little is generally known of Henry Gray, the author of Gray's Anatomy, and even less of his colleague Henry Vandyke Carter, who played a vital role in the dissections and illustrations leading to the production of the first volume in 1859. This essay attempts to sketch briefly the salient, know aspects of these two men and their divergent careers. It traces succinctly the subsequent fate of the unique anatomy book that has influenced and instructed almost every student of medicine. (c) 2009 Wiley-Liss, Inc.

  11. Anatomy of the clitoris. (United States)

    O'Connell, Helen E; Sanjeevan, Kalavampara V; Hutson, John M


    We present a comprehensive account of clitoral anatomy, including its component structures, neurovascular supply, relationship to adjacent structures (the urethra, vagina and vestibular glands, and connective tissue supports), histology and immunohistochemistry. We related recent anatomical findings to the historical literature to determine when data on accurate anatomy became available. An extensive review of the current and historical literature was done. The studies reviewed included dissection and microdissection, magnetic resonance imaging (MRI), 3-dimensional sectional anatomy reconstruction, histology and immunohistochemical studies. The clitoris is a multiplanar structure with a broad attachment to the pubic arch and via extensive supporting tissue to the mons pubis and labia. Centrally it is attached to the urethra and vagina. Its components include the erectile bodies (paired bulbs and paired corpora, which are continuous with the crura) and the glans clitoris. The glans is a midline, densely neural, non-erectile structure that is the only external manifestation of the clitoris. All other components are composed of erectile tissue with the composition of the bulbar erectile tissue differing from that of the corpora. The clitoral and perineal neurovascular bundles are large, paired terminations of the pudendal neurovascular bundles. The clitoral neurovascular bundles ascend along the ischiopubic rami to meet each other and pass along the superior surface of the clitoral body supplying the clitoris. The neural trunks pass largely intact into the glans. These nerves are at least 2 mm in diameter even in infancy. The cavernous or autonomic neural anatomy is microscopic and difficult to define consistently. MRI complements dissection studies and clarifies the anatomy. Clitoral pharmacology and histology appears to parallel those of penile tissue, although the clinical impact is vastly different. Typical textbook descriptions of the clitoris lack detail and

  12. [Bath Plug Closure Method for Cerebrospinal Fluid Leakage by Endoscopic Endonasal Approach:Cooperative Treatment by Neurosurgeons and Otolaryngologists]. (United States)

    Kawaguchi, Tomohiro; Arakawa, Kazuya; Nomura, Kazuhiro; Ogawa, Yoshikazu; Katori, Yukio; Tominaga, Teiji


    Endoscopic endonasal surgery, an innovative surgical technique, is used to approach sinus lesions, lesions of the skull base, and intradural tumors. The cooperation of experienced otolaryngologists and neurosurgeons is important to achieve safe and reliable surgical results. The bath plug closure method is a treatment option for patients with cerebrospinal fluid(CSF)leakage. Although it includes dural and/or intradural procedures, surgery tends to be performed by otolaryngologists because its indications, detailed maneuvers, and pitfalls are not well recognized by neurosurgeons. We reviewed the cases of patients with CSF leakage treated by using the bath plug closure method with an endoscopic endonasal approach at our institution. Three patients were treated using the bath plug closure method. CSF leakage was caused by a meningocele in two cases and trauma in one case. No postoperative intracranial complications or recurrence of CSF leakage were observed. The bath plug closure method is an effective treatment strategy and allows neurosurgeons to gain in-depth knowledge of the treatment options for CSF leakage by using an endoscopic endonasal approach.

  13. Endoscopic endonasal pituitary adenomas surgery: the surgical experience of 178 consecutive patients and learning curve of two neurosurgeons. (United States)

    Shou, Xuefei; Shen, Ming; Zhang, Qilin; Zhang, Yichao; He, Wenqiang; Ma, Zengyi; Zhao, Yao; Li, Shiqi; Wang, Yongfei


    We aim to study surgical technique and analyze the related factors affecting tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery. We retrospectively analyzed 178 endoscopic endonasal pituitary adenomas surgery from March 2011 to May 2014. Endonasal approach included the routine transnasal-sphenoidal approach, transnasal- maxillary sinus approach in four cases and transnasal-clivus approach in one case. According to postoperative imaging data and endocrine examination results, total removal was achieved in 129 patients (72.5%), and endocrinological remission was achieved in 38 patients with functional adenomas (44.1%). Statistical analysis of the clinical data showed that total removal rate was much closely related to tumor volume (P = 0.006), and tumor invasiveness (P < 0.001). In this study, we found tumor sizes and invasion of cavernous sinus were related to total removal rate and endocrinological remission rate; the direction and degree of tumor invasion, and the surgeon's experience were the key influence factors of the endocrinological remission rate for invasive functional pituitary adenomas.

  14. Partial maxillectomy for ameloblastoma of the maxilla with infratemporal fossa involvement: A combined endoscopic endonasal and transoral approach. (United States)

    Guha, A; Hart, L; Polachova, H; Chovanec, M; Schalek, P


    Ameloblastoma represents the most common epithelial odontogenic tumor. Because of the proximity of the maxillary tumors to the orbit and skull base, it should be managed as radically as possible. Maxillectomy, mainly via the transfacial or transoral approach, represents the most common type of surgical procedure. Drawback of these approaches is limited control of the superiomedial extent of the tumour in the paranasal area. We report the use of a combined endoscopic endonasal and transoral approach to manage maxillary plexiform ameloblastoma in a 48-year-old male patient. A combined endoscopic endonasal and transoral approach enabled the radical removal of tumour with a 1.5cm margin of radiographically intact bone with good control from both intrasinusal and intraoral aspects. Adequate visualization of the extent of the lesion (e.g. orbit, infratemporal fossa, anterior cranial base) had been achieved. Non-complicated healing was achieved. This technique of partial maxillectomy led to very good aesthetic and functional results. No recurrence had been noted during review appointments. The combination of endoscopic endonasal and transoral approach for a partial maxillectomy allows sufficient reduction of the defect, thus eliminating the necessity for reconstruction and reducing the morbidity associated with it. Copyright © 2018 Elsevier Masson SAS. All rights reserved.


    Directory of Open Access Journals (Sweden)

    A. M. Razumovskaya


    Full Text Available Research objective: comparative assessment of efficiency of use of Emoxypin® by an endonasal electrophoresis and parabulbar injections at a chorioretinal dystrophy. Methods: 71 patients (average age of 55±3 years suffering from a chorioretinal dystrophy of various genesis were in the study. The ophthalmologic examination included: evaluation of visual acuity, a field of vision, a visual fatigue, a condition of bulbar microcirculation (the general conjunctiva index. Besides, electrophysiological examination was conducted, including critical frequency of merge of flickers and electric sensitivity of an eye. The patients were divided into 2 groups. The main group (28 patients received Emoxypin® with endonasal electrophoresis and group B (43 patients received Emoxypin® by parabulbar injections. Results: Results of the statistical analysis in both groups showed visual acuity increasment, expansion of borders of a field of vision, depression of visual fatigability, indicators of electrophysiological examination and bulbar microcirculation improved. Conclusion: The comparative assessment of efficiency of use of Emoxypin® by an endonasal electrophoresis and parabulbar injections at a chorioretinal dystrophic various a genesis showed appreciable medical effect in the course of restoration of visual functions which in some cases (18% even better effect observed at parabulbar injections.

  16. Neurophysiological Identification of Cranial Nerves During Endoscopic Endonasal Surgery of Skull Base Tumors: Pilot Study Technical Report. (United States)

    Shkarubo, Alexey Nikolaevich; Chernov, Ilia Valerievich; Ogurtsova, Anna Anatolievna; Moshchev, Dmitry Aleksandrovich; Lubnin, Andrew Jurievich; Andreev, Dmitry Nicolaevich; Koval, Konstantin Vladimirovich


    Intraoperative identification of cranial nerves is crucial for safe surgery of skull base tumors. Currently, only a small number of published papers describe the technique of trigger electromyography (t-EMG) in endoscopic endonasal removal of such tumors. To assess the effectiveness of t-EMG in preventing intraoperative cranial nerve damage in endoscopic endonasal surgery of skull base tumors. Nine patients were operated on using the endoscopic endonasal approach within a 1-year period. The tumors included large skull base chordomas and trigeminal neurinomas localized in the cavernous sinus. During the surgical process, cranial nerve identification was carried out using monopolar and bipolar t-EMG methods. Assessment of cranial nerve functional activity was conducted both before and after tumor removal. We mapped 17 nerves in 9 patients. Third, fifth, and sixth cranial nerves were identified intraoperatively. There were no cases of postoperative functional impairment of the mapped cranial nerves. In one case we were unable to get an intraoperative response from the fourth cranial nerve and observed its postoperative transient plegia (the function was normal before surgery). t-EMG allows surgeons to control the safety of cranial nerves both during and after skull base tumor removal. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Learning Anatomy Enhances Spatial Ability (United States)

    Vorstenbosch, Marc A. T. M.; Klaassen, Tim P. F. M.; Donders, A. R. T.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.


    Spatial ability is an important factor in learning anatomy. Students with high scores on a mental rotation test (MRT) systematically score higher on anatomy examinations. This study aims to investigate if learning anatomy also oppositely improves the MRT-score. Five hundred first year students of medicine ("n" = 242, intervention) and…

  18. Anatomy for Biomedical Engineers (United States)

    Carmichael, Stephen W.; Robb, Richard A.


    There is a perceived need for anatomy instruction for graduate students enrolled in a biomedical engineering program. This appeared especially important for students interested in and using medical images. These students typically did not have a strong background in biology. The authors arranged for students to dissect regions of the body that…

  19. The Anatomy Puzzle Book. (United States)

    Jacob, Willis H.; Carter, Robert, III

    This document features review questions, crossword puzzles, and word search puzzles on human anatomy. Topics include: (1) Anatomical Terminology; (2) The Skeletal System and Joints; (3) The Muscular System; (4) The Nervous System; (5) The Eye and Ear; (6) The Circulatory System and Blood; (7) The Respiratory System; (8) The Urinary System; (9) The…

  20. Illustrated Speech Anatomy. (United States)

    Shearer, William M.

    Written for students in the fields of speech correction and audiology, the text deals with the following: structures involved in respiration; the skeleton and the processes of inhalation and exhalation; phonation and pitch, the larynx, and esophageal speech; muscles involved in articulation; muscles involved in resonance; and the anatomy of the…

  1. Deep dissection: motivating students beyond rote learning in veterinary anatomy. (United States)

    Cake, Martin A


    The profusion of descriptive, factual information in veterinary anatomy inevitably creates pressure on students to employ surface learning approaches and "rote learning." This phenomenon may contribute to negative perceptions of the relevance of anatomy as a discipline. Thus, encouraging deep learning outcomes will not only lead to greater satisfaction for both instructors and learners but may have the added effect of raising the profile of and respect for the discipline. Consideration of the literature reveals the broad scope of interventions required to motivate students to go beyond rote learning. While many of these are common to all disciplines (e.g., promoting active learning, making higher-order goals explicit, reducing content in favor of concepts, aligning assessment with outcomes), other factors are peculiar to anatomy, such as the benefits of incorporating clinical tidbits, "living anatomy," the anatomy museum, and dissection classes into a "learning context" that fosters deep approaches. Surprisingly, the 10 interventions discussed focus more on factors contributing to student perceptions of the course than on drastic changes to the anatomy course itself. This is because many traditional anatomy practices, such as dissection and museum-based classes, are eminently compatible with active, student-centered learning strategies and the adoption of deep learning approaches by veterinary students. Thus the key to encouraging, for example, dissection for deep learning ("deep dissection") lies more in student motivation, personal engagement, curriculum structure, and "learning context" than in the nature of the learning activity itself.

  2. A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy. (United States)

    Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S


    Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

  3. Radiation therapy rather than prior surgery reduces extent of resection during endonasal endoscopic reoperation for craniopharyngioma. (United States)

    Younus, Iyan; Forbes, Jonathan A; Ordóñez-Rubiano, Edgar G; Avendano-Pradel, Rafael; La Corte, Emanuele; Anand, Vijay K; Schwartz, Theodore H


    Radiation therapy is often advocated for residual or recurrent craniopharyngioma following surgical resection to prevent local recurrence. However, radiation therapy is not always effective and may render tumors more difficult to remove. If this is the case, patients may benefit more from reoperation if gross total resection can be achieved. Nevertheless, there is little data on the impact of radiation on reoperations for craniopharyngioma. In this study, we sought to analyze whether a history of previous radiation therapy (RT) affected extent of resection in patients with recurrent craniopharyngiomas subsequently treated with reoperation via endoscopic endonasal approach (EEA). The authors reviewed a prospectively acquired database of EEA reoperations of craniopharyngiomas over 13 years at Weill Cornell, NewYork-Presbyterian Hospital. All procedures were performed by the senior author. The operations were separated into two groups based on whether the patient had surgery alone (group A) or surgery and RT (group B) prior to recurrence. A total of 24 patients (16 male, 8 female) who underwent surgery for recurrent craniopharyngioma were identified. The average time to recurrence was 7.64 ± 4.34 months (range 3-16 months) for group A and 16.62 ± 12.1 months (range 6-45 months) for group B (p < 0.05). The average tumor size at recurrence was smaller in group A (1.85 ± 0.72 cm; range 0.5-3.2) than group B (2.59 ± 0.91 cm; range 1.5-4.6; p = 0.00017). Gross total resection (GTR) was achieved in 91% (10/11) of patients in group A and 54% (7/13) of patients in group B (p = 0.047). There was a near significant trend for higher average Karnofsky performance status (KPS) score at last follow-up for group A (83 ± 10.6) compared with group B (70 ± 16.3, p = 0.056). While RT for residual or recurrent craniopharyngioma may delay time to recurrence, ability to achieve GTR with additional surgery is reduced. In the case of

  4. The anatomy workbook

    International Nuclear Information System (INIS)

    Hagen-Ansert, S.L.


    This is an atlas of human anatomy presented in the form of line drawings, many of which correspond to imaging planes used in ultrasound (US), computed tomography (CT), and magnetic resonance (MR). The book is organized into 17 sections, each covering a specific structure or organ system. Large, uncluttered drawings are labeled for identification of structures of interest. Many illustrations include captions consisting of comments explaining major divisions within organs, specific anatomic relationships and landmarks, and pertinent vascular anatomy. Most organs are first depicted in isolation or in relation to important adjacent organs or blood vessels and are rendered as if viewed from anterior, posterior, inferior, or superior perspectives. The organs are demonstrated again in serial transverse, saggital, and coronal sections, each accompanied by a drawing of a body in anatomic position denoting the plane of the section

  5. Breast development and anatomy. (United States)

    Pandya, Sonali; Moore, Richard G


    In this article, the development of the female breast, as well as the functional anatomy, blood supply, innervation and lymphatic drainage are described. A thorough understanding of the breast anatomy is an important adjunct to a meticulous clinical breast examination. Breast examination is a complex skill involving key maneuvers, including careful inspection and palpation. Clinical breast examination can provide an opportunity for the clinician to educate patients about their breast and about breast cancer, its symptoms, risk factors, early detection, and normal breast composition, and specifically variability. Clinical breast examination can help to detect some cancers not found by mammography, and clinicians should not override their examination findings if imaging is not supportive of the physical findings.

  6. Anatomy of the cerebellopontine angle; Anatomie des Kleinhirnbrueckenwinkels

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Papanagiotou, P.; Politi, M.; Reith, W. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Nabhan, A. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Neurochirurgische Klinik


    The cerebellopontine angle (CPA) is an anatomically complex region of the brain. In this article we describe the anatomy of the CPA cisterns, of the internal auditory canal, the topography of the cerebellum and brainstem, and the neurovascular structures of this area. (orig.) [German] Der Kleinhirnbrueckenwinkel ist eine umschriebene anatomische Region. Im diesem Artikel werden die Subarachnoidalraeume im Kleinhirnbrueckenwinkel, die Anatomie der Felsenbeinflaeche, Anatomie und Topographie des Kleinhirns und des Hirnstamms, die arteriellen Beziehungen und venoese Drainage des Kleinhirnbrueckenwinkels besprochen. (orig.)

  7. Endoscopic Endonasal Dacryocystorhinostomy Combined with Canaliculus Repair for the Management of Dacryocystitis with Canalicular Obstruction

    Directory of Open Access Journals (Sweden)

    Yunhai Tu


    Full Text Available Purpose. The aim of this study is to propose a simple and efficient combination surgery for the management of dacryocystitis with canalicular obstruction. Methods. A retrospective noncomparative case series of dacryocystitis with canalicular obstruction has been studied. Twelve patients with dacryocystitis and canalicular obstruction underwent a conventional endoscopic endonasal dacryocystorhinostomy (EE-DCR combined with a modified canalicular repair. Postoperative observations included slit lamp, fluorescein dye disappearance test, lacrimal syringing, lacrimal endoscopy, and nasal endoscopy. Results. After 6–18 months of postoperative follow-up, the symptoms of epiphora and mucopurulent discharge disappeared completely in 10 patients, and occasional or intermittent epiphora remained in 2 patients. All of the twelve patients showed an opened intranasal ostium and normal fluorescein dye disappearance test. Patent bicanalicular irrigation was achieved in 9 patients. One patient had a partial and the other two had a complete reobstruction by lacrimal irrigation to their repaired lower canaliculus; however, all of them had a patent lacrimal irrigation to upper canaliculus. The functional success rate for the combination surgery is 83% (10/12, and anatomical success rate is 75% (9/12. Conclusion. EE-DCR combined with modified canalicular repair is a simple and efficient method for the management of dacryocystitis with canalicular obstruction.

  8. [Endonasal endoscopic surgery in the treatment of spontaneous or post-traumatic cerebrospinal fluid (csf) leaks]. (United States)

    Nallet, E; Decq, P; Bezzo, A; Le Lievre, G; Peynegre, R; Coste, A


    The incidence and the risk of meningitidis justify treatment in all cases of cerebrospinal fluid rhinorrhea with spontaneous etiology or after traumatic injury. Endonasal surgery with endoscopic instruments provides many advantages compared with transcranial or transfacial approach used by neurosurgeons. We report our experience and our surgical technique in the treatment of CSF leaks in 5 patients. Intrathecal injection of fluoresceine was very useful in all cases for detecting the CSF leak. Total or selected ethmoidectomy depended on the localization of the leakage. Wide sphenoidotomy enables detection and repair of CSF leaks from the sphenoid cavity. A free graft of inferior turbinal mucosal was used to repair the breache. This rapid low morbidity surgery offered secure closure of rhinorrhea in 4 cases after one procedure and in 1 case after two procedures with an average follow up of 22 months. Cerebrospinal fluid rhinorrhea can be managed in first line therapy with endoscopic intranasal surgical techniques when they are localized in the anterior ethmoid or in the sphenoid cavity.

  9. Endoscopic Endonasal Transsphenoidal Drainage of a Spontaneous Candida glabrata Pituitary Abscess. (United States)

    Strickland, Ben A; Pham, Martin; Bakhsheshian, Joshua; Carmichael, John; Weiss, Martin; Zada, Gabriel


    Noniatrogenic pituitary abscess remains a rare clinical entity, and is the indication for surgery in abscess caused by Candida species, and also provide an intraoperative video showing the endoscopic management of this pathology. A 33-year-old woman presented with headache, hypopituitarism, and vision loss in the setting of diabetic ketoacidosis, and was found to have multiple abscesses in the liver, lung, kidney, and uterus. Brain magnetic resonance imaging revealed a 15-mm cystic sellar mass with restricted diffusion. The patient underwent urgent evacuation of the abscess via an endoscopic endonasal transsphenoidal route, with obvious purulent material filling the sella, later identified as Candida glabrata. Antimicrobial therapy was refined appropriately, and she exhibited significant improvement in neurologic function, although endocrinopathy has persisted. With timely management, including a combination of surgical drainage and appropriate antimicrobial therapy, neurologic outcomes are good in most cases of pituitary abscess; however, endocrinopathy often does not improve. Although most reported cases with identified causative organisms speciate bacteria, some cases are of fungal etiology and require different antimicrobial agents. This further underscores the importance of identifying the causative agent. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Endoscopic Endonasal Approach for Resection of a Pediatric Craniopharyngioma: Operative Video and Technical Nuances. (United States)

    Liu, James K; Eloy, Jean Anderson


    We present a pediatric case of a retrochiasmatic craniopharyngioma in the suprasellar region with third ventricular extension that was resected through a purely endoscopic endonasal approach (EEA) via the transplanum transtuberculum corridor. The patient is a 12-year-old boy who presented with progressive visual loss and panhypopituitarism. The EEA allows direct visualization of the undersurface of the optic chiasm and hypothalamus so that safe and meticulous tumor dissection can be performed to preserve these critical neurovascular structures. This video atlas demonstrates the operative technique and surgical nuances of the endoscopic skull base approach, microdissection of the tumor from the critical neurovascular structures, and multilayered reconstruction of the skull base defect with a nasoseptal flap. A gross total resection was achieved, and the patient was neurologically intact with improved visual acuity and visual fields. In summary, the EEA via the transplanum transtuberculum corridor is an important strategy in the armamentarium for surgical management of pediatric craniopharyngiomas. The link to the video can be found at: .

  11. Endoscopic endonasal dacryocystorhinostomy combined with stent implantation as treatment for acute dacryocystitis

    Directory of Open Access Journals (Sweden)

    Si-Si Pu


    Full Text Available AIM: To discuss the feasibility and clinical efficacy of endoscopic endonasal dacryocystorhinostomy(EN-DCRcombined with stent implantation for treatment of acute dacryocystitis. METHODS: A total of 31 patients(32 eyespresenting with acute dacryocystitis were treated with EN-DCR combined with stent implantation under antibiotic cover from April 2014 to December 2015. These patients were followed up for 3 to 12mo. RESULTS: The medial canthal edema and erythema was gradually reducing within 48h in all patients. The hospitalization time took 2 to 8d(average 3.8±1.6d. Patients underwent removal of stent about 3mo after surgery. Thirty-one eyes showed no symptoms such as lacrimation or pus discharging, and irrigation of lacrimal duct was unobstructed. Irrigation of lacrimal duct was passable in 1 of 32 patients who has a relative narrow ostial. Results in this series, 31 cases were cured,1case improved, the total cure rate was 97%. CONCLUSION: There is no evidence shown that EN-DCR combined with stent implantation can increase the risk of spreading infection through tissue planes, causing septicemia, and exacerbating inflammation. Instead, it has advantages like gradual reduction in inflammatory symptoms, economic benefits of reduced patient stay, maintenance of the orbicularis muscle lacrimal pump and absence of external scar. It is indicated that EN-DCR combined with stent implantation is a safe and feasible surgical procedure for patients with acute dacryocystitis.

  12. Endoscopic Endonasal Transturbinate Approach to the Pterygopalatine Fossa in the Management of Juvenile Nasopharyngeal Angiofibromas

    Directory of Open Access Journals (Sweden)

    Satoru Kodama


    Full Text Available Pterygopalatine fossa (PPF is a difficult-to-access anatomic area located behind the posterior wall of the maxillary sinus. Juvenile nasopharyngeal angiofibroma (JNA often affects this area, and the management of feeding artery to the tumor is important in the surgery. Endoscopic endonasal approach to the PPF without endangering all other nasal structures is useful in the management of JNA. We describe a new approach to the PPF, endoscopic transturbinate approach, which is effective in the management of JNA. Submucous inferior turbinoplasty was performed, and sphenopalatine artery, the feeder to the tumor, was identified at the sphenopalatine foramen. The posterior wall of maxillary sinus was removed. Internal maxillary artery was identified in the PPF and was ligated with a hemoclip. The tumor in the PPF was pushed into the nasal cavity. These procedures were all performed via submucous turbinate tunnel. Then, the tumor was successfully removed in en bloc from the nasal cavity by transnasal approach without ethmoidectomy. This approach improves accessibility and visualization in the PPF and potential to reduce intraoperative bleeding due to ligation of the feeder safely without touching the tumor. Endoscopic transturbinate approach is effective in the management of early stage of JNA.

  13. Endoscopic Endonasal Transsphenoidal Approach for Apoplectic Pituitary Tumor: Surgical Outcomes and Complications in 45 Patients. (United States)

    Zhan, Rucai; Li, Xueen; Li, Xingang


    Objective To assess the safety and effectiveness of the endoscopic endonasal transsphenoidal approach (EETA) for apoplectic pituitary adenoma. Design A retrospective study. Setting Qilu Hospital of Shandong University; Brain Science Research Institute, Shandong University. Participants Patients admitted to Qilu Hospital of Shandong University who were diagnosed with an apoplectic pituitary tumor and underwent EETA for resection of the tumor. Main Outcome Measures In total 45 patients were included in a retrospective chart review. Data regarding patient age, sex, presentation, lesion size, surgical procedure, extent of resection, clinical outcome, and surgical complications were obtained from the chart review. Results In total, 38 (92.7%) of 41 patients with loss of vision obtained visual remission postoperatively. In addition, 16 patients reported a secreting adenoma, and postsurgical hormonal levels were normal or decreased in 14 patients. All other symptoms, such as headache and alteration of mental status, recovered rapidly after surgery. Two patients (4.4%) incurred cerebrospinal fluid leakage. Six patients (13.3%) experienced transient diabetes insipidus (DI) postoperatively, but none of these patients developed permanent DI. Five patients (11.1%) developed hypopituitarism and were treated with replacement of hormonal medicine. No cases of meningitis, carotid artery injury, or death related to surgery were reported. Conclusion EETA offers a safe and effective surgical option for apoplectic pituitary tumors and is associated with low morbidity and mortality.

  14. Comparison of a gross anatomy laboratory to online anatomy software for teaching anatomy. (United States)

    Mathiowetz, Virgil; Yu, Chih-Huang; Quake-Rapp, Cindee


    This study was designed to assess the grades, self-perceived learning, and satisfaction between occupational therapy students who used a gross anatomy laboratory versus online anatomy software (AnatomyTV) as tools to learn anatomy at a large public university and a satellite campus in the mid-western United States. The goal was to determine if equivalent learning outcomes could be achieved regardless of learning tool used. In addition, it was important to determine why students chose the gross anatomy laboratory over online AnatomyTV. A two group, post-test only design was used with data gathered at the end of the course. Primary outcomes were students' grades, self-perceived learning, and satisfaction. In addition, a survey was used to collect descriptive data. One cadaver prosection was available for every four students in the gross anatomy laboratory. AnatomyTV was available online through the university library. At the conclusion of the course, the gross anatomy laboratory group had significantly higher grade percentage, self-perceived learning, and satisfaction than the AnatomyTV group. However, the practical significance of the difference is debatable. The significantly greater time spent in gross anatomy laboratory during the laboratory portion of the course may have affected the study outcomes. In addition, some students may find the difference in (B+) versus (A-) grade as not practically significant. Further research needs to be conducted to identify what specific anatomy teaching resources are most effective beyond prosection for students without access to a gross anatomy laboratory. © 2015 American Association of Anatomists.

  15. Two-Dimensional High Definition Versus Three-Dimensional Endoscopy in Endonasal Skull Base Surgery: A Comparative Preclinical Study. (United States)

    Rampinelli, Vittorio; Doglietto, Francesco; Mattavelli, Davide; Qiu, Jimmy; Raffetti, Elena; Schreiber, Alberto; Villaret, Andrea Bolzoni; Kucharczyk, Walter; Donato, Francesco; Fontanella, Marco Maria; Nicolai, Piero


    Three-dimensional (3D) endoscopy has been recently introduced in endonasal skull base surgery. Only a relatively limited number of studies have compared it to 2-dimensional, high definition technology. The objective was to compare, in a preclinical setting for endonasal endoscopic surgery, the surgical maneuverability of 2-dimensional, high definition and 3D endoscopy. A group of 68 volunteers, novice and experienced surgeons, were asked to perform 2 tasks, namely simulating grasping and dissection surgical maneuvers, in a model of the nasal cavities. Time to complete the tasks was recorded. A questionnaire to investigate subjective feelings during tasks was filled by each participant. In 25 subjects, the surgeons' movements were continuously tracked by a magnetic-based neuronavigator coupled with dedicated software (ApproachViewer, part of GTx-UHN) and the recorded trajectories were analyzed by comparing jitter, sum of square differences, and funnel index. Total execution time was significantly lower with 3D technology (P < 0.05) in beginners and experts. Questionnaires showed that beginners preferred 3D endoscopy more frequently than experts. A minority (14%) of beginners experienced discomfort with 3D endoscopy. Analysis of jitter showed a trend toward increased effectiveness of surgical maneuvers with 3D endoscopy. Sum of square differences and funnel index analyses documented better values with 3D endoscopy in experts. In a preclinical setting for endonasal skull base surgery, 3D technology appears to confer an advantage in terms of time of execution and precision of surgical maneuvers. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors. (United States)

    Graffeo, Christopher S; Dietrich, August R; Grobelny, Bartosz; Zhang, Meng; Goldberg, Judith D; Golfinos, John G; Lebowitz, Richard; Kleinberg, David; Placantonakis, Dimitris G


    Endoscopic endonasal surgery has been established as the safest approach to pituitary tumors, yet its role in other common skull base lesions has not been established. To answer this question, we carried out a systematic review of reported series of open and endoscopic endonasal approaches to four major skull base tumors: olfactory groove meningiomas (OGM), tuberculum sellae meningiomas (TSM), craniopharyngiomas (CRA), and clival chordomas (CHO). Data from 162 studies containing 5,701 patients were combined and compared for differences in perioperative mortality, gross total resection (GTR), cerebrospinal fluid (CSF) leak, neurological morbidity, post-operative visual function, post-operative anosmia, post-operative diabetes insipidus (DI), and post-operative obesity/hyperphagia. Weighted average rates for each outcome were calculated using relative study size. Our findings indicate similar rates of GTR and perioperative mortality between open and endoscopic approaches for all tumor types. CSF leak was increased after endoscopic surgery. Visual function symptoms were more likely to improve after endoscopic surgery for TSM, CRA, and CHO. Post-operative DI and obesity/hyperphagia were significantly increased after open resection in CRA. Recurrence rates per 1,000 patient-years of follow-up were higher in endoscopy for OGM, TSM, and CHO. Trends for open and endoscopic surgery suggested modest improvement in all outcomes over time. Our observations suggest that endonasal endoscopy is a safe alternative to craniotomy and may be preferred for certain tumor types. However, endoscopic surgery is associated with higher rates of CSF leak, and possibly increased recurrence rates. Prospective study with long-term follow-up is required to verify these preliminary observations.

  17. Relevancia de la anatomía humana en el ejercicio de la medicina de asistencia primaria y en el estudio de las asignaturas de segundo ciclo de la licenciatura en medicina Relevance of Gross Human Anatomy in health primary care and in clinical disciplines of medical studies

    Directory of Open Access Journals (Sweden)

    Blanca Mompeó


    Full Text Available El objetivo de este trabajo fue conocer la relevancia y la necesidad que de conocimientos en Anatomía macroscópica tenían los médicos de asistencia primaria y los alumnos del segundo ciclo de la licenciatura en Medicina. También nos interesó saber cual era su opinión sobre esta disciplina del curriculum médico. Para ello, médicos de asistencia primaria de los Centros de Salud de la provincia de las Palmas y alumnos de 6º curso de la Licenciatura en Medicina de la U.L.P.G.C., cumplimentaron un cuestionario en el que se valoraron los aspectos referidos. Ambos grupos consideraron que la Anatomía era fundamental para la exploración física y para la interpretación de técnicas de imagen. Los conocimientos más necesarios a la hora de su aplicación a la práctica y al estudio de las asignaturas clínicas fueron los de sistema nervioso y aparato locomotor. Modificarían la docencia que recibieron, incrementando el número de clases prácticas y dándole un mayor enfoque clínico. Los tres objetivos fundamentales de aprendizaje propuestos por los profesionales en ejercicio fueron: 1. Conocer las estructuras anatómicas y relaciones entre ellas 2. Reconocer estructuras anatómicas mediante técnicas de imagen y 3. Ser capaz de describir las bases anatómicas de la patología.The aim of this work was to highlight the relevance and necessity about gross anatomy knowledge had on family physicians and clinical-courses medical students. We also wanted to know their suggestions about the discipline Human Anatomy in Medical studies. To obtain our objective, physicians of Health Centres in Las Palmas and last-year medical students of U.L.P.G.C. were asked to fill a questionnaire. In this questionnaire the referred items were considered. The data obtained showed that both groups thought that Gross Anatomy was fundamental in the physical exploration and the image techniques interpretation. They considered that anatomical knowledge more necessary for


    Directory of Open Access Journals (Sweden)

    Mani Ram


    Full Text Available INTRODUCTION Between September 2013 and October 2014, we conducted a retrospective analysis to assess the complications related to endoscopic pituitary surgery in a series of 50 patients. We analysed the complications in preoperative, postoperative and endocrinological categories. We had a follow up of 1-2 years. Endonasal endoscopic transsphenoidal surgery (ETSS is an effective option for pituitary tumors. Complications do occur, but they can be reduced with experience & expertise and there is a steep learning curve. It demands a multidisciplinary approach.

  19. Who Is Repeating Anatomy? Trends in an Undergraduate Anatomy Course (United States)

    Schutte, Audra F.


    Anatomy courses frequently serve as prerequisites or requirements for health sciences programs. Due to the challenging nature of anatomy, each semester there are students remediating the course (enrolled in the course for a second time), attempting to earn a grade competitive for admissions into a program of study. In this retrospective study,…

  20. CT of the lesser pelvis - normal and abnormal anatomy, indications, results

    International Nuclear Information System (INIS)

    Steinbrich, W.; Friedmann, G.


    385 abnormal computer tomograms of the organs in the lesser pelvis were analysed; the normal anatomy, indications for CT and its value are discussed. Particular attention is paid to the relevance of the computer tomographic information for treatment. (orig.) [de

  1. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT

    NARCIS (Netherlands)

    van Ooijen, P.M.A.; Dorgelo, J.; Zijlstra, F.; Oudkerk, M.


    Early identification and evaluation of relatively frequent anomalous coronary anatomy is quite relevant because of the occurrence of sudden cardiac death or related symptoms of myocardial ischemia. Selective coronary angiography (CAG) is invasive, expensive and cannot always provide the required

  2. Normal cranial CT anatomy

    International Nuclear Information System (INIS)

    Gado, M.H.; Rao, K.C.V.G.


    The human brain consists of well-known anatomical components. Some parts of these components have been shown to be concerned with certain functions. A complete cranial CT examination consists of a series of several slices obtained in a sequence usually from the base to the vertex of the cranial vault, in the axial mode. The ultimate goal of this chapter is to pinpoint those slices that depict a given anatomical structure or several structures that deal with a given function. To achieve this goal, the discussion of CT cranial anatomy is presented in three sections

  3. Can "YouTube" help students in learning surface anatomy? (United States)

    Azer, Samy A


    In a problem-based learning curriculum, most medical students research the Internet for information for their "learning issues." Internet sites such as "YouTube" have become a useful resource for information. This study aimed at assessing YouTube videos covering surface anatomy. A search of YouTube was conducted from November 8 to 30, 2010 using research terms "surface anatomy," "anatomy body painting," "living anatomy," "bone landmarks," and "dermatomes" for surface anatomy-related videos. Only relevant video clips in the English language were identified and related URL recorded. For each videotape the following information were collected: title, authors, duration, number of viewers, posted comments, and total number of days on YouTube. The data were statistically analyzed and videos were grouped into educationally useful and non-useful videos on the basis of major and minor criteria covering technical, content, authority, and pedagogy parameters. A total of 235 YouTube videos were screened and 57 were found to have relevant information to surface anatomy. Analysis revealed that 15 (27%) of the videos provided useful information on surface anatomy. These videos scored (mean ± SD, 14.0 ± 0.7) and mainly covered surface anatomy of the shoulder, knee, muscles of the back, leg, and ankle, carotid artery, dermatomes, and anatomical positions. The other 42 (73%) videos were not useful educationally, scoring (mean ± SD, 7.4 ± 1.8). The total viewers of all videos were 1,058,634. Useful videos were viewed by 497,925 (47% of total viewers). The total viewership per day was 750 for useful videos and 652 for non-useful videos. No video clips covering surface anatomy of the head and neck, blood vessels and nerves of upper and lower limbs, chest and abdominal organs/structures were found. Currently, YouTube is an inadequate source of information for learning surface anatomy. More work is needed from medical schools and educators to add useful videos on You

  4. Orbita - Anatomy, development and deformities

    International Nuclear Information System (INIS)

    Hartmann, K.M.; Reith, W.; Golinski, M.; Schroeder, A.C.


    The development of the structures of the human orbita is very complex, but understanding the development makes it easier to understand normal anatomy and dysplasia. The following article first discusses the embryonic development of the eye structures and then presents the ''normal'' radiological anatomy using different investigation techniques and the most common deformities. (orig.) [de

  5. Health Instruction Packages: Cardiac Anatomy. (United States)

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw…

  6. Extended endoscopic endonasal surgery using three-dimensional endoscopy in the intra-operative MRI suite for supra-diaphragmatic ectopic pituitary adenoma. (United States)

    Fuminari, Komatsu; Hideki, Atsumi; Manabu, Osakabe; Mitsunori, Matsumae


    We describe a supra-diaphragmatic ectopic pituitary adenoma that was safely removed using the extended endoscopic endonasal approach, and discuss the value of three-dimensional (3D) endoscopy and intra-operative magnetic resonance imaging (MRI) to this type of procedure. A 61-year-old-man with bitemporal hemianopsia was referred to our hospital, where MRI revealed an enhanced suprasellar tumor compressing the optic chiasma. The tumor extended on the planum sphenoidale and partially encased the right internal carotid artery. An endocrinological assessment indicated normal pituitary function. The extended endoscopic endonasal approach was taken using a 3D endoscope in the intraoperative MRI suite. The tumor was located above the diaphragma sellae and separated from the normal pituitary gland. The pathological findings indicated non-functioning pituitary adenoma and thus the tumor was diagnosed as a supra-diaphragmatic ectopic pituitary adenoma. Intra-operative MRI provided useful information to minimize dural opening and the supra-diaphragmatic ectopic pituitary adenoma was removed from the complex neurovascular structure via the extended endoscopic endonasal approach under 3D endoscopic guidance in the intra-operative suite. Safe and effective removal of a supra-diaphragmatic ectopic pituitary adenoma was accomplished via the extended endoscopic endonasal approach with visual information provided by 3D endoscopy and intra-operative MRI.

  7. Applied anatomy of the lingual nerve: relevance to dental anaesthesia. (United States)

    Tan, Vui Leng; Andrawos, Alice; Ghabriel, Mounir N; Townsend, Grant C


    (1) to classify the external morphology of the lingual nerve and investigate any relationship between its external and internal morphology, (2) to explore the fascicular structure, nerve tissue density and capillary density of the lingual nerve, and (3) to provide an anatomical explanation as to why adverse clinical outcomes more commonly affect the lingual nerve following local dental anaesthesia. Where possible, comparisons were made between the lingual and inferior alveolar nerves. The lingual and inferior alveolar nerves were examined in 23 hemi-sectioned heads macroscopically and microscopically 2mm above the lingula. The lingual nerve was also examined in the regions of the third and second molars. Specimens underwent histological processing and staining with Haematoxylin & Eosin, Masson's Trichrome, anti-GLUT-1 and anti-CD 34. The lingual nerve became flatter as it traversed through the pterygomandibular space. There was an increase in the connective tissue and a decrease in nerve tissue density along the lingual nerve (p<0.001). At 2mm above the lingula, the lingual nerve was uni-fascicular in 39% of cases, whilst the inferior alveolar nerve consistently had more fascicles (p<0.001). The lingual nerve fascicles had thicker perineurium but the endoneurial vascular density was not significantly different in the two nerves. The greater susceptibility of lingual nerve dysfunction during inferior alveolar nerve blocks may be due to its uni-fascicular structure and the thicker perineurium, leading to increased endoneurial pressure and involvement of all axons if oedema or haemorrhage occurs due to trauma. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. [Anatomy, physiology and clinical relevance of the connecting tubule]. (United States)

    Miranda, N; Simeoni, M A; Ciriana, E; Panico, C; Cappello, E; Capasso, G B


    The cortical distal nephron is the site of fine regulation of salt and water excretion by peptide and mineralocorticoid hormones and the site for specific actions of diuretics. Some data suggest that sodium reabsorption and potassium secretion in the distal convoluted tubule and the connecting tubule (CNT) are sufficient to maintain the sodium and potassium balance, with little or no contribution of the collecting duct. The homeostatic role of the sodium and potassium transport systems in the collecting duct can be questioned, especially in conditions where dietary sodium intake is high and potassium intake is low compared with the physiological needs of the organism. The functional expression of epithelial sodium channels (ENaC) in the CNT is sufficient for furosemide-stimulated urinary acidification and identifies the CNT as a major segment in electrogenic urinary acidification. In the outer renal cortex, the CNT returns to the glomerular hilus and contacts the renal afferent arterioles (Af-Art). This morphology is compatible with a cross-talk between the CNT and Af-Art. This novel regulatory mechanism of the renal microcirculation may participate in the vasodilatation observed during high salt intake, perhaps by antagonizing tubuloglomerular feedback. In conclusion, the cortical distal nephron appears to be a complex site for several physiological mechanisms; it is mainly involved in salt and fluid homeostasis and in acid-base balance maintenance. Furthermore, the CNT segment appears to promote a CNT-Af-Art feedback loop.

  9. Endonasal endoscopic transsphenoidal pituitary surgery: early experience and outcome in paediatric Cushing's disease. (United States)

    Storr, Helen L; Drake, William M; Evanson, Jane; Matson, Matthew; Berney, Dan M; Grossman, Ashley B; Akker, Scott A; Monson, John P; Alusi, Ghassan; Savage, Martin O; Sabin, Ian


    Selective adenomectomy remains the first-line treatment for Cushing's disease (CD), until recently by microscopic transsphenoidal pituitary surgery. Endonasal transsphenoidal endoscopic surgery (ETES) is emerging as a novel, less invasive treatment for pituitary adenomas and has become the optimal surgical approach. There are no published series for the treatment of paediatric CD by ETES, and we report our centre's preliminary results. Retrospective analysis. Six paediatric patients (median age 15·8 years; range 11·7-17·0 years) fulfilled standard diagnostic criteria for CD. Preoperatively, no abnormality was identified on pituitary MR scanning in 3 (50%) patients, one had a macroadenoma. Bilateral petrosal sinus sampling demonstrated central ACTH secretion (IPS/P ACTH ratio ≥3·0, post-CRH) in 3/6 (50%) patients. The same neurosurgeon and endoscopic nasal surgeon undertook all the operations. Therapeutic outcome and rate of complications. Clinical recovery and biochemical 'cure' were achieved in 5 (83%) patients, and a corticotroph adenoma was confirmed histologically in all cured cases. One case developed post-operative CSF leak requiring lumbar drain insertion and patching. At a mean interval of 4·7 years (0·1-10·8 years) post-operatively, cured patients have shown no recurrence. One patient, with a large diffuse adenoma requiring more extensive surgery, has panhypopituitarism, and another patient has GH and gonadotrophin deficiencies. Our experience shows that ETES for removing corticotroph adenomas in children, in most cases not visualized on MRI, is minimally invasive and gave excellent post-operative recovery/results. In skilled hands, this technique provides an alternative to conventional transsphenoidal microscopic surgery in managing paediatric CD. © 2013 John Wiley & Sons Ltd.

  10. A practical 3D printed simulator for endoscopic endonasal transsphenoidal surgery to improve basic operational skills. (United States)

    Wen, Guodao; Cong, ZiXiang; Liu, KaiDong; Tang, Chao; Zhong, Chunyu; Li, Liwen; Dai, XuJie; Ma, Chiyuan


    We aimed to present a practical three-dimensional (3D) printed simulator to comprehensively and effectively accelerate the learning curve of endoscopic endonasal transsphenoidal surgery (EETS). The 3D printed simulator consists of three parts: (1) skull frame, (2) the nasal passage and the nasal alar of the face, and (3) a modified sella turcica. We aimed to improve three basic operational skills of surgeons: drilling, curetting, and aspirating. Eighteen neurosurgeons and five post-graduates were recruited and consented for the training. For trainees, (1) as the training progressed, the scores increased gradually, (2) a significant increase in the average scores was observed in the tenth training compared to the first training, and (3) there is a significant decrease in trainee variability in the shortening of the gap. The 18 neurosurgeons were divided into three groups: experts, assistants, and observers. For all three basic operations, (1) the average score of experts was obviously higher than that of the assistants, observers, and trainees' tenth training and (2) the average scores of assistants and observers were obviously higher than that of trainees' first training. A significant high in the average score between the assistants and the observers was seen for aspirating, but not for drilling or curetting. For curetting and aspirating, the tenth training average score of trainees was obviously higher than that of assistants and observers. This 3D printed simulator allows different endoscopic basic operations to be simulated and improves the EETS techniques of surgeons. We believed it to be a practical, simple, and low-cost simulator.

  11. Modified Graded Repair of Cerebrospinal Fluid Leaks in Endoscopic Endonasal Transsphenoidal Surgery (United States)

    Park, Jae-Hyun; Choi, Jai Ho; Kim, Young-Il; Kim, Sung Won


    Objective Complete sellar floor reconstruction is critical to avoid postoperative cerebrospinal fluid (CSF) leakage during transsphenoidal surgery. Recently, the pedicled nasoseptal flap has undergone many modifications and eventually proved to be valuable and efficient. However, using these nasoseptal flaps in all patients who undergo transsphenoidal surgery, including those who had none or only minor CSF leakage, appears to be overly invasive and time-consuming. Methods Patients undergoing endoscopic endonasal transsphenoidal tumor surgery within a 5 year-period were reviewed. Since 2009, we classified the intraoperative CSF leakage into grades from 0 to 3. Sellar floor reconstruction was tailored to each leak grade. We did not use any tissue grafts such as abdominal fat and did not include any procedures of CSF diversions such as lumbar drainage. Results Among 200 cases in 188 patients (147 pituitary adenoma and 41 other pathologies), intraoperative CSF leakage was observed in 27.4% of 197 cases : 14.7% Grade 1, 4.6% Grade 2a, 3.0% Grade 2b, and 5.1% Grade 3. Postoperative CSF leakage was observed in none of the cases. Septal bone buttress was used for Grade 1 to 3 leakages instead of any other foreign materials. Pedicled nasoseptal flap was used for Grades 2b and 3 leakages. Unused septal bones and nasoseptal flaps were repositioned. Conclusion Modified classification of intraoperative CSF leaks and tailored repair technique in a multilayered fashion using an en-bloc harvested septal bone and vascularized nasoseptal flaps is an effective and reliable method for the prevention of postoperative CSF leaks. PMID:26279811

  12. Endoscopic Endonasal Versus Microscopic Transsphenoidal Surgery for Recurrent and/or Residual Pituitary Adenomas. (United States)

    Esquenazi, Yoshua; Essayed, Walid I; Singh, Harminder; Mauer, Elizabeth; Ahmed, Mudassir; Christos, Paul J; Schwartz, Theodore H


    Surgery for recurrent/residual pituitary adenomas is increasingly being performed through endoscopic surgery. Whether this new technology has altered the indications and outcomes of surgery is unknown. We conducted a systematic review and meta-analysis of published studies to compare the indications and outcomes between microscopic and endoscopic approaches. A PubMed search was conducted (1985-2015) to identify surgical series of endoscopic endonasal and microscopic transsphenoidal resection of residual or recurrent pituitary adenomas. Data were extracted regarding tumor characteristics, surgical treatment, extent of resection, endocrine remission, visual outcome, and complications. Twenty-one studies met inclusion criteria. A total of 292 patients were in the endoscopic group, and 648 patients were in the microscopic group. Endoscopic cases were more likely nonfunctional (P < 0.001) macroadenomas (P < 0.001) with higher rates of cavernous sinus invasion (P = 0.012). The pooled rate of gross total tumor resection was 53.5% for the endoscopic group and 46.6% for the microscopic group. Endocrine remission was achieved in 53.0% and 46.7% of patients, and visual improvement occurred in 73.2% and 49.6% for the endoscopic and microscopic groups. Cerebrospinal fluid leak and pituitary insufficiency were higher in the endoscopic group. This meta-analysis indicates that the use of the endoscope to reoperate on residual or recurrent adenomas has only led to modest increases in resection rates. However, larger more complex cases are being tackled, so direct comparisons are misleading. The most dramatic change has been in visual improvement along with modest increases in risk. Reoperation for recurrent or residual adenomas is a safe and effective treatment option. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Experimental assessment of energy requirements and tool tip visibility for photoacoustic-guided endonasal surgery (United States)

    Lediju Bell, Muyinatu A.; Dagle, Alicia B.; Kazanzides, Peter; Boctor, Emad M.


    Endonasal transsphenoidal surgery is an effective approach for pituitary adenoma resection, yet it poses the serious risk of internal carotid artery injury. We propose to visualize these carotid arteries, which are hidden by bone, with an optical fiber attached to a surgical tool and a transcranial ultrasound probe placed on the patient's temple (i.e. intraoperative photoacoustic imaging). To investigate energy requirements for vessel visualization, experiments were conducted with a phantom containing ex vivo sheep brain, ex vivo bovine blood, and 0.5-2.5 mm thick human cadaveric skull specimens. Photoacoustic images were acquired with 1.2-9.3 mJ laser energy, and the resulting vessel contrast was measured at each energy level. The distal vessel boundary was difficult to distinguish at the chosen contrast threshold for visibility (4.5 dB), which was used to determine the minimum energies for vessel visualization. The blood vessel was successfully visualized in the presence of the 0-2.0 mm thick sphenoid and temporal bones with up to 19.2 dB contrast. The minimum energy required ranged from 1.2-5.0 mJ, 4.2-5.9 mJ, and 4.6-5.2 mJ for the 1.0 temporal and 0-1.5 mm sphenoid bones, 1.5 mm temporal and 0-0.5 mm sphenoid bones, and 2.0 mm temporal and 0-0.5 mm sphenoid bones, respectively, which corresponds to a fluence range of 4-21 mJ/cm2. These results hold promise for vessel visualization within safety limits. In a separate experiment, a mock tool tip was placed, providing satisfactory preliminary evidence that surgical tool tips can be visualized simultaneously with blood vessels.

  14. Low complication rate of sellar reconstruction by artificial dura mater during endoscopic endonasal transsphenoidal surgery. (United States)

    Ye, Yuanliang; Wang, Fuyu; Zhou, Tao; Luo, Yi


    To evaluate effect of sellar reconstruction during pituitary adenoma resection surgery by the endoscopic endonasal transsphenoidal approach using artificial cerebral dura mater patch.This was a retrospective study of 1281 patients who underwent endoscopic transsphenoidal resection for the treatment of pituitary adenomas between December 2006 and May 2014 at the Neurosurgery Department of the People's Liberation Army General Hospital. The patients were classified into 4 grades according to intraoperative cerebrospinal fluid (CSF) leakage site. All patients were followed up for 3 months by telephone and outpatient visits.One thousand seventy three (83.7%) patients underwent sellar reconstruction using artificial dura matter patched outside the sellar region (method A), 106 (8.3%) using artificial dura matter patched inside the sellar region (method B), and 102 (8.0%) using artificial dura matter and a mucosal flap (method C). Method A was used for grade 0-1 leakage, method B for grade 1 to 2 leakage, and method C for grade 2 to 3 leakage. During the 3-month follow-up, postoperative CSF leakage was observed in 7 patients (0.6%): 2 among patients who underwent method B (1.9%) and 5 among those who underwent method C (4.9%). Meningitis was diagnosed in 13 patients (1.0%): 2 among patients who underwent method A (0.2%), 4 among those who underwent method B (3.8%), and 7 among those who underwent method C (6.7%).Compared with other reconstruction methods, sellar reconstruction surgery that only use artificial dura mater as repair material had a low rate of complications. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  15. Pure endoscopic expanded endonasal approach for olfactory groove and tuberculum sellae meningiomas. (United States)

    Khan, Osaama H; Krischek, Boris; Holliman, Damian; Klironomos, George; Kucharczyk, Walter; Vescan, Allan; Gentili, Fred; Zadeh, Gelareh


    The expanded endoscopic endonasal (EEE) approach for the removal of olfactory groove (OGM) and tuberculum sellae (TSM) meningiomas is currently becoming an acceptable surgical approach in neurosurgical practice, although it is still controversial with respect to its outcomes, indications and limitations. Here we provide a review of the available literature reporting results with use of the EEE approach for these lesions together with our experience with the use of the endoscope as the sole means of visualization in a series of patients with no prior surgical biopsy or resection. Surgical cases between May 2006 and January 2013 were retrospectively reviewed. Twenty-three patients (OGM n=6; TSM n=17) were identified. In our series gross total resection (GTR) was achieved in 4/6 OGM (66.7%) and 11/17 (64.7%) TSM patients. Vision improved in the OGM group (2/2) and 8/11 improved in the TSM group with no change in visual status in the remaining three patients. Post-operative cerebrospinal fluid (CSF) leak occurred in 2/6 (33%) OGM and 2/17 (11.8%) TSM patients. The literature review revealed a total of 19 OGM and 174 TSM cases which were reviewed. GTR rate was 73% for OGM and 56.3% for TSM. Post-operative CSF leak was 30% for OGM and 14% for TSM. With careful patient selection and a clear understanding of its limitations, the EEE technique is both feasible and safe. However, longer follow-ups are necessary to better define the appropriate indications and ideal patient population that will benefit from the use of these newer techniques. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  16. Transbasal versus endoscopic endonasal versus combined approaches for olfactory groove meningiomas: importance of approach selection. (United States)

    Liu, James K; Silva, Nicole A; Sevak, Ilesha A; Eloy, Jean Anderson


    OBJECTIVE There has been much debate regarding the optimal surgical approach for resecting olfactory groove meningiomas (OGMs). In this paper, the authors analyzed the factors involved in approach selection and reviewed the surgical outcomes in a series of OGMs. METHODS A retrospective review of 28 consecutive OGMs from a prospective database was conducted. Each tumor was treated via one of 3 approaches: transbasal approach (n = 15), pure endoscopic endonasal approach (EEA; n = 5), and combined (endoscope-assisted) transbasal-EEA (n = 8). RESULTS The mean tumor volume was greatest in the transbasal (92.02 cm 3 ) and combined (101.15 cm 3 ) groups. Both groups had significant lateral dural extension over the orbits (transbasal 73.3%, p 95%) was achieved in 20% of transbasal and 37.5% of combined cases, all due to tumor adherence to the critical neurovascular structures. The rate of CSF leakage was 0% in the transbasal and combined groups, and there was 1 leak in the EEA group (20%), resulting in an overall CSF leakage rate of 3.6%. Olfaction was preserved in 66.7% in the transbasal group. There was no significant difference in length of stay or 30-day readmission rate between the 3 groups. The mean modified Rankin Scale score was 0.79 after the transbasal approach, 2.0 after EEA, and 2.4 after the combined approach (p = 0.0604). The mean follow-up was 14.5 months (range 1-76 months). CONCLUSIONS The transbasal approach provided the best clinical outcomes with the lowest rate of complications for large tumors (> 40 mm) and for smaller tumors (OGMs invading the sinonasal cavity. Careful patient selection using an individualized, tailored strategy is important to optimize surgical outcomes.

  17. Supraorbital Versus Endoscopic Endonasal Approaches for Olfactory Groove Meningiomas: A Cost-Minimization Study. (United States)

    Gandhoke, Gurpreet S; Pease, Matthew; Smith, Kenneth J; Sekula, Raymond F


    To perform a cost-minimization study comparing the supraorbital and endoscopic endonasal (EEA) approach with or without craniotomy for the resection of olfactory groove meningiomas (OGMs). We built a decision tree using probabilities of gross total resection (GTR) and cerebrospinal fluid (CSF) leak rates with the supraorbital approach versus EEA with and without additional craniotomy. The cost (not charge or reimbursement) at each "stem" of this decision tree for both surgical options was obtained from our hospital's finance department. After a base case calculation, we applied plausible ranges to all parameters and carried out multiple 1-way sensitivity analyses. Probabilistic sensitivity analyses confirmed our results. The probabilities of GTR (0.8) and CSF leak (0.2) for the supraorbital craniotomy were obtained from our series of 5 patients who underwent a supraorbital approach for the resection of an OGM. The mean tumor volume was 54.6 cm 3 (range, 17-94.2 cm 3 ). Literature-reported rates of GTR (0.6) and CSF leak (0.3) with EEA were applied to our economic analysis. Supraorbital craniotomy was the preferred strategy, with an expected value of $29,423, compared with an EEA cost of $83,838. On multiple 1-way sensitivity analyses, supraorbital craniotomy remained the preferred strategy, with a minimum cost savings of $46,000 and a maximum savings of $64,000. Probabilistic sensitivity analysis found the lowest cost difference between the 2 surgical options to be $37,431. Compared with EEA, supraorbital craniotomy provides substantial cost savings in the treatment of OGMs. Given the potential differences in effectiveness between approaches, a cost-effectiveness analysis should be undertaken. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Endoscopic Endonasal Resection of Retrochiasmatic Craniopharyngioma with Fascia Lata Button and Nasoseptal Flap Reconstruction. (United States)

    Kshettry, Varun R; Nyquist, Gurston; Evans, James J


    Surgery for craniopharyngiomas can be challenging due to the involvement of multiple critical neurovascular structures. The expanded endoscopic endonasal approach can provide superior access to suprasellar craniopharyngiomas, particularly with retrochiasmatic extension and significant hypothalamic involvement. We describe the surgical technique used to treat a 30-year-old patient who presented with 4 weeks of worsening vision, fatigue, and memory loss. His vision was counting fingers at 1 feet on the right and 20/800 on the left with a temporal hemianopsia. Laboratory evaluation demonstrated central hypoadrenalism, hypothyroidism, and hypogonadism. Imaging showed a large solid and cystic suprasellar mass. The transtubercular approach with removal of the lateral tubercular strut can provide wide bilateral access to the opticocarotid region. The superior intercavernous sinus must be coagulated and ligated. Initial arachnoid dissection is centered at the midline, mobilizing the superior hypophyseal branches to the optic apparatus laterally. The cyst capsule is opened and care is taken to minimize spillage of cyst fluid into the subarachnoid space. Central debulking and then extracapsular dissection is performed under direct visualization using sharp dissection. Reconstruction of the dura is performed with an inlay/onlay fascia lata button that is held together with four sutures that hold the graft edges against the native dural edges. This is followed by vascularized nasoseptal flap reconstruction. No lumbar drain or nonabsorbable packing is required. The patient's vision had dramatic improvement and by 1 week postoperatively was 20/20 with full visual fields. Postoperative diabetes insipidus was managed with nasal desmopressin. Postoperative MRI demonstrated complete removal. The link to the video can be found at: .

  19. Time to Revive the Value of the Pseudocapsule in Endoscopic Endonasal Transsphenoidal Surgery for Growth Hormone Adenomas. (United States)

    Xie, Tao; Liu, Tengfei; Zhang, Xiaobiao; Chen, Lingli; Luo, Rongkui; Sun, Wei; Hu, Fan; Yu, Yong; Gu, Ye; Lu, Zhiqiang


    To investigate the role of endoscopic endonasal transsphenoidal surgery and the pseudocapsule in the treatment of growth hormone adenomas. The study included 43 patients (age range, 21-64 years) with growth hormone adenomas treated with an endoscopic endonasal approach. We compared the tumor characteristics and surgical outcomes of cases with (group A, 21 cases, from November 2013 to January 2015) and without (group B, 22 cases, from October 2011 to October 2013) extra-pseudocapsule resection. The preoperative demographics, tumor characteristics, and surgical complications were not significantly different between groups A and B. Postoperative remission without adjuvant therapy was achieved in 18 of 21 cases (85.7%) in group A, which was significantly greater than that observed in group B (12 of 22 cases [54.4%]). In group A, the pseudocapsules were verified by endoscopy and histopathology. The pseudocapsule was removed en bloc with the whole adenoma in only 5 cases (23.8%). For the remaining 16 patients (76.2%), following extra-pseudocapsule dissection, incomplete pseudocapsule removals with intracapsule procedures were achieved. The combination of extra-pseudocapsule resection and endoscopy led to a high rate of gross total tumor resection and endocrinologicl remission in acromegalic patients compared with the group with intracapsular resection. Extra-pseudocapsule resection resulted in no additional postoperative complications. Copyright © 2016. Published by Elsevier Inc.

  20. A road map to the internal carotid artery in expanded endoscopic endonasal approaches to the ventral cranial base. (United States)

    Labib, Mohamed A; Prevedello, Daniel M; Carrau, Ricardo; Kerr, Edward E; Naudy, Cristian; Abou Al-Shaar, Hussam; Corsten, Martin; Kassam, Amin


    Injuring the internal carotid artery (ICA) is a feared complication of endoscopic endonasal approaches. To introduce a comprehensive ICA classification scheme pertinent to safe endoscopic endonasal cranial base surgery. Anatomic dissections were performed in 33 cadaveric specimens (bilateral). Anatomic correlations were analyzed. Based on anatomic correlations, the ICA may be described as 6 distinct segments: (1) parapharyngeal (common carotid bifurcation to ICA foramen); (2) petrous (carotid canal to posterolateral aspect of foramen lacerum); (3) paraclival (posterolateral foramen lacerum to the superomedial aspect of the petrous apex); (4) parasellar (superomedial petrous apex to the proximal dural ring); (5) paraclinoid (from the proximal to the distal dural rings); and (6) intradural (distal ring to ICA bifurcation). Corresponding surgical landmarks included the Eustachian tube, the fossa of Rosenmüller, and levator veli palatini for the parapharyngeal segment; the vidian canal and V3 for the petrous segment; the fibrocartilage of foramen lacerum, foramen rotundum, maxillary strut, lingular process of the sphenoid bone, and paraclival protuberance for the paraclival segment; the sellar floor and petrous apex for the parasellar segment; and the medial and lateral opticocarotid and lateral tubercular recesses, as well as the distal osseous arch of the carotid sulcus for the paraclinoid segment. The proposed endoscopic classification outlines key anatomic reference points independent of the vessel's geometry or the sinonasal pneumatization, thus serving as (1) a practical guide to navigate the ventral cranial base while avoiding injury to the ICA and (2) further foundation for a modular access system.

  1. Innovative activities for teaching anatomy of speech production. (United States)

    Skinder-Meredith, Amy E


    Courses in anatomy have traditionally relied on lectures and cadaver dissection laboratories. In speech and hearing sciences, there tends to be less access to cadavers than in medical schools and other allied health professions. It is more typical to use anatomical models, diagrams and lecture slides. Regardless of the resources available, anatomy is a subject that lends itself to hands-on learning. This article briefly reviews teaching methods and describes a variety of innovative activities to enhance learning of anatomical concepts and clinical relevance of anatomy for speech production. Teaching strategies and activities were developed to capitalize on students' multimodal learning preferences as revealed by responses to a survey administered to 49 undergraduates in the beginning of an anatomy of speech production course. At the end of the semester, students completed a second survey. A five-point Likert scale was used to assess the usefulness of each activity as a learning tool or level of clinical relevance and the level of enjoyability. The responses were overwhelmingly positive with level of usefulness and level of clinical relevance rated higher on average than the level of enjoyment.

  2. Blended learning in anatomy

    DEFF Research Database (Denmark)

    Østergaard, Gert Værge; Brogner, Heidi Marie

    behind DBR is that new knowledge is generated through processes that simultaneously develop, test and improve a design, in this case, an educational design (1) The main principles used in the project is blended learning and flipped learning (2). …"I definitely learn best in practice, but the theory...... in working with the assignments in the classroom."... External assesor, observer and interviewer Based on the different evaluations, the conclusion are that the blended learning approach combined with the ‘flipped classroom’ is a very good way to learn and apply the anatomy, both for the students......The aim of the project was to bridge the gap between theory and practice by working more collaboratively, both peer-to-peer and between student and lecturer. Furthermore the aim was to create active learning environments. The methodology of the project is Design-Based Research (DBR). The idea...

  3. The peritoneum - anatomy and imaging

    International Nuclear Information System (INIS)

    Ribarova, V.


    The peritoneum is a large and complex serous membrane The peritoneal spaces and the natural flow of peritoneal fluid determine the route of spread of the disease processes within the abdominal cavity. The goal of this article is to review the normal peritoneal anatomy and the role of the imaging in the diagnostic of the disease processes. Among the imaging methods, the computed tomography at greater extent allows the accurate examination of the complex anatomy of the peritoneal cavity and to assess the extent of the pathological processes affecting it. Key words: Peritoneal Anatomy. Imaging. CT [bg

  4. Patient satisfaction following endoscopic endonasal dacryocystorhinostomy: a quality of life study. (United States)

    Jutley, G; Karim, R; Joharatnam, N; Latif, S; Lynch, T; Olver, J M


    To assess the subjective success and quality of life of adult patients post endoscopic endonasal dacryocystorhinostomy (EE-DCR) for acquired nasolacrimal duct obstruction. Retrospective, questionnaire study performed at least 6 months post EE-DCR. Hundred and ten of the 282 consecutive patients who underwent EE-DCR. A standardised questionnaire (Glasgow Benefit Inventory, GBI) was used to analyse the quality of life. The questionnaire examines four parameters, providing total, subscale, social, and physical scores. We aimed to assess patient experience following EE-DCR surgery. Total GBI scores range from -100 to +100, the former reflecting maximal negative benefit and corresponding to subjective worsening of tearing and impact on quality of life. Any positive score reflects a satisfactory surgical outcome and +100 represents maximal positive benefit. A score of zero is no perceived benefit. The average age was 62 years, 63% were female. In three of the parameters measured, there was a subjective improvement post surgery: subscale score 22.16 (95% CI: 15.23-29.09), total score 15.04 (95% CI: 9.74-20.35), and social support score 4.67 (95% CI: 0.93-8.42). Physical health scored -4.47 (95% CI: -10.25 to 1.32). Secondary analyses demonstrate no statistical significance with respect to outcome whether a trainee or consultant performed the procedure. Younger patients (under split median of 63.5) had a better total score 19.04 (95% CI: 11.35-27.74) than those older than 63.5 years (11.04, 95% CI: 3.61-18.47). This study shows that EE-DCR gave patients improvement in quality of life, proven by a validated questionnaire. The mean total score of 15.04 found in our study compares with the 18.7 recorded by Feretis et al in 2009. Results were irrespective of the grade of surgeon, similar to the findings of Fayers et al for functional successes. This study supports the use of EE-DCR for the improvement of quality of life in adult patients.

  5. Comparison of external dacryocystorhinostomy and 5-fluorouracil augmented endonasal laser dacryocystorhinostomy. A Retrospective review

    Directory of Open Access Journals (Sweden)

    Watts Patrick


    Full Text Available Purpose: To compare the success rates of external dacryocystorhinostomy (EXT-DCR with 5-fluorouracil (5-FU augmented endonasal laser dacryocystorhinostomy (ENL-DCR and to record the complications associated with 5-FU augmented ENL-DCR Materials and Methods: This was a retrospective non-randomised study. Forty-one patients with primary acquired nasolacrimal duct obstruction underwent an EXT-DCR (19 patients or an ENL-DCR (22 patients over a 3-year period. A Holmium YAG laser (Ho:YAG was used in the latter group of patients. Silicone tubes intubated in all patients were removed at three months. 5-FU was applied intraoperatively at the site of the ostium in the ENL-DCR patients. The median follow-up was 12 months (range 3-24 months for the ENL-DCR group and 22 months (range 6-28 months for the EXT-DCR group. The patency of the lacrimal system and the severity of epiphora were assessed at a final-review. Results: The median age of the EXT-DCR group was 77 years (range 53-87 and that of the ENL-DCR group was 71 years (range 23 to 84. There were 12 female patients in the former group and 19 in the latter. The percentage of success in the EXT-DCR group was 94.7% (95% confidence interval (CI = 75.4-99.1 = , and 63.6% in the ENL-DCR group (95% CI= 43.0-80.3. The confidence interval for the difference of 31.1% was 5.6-52.2. There was a statistically significant difference between the two groups, p=0.024 (Fisher exact test. Conclusions: These data suggest that EXT-DCR provides better results than 5-FU augmented ENL-DCR. However, ENL-DCR is the procedure of choice in certain circumstances such as in elderly, frail or medically unfit patients. Our results of 5-FU augmented ENL-DCR compare favourably with other published series.

  6. Training to acquire psychomotor skills for endoscopic endonasal surgery using a personal webcam trainer. (United States)

    Hirayama, Ryuichi; Fujimoto, Yasunori; Umegaki, Masao; Kagawa, Naoki; Kinoshita, Manabu; Hashimoto, Naoya; Yoshimine, Toshiki


    Existing training methods for neuroendoscopic surgery have mainly emphasized the acquisition of anatomical knowledge and procedures for operating an endoscope and instruments. For laparoscopic surgery, various training systems have been developed to teach handling of an endoscope as well as the manipulation of instruments for speedy and precise endoscopic performance using both hands. In endoscopic endonasal surgery (EES), especially using a binostril approach to the skull base and intradural lesions, the learning of more meticulous manipulation of instruments is mandatory, and it may be necessary to develop another type of training method for acquiring psychomotor skills for EES. Authors of the present study developed an inexpensive, portable personal trainer using a webcam and objectively evaluated its utility. Twenty-five neurosurgeons volunteered for this study and were divided into 2 groups, a novice group (19 neurosurgeons) and an experienced group (6 neurosurgeons). Before and after the exercises of set tasks with a webcam box trainer, the basic endoscopic skills of each participant were objectively assessed using the virtual reality simulator (LapSim) while executing 2 virtual tasks: grasping and instrument navigation. Scores for the following 11 performance variables were recorded: instrument time, instrument misses, instrument path length, and instrument angular path (all of which were measured in both hands), as well as tissue damage, max damage, and finally overall score. Instrument time was indicated as movement speed; instrument path length and instrument angular path as movement efficiency; and instrument misses, tissue damage, and max damage as movement precision. In the novice group, movement speed and efficiency were significantly improved after the training. In the experienced group, significant improvement was not shown in the majority of virtual tasks. Before the training, significantly greater movement speed and efficiency were demonstrated in

  7. [Clinical observation on controlling antihypertension with the general anesthesia of TEAS and anesthetics in endoscopic endonasal surgery]. (United States)

    Zhao, Wensheng; Zhao Xian; Li, Jinjin; Fang, Jianqiao


    To study whether the dose of controlling antihypertensive drug is reduced by transcutaneous electrical acupoint stimulation (TEAS) and the anesthetics, as well as the control of blood pressure (BP) and heart rate (HR) in endoscopic endonasal surgery with general anesthesia. Sixty patients for selective endoscopic endonasal surgery with general anesthetics and controlling antihypertension involved were selected and randomized into a TEAS group, a sham-TEAS group, 30 cases in each one. The electric pads were attached to bilateral Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6) and Quchi (LI 11), stimulated with Hans-200 apparatus, 3 to 5 mA, 2 Hz/100 Hz in the TEAS group based on the patients' response to comfort. No electric stimulation was applied to the sham-TEAS group. The general anesthesia started after 30 min intervention and lasted till the end of surgery. The BP and HR were observed and recorded at the end of monitoring in operation room, 10 min after tranquilization (T0), 30 min after intervention (Tj, after induction~of general anestiesa (T2), 30 min after surgery start (T3), 60 min after surgery start (T4) and 30 min after extubation (T5). The doses of vecuronium bromide, propofol and nitroglycerin were recorded statistically in surgery, as well as the operative bleeding volume, the operative time, the resuscitation time and the visual analogue scale (VAS) score after resuscitation. Compared with that at T0, the mean arterial pressure (MAP) at T2, T3, T4 and T5 in the TEAS group and at T3 and T4 in the sham-TEAS group was all reduced, indicating the significant difference (all P 0.05). HR was different at T2 to Ts in the sham-TEAS group statistically (all P 0.05). The general anesthesia with TEAS and anesthetics involved for controlling antihypertension contributes to the control of BP and HR in the patients in endoscopic endonasal surgery. The impacts are not obvious on the doses of antihypertensive drug, the general anesthetics, the operative bleeding

  8. Integrating Anatomy Training into Radiation Oncology Residency: Considerations for Developing a Multidisciplinary, Interactive Learning Module for Adult Learners (United States)

    Labranche, Leah; Johnson, Marjorie; Palma, David; D'Souza, Leah; Jaswal, Jasbir


    Radiation oncologists require an in-depth understanding of anatomical relationships for modern clinical practice, although most do not receive formal anatomy training during residency. To fulfill the need for instruction in relevant anatomy, a series of four multidisciplinary, interactive learning modules were developed for a cohort of radiation…

  9. Penile embryology and anatomy. (United States)

    Yiee, Jenny H; Baskin, Laurence S


    Knowledge of penile embryology and anatomy is essential to any pediatric urologist in order to fully understand and treat congenital anomalies. Sex differentiation of the external genitalia occurs between the 7th and 17th weeks of gestation. The Y chromosome initiates male differentiation through the SRY gene, which triggers testicular development. Under the influence of androgens produced by the testes, external genitalia then develop into the penis and scrotum. Dorsal nerves supply penile skin sensation and lie within Buck's fascia. These nerves are notably absent at the 12 o'clock position. Perineal nerves supply skin sensation to the ventral shaft skin and frenulum. Cavernosal nerves lie within the corpora cavernosa and are responsible for sexual function. Paired cavernosal, dorsal, and bulbourethral arteries have extensive anastomotic connections. During erection, the cavernosal artery causes engorgement of the cavernosa, while the deep dorsal artery leads to glans enlargement. The majority of venous drainage occurs through a single, deep dorsal vein into which multiple emissary veins from the corpora and circumflex veins from the spongiosum drain. The corpora cavernosa and spongiosum are all made of spongy erectile tissue. Buck's fascia circumferentially envelops all three structures, splitting into two leaves ventrally at the spongiosum. The male urethra is composed of six parts: bladder neck, prostatic, membranous, bulbous, penile, and fossa navicularis. The urethra receives its blood supply from both proximal and distal directions.

  10. Penile Embryology and Anatomy

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    Jenny H. Yiee


    Full Text Available Knowledge of penile embryology and anatomy is essential to any pediatric urologist in order to fully understand and treat congenital anomalies. Sex differentiation of the external genitalia occurs between the 7thand 17th weeks of gestation. The Y chromosome initiates male differentiation through the SRY gene, which triggers testicular development. Under the influence of androgens produced by the testes, external genitalia then develop into the penis and scrotum. Dorsal nerves supply penile skin sensation and lie within Buck's fascia. These nerves are notably absent at the 12 o'clock position. Perineal nerves supply skin sensation to the ventral shaft skin and frenulum. Cavernosal nerves lie within the corpora cavernosa and are responsible for sexual function. Paired cavernosal, dorsal, and bulbourethral arteries have extensive anastomotic connections. During erection, the cavernosal artery causes engorgement of the cavernosa, while the deep dorsal artery leads to glans enlargement. The majority of venous drainage occurs through a single, deep dorsal vein into which multiple emissary veins from the corpora and circumflex veins from the spongiosum drain. The corpora cavernosa and spongiosum are all made of spongy erectile tissue. Buck's fascia circumferentially envelops all three structures, splitting into two leaves ventrally at the spongiosum. The male urethra is composed of six parts: bladder neck, prostatic, membranous, bulbous, penile, and fossa navicularis. The urethra receives its blood supply from both proximal and distal directions.

  11. Endoscopic endonasal transsphenoidal surgery using the iArmS operation support robot: initial experience in 43 patients. (United States)

    Ogiwara, Toshihiro; Goto, Tetsuya; Nagm, Alhusain; Hongo, Kazuhiro


    Objective The intelligent arm-support system, iArmS, which follows the surgeon's arm and automatically fixes it at an adequate position, was developed as an operation support robot. iArmS was designed to support the surgeon's forearm to prevent hand trembling and to alleviate fatigue during surgery with a microscope. In this study, the authors report on application of this robotic device to endoscopic endonasal transsphenoidal surgery (ETSS) and evaluate their initial experiences. Methods The study population consisted of 43 patients: 29 with pituitary adenoma, 3 with meningioma, 3 with Rathke's cleft cyst, 2 with craniopharyngioma, 2 with chordoma, and 4 with other conditions. All patients underwent surgery via the endonasal transsphenoidal approach using a rigid endoscope. During the nasal and sphenoid phases, iArmS was used to support the surgeon's nondominant arm, which held the endoscope. The details of the iArmS and clinical results were collected. Results iArmS followed the surgeon's arm movement automatically. It reduced the surgeon's fatigue and stabilized the surgeon's hand during ETSS. Shaking of the video image decreased due to the steadying of the surgeon's scope-holding hand with iArmS. There were no complications related to use of the device. Conclusions The intelligent armrest, iArmS, seems to be safe and effective during ETSS. iArmS is helpful for improving the precision and safety not only for microscopic neurosurgery, but also for ETSS. Ongoing advances in robotics ensure the continued evolution of neurosurgery.

  12. Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update. (United States)

    Dlouhy, Brian J; Dahdaleh, Nader S; Menezes, Arnold H


    The craniovertebral junction (CVJ), or the craniocervical junction (CCJ) as it is otherwise known, houses the crossroads of the CNS and is composed of the occipital bone that surrounds the foramen magnum, the atlas vertebrae, the axis vertebrae, and their associated ligaments and musculature. The musculoskeletal organization of the CVJ is unique and complex, resulting in a wide range of congenital, developmental, and acquired pathology. The refinements of the transoral approach to the CVJ by the senior author (A.H.M.) in the late 1970s revolutionized the treatment of CVJ pathology. At the same time, a physiological approach to CVJ management was adopted at the University of Iowa Hospitals and Clinics in 1977 based on the stability and motion dynamics of the CVJ and the site of encroachment, incorporating the transoral approach for irreducible ventral CVJ pathology. Since then, approaches and techniques to treat ventral CVJ lesions have evolved. In the last 40 years at University of Iowa Hospitals and Clinics, multiple approaches to the CVJ have evolved and a better understanding of CVJ pathology has been established. In addition, new reduction strategies that have diminished the need to perform ventral decompressive approaches have been developed and implemented. In this era of surgical subspecialization, to properly treat complex CVJ pathology, the CVJ specialist must be trained in skull base transoral and endoscopic endonasal approaches, pediatric and adult CVJ spine surgery, and must understand and be able to treat the complex CSF dynamics present in CVJ pathology to provide the appropriate, optimal, and tailored treatment strategy for each individual patient, both child and adult. This is a comprehensive review of the history and evolution of the transoral approaches, extended transoral approaches, endoscopie assisted transoral approaches, endoscopie endonasal approaches, and CVJ reduction strategies. Incorporating these advancements, the authors update the

  13. Extended Endoscopic Endonasal Resection of a Suprasellar and Third Ventricular Retrochiasmatic Craniopharyngioma with a Narrow Pituitary Gland-Optic Chiasm Interval: Techniques to Optimize Resection. (United States)

    Kenning, Tyler J; Pinheiro-Neto, Carlos D


    The extended endoscopic endonasal approach can be utilized to surgically treat pathology within the suprasellar space. This relies on a sufficient corridor and interval between the superior aspect of the pituitary gland and the optic chiasm. Tumors located in the retrochiasmatic space and within the third ventricle, however, may not have a widened interval through which to work. With mass effect on the superior and posterior aspect of the optic chiasm, the corridor between the chiasm and the pituitary gland might even be further narrowed. This may negate the possibility of utilizing the endoscopic endonasal approach for the management of pathology in this location. We present a case of a retrochiasmatic craniopharyngioma with a narrow resection corridor that was treated with the extended endoscopic approach and we review techniques to potentially overcome this limitation. The link to the video can be found at: .

  14. A Case of Pseudoaneurysm of the Internal Carotid Artery Following Endoscopic Endonasal Pituitary Surgery: Endovascular Treatment with Flow-Diverting Stent Implantation

    Directory of Open Access Journals (Sweden)

    Ali Karadag


    Full Text Available Internal carotid artery (ICA pseudoaneurysm is a rare complication of endoscopic endonasal surgery occurring in 0.4–1.1% of cases. Pseudoaneurysms can subsequently result in other complications, such as subarachnoid hemorrhage, epistaxis, and caroticocavernous fistula with resultant death or permanent neurologic deficit. In this case, we illustrate endovascular treatment with a flow-diverting stent for an ICA pseudoaneurysm after endoscopic endonasal surgery for a pituitary adenoma in a 56-year-old male. Surgery was complicated by excessive intraoperative bleeding and emergent CT angiography confirmed an iatrogenic pseudoaneurysm on the anteromedial surface of the ICA. The pseudoaneurysm was treated endovascularly with flow-diverting stent implantation only. Follow-up CT angiography after three months demonstrated occlusion of the pseudoaneurysm.

  15. The place of surface anatomy in the medical literature and undergraduate anatomy textbooks. (United States)

    Azer, Samy A


    The aims of this review were to examine the place of surface anatomy in the medical literature, particularly the methods and approaches used in teaching surface and living anatomy and assess commonly used anatomy textbooks in regard to their surface anatomy contents. PubMed and MEDLINE databases were searched using the following keywords "surface anatomy," "living anatomy," "teaching surface anatomy," "bony landmarks," "peer examination" and "dermatomes". The percentage of pages covering surface anatomy in each textbook was calculated as well as the number of images covering surface anatomy. Clarity, quality and adequacy of surface anatomy contents was also examined. The search identified 22 research papers addressing methods used in teaching surface anatomy, 31 papers that can help in the improvement of surface anatomy curriculum, and 12 anatomy textbooks. These teaching methods included: body painting, peer volunteer surface anatomy, use of a living anatomy model, real time ultrasound, virtual (visible) human dissector (VHD), full body digital x-ray of cadavers (Lodox(®) Statscan(®) images) combined with palpating landmarks on peers and the cadaver, as well as the use of collaborative, contextual and self-directed learning. Nineteen of these studies were published in the period from 2006 to 2013. The 31 papers covered evidence-based and clinically-applied surface anatomy. The percentage of surface anatomy in textbooks' contents ranged from 0 to 6.2 with an average of 3.4%. The number of medical illustrations on surface anatomy varied from 0 to 135. In conclusion, although there has been a progressive increase in publications addressing methods used in teaching surface anatomy over the last six to seven years, most anatomy textbooks do not provide students with adequate information about surface anatomy. Only three textbooks provided a solid explanation and foundation of understanding surface anatomy. © 2013 American Association of Anatomists.

  16. An anatomy precourse enhances student learning in veterinary anatomy. (United States)

    McNulty, Margaret A; Stevens-Sparks, Cathryn; Taboada, Joseph; Daniel, Annie; Lazarus, Michelle D


    Veterinary anatomy is often a source of trepidation for many students. Currently professional veterinary programs, similar to medical curricula, within the United States have no admission requirements for anatomy as a prerequisite course. The purpose of the current study was to evaluate the impact of a week-long precourse in veterinary anatomy on both objective student performance and subjective student perceptions of the precourse educational methods. Incoming first year veterinary students in the Louisiana State University School of Veterinary Medicine professional curriculum were asked to participate in a free precourse before the start of the semester, covering the musculoskeletal structures of the canine thoracic limb. Students learned the material either via dissection only, instructor-led demonstrations only, or a combination of both techniques. Outcome measures included student performance on examinations throughout the first anatomy course of the professional curriculum as compared with those who did not participate in the precourse. This study found that those who participated in the precourse did significantly better on examinations within the professional anatomy course compared with those who did not participate. Notably, this significant improvement was also identified on the examination where both groups were exposed to the material for the first time together, indicating that exposure to a small portion of veterinary anatomy can impact learning of anatomical structures beyond the immediate scope of the material previously learned. Subjective data evaluation indicated that the precourse was well received and students preferred guided learning via demonstrations in addition to dissection as opposed to either method alone. Anat Sci Educ 9: 344-356. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

  17. Improving gross anatomy learning using reciprocal peer teaching. (United States)

    Manyama, Mange; Stafford, Renae; Mazyala, Erick; Lukanima, Anthony; Magele, Ndulu; Kidenya, Benson R; Kimwaga, Emmanuel; Msuya, Sifael; Kauki, Julius


    The use of cadavers in human anatomy teaching requires adequate number of anatomy instructors who can provide close supervision of the students. Most medical schools are facing challenges of lack of trained individuals to teach anatomy. Innovative techniques are therefore needed to impart adequate and relevant anatomical knowledge and skills. This study was conducted in order to evaluate the traditional teaching method and reciprocal peer teaching (RPT) method during anatomy dissection. Debriefing surveys were administered to the 227 first year medical students regarding merits, demerits and impact of both RPT and Traditional teaching experiences on student's preparedness prior to dissection, professionalism and communication skills. Out of this, 159 (70 %) completed the survey on traditional method while 148 (65.2 %) completed survey on RPT method. An observation tool for anatomy faculty was used to assess collaboration, professionalism and teaching skills among students. Student's scores on examinations done before introduction of RPT were compared with examinations scores after introduction of RPT. Our results show that the mean performance of students on objective examinations was significantly higher after introduction of RPT compared to the performance before introduction of RPT [63.7 ± 11.4 versus 58.6 ± 10, mean difference 5.1; 95 % CI = 4.0-6.3; p-value peers and faculty compared to 38 % for the tradition method. The majority of faculty reported that the learning environment of the dissection groups was very active learning during RPT sessions and that professionalism was observed by most students during discussions. Introduction of RPT in our anatomy dissection laboratory was generally beneficial to both students and faculty. Both objective (student performance) and subjective data indicate that RPT improved student's performance and had a positive learning experience impact. Our future plan is to continue RPT practice and continually

  18. Papilian's anatomy - celebrating six decades. (United States)

    Dumitraşcu, Dinu Iuliu; Crivii, Carmen Bianca; Opincariu, Iulian


    Victor Papilian was born an artist, during high school he studied music in order to become a violinist in two professional orchestras in Bucharest. Later on he enrolled in the school of medicine, being immediately attracted by anatomy. After graduating, with a briliant dissertation, he became a member of the faculty and continued to teach in his preferred field. His masters, Gh. Marinescu and Victor Babes, proposed him for the position of professor at the newly established Faculty of Medicine of Cluj. Here he reorganized the department radically, created an anatomy museum and edited the first dissection handbook and the first Romanian anatomy (descriptive and topographic) treatise, both books received with great appreciation. He received the Romanian Academy Prize. His knowledge and skills gained him a well deserved reputation and he created a prestigious school of anatomy. He published over 250 scientific papers in national and international journals, ranging from morphology to functional, pathological and anthropological topics. He founded the Society of Anthropology, with its own newsletter; he was elected as a member of the French Society of Anatomy. In parallel he had a rich artistic and cultural activity as writer and playwright: he was president of the Transylvanian Writers' Society, editor of a literary review, director of the Cluj theater and opera, leader of a book club and founder of a symphony orchestra.

  19. Lumbar Drains Decrease the Risk of Postoperative Cerebrospinal Fluid Leak Following Endonasal Endoscopic Surgery for Suprasellar Meningiomas in Patients With High Body Mass Index. (United States)

    Cohen, Salomon; Jones, Samuel H; Dhandapani, Sivashanmugam; Negm, Hazem M; Anand, Vijay K; Schwartz, Theodore H


    Postoperative cerebrospinal fluid (CSF) leak is a persistent, albeit much less prominent, complication following endonasal endoscopic surgery. The pathology with highest risk is suprasellar meningiomas. A postoperative lumbar drain (LD) is used to decrease the risk of CSF leak but is not universally accepted. To compare the rates of postoperative CSF leak between patients with and without LD who underwent endonasal endoscopic surgical resection of suprasellar meningiomas. A consecutive series of newly diagnosed suprasellar meningiomas was drawn from a prospectively acquired database of endonasal endoscopic surgeries at our institution. An intraoperative, preresection LD was placed and left open at 5 cc/h for ∼48 h. In a subset of patients, the LD could not be placed. Rates of postoperative CSF leak were compared between patients with and without an LD. Twenty-five patients underwent endonasal endoscopic surgical resection of suprasellar meningiomas. An LD could not be placed in 2 patients. There were 2 postoperative CSF leaks (8%), both of which occurred in the patients who did not have an LD (P = .0033). The average body mass index (BMI) of the patients in whom the LD could not be placed was 39.1 kg/m2, compared with 27.6 kg/m2 for those in whom the LD could be placed (P = .009). In the subgroup of obese patients (BMI > 30 kg/m2), LD placement was protective against postoperative CSF leak (P = .022). The inability to place an LD in patients with obesity is a risk factor for postoperative CSF leak. An LD may be useful to prevent postoperative CSF leak, particularly in patients with elevated BMI. Copyright © 2017 by the Congress of Neurological Surgeons

  20. The mandible and its foramen: anatomy, anthropology, embryology and resulting clinical implications. (United States)

    Lipski, M; Tomaszewska, I M; Lipska, W; Lis, G J; Tomaszewski, K A


    The aim of this paper is to summarise the knowledge about the anatomy, embryology and anthropology of the mandible and the mandibular foramen and also to highlight the most important clinical implications of the current studies regarding anaesthesia performed in the region of the mandible. An electronic journal search was undertaken to identify all the relevant studies published in English. The search included MEDLINE and EMBASE databases and years from 1950 to 2012. The subject search used a combination of controlled vocabulary and free text based on the search strategy for MEDLINE using key words: 'mandible', 'mandibular', 'foramen', 'anatomy', 'embryology', 'anthropology', and 'mental'. The reference lists of all the relevant studies and existing reviews were screened for additional relevant publications. Basing on relevant manuscripts, this short review about the anatomy, embryology and anthropology of the mandible and the mandibular foramen was written.

  1. Endoscopic endonasal approach for craniopharyngioma: the importance of the relationship between pituitary stalk and tumor. (United States)

    Dho, Yun-Sik; Kim, Yong Hwy; Se, Young-Bem; Han, Doo Hee; Kim, Jung Hee; Park, Chul-Kee; Wang, Kyu-Chang; Kim, Dong Gyu


    OBJECTIVE The endoscopic endonasal approach (EEA) is commonly used for the treatment of craniopharyngioma; therefore, it is essential to analyze outcomes in order to understand the benefits and drawbacks. The goal of this paper was to evaluate the clinical features and outcomes associated with this treatment approach. METHODS From July 2010 to March 2016, 82 adult craniopharyngioma patients underwent an EEA at the authors' institution. Of these cases, intraoperative records and immediate postoperative MR images were available for 68 patients. The patients underwent systemized endocrinological evaluation. Eighteen of 68 patients who underwent EEA for recurrence or regrowth of residual lesions after previous surgical management were excluded in the analysis of the anatomical tumor classification. The authors retrospectively analyzed preoperative clinical features and previous anatomical classifications, focusing on the relationship of the pituitary stalk and tumor, to determine predictive factors for the clinical outcome, such as the extent of resection, visual function, endocrinological function, recurrence rate, and complications. RESULTS The mean tumor size was 2.5 cm (3.1 cm for primary tumors and 1.9 cm for recurrent lesions). Gross-total resection (GTR) was achieved in 62 (91.1%) patients (48 [96.0%] patients with primary tumors and 14 [77.8%] patients with recurrent tumors). The rate of GTR was higher in the primary group than in the group with recurrence (p = 0.038). The overall pre- and postoperative visual impairment scale (VIS) scores were 40.8 and 22.1, respectively (50.9 and 14.3 in the primary group and 30.7 and 29.9 in patients with recurrence, respectively). The improvement rate in VIS score was higher in the primary group than in the recurrent group (p = 0.001). Endocrinological function was improved in 4 patients (5.9%) and deteriorated in 32 of 68 patients (47.1%). Tumor invasion into the center of the pituitary stalk affected the postoperative

  2. Normal feline brain: clinical anatomy using magnetic resonance imaging. (United States)

    Mogicato, G; Conchou, F; Layssol-Lamour, C; Raharison, F; Sautet, J


    The purpose of this study was to provide a clinical anatomy atlas of the feline brain using magnetic resonance imaging (MRI). Brains of twelve normal cats were imaged using a 1.5 T magnetic resonance unit and an inversion/recovery sequence (T1). Fourteen relevant MRI sections were chosen in transverse, dorsal, median and sagittal planes. Anatomic structures were identified and labelled using anatomical texts and Nomina Anatomica Veterinaria, sectioned specimen heads, and previously published articles. The MRI sections were stained according to the major embryological and anatomical subdivisions of the brain. The relevant anatomical structures seen on MRI will assist clinicians to better understand MR images and to relate this neuro-anatomy to clinical signs. © 2011 Blackwell Verlag GmbH.

  3. Building foundations for transcatheter intervascular anastomoses: 3D anatomy of the great vessels in large experimental animals

    NARCIS (Netherlands)

    Sizarov, Aleksander; de Bakker, Bernadette S.; Klein, Karina; Ohlerth, Stefanie


    To provide comprehensive illustrations of anatomy of the relevant vessels in large experimental animals in an interactive format as preparation for developing an effective and safe transcatheter technique of aortopulmonary and bidirectional cavopulmonary intervascular anastomoses. Computed

  4. Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications

    Directory of Open Access Journals (Sweden)

    Edson Rocha Constantino


    Full Text Available ABSTRACT Objective In this study, we investigate our institutional experience of patients who underwent endoscopic endonasal transsphenoidal approach for treatment of large and giant pituitary adenomas emphasizing the surgical results and approach-related complications. Method The authors reviewed 28 consecutive patients who underwent surgery between March, 2010 and March, 2014. Results The mean preoperative tumor diameter was 4.6 cm. Gross-total resection was achieved in 14.3%, near-total in 10.7%, subtotal in 39.3%, and partial in 35.7%. Nine patients experienced improvement in visual acuity, while one patient worsened. The most common complications were transient diabetes insipidus (53%, new pituitary deficit (35.7%, endonasal adhesions (21.4%, and cerebrospinal fluid leak (17.8%. Surgical mortality was 7.1%. Conclusions Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for large or giant pituitary adenomas, which results in high rates of surgical decompression of cerebrovascular structures.

  5. Urgent Optic Nerve Decompression via an Endoscopic Endonasal Transsphenoidal Approach for Craniopharyngioma in a 12-Month-Old Infant: A Case Report. (United States)

    Shibata, Teishiki; Tanikawa, Motoki; Sakata, Tomohiro; Mase, Mitsuhito


    Craniopharyngiomas are benign tumors and account for approximately 5.6-13% of all intracranial tumors in children. Diagnosis of pediatric craniopharyngioma is often delayed until the tumor becomes relatively large and manifests severe visual and/or endocrine disturbance. Endoscopic endonasal approaches have recently been introduced to surgery for craniopharyngioma. These techniques, however, have rarely been utilized in patients affected with craniopharyngioma as young as 1 year old. This report documents a 12-month-old male infant with sellar craniopharyngioma who presented with acute total vision loss. To increase the chances of visual recovery, an endoscopic endonasal optic nerve decompression was performed as an urgent procedure. After decompression, which resulted in improvement of his visual disturbance, gross total resection of the tumor was undertaken through an anterior interhemispheric approach at a later date. Tumor mass reduction through an endoscopic endonasal transsphenoidal approach followed by secondary radical total resection under craniotomy was considered to be useful in cases such as this when urgent optic nerve decompression is required. © 2018 S. Karger AG, Basel.

  6. Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture

    Directory of Open Access Journals (Sweden)

    Iacoangeli M


    Full Text Available Maurizio Iacoangeli,1 Alessandro Di Rienzo,1 Massimo Re,2 Lorenzo Alvaro,1 Niccolò Nocchi,1 Maurizio Gladi,1 Maurizio De Nicola,3 Massimo Scerrati11Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy; 2Department of Ear, Nose, and Throat Surgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy; 3Department of Radiology, Interventional Radiology Section, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Giant cell tumors (GCTs are primary bone neoplasms that rarely involve the skull base. These lesions are usually locally aggressive and require complete removal, including the surrounding apparently healthy bone, to provide the best chance of cure. GCTs, as well as other lesions located in the clivus, can nowadays be treated by a minimally invasive fully endoscopic extended endonasal approach. This approach ensures a more direct route to the craniovertebral junction than other possible approaches (transfacial, extended lateral, and posterolateral approaches. The case reported is a clival GCT operated on by an extended endonasal approach that provides another contribution on how to address one of the most feared complications attributed to this approach: a massive bleed due to an internal carotid artery injury.Keywords: clival giant cell tumor, endoscopic endonasal approach, internal carotid artery injury, minimally invasive surgery

  7. Den gode argumentations anatomi

    DEFF Research Database (Denmark)

    Kock, Christian Erik J


    God argumentation har tre dimensioner: Den er faktuelt retvisende, den er relevant, og den er vægtig. Desværre slipper politikerne ofte af sted med mangelfuld argumentation fordi de forklæder den godt. Derfor får du her de vigtigste redskaber til at spotte uskikkene i politisk argumentation...

  8. Coronary artery anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Malago, Roberto; Pezzato, Andrea; Barbiani, Camilla; Alfonsi, Ugolino; Nicoli, Lisa; Caliari, Giuliana; Pozzi Mucelli, Roberto [Policlinico G.B. Rossi, University of Verona, Department of Radiology, Verona (Italy)


    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

  9. [Imaging anatomy of cranial nerves]. (United States)

    Hermier, M; Leal, P R L; Salaris, S F; Froment, J-C; Sindou, M


    Knowledge of the anatomy of the cranial nerves is mandatory for optimal radiological exploration and interpretation of the images in normal and pathological conditions. CT is the method of choice for the study of the skull base and its foramina. MRI explores the cranial nerves and their vascular relationships precisely. Because of their small size, it is essential to obtain images with high spatial resolution. The MRI sequences optimize contrast between nerves and surrounding structures (cerebrospinal fluid, fat, bone structures and vessels). This chapter discusses the radiological anatomy of the cranial nerves.

  10. Pocket atlas of radiographic anatomy

    International Nuclear Information System (INIS)

    Moeller, T.B.; Reif, E.; Stark, P.


    The 'Pocket Atlas of Radiographic Anatomy' presents 170 radiographs of the various body regions of adults, showing only the normal radiographic anatomy. Each radiograph is supplemented on the opposite page by a drawing of the particular body region. There is no commenting text, but the drawings are provided with captions in English. The atlas is a useful guide for interpreting radiographs. The pictures are arranged in chapters entitled as follows: Skeletal Imaging (skull, spine, upper extremity), lower extremity; Miscellaneous Plain Films (chest, mammogram, trachea, lung tomograms); Contrast Examinations (gastrointestinal tract, intravenous contrast examinations, arthrography, angiography); Special Examinations (myelograms, lymphangiograms, bronchograms, sialograms). (UWA). 348 figs [de

  11. External and internal anatomy of mandibular molars. (United States)

    Rocha, L F; Sousa Neto, M D; Fidel, S R; da Costa, W F; Pécora, J D


    The external and internal anatomy of 628 extracted, mandibular first and second molars was studied. The external anatomy was studied by measuring each tooth and by observing the direction of the root curvatures from the facial surface. The internal anatomy of the pulp cavity was studied by a method of making the teeth translucent.

  12. 3D virtual table in anatomy education

    DEFF Research Database (Denmark)

    Dahl, Mads Ronald; Simonsen, Eivind Ortind

    The ‘Anatomage’ is a 3D virtual human anatomy table, with touchscreen functionality, where it is possible to upload CT-scans and digital. Learning the human anatomy terminology requires time, a very good memory, anatomy atlas, books and lectures. Learning the 3 dimensional structure, connections...

  13. Anatomy of the trigeminal nerve

    NARCIS (Netherlands)

    van Eijden, T.M.G.J.; Langenbach, G.E.J.; Baart, J.A.; Brand, H.S.


    The trigeminal nerve is the fifth cranial nerve (n. V), which plays an important role in the innervation of the head and neck area, together with other cranial and spinal nerves. Knowledge of the nerve’s anatomy is very important for the correct application of local anaesthetics.


    African Journals Online (AJOL)


    Aug 8, 2005 ... Learning anatomy through the dissected ... practice. Sushruta was the first person who had established the ... graduate had to obtain the permission of the ... importance to neuroembryology in the Sarira- .... Faculty of the History of Medicine and Pharmacy, and held at the Royal College of Physicians.

  15. Soul Anatomy: A virtual cadaver

    Directory of Open Access Journals (Sweden)

    Moaz Bambi


    Full Text Available In the traditional science of medicine and medical education, teaching human anatomy in the class has always been done using human cadavers. Not only does this violate human sanctity, but according to our research, it is not adequate to provide students with the alleged educational value that it is supposed to deliver. It is very cumbersome to organise all the aspects of cadaver care. Cadavers are also very limited when it comes to controlling their structures and any benefit is almost completely altered the first time the cadaver is used (dissected, and ironically, it is very weak at delivering actual real-life scenarios of a human body to students. Virtual anatomy has been a promising solution that many are counting on. But even today, we have not found a complete solution that combines all the benefits of using human cadavers and those introduced by its technical counterparts. "Soul Anatomy" aims to do just that. It brings the best of all worlds, from a natural intuitive control system, life-like feel of organs, precise accuracy in moving and controlling bodily structures, to the smallest details of being able to show medical information overlays from various medical databases connected to the internet; thus making use of technology in teaching human anatomy by providing a modern learning experience.

  16. DAGAL: Detailed Anatomy of Galaxies (United States)

    Knapen, Johan H.


    The current IAU Symposium is closely connected to the EU-funded network DAGAL (Detailed Anatomy of Galaxies), with the final annual network meeting of DAGAL being at the core of this international symposium. In this short paper, we give an overview of DAGAL, its training activities, and some of the scientific advances that have been made under its umbrella.

  17. Stem anatomy variation in cottonwood (United States)

    A.N. Foulger; J. Hacskaylo


    Investigations of mineral nutrient-tree growth relationships have dealt mainly with associations involving foliage composition, root formation, or volume production of wood. Few studies have been concerned with changes in wood anatomy associated with element deficiency. In 1949 Davis reported that calcium deficiency was accompanied by a reduction of primary tissue and...

  18. [Imaging evaluation on adaptability of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis]. (United States)

    Shi, Youxing; Tang, Kanglai; Yuan, Chengsong; Tao, Xu; Wang, Huaqing; Chen, Bo; Guo, Yupeng


    Modern shoulder prosthesis has evolved through four generations. And the fourth generation technology has a core three-dimensional design of restoring 3D reconstruction of proximal humeral anatomy. Thus a new shoulder prosthesis is developed on the basis of the technology of 3D prosthesis. Assessment of whether shoulder prosthesis can restore individualized reconstruction of proximal humeral anatomy is based on the adaptability of proximal humeral anatomy. To evaluate the adaptability of proximal humeral anatomy through measuring the parameters of proximal humeral anatomy after shoulder replacement with individualized shoulder prosthesis and compare with normal data. The parameters of proximal humeral anatomy were analyzed and evaluated for a total of 12 cases undergoing shoulder replacement with individualized shoulder prosthesis. The relevant anatomical parameters included neck-shaft angle (NSA), retroversion angle (RA), humeral head height (HH) and humeral head diameter (HD). And the anatomical parameters were compared with the data from normal side. All underwent shoulder replacement with individualized shoulder prosthesis. The postoperative parameters of proximal humeral anatomy were compared with those of normal side. And the difference of NSA was 0.05). Individualized shoulder prosthesis has excellent adaptability to shoulder. All core parameters are freely adjustable and specification models may be optimized. With matching tools, individualized shoulder prosthesis improves the accuracy and reliability in shoulder replacement.

  19. Anatomy of Teaching Anatomy: Do Prosected Cross Sections Improve Students Understanding of Spatial and Radiological Anatomy?

    Directory of Open Access Journals (Sweden)

    L. B. Samarakoon


    Full Text Available Introduction. Cadaveric dissections and prosections have traditionally been part of undergraduate medical teaching. Materials and Methods. Hundred and fifty-nine first-year students in the Faculty of Medicine, University of Colombo, were invited to participate in the above study. Students were randomly allocated to two age and gender matched groups. Both groups were exposed to identical series of lectures regarding anatomy of the abdomen and conventional cadaveric prosections of the abdomen. The test group (n=77, 48.4% was also exposed to cadaveric cross-sectional slices of the abdomen to which the control group (n=82, 51.6% was blinded. At the end of the teaching session both groups were assessed by using their performance in a timed multiple choice question paper as well as ability to identify structures in abdominal CT films. Results. Scores for spatial and radiological anatomy were significantly higher among the test group when compared with the control group (P<0.05, CI 95%. Majority of the students in both control and test groups agreed that cadaveric cross section may be useful for them to understand spatial and radiological anatomy. Conclusion. Introduction of cadaveric cross-sectional prosections may help students to understand spatial and radiological anatomy better.

  20. Classic versus millennial medical lab anatomy. (United States)

    Benninger, Brion; Matsler, Nik; Delamarter, Taylor


    This study investigated the integration, implementation, and use of cadaver dissection, hospital radiology modalities, surgical tools, and AV technology during a 12-week contemporary anatomy course suggesting a millennial laboratory. The teaching of anatomy has undergone the greatest fluctuation of any of the basic sciences during the past 100 years in order to make room for the meteoric rise in molecular sciences. Classically, anatomy consisted of a 2-year methodical, horizontal, anatomy course; anatomy has now morphed into a 12-week accelerated course in a vertical curriculum, at most institutions. Surface and radiological anatomy is the language for all clinicians regardless of specialty. The objective of this study was to investigate whether integration of full-body dissection anatomy and modern hospital technology, during the anatomy laboratory, could be accomplished in a 12-week anatomy course. Literature search was conducted on anatomy text, journals, and websites regarding contemporary hospital technology integrating multiple image mediums of 37 embalmed cadavers, surgical suite tools and technology, and audio/visual technology. Surgical and radiology professionals were contracted to teach during the anatomy laboratory. Literature search revealed no contemporary studies integrating full-body dissection with hospital technology and behavior. About 37 cadavers were successfully imaged with roentograms, CT, and MRI scans. Students were in favor of the dynamic laboratory consisting of multiple activity sessions occurring simultaneously. Objectively, examination scores proved to be a positive outcome and, subjectively, feedback from students was overwhelmingly positive. Despite the surging molecular based sciences consuming much of the curricula, full-body dissection anatomy is irreplaceable regarding both surface and architectural, radiological anatomy. Radiology should not be a small adjunct to understand full-body dissection, but rather, full-body dissection

  1. Dancers' Perceived and Actual Knowledge of Anatomy. (United States)

    Kotler, Dana H; Lynch, Meaghan; Cushman, Daniel; Hu, Jason; Garner, Jocelyn


    Dancers are highly susceptible to musculoskeletal injuries and frequently require interaction with medical professionals. While many dancers have a finely tuned awareness of their bodies, their knowledge of the fundamentals of human anatomy is not uniform. There is a paucity of literature on the benefits of human anatomy education in dancers, though it seems intuitive that there should be a relationship. The purpose of this study was to assess dancers' perceived and actual knowledge of basic musculoskeletal anatomy and its relationship to function. Adult dancers at the undergraduate, pre-professional, and professional levels were surveyed through an anonymous online questionnaire. Questions included demographic information, dance techniques studied, anatomy training, and injury history. Subjects rated their perceived knowledge of anatomy and were tested with 15 multiple-choice questions on basic musculoskeletal anatomy. Four hundred seventy-five surveys were completed. Ordinal regression showed a correlation of perceived to actual knowledge of anatomy (p < 0.001). Factors that correlated with increases in both perceived and actual knowledge of anatomy included having taken an anatomy course of any type (p < 0.001) and increased age (p ≤ 0.001). Years of dance training and professional dancer status both significantly correlated with increased knowledge of anatomy (p < 0.001) but not perceived knowledge. Chi-square analysis showed that dancers with training in either modern or jazz dance had a significantly higher perceived, but not actual, knowledge when compared to those without training in those styles of dance (p < 0.001 and p = 0.011, respectively). In conclusion, dancers generally scored well on questions pertaining to basic musculoskeletal anatomy, and their perception correlated with their actual knowledge of anatomy. Factors that contribute to dancers' knowledge of anatomy include age, years of experience, professional dancer status, and anatomy training.

  2. Anatomy of a Jam (United States)

    Tang, Junyao; Sagdighpour, Sepehr; Behringer, Robert


    Flow in a hopper is both a fertile testing ground for understanding models for granular flow and industrially highly relevant. However, the formation of arches in the hopper opening, which halts the hopper flow unpredictably, is still poorly understood. In this work, we conduct a two-dimension hopper experiments, using photoelastic particles, and characterize these experiments in terms of a statistical model that considers the probability of jamming. The distribution of the hopper flow times exhibits an exponential decay, which shows the existence of a characteristic ``mean flow time.'' We then conduct further experiments to examine the connection between the mean flow time, the hopper geometry, the local density, and geometric structures and forces at the particle scale.

  3. New insights into dinosaur jaw muscle anatomy. (United States)

    Holliday, Casey M


    Jaw muscles are key components of the head and critical to testing hypotheses of soft-tissue homology, skull function, and evolution. Dinosaurs evolved an extraordinary diversity of cranial forms adapted to a variety of feeding behaviors. However, disparate evolutionary transformations in head shape and function among dinosaurs and their living relatives, birds and crocodylians, impair straightforward reconstructions of muscles, and other important cephalic soft tissues. This study presents the osteological correlates and inferred soft tissue anatomy of the jaw muscles and relevant neurovasculature in the temporal region of the dinosaur head. Hypotheses of jaw muscle homology were tested across a broad range archosaur and sauropsid taxa to more accurately infer muscle attachments in the adductor chambers of non-avian dinosaurs. Many dinosaurs likely possessed m. levator pterygoideus, a trait shared with lepidosaurs but not extant archosaurs. Several major clades of dinosaurs (e.g., Ornithopoda, Ceratopsidae, Sauropoda) eliminated the epipterygoid, thus impacting interpretations of m. pseudotemporalis profundus. M. pseudotemporalis superficialis most likely attached to the caudoventral surface of the laterosphenoid, a trait shared with extant archosaurs. Although mm. adductor mandibulae externus profundus and medialis likely attached to the caudal half of the dorsotemporal fossa and coronoid process, clear osteological correlates separating the individual bellies are rare. Most dinosaur clades possess osteological correlates indicative of a pterygoideus ventralis muscle that attaches to the lateral surface of the mandible, although the muscle may have extended as far as the jugal in some taxa (e.g., hadrosaurs, tyrannosaurs). The cranial and mandibular attachments of mm adductor mandibulae externus superficialis and adductor mandibulae posterior were consistent across all taxa studied. These new data greatly increase the interpretive resolution of head anatomy in

  4. Endoscopic endonasal skull base surgery: advantages, limitations, and our techniques to overcome cerebrospinal fluid leakage: technical note. (United States)

    Ishii, Yudo; Tahara, Shigeyuki; Teramoto, Akira; Morita, Akio


    In recent years, resections of midline skull base tumors have been conducted using endoscopic endonasal skull base (EESB) approaches. Nevertheless, many surgeons reported that cerebrospinal fluid (CSF) leakage is still a major complication of these approaches. Here, we report the results of our 42 EESB surgeries and discuss the advantages and limits of this approach for resecting various types of tumors, and also report our technique to overcome CSF leakage. All 42 cases involved midline skull base tumors resected using the EESB technique. Dural incisions were closed using nasoseptal flaps and fascia patch inlay sutures. Total removal of the tumor was accomplished in seven pituitary adenomas (33.3%), five craniopharyngiomas (62.5%), five tuberculum sellae meningiomas (83.3%), three clival chordomas (100%), and one suprasellar ependymoma. Residual regions included the cavernous sinus, the outside of the intracranial part of the internal carotid artery, the lower lateral part of the posterior clivus, and the posterior pituitary stalk. Overall incidence of CSF leakage was 7.1%. Even though the versatility of the approach is limited, EESB surgery has many advantages compared to the transcranial approach for managing mid-line skull base lesions. To avoid CSF leakage, surgeons should have skills and techniques for complete closure, including use of the nasoseptal flap and fascia patch inlay techniques.

  5. Value of free-run electromyographic monitoring of lower cranial nerves in endoscopic endonasal approach to skull base surgeries. (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey


    Objective The main objective of this study was to evaluate the value of free-run electromyography (f-EMG) monitoring of cranial nerves (CNs) VII, IX, X, XI, and XII in skull base surgeries performed using endoscopic endonasal approach (EEA) to reduce iatrogenic CN deficits. Design We retrospectively identified 73 patients out of 990 patients who had EEA in our institution who had at least one CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as group I and those who did not as group II. Results We monitored a total of 342 CNs. A total of 62 nerves had SG f-EMG activity including CN VII = 18, CN IX = 16, CN X = 13, CN XI = 5, and CN XII = 10. No nerve deficit was found in the nerves that had significant activity during procedure. A total of five nerve deficits including (CN IX = 1, CN X = 2, CN XII = 2) were observed in the group that did not display SG f-EMG activity during surgery. Conclusions f-EMG seems highly sensitive to surgical manipulations and in locating CNs. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of lower CNs during EEA procedures need to be done with both f-EMG and triggered EMG.

  6. Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base. (United States)

    Thirumala, Parthasarathy D; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-Fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J; Balzer, Jeffrey


    Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits. Design We retrospectively identified 200 patients out of 990 who had at least one EOCN monitored during EES. We further separated patients into groups according to the specific CN monitored. In each CN group, we classified patients who had significant (SG) f-EMG activity as Group I and those who did not as Group II. Results A total of 696 EOCNs were monitored. The number of muscles supplied by EOCNs that had SG f-EMG activity was 88, including CN III = 46, CN IV = 21, and CN VI = 21. There were two deficits involving CN VI in patients who had SG f-EMG activity during surgery. There were 14 deficits observed, including CN III = 3, CN IV = 2, and CN VI = 9 in patients who did not have SG f-EMG activity during surgery. Conclusions f-EMG monitoring of EOCN during EES can be useful in identifying the location of the nerve. It seems to have limited value in predicting postoperative neurological deficits. Future studies to evaluate the EMG of EOCN during EES need to be done with both f-EMG and triggered EMG.

  7. Clinically related anatomy for physicists

    International Nuclear Information System (INIS)

    Wright, A.E.; Boyer, A.L.


    With the advent of CT and MR imaging, delineation of malignancies and the shaping of radiation treatment fields have become much more precise. Treatment planning in more than one transverse plane is more widely practiced as the use of sophisticated computers grow. These developments emphasize the need for the physicist to have a basic knowledge of human anatomy. This course is designed to familiarize the clinical physicist with the gross anatomy and topographic landmarks used by the physician in planning three-dimensional radiation treatment volumes. The significance of the various anatomic structures and their related lymphatics in the spread of disease is discussed. Emphasis is placed on disease entities that pose particular problems due to overlying or nearby healthy structures at risk

  8. Ecological anatomy of ferns fronds

    Directory of Open Access Journals (Sweden)

    Nina M. Derzhavina


    Full Text Available Structural types of frond anatomy are distinguished on the basis of investigation of 30 species of homosporous ferns and with regard for literature: hydromorphic, hygromorphic, mesomorphic, subxeromorphic, and subsucculent (cryptic succulent. Following frond traits are of highest adaptive value: their area and thickness, type of mesophyll, dry weight of an area unit – specific superficial density, cellular volume, and number of cells per unit of frond area.

  9. Magkänslans anatomi

    DEFF Research Database (Denmark)

    Ahlström, Kristoffer

    Varför dog 1500 personer i onödan i biltrafiken efter den 11 september 2001? Vad har FBI-agenter gemensamt med barn till alkoholister? Och vad fick författaren George Orwell att börja utöva svart magi? Magkänslans anatomi är en fascinerande kartläggning av de psykologiska mekanismer som ligger...

  10. Roentgenologic anatomy of dog arteries

    International Nuclear Information System (INIS)

    Rehak, J.; Hlava, A.; Bavor, J.


    In catheter methods in dogs the knowledge of the roentgenologic anatomy of blood vessels is very important. Because of lacking in such roentgenologic anatomic schemes 5 arterial schemes in relation to the skeleton were elaborated. The system of arteries was divided into five regions: chest, head and neck in submentooccipital and lateral projection, abdomen and pelvis. The schemes comprise 75 of the main arteries of the dog. (author)


    DEFF Research Database (Denmark)


    A system and method for visualization of subsurface anatomy includes obtaining a first image from a first camera and a second image from a second camera or a second channel of the first camera, where the first and second images contain shared anatomical structures. The second camera and the secon....... A visual interface displays the registered visualization of the first and second images. The system and method are particularly useful for imaging during minimally invasive surgery, such as robotic surgery....

  12. Anatomy of the infant head

    International Nuclear Information System (INIS)

    Bosma, J.F.


    This text is mainly an atlas of illustration representing the dissection of the head and upper neck of the infant. It was prepared by the author over a 20-year period. The commentary compares the anatomy of the near-term infant with that of a younger fetus, child, and adult. As the author indicates, the dearth of anatomic information about postnatal anatomic changes represents a considerable handicap to those imaging infants. In part 1 of the book, anatomy is related to physiologic performance involving the pharynx, larynx, and mouth. Sequential topics involve the regional anatomy of the head (excluding the brain), the skeleton of the cranium, the nose, orbit, mouth, larynx, pharynx, and ear. To facilitate use of this text as a reference, the illustrations and text on individual organs are considered separately (i.e., the nose, the orbit, the eye, the mouth, the larynx, the pharynx, and the ear). Each part concerned with a separate organ includes materials from the regional illustrations contained in part 2 and from the skeleton, which is treated in part 3. Also included in a summary of the embryologic and fetal development of the organ

  13. Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region. (United States)

    Mason, Eric; Van Rompaey, Jason; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo


    Advances in the field of skull base surgery aim to maximize anatomical exposure while minimizing patient morbidity. The petroclival region of the skull base presents numerous challenges for surgical access due to the complex anatomy. The transcochlear approach to the region provides adequate access; however, the resection involved sacrifices hearing and results in at least a grade 3 facial palsy. An endoscopic endonasal approach could potentially avoid negative patient outcomes while providing a desirable surgical window in a select patient population. Cadaveric study. Endoscopic access to the petroclival region was achieved through an endonasal approach. For comparison, a transcochlear approach to the clivus was performed. Different facets of the dissections, such as bone removal volume and exposed surface area, were computed using computed tomography analysis. The endoscopic endonasal approach provided a sufficient corridor to the petroclival region with significantly less bone removal and nearly equivalent exposure of the surgical target, thus facilitating the identification of the relevant anatomy. The lateral approach allowed for better exposure from a posterolateral direction until the inferior petrosal sinus; however, the endonasal approach avoided labyrinthine/cochlear destruction and facial nerve manipulation while providing an anteromedial viewpoint. The endonasal approach also avoided external incisions and cosmetic deficits. The endonasal approach required significant sinonasal resection. Endoscopic access to the petroclival region is a feasible approach. It potentially avoids hearing loss, facial nerve manipulation, and cosmetic damage. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Anatomy of Cyberterrorism: Is America Vulnerable?

    National Research Council Canada - National Science Library

    Ashley, Bradley


    ... it means. It also presents a model to understand the anatomy of cyberterrorism, describing some real-world cyber events, assesses cyberterrorist capabilities, and finally makes specific recommendations...

  15. Remediation Trends in an Undergraduate Anatomy Course and Assessment of an Anatomy Supplemental Study Skills Course (United States)

    Schutte, Audra Faye


    Anatomy A215: Basic Human Anatomy (Anat A215) is an undergraduate human anatomy course at Indiana University Bloomington (IUB) that serves as a requirement for many degree programs at IUB. The difficulty of the course, coupled with pressure to achieve grades for admittance into specific programs, has resulted in high remediation rates. In an…

  16. [Juan Valverde de Amusco c. 1525-1588 and his vocation for anatomy in the Hispano-Italian Renaissance]. (United States)

    Hernández-Mansilla, José Miguel


    The XVIth century witnessed a glorious period in the progress of some of the basic medical sciences among which anatomy stands out. One of the well-known figures involved in the development of this subject was Juan Valverde de Amusco, a notable Spanish scientist. This research shows the most relevant data currently known on his life, sociocultural environment and his celebrated treaty on anatomy titled: "Historia de la composición del cuerpo humano". (History of the human body).

  17. Anatomy and Surgical Approaches to the Rabbit Nasal Septum. (United States)

    Badran, Karam W; Chang, John C; Kuan, Edward C; Wong, Brian J F


    The rabbit is the primary animal model used to investigate aspects of nasal surgery. Although several studies have used this model, none has provided a comprehensive analysis of the surgical anatomy and techniques used to gain access to the rabbit nasal fossae and septum. To describe and optimize the surgical anatomy and approach to the rabbit nasal vault and septal cartilage. In an ex vivo animal study conducted at an academic medical center, preliminary cadaveric dissections were performed on rabbit head specimens to establish familiarity with relevant anatomy and rehearse various approaches. Live Pasteurella-free New Zealand white rabbits (3.5-4.0 kg) were used to further develop this surgical technique developed here. Access of the nasal vault was gained through a midline nasal dorsum incision and creation of an osteoplastic flap with a drill. Submucosal resection was performed with preservation of the mucoperichondrium. All rabbits were monitored daily for 4 weeks in the postoperative period for signs of infection, pain, and complications. The study was conducted from June 1, 2014, to December 1, 2014. Surgical anatomy and techniques used to gain access to the rabbit nasal vault and harvest septal cartilage. Four Pasteurella-free New Zealand white rabbits (Western Organ Rabbit Co), ranging in age from 9 to 12 months and weighing between 3.5 and 4.0 kg, were used in this study. Initial dissections demonstrated the feasibility of harvesting septal cartilage while preserving the mucoperichondrial envelope. Access to the nasal vault through this 3-osteotomy approach allowed for maximal exposure to the nasal cavity bilaterally while maintaining the integrity of the mucoperichondrium following septal cartilage harvest. The maximum amount of bulk, en bloc, cartilage harvested was 1.0 × 2.5 cm. Following surgical dissection, all animals maintained adequate airway patency and support to midface structures. Furthermore, all specimens preserved the integrity of the

  18. Venous chest anatomy: clinical implications

    International Nuclear Information System (INIS)

    Chasen, M.H.; Charnsangavej, C.


    This article provides a practical approach to the clinical implications and importance of understanding the collateral venous anatomy of the thorax. Routine radiography, conventional venography, computed tomography (CT), and magnetic resonance (MR) imaging studies provide correlative anatomic models for the demonstration of how interconnecting collateral vascular networks within the thorax maintain venous stability at all times. Five major systems comprise the collateral venous network of the thorax ( Fig. 1 ). These include the paravertebral, azygos-hemiazygos, internal mammary, lateral thoracic, and anterior jugular venous systems (AJVS). The five systems are presented in the following sequence: (a) a brief introduction to the importance of catheter position and malposition in understanding access to the thoracic venous system, (b) the anatomy of the azygos-hemiazygos systems and their relationship with the paravertebral plexus, (c) the importance of the AJVS, (d) 'loop' concepts interconnecting the internal mammary and azygos-hemiazygos systems by means of the lateral thoracic and intercostal veins, and (e) the interconnecting venous networks on the thoracic side of the thoracoabdominal junction. Certain aspects of the venous anatomy of the thorax will not be discussed in this chapter and include (a) the intra-abdominal anastomoses between the superior and inferior vena cavae (IVC) via the internal mammary, lateral thoracic, and azygos-hemiazygos systems (beyond the scope of this article), (b) potential collateral vessels involving vertebral, parascapular, thyroidal, thymic, and other smaller veins that might anastomose with the major systems, and (c) anatomic variants and pitfalls that may mimic pathologic conditions (space limitations). (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  19. SnapAnatomy, a computer-based interactive tool for independent learning of human anatomy. (United States)

    Yip, George W; Rajendran, Kanagasuntheram


    Computer-aided instruction materials are becoming increasing popular in medical education and particularly in the teaching of human anatomy. This paper describes SnapAnatomy, a new interactive program that the authors designed for independent learning of anatomy. SnapAnatomy is primarily tailored for the beginner student to encourage the learning of anatomy by developing a three-dimensional visualization of human structure that is essential to applications in clinical practice and the understanding of function. The program allows the student to take apart and to accurately put together body components in an interactive, self-paced and variable manner to achieve the learning outcome.

  20. Gross anatomy of network security (United States)

    Siu, Thomas J.


    Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

  1. ZBrush Digital Sculpting Human Anatomy

    CERN Document Server

    Spencer, Scott


    Taking into account that many of today?s digital artists?particularly 3D character animators?lack foundational artistic instruction, this book teaches anatomy in a coherent and succinct style. A clear writing style explains how to sculpt an accurate human figure, starting with the skeleton and working out to muscle, fat, and skin. Insightful explanations enable you to quickly and easily create and design characters that can be used in film, game, or print, and allows you to gain a strong understanding of the foundational artistic concepts.

  2. Imaging Evaluation of the Location and Fenestration of Sellar Floor during Endonasal Transsphenoidal Surgery in Patients with Pituitary Adenomas. (United States)

    Wang, Shousen; Qin, Yong; Xiao, Deyong; Wu, Zhifeng; Wei, Liangfeng


    To evaluate the clinical value of three-dimensional (3D) CT reconstruction of the sphenoidal sinus separation in localizing sellar floor during endonasal transsphenoidal surgery, and determine the size and location of sellar floor fenestration. After exclusion,51 patients were eligible for study inclusion. A pre-operative CT scan of the paranasal sinus and CT scan and MRI of the pituitary gland were obtained. Sphenoidal sinus separation was reconstructed using Mimics 15.0 software and the quantity, shape, and orientation were observed and compared with intra-operative data, the purpose of which was to guide the localization of sellar floor. Anatomic variation of the sphenoidal sinus and adjacent structures, tumor and sella turcica morphology, minimal distance between the cavernous segment of the internal carotid artery(CSICA) bilaterally, and the shortest distance from the midline were measured. Based upon the shape of the sphenoidal sinus separation, sellar floor was accurately localized in all cases. Intra-operative sphenoidal sinus separation was consistent with pre-operative 3D CT reconstruction images. The sellar floor was extremely small in two patients, and insufficient fenestration of the sellar floor negatively affected tumor resection. Pre-operative 3D CT reconstruction is helpful for accurate and rapid localization of the saddle floor. The anatomic variation of sphenoidal sinus and adjacent structures, the characteristics of tumor and Sella, the minimum distance between bilateral CSICA and the shortest distance from the midline are helpful for the establishment of individualized Sellar bottom fenestration. Copyright © 2018. Published by Elsevier Inc.

  3. Endoscopic endonasal transsphenoidal surgery for patients aged over 80 years with pituitary adenomas: Surgical and follow-up results. (United States)

    Fujimoto, Kenji; Yano, Shigetoshi; Shinojima, Naoki; Hide, Takuichiro; Kuratsu, Jun-Ichi


    With the rapid aging of the general population, the number of pituitary adenoma (PA) diagnosed in elderly patients is increasing. The aim of this study was to evaluate the efficacy of endoscopic endonasal transsphenoidal surgery (ETSS) for PA in patients aged ≥80 years. We retrospectively reviewed the medical records of all patients aged ≥80 years who underwent ETSS for PA at our hospital from January 2001 through December 2014. Treatment results were assessed by the extent of surgical removal, symptom improvement, postoperative complications, and Karnofsky performance status (KPS). The results were also compared with the surgical result of PA patients aged <80 years. Twelve patients aged ≥80 years underwent ETSS for PA. Recovery of visual function was observed in 11 patients (91.7%). Postoperative cerebrospinal fluid (CSF) leakage was observed in 3 patients. New hormonal replacement therapy was required in 2 patients. These complications had not affected patient prognosis. During the follow-up periods, deterioration of KPS was observed in 2 patients due to pneumonia or cerebral infarction. In total, 150 PA patients aged <80 years were compared with the patients aged ≥80 years. The percentage of total removal was significantly higher in the younger patient group than that in the older one (54.0% vs 16.6%, respectively; P = 0.016). Visual improvement was observed in 93.2% of the younger patient group, which was almost equal to that in the older one. ETSS is a safe and effective surgical technique in PA patients aged ≥80 years.

  4. Endoscopic Endonasal Transsphenoidal Surgery, A Reliable Method for Treating Primary and Recurrent/Residual Craniopharyngiomas: Nine Years of Experience. (United States)

    Bal, Ercan; Öge, Kamil; Berker, Mustafa


    Craniopharyngioma resection is one of the most challenging surgical procedures. Herein, we describe our extended endoscopic endonasal transsphenoidal surgery (EETS) technique, and the results of 9 years of use on primary and recurrent/residual craniopharyngiomas. This study reviewed 28 EETSs in 25 patients with craniopharyngiomas between January 2006 and September 2015. The patients were divided into 2 groups, newly diagnosed patients (group A, n = 15), and patients having residual or recurrent tumors (group B, n = 10). There was no significant difference between the groups in terms of the largest tumor diameter (P = 0.495), and all patients underwent EETS. The clinical and ophthalmologic examinations, imaging studies, endocrinologic studies, and operative findings for these cases were reviewed retrospectively. The number of gross total resections in group A was 13/15, and 7/10 in group B. Three of the patients developed postoperative cerebrospinal fluid leakage (all in group A). There were no neurovascular or ophthalmologic complications, and no meningitis or mortality was observed. There has been a notable increase in the use of EETS in the treatment of craniopharyngiomas during the last decade. Despite its increased use in the treatment of primary craniopharyngiomas, its implementation for recurrent or residual craniopharyngiomas has been viewed with suspicion. In this study, the results have been presented separately for primary and recurrent/residual craniopharyngiomas, so that the results can be compared. Overall, EETS is a reliable and successful surgical treatment method for primary and recurrent/residual craniopharyngiomas. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Endoscopic Endonasal Surgery for Remission of Cushing Disease Caused by Ectopic Intracavernous Macroadenoma: Case Report and Literature Review. (United States)

    Koutourousiou, Maria; Winstead, Welby I


    Complete surgical resection of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the gold standard of treatment of Cushing disease. Ectopic location of these adenomas is an extremely rare condition that may compromise the diagnosis and surgical success. We present the first case of an ectopic intracavernous ACTH-secreting macroadenoma totally resected with endoscopic endonasal surgery (EES). A 36-year-old woman presented with Cushing syndrome. Increased ACTH, serum cortisol, and free urine cortisol levels were identified; however, pituitary magnetic resonance imaging failed to show a pituitary tumor; instead, a parasellar lesion in the left cavernous sinus (CS) was noticed. Inferior petrosal sinus sampling showed a significant central to peripheral and lateralized left-sided ACTH gradient. The patient underwent EES. No tumor was found in the sella; however, the left CS was widely explored and a tumor was found lateral to the paraclival segment of the carotid artery. There were no complications after EES. Pathology confirmed the diagnosis of an ACTH-secreting adenoma. During the immediate postoperative course, serum cortisol levels decreased lower than 5 μg/dL. Postoperative magnetic resonance imaging showed complete tumor resection. At 20 months follow-up, the patient remained in clinical and biochemical remission of Cushing disease. Only 12 cases of ectopic intracavernous ACTH-secreting adenomas have been reported and all were microadenomas. The presence of an ectopic ACTH-secreting macroadenoma in the CS represents a surgical challenge. EES is the ideal approach for complete resection of ectopic intracavernous adenomas, allowing for a wide exploration of the CS with no surgical complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The Virtual Surgical Pelvis : Anatomy Visualization for Education and Surgical Planning

    NARCIS (Netherlands)

    Smit, N.N.


    This thesis deals with visualizing anatomical data for medical education and surgical planning purposes. To this end, we have developed a detailed virtual atlas, the Virtual Surgical Pelvis (VSP),which unifies surgically relevant knowledge on pelvic anatomy. We provide methods to share the knowledge

  7. Functional anatomy of the prostate: Implications for treatment planning

    International Nuclear Information System (INIS)

    McLaughlin, Patrick W.; Troyer, Sara; Berri, Sally; Narayana, Vrinda; Meirowitz, Amichay; Roberson, Peter L.; Montie, James


    Purpose: To summarize the functional anatomy relevant to prostate cancer treatment planning. Methods and Materials: Coronal, axial, and sagittal T2 magnetic resonance imaging (MRI) and MRI angiography were fused by mutual information and registered with computed tomography (CT) scan data sets to improve definition of zonal anatomy of the prostate and critical adjacent structures. Results: The three major prostate zones (inner, outer, and anterior fibromuscular) are visible by T2 MRI imaging. The bladder, bladder neck, and internal (preprostatic) sphincter are a continuous muscular structure and clear definition of the preprostatic sphincter is difficult by MRI. Transition zone hypertrophy may efface the bladder neck and internal sphincter. The external 'lower' sphincter is clearly visible by T2 MRI with wide variations in length. The critical erectile structures are the internal pudendal artery (defined by MRI angiogram or T2 MRI), corpus cavernosum, and neurovascular bundle. The neurovascular bundle is visible along the posterior lateral surface of the prostate on CT and MRI, but its terminal branches (cavernosal nerves) are not visible and must be defined by their relationship to the urethra within the genitourinary diaphragm. Visualization of the ejaculatory ducts within the prostate is possible on sagittal MRI. The anatomy of the prostate-rectum interface is clarified by MRI, as is the potentially important distinction of rectal muscle and rectal mucosa. Conclusion: Improved understanding of functional anatomy and imaging of the prostate and critical adjacent structures will improve prostate radiation therapy by improvement of dose and toxicity correlation, limitation of dose to critical structures, and potential improvement in post therapy quality of life

  8. How useful is YouTube in learning heart anatomy? (United States)

    Raikos, Athanasios; Waidyasekara, Pasan


    Nowadays more and more modern medical degree programs focus on self-directed and problem-based learning. That requires students to search for high quality and easy to retrieve online resources. YouTube is an emerging platform for learning human anatomy due to easy access and being a free service. The purpose of this study is to make a quantitative and qualitative analysis of the available human heart anatomy videos on YouTube. Using the search engine of the platform we searched for relevant videos using various keywords. Videos with irrelevant content, animal tissue, non-English language, no sound, duplicates, and physiology focused were excluded from further elaboration. The initial search retrieved 55,525 videos, whereas only 294 qualified for further analysis. A unique scoring system was used to assess the anatomical quality and details, general quality, and the general data for each video. Our results indicate that the human heart anatomy videos available on YouTube conveyed our anatomical criteria poorly, whereas the general quality scoring found borderline. Students should be selective when looking up on public video databases as it can prove challenging, time consuming, and the anatomical information may be misleading due to absence of content review. Anatomists and institutions are encouraged to prepare and endorse good quality material and make them available online for the students. The scoring rubric used in the study comprises a valuable tool to faculty members for quality evaluation of heart anatomy videos available on social media platforms. Copyright © 2013 American Association of Anatomists.

  9. Surgical Outcome of Endoscopic Endonasal Surgery for Non-Functional Pituitary Adenoma by a Team of Neurosurgeons and Otolaryngologists Adenoma by a Team of Neurosurgeons and Otolaryngologists. (United States)

    Kikuchi, Ryogo; Toda, Masahiro; Tomita, Toshiki; Ogawa, Kaoru; Yoshida, Kazunari


    This study aimed to assess the efficacy of endoscopic endonasal surgery, conducted by a team of neurosurgeons and otolaryngologists. We studied 40 patients who were undergoing surgery for primary non-functional pituitary adenomas with Knosp grades 1 to 3, at Keio University Hospital between 2005 and 2012. We compared the endoscopic endonasal transsphenoidal approach (team-eTSS; T-eTSS), with a microscopic transsphenoidal approach (mTSS). Analyses were conducted for differences between the two groups in tumor resection rates, operating durations, and complications from the non-functional pituitary adenomas. We also compared the heminostril and binostril approaches for T-eTSS. Tumor resection rates were higher when the surgeries were conducted by T-eTSS than mTSS. In particular, when the maximum tumor diameter was more than 25 mm, resection rates were significantly higher for T-eTSS than for mTSS. There were no unexpected complications in either group. There was no significant difference in resection rates between the heminostril and binostril approaches when T-eTSS was performed. T-eTSS is an efficacious surgical option for non-functional pituitary adenomas, particularly when the adenoma is of large size. Benefits of the heminostril approach are evident.

  10. Frontal anatomy and reaction time in Autism

    NARCIS (Netherlands)

    Schmitz, Nicole; Daly, Eileen; Murphy, Declan


    Widespread frontal lobe abnormalities, encompassing anatomy and function, are known to be implicated in Autistic Spectrum Disorders (ASD). The correlation between neurobiology and behaviour, however, is poorly understood in ASD. The aim of this study was to investigate frontal lobe anatomy and

  11. Porcine Tricuspid Valve Anatomy and Human Compatibility

    DEFF Research Database (Denmark)

    Waziri, Farhad; Lyager Nielsen, Sten; Hasenkam, J. Michael


    before clinical use. The study aim was to evaluate and compare the tricuspid valve anatomy of porcine and human hearts. METHODS: The anatomy of the tricuspid valve and the surrounding structures that affect the valve during a cardiac cycle were examined in detail in 100 fresh and 19 formalin...

  12. An introduction to human brain anatomy

    NARCIS (Netherlands)

    Forstmann, B.U.; Keuken, M.C.; Alkemade, A.; Forstmann, B.U.; Wagenmakers, E.-J.


    This tutorial chapter provides an overview of the human brain anatomy. Knowledge of brain anatomy is fundamental to our understanding of cognitive processes in health and disease; moreover, anatomical constraints are vital for neurocomputational models and can be important for psychological

  13. Design Projects in Human Anatomy & Physiology (United States)

    Polizzotto, Kristin; Ortiz, Mary T.


    Very often, some type of writing assignment is required in college entry-level Human Anatomy and Physiology courses. This assignment can be anything from an essay to a research paper on the literature, focusing on a faculty-approved topic of interest to the student. As educators who teach Human Anatomy and Physiology at an urban community college,…

  14. Journal of Experimental and Clinical Anatomy

    African Journals Online (AJOL)

    The Journal of Experimental and Clinical Anatomy accepts for publication manuscripts of high standard containing reports of original scientific research in the morphology, mechanical functioning and development of man and animals. The scope the journal embraces articles of human and comparative anatomy, embryology ...

  15. Human fetal anatomy: MR imaging. (United States)

    Weinreb, J C; Lowe, T; Cohen, J M; Kutler, M


    Twenty-four pregnant women carrying 26 fetuses (two sets of twins) were imaged with magnetic resonance (MR) imaging at 0.35 T following sonographic evaluation. Each study was retrospectively evaluated to determine which of 33 normal fetal structures were visible on the images and which imaging parameters were most useful for depicting fetal anatomy. Fetal motion degraded fetal images in all but two cases, both with oligohydramnios and in the third trimester of gestation. Nevertheless, many fetal structures were identifiable, particularly in the third trimester. Visualization of fetal anatomy improved with intravenous maternal sedation in five cases. Relatively T1-weighted images occasionally offered the advantage of less image degradation owing to fetal motion and improved contrast between different fetal structures. More T2 weighting was believed to be advantageous in one case for outlining the fetal head and in one case for delineation of the brain. In many cases, structures were similarly identifiable (though with different signal intensities) regardless of the parameters selected. The authors conclude that MR imaging of many fetal structures is currently unsatisfactory and is probably of limited value, particularly in the first and second trimesters. However, the relative frequency and detail with which the fetal head and liver can be depicted indicate that these may be areas for further investigation, and the potential utility of imaging fetal fat warrants further investigation.

  16. Anatomy of the Spinal Meninges. (United States)

    Sakka, Laurent; Gabrillargues, Jean; Coll, Guillaume


    The spinal meninges have received less attention than the cranial meninges in the literature, although several points remain debatable and poorly understood, like their phylogenesis, their development, and their interactions with the spinal cord. Their constancy among the chordates shows their crucial importance in central nervous system homeostasis and suggests a role far beyond mechanical protection of the neuraxis. This work provides an extensive study of the spinal meninges, from an overview of their phylogenesis and embryology to a descriptive and topographic anatomy with clinical implications. It examines their involvement in spinal cord development, functioning, and repair. This work is a review of the literature using PubMed as a search engine on Medline. The stages followed by the meninges along the phylogenesis could not be easily compared with their development in vertebrates for methodological aspects and convergence processes throughout evolution. The distinction between arachnoid and pia mater appeared controversial. Several points of descriptive anatomy remain debatable: the functional organization of the arterial network, and the venous and lymphatic drainages, considered differently by classical anatomic and neuroradiological approaches. Spinal meninges are involved in neurodevelopment and neurorepair producing neural stem cells and morphogens, in cerebrospinal fluid dynamics and neuraxis functioning by the synthesis of active molecules, and the elimination of waste products of central nervous system metabolism. The spinal meninges should be considered as dynamic functional formations evolving over a lifetime, with ultrastructural features and functional interactions with the neuraxis remaining not fully understood.


    Directory of Open Access Journals (Sweden)

    Kemaz A Dewangga


    Full Text Available The objective of this study is to observe the anatomical structure of horse hooves collected from the Laboratory of Anatomy FKH IPB. Twenty five hoof specimens, consisting of ten fore hooves and fifteen hind hooves were used as research materials. The external morphology such as color, angle, structure and condition of the hoof wall were described. The observation on external morphology showed that the hooves have two basic colors, black and white. Generally, all of the hoof specimens showed abnormalities in such aspect as angle, structure and condition of the wall. The structures of fore hoof and hind hoof from this study are classified into 8 categories, they are: flat foot, flared foot, knol hoef, fever rings, sand crack, club foot, contracted foot and bull nosed foot.

  18. Clinical anatomy and imaging of the cranial nerves and skull base. (United States)

    Jha, Ruchira M; Klein, Joshua P


    Evaluation of patients with cranial neuropathies requires an understanding of brainstem anatomy and nerve pathways. Advances in neuroimaging, particularly high spatial resolution magnetic resonance imaging (MRI), have enabled visualization of these tiny structures and their related pathology. This review provides an approach toward using imaging in the evaluation of cranial nerve (CN) and skull base anatomy and pathology. Because brainstem nuclei are inextricably linked to the information contained within CNs, they are briefly mentioned whenever relevant; however, a comprehensive discussion of brainstem syndromes is beyond the scope of this review. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.


    DEFF Research Database (Denmark)

    Nørgaard, Cita; Dyhrberg O'Neill, Lotte; Nielsen, Kurt Gammelgaard

    An Augmented Reality (AR) app for Hololens glasses was developed to help students learn the anatomy of the human body mediastinum. In this research project, we wanted to evaluate whether AR: strengthened the students’ self-efficacy and motivation, helped students to improve learning, and provided...... a questionnaire regarding their self-efficacy and motivation, presence in the virtual room, experiences with Hololens teaching, and how they used the quizzes. In addition, students answered a test with the same 20 questions used in the app and three additional transfer questions new to students. Finally, students......’ scores on the mediastinum questions in the exam 2 month later were collected to examine the long-term memory of content. Internal consistency was estimated for all measures. Correlations between measures were examined with a correlation matrix, and group differences were examined with one-way analysis...

  20. An atlas of radiological anatomy

    International Nuclear Information System (INIS)

    Weir, J.; Abrahams, P.


    This book contains a wealth of radiologic images of normal human anatomy; plain radiographs, contrast-enhanced radiographs, and computed tomography (CT) scans. There are 18 pages of magnetic resonance (MR) images, most on the brain and spinal cord, so that there are only two pages on MR imaging of the heart and two pages on abdominal and pelvic MR imaging. Twelve pages of ultrasound (US) images are included. This book has the radiologic image paired with an explanatory drawing; the image is on the left with a paragraph or two of text, and the drawing is on the right with legends. This book includes images of the brain and spinal cord obtained with arteriography, venography, myelography, encephalography, CT, and MR imaging

  1. Anterior ethmoid anatomy facilitates dacryocystorhinostomy. (United States)

    Blaylock, W K; Moore, C A; Linberg, J V


    The ethmoid air cell labyrinth lies adjacent to the medial orbital wall, extending even beyond the sutures of the ethmoid bone. Its anatomic relationship to the lacrimal sac fossa is important in lacrimal surgery. We evaluated computed tomographic scans of 190 orbits with normal ethmoid anatomy to define the anatomic relationship of anterior ethmoid air cells to the lacrimal sac fossa. In 93% of the orbits, the cells extended anterior to the posterior lacrimal crest, with 40% entering the frontal process of the maxilla. This anatomic relationship may be used to facilitate the osteotomy during dacryocystorhinostomy. During a 10-year period (310 cases), one of us routinely entered the anterior ethmoid air cells to initiate the osteotomy during dacryocystorhinostomy. This technique has helped to avoid lacerations of the nasal mucosa.

  2. Anatomy of the Platysma Muscle. (United States)

    Hwang, Kun; Kim, Ji Yeon; Lim, Jae Hyun


    The aim of this paper was to review the anatomy the platysma systematically.The term "platysma AND anatomy" was used to search PubMed and Scopus, producing 394 and 214 papers, respectively. After excluding 95 duplicate titles, 513 abstracts and 98 full papers were reviewed. Among these 98 papers, 83 were excluded and 5 were added. Ultimately, 20 papers were analyzed.The most common aging-related change of the platysma was shortening (70.7%), followed by thinning (25.2%). The platysma most commonly originated from the upper portion of thorax anterior to clavicle (67.7%), followed by the subcutaneous tissue of the subclavicular and acromial regions (22.6%) and pectoralis (9.7%). The platysma ascended upward and medially (68.5%) or ascended from the clavicle to the face (31.5%). The platysma most commonly inserted on the cheek skin (57.5%), followed by the cutaneous muscles around the mouth (18.6%), the mandibulocutaneous ligament or zygoma (18.6%), and the parotid fascia or periosteum of the mandible (5.3%). The platysma was most commonly innervated by the cervical branch of the facial nerve (38.2%) or the cervical branch and mandibular branch of the facial nerve (60.5%), followed by the cervical plexus (0.6%), the cervical motor nucleus (0.6%), and the glossopharyngeal nerve (0.1%). The most common action of the platysma was drawing the lips inferiorly (83.3%) or posteriorly (12.9%). Four papers classified the platysma into subtypes; however, these classification strategies used arbitrary standards.Further studies will be necessary to establish the thickness of the platysma and to characterize age-related changes of the platysma.

  3. High precision anatomy for MEG. (United States)

    Troebinger, Luzia; López, José David; Lutti, Antoine; Bradbury, David; Bestmann, Sven; Barnes, Gareth


    Precise MEG estimates of neuronal current flow are undermined by uncertain knowledge of the head location with respect to the MEG sensors. This is either due to head movements within the scanning session or systematic errors in co-registration to anatomy. Here we show how such errors can be minimized using subject-specific head-casts produced using 3D printing technology. The casts fit the scalp of the subject internally and the inside of the MEG dewar externally, reducing within session and between session head movements. Systematic errors in matching to MRI coordinate system are also reduced through the use of MRI-visible fiducial markers placed on the same cast. Bootstrap estimates of absolute co-registration error were of the order of 1mm. Estimates of relative co-registration error were <1.5mm between sessions. We corroborated these scalp based estimates by looking at the MEG data recorded over a 6month period. We found that the between session sensor variability of the subject's evoked response was of the order of the within session noise, showing no appreciable noise due to between-session movement. Simulations suggest that the between-session sensor level amplitude SNR improved by a factor of 5 over conventional strategies. We show that at this level of coregistration accuracy there is strong evidence for anatomical models based on the individual rather than canonical anatomy; but that this advantage disappears for errors of greater than 5mm. This work paves the way for source reconstruction methods which can exploit very high SNR signals and accurate anatomical models; and also significantly increases the sensitivity of longitudinal studies with MEG. © 2013. Published by Elsevier Inc. All rights reserved.

  4. High precision anatomy for MEG☆ (United States)

    Troebinger, Luzia; López, José David; Lutti, Antoine; Bradbury, David; Bestmann, Sven; Barnes, Gareth


    Precise MEG estimates of neuronal current flow are undermined by uncertain knowledge of the head location with respect to the MEG sensors. This is either due to head movements within the scanning session or systematic errors in co-registration to anatomy. Here we show how such errors can be minimized using subject-specific head-casts produced using 3D printing technology. The casts fit the scalp of the subject internally and the inside of the MEG dewar externally, reducing within session and between session head movements. Systematic errors in matching to MRI coordinate system are also reduced through the use of MRI-visible fiducial markers placed on the same cast. Bootstrap estimates of absolute co-registration error were of the order of 1 mm. Estimates of relative co-registration error were < 1.5 mm between sessions. We corroborated these scalp based estimates by looking at the MEG data recorded over a 6 month period. We found that the between session sensor variability of the subject's evoked response was of the order of the within session noise, showing no appreciable noise due to between-session movement. Simulations suggest that the between-session sensor level amplitude SNR improved by a factor of 5 over conventional strategies. We show that at this level of coregistration accuracy there is strong evidence for anatomical models based on the individual rather than canonical anatomy; but that this advantage disappears for errors of greater than 5 mm. This work paves the way for source reconstruction methods which can exploit very high SNR signals and accurate anatomical models; and also significantly increases the sensitivity of longitudinal studies with MEG. PMID:23911673

  5. A three-year prospective longitudinal cohort study of medical students' attitudes toward anatomy teaching and their career aspirations. (United States)

    Bhangu, Aneel; Boutefnouchet, Tarek; Yong, Xu; Abrahams, Peter; Joplin, Ruth


    Today's medical students are faced with numerous learning needs. Continuously developing curricula have reduced time for basic science subjects such as anatomy. This study aimed to determine the students' views on the relevance of anatomy teaching, anatomical knowledge, and the effect these have on their career choices. A Likert scale questionnaire was distributed to second year medical students [response rate 91% (n = 292/320)]. The same questionnaire was subsequently distributed to the cohort three years later when they were final year students [response rate 37% (n = 146/392)]. Students in both the cohorts of study agreed strongly that clinically correlated anatomical teaching was relevant to clinical practice (92% and 86% of second and final year respondents, respectively) and helped them during their clinical placements (73% and 92%, respectively). Only 28% of the second year and 31% of the final year students agreed that their anatomy teaching prepared them to interpret clinical images (P = 0.269). Only 14% of the final year students felt confident in their knowledge of anatomy. Of the final year students, 30% felt that they had enough opportunity to scrub in the operating room. Nearly half of those students who would consider surgery as a career (19%) think that they will eventually become surgeons (11%). This data suggests that modern anatomy curriculum should focus on clinical correlations and clinical image interpretation. Students would value more opportunities to participate in surgeries. Vertical integration of anatomy teaching throughout the full medical course may be useful. Copyright 2010 American Association of Anatomists.

  6. Anatomy and function of the hypothenar muscles. (United States)

    Pasquella, John A; Levine, Pam


    The hypothenar eminence is the thick soft tissue mass located on the ulnar side of the palm. Understanding its location and contents is important for understanding certain aspects of hand function. Variation in motor nerve distribution of the hypothenar muscles makes surgery of the ulnar side of the palm more challenging. To avoid injury to nerve branches, knowledge of these differences is imperative. This article discusses the muscular anatomy and function, vascular anatomy, and nerve anatomy and innervation of the hypothenar muscles. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Normal CT anatomy of the calcaneus

    International Nuclear Information System (INIS)

    Lee, Mun Gyu; Kang, Heung Sik


    Normal sectional anatomy of the calcaneus with multiplanar CT examination was studied in 5 volunteers as the background for interpretation of various abnormalities. Major 3 sectional anatomy including plantar, coronal, sagittal and additional tuberosity planes are described. With CT examination of the calcaneus, 1. More detailed anatomy of 3 facets of subtalar joint (anterior, middle, and posterior facet) can be well visualized. 2. Its clinical applications in the tarsal trauma, tarsal coalition, subtalar infection, degenerative arthritis, club foot, pes planus and tarsal tumor could provide much more information's, which not obtained by conventional radiographic studies.

  8. Leaf anatomy of the South African Danthonieae (Poaceae. XIII. Pentameris macrocalycina and P. obtusifolia

    Directory of Open Access Journals (Sweden)

    R. P. Ellis


    Full Text Available The leaf blade anatomy of Peniameris macrocalycina (Steud. Schweick. and P. obtusifolia (Hochst, Schweick. is described and illustrated. The leaf anatomy of these two species shows many similarities suggesting a close relationship between them. A slight problem appears to exist with the circumscription of P. obtusifolia and a minor taxonomic adjustment may result in a classification which agrees totally with that based on leaf anatomy. This would result in details of the leaf outline being diagnostic for these two taxa. The nomenclature of P. obtusifolia is also very confusing and clarification is needed by reference to the relevant type specimens. P. macrocalycina and P. obtusifolia together with  P. longiglumis (Nees Stapf, appear to form a distinct genus and do not bear close anatomical resemblances to either P. thuarri Beauv. or P. dregeana Stapf.

  9. Design and Validation of an Open-Source, Partial Task Trainer for Endonasal Neuro-Endoscopic Skills Development: Indian Experience. (United States)

    Singh, Ramandeep; Baby, Britty; Damodaran, Natesan; Srivastav, Vinkle; Suri, Ashish; Banerjee, Subhashis; Kumar, Subodh; Kalra, Prem; Prasad, Sanjiva; Paul, Kolin; Anand, Sneh; Kumar, Sanjeev; Dhiman, Varun; Ben-Israel, David; Kapoor, Kulwant Singh


    Box trainers are ideal simulators, given they are inexpensive, accessible, and use appropriate fidelity. The development and validation of an open-source, partial task simulator that teaches the fundamental skills necessary for endonasal skull-base neuro-endoscopic surgery. We defined the Neuro-Endo-Trainer (NET) SkullBase-Task-GraspPickPlace with an activity area by analyzing the computed tomography scans of 15 adult patients with sellar suprasellar parasellar tumors. Four groups of participants (Group E, n = 4: expert neuroendoscopists; Group N, n =19: novice neurosurgeons; Group R, n = 11: neurosurgery residents with multiple iterations; and Group T, n = 27: neurosurgery residents with single iteration) performed grasp, pick, and place tasks using NET and were graded on task completion time and skills assessment scale score. Group E had lower task completion times and greater skills assessment scale scores than both Group N and R (P ≤ 0.03, 0.001). The performance of Groups N and R was found to be equivalent; in self-assessing neuro-endoscopic skill, the participants in these groups were found to have equally low pretraining scores (4/10) with significant improvement shown after NET simulation (6, 7 respectively). Angled scopes resulted in decreased scores with tilted plates compared with straight plates (30° P ≤ 0.04, 45° P ≤ 0.001). With tilted plates, decreased scores were observed when we compared the 0° with 45° endoscope (right, P ≤ 0.008; left, P ≤ 0.002). The NET, a face and construct valid open-source partial task neuroendoscopic trainer, was designed. Presimulation novice neurosurgeons and neurosurgical residents were described as having insufficient skills and preparation to practice neuro-endoscopy. Plate tilt and endoscope angle were shown to be important factors in participant performance. The NET was found to be a useful partial-task trainer for skill building in neuro-endoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Commentary: the importance of musculoskeletal medicine and anatomy in medical education. (United States)

    Day, Charles S; Ahn, Christine S


    Medical schools in the United States have continued to demonstrate deficiencies in musculoskeletal education. In response to the findings of numerous studies and to the objectives of the U.S. Bone and Joint Decade (an international collaborative movement sanctioned by the United Nations and the World Health Organization for the purpose of promoting awareness of musculoskeletal disease), several institutions, including Harvard Medical School, have reassessed the preclinical musculoskeletal curriculum at their respective medical schools. A cross-sectional survey at Harvard in 2004 found that students lacked clinical confidence in dealing with the musculoskeletal system. In addition, only one quarter of the graduating class of medical students passed a nationally validated exam in basic musculoskeletal competency. In 2005, 33 total hours of musculoskeletal medicine were added to the musculoskeletal blocks of the preclinical anatomy, pathophysiology, and physical examination courses. Alongside this movement toward more musculoskeletal education, there has been continued debate over the relevance and cost-effectiveness of cadaveric and surface anatomy labs. With the advent of advanced imaging technology, some argue that dissection anatomy is outdated and labor-intensive, whereas three-dimensional images are more accessible and time-effective for today's students. However, knowledge of anatomy is a critical foundation to learning musculoskeletal medicine. Thus, making room for more musculoskeletal curriculum time by cutting out cadaveric anatomy labs may ultimately be counterproductive.

  11. Learning surgically oriented anatomy in a student-run extracurricular club: an education through recreation initiative. (United States)

    Ullah, Shahnoor M; Bodrogi, Andrew; Cristea, Octav; Johnson, Marjorie; McAlister, Vivian C


    Didactic and laboratory anatomical education have seen significant reductions in the medical school curriculum due, in part, to the current shift from basic science to more clinically based teaching in North American medical schools. In order to increase medical student exposure to anatomy, with clinical applicability, a student-run initiative called surgically oriented anatomy prosectors (SOAP) club was created within the extracurricular program at the Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada. SOAP invites surgeons and residents from various surgical specialties to demonstrate, on a cadaver, a surgical procedure of their choosing. During the demonstration, the anatomy, as it relates to the surgical procedure, is discussed. The students then break into smaller groups to examine the relevant anatomy on the cadavers, during which time the discussion is broadened. The group continues the conversation in a social environment with refreshments. SOAP is one of the most popular extracurricular clubs with 65% of first and second year medical students registered as members. The high demand for SOAP, along with the positive participant feedback, may be due to its utilization of the principle of education through recreation, which seeks to provide opportunities for learning seamlessly throughout all facets of life. It also demonstrates the desire, amongst certain medical students, to learn applied anatomy, particularly within a surgical context. Copyright © 2012 American Association of Anatomists.

  12. A reappraisal of adult thoracic and abdominal surface anatomy in Iranians in vivo using computed tomography. (United States)

    Pak, Neda; Patel, Shilpan G; Hashemi Taheri, Amir P; Hashemi, Fariba; Eftekhari Vaghefi, Raana; Naybandi Atashi, Sara; Mirjalili, S Ali


    Surface anatomy is a core component of human anatomy in clinical practice. It allows clinicians to assess patients accurately and quickly; however, recent studies have revealed variability among individuals and ethnicities. The aim of this study is to investigate possible variations in adult thoracic and abdominal surface anatomy landmarks in an Iranian population. This study used 100 thoracoabdominal CT scans (mean age: 47 ± 17 years, age range: 20-77 years, 47% females), noted the most common locations of clinically relevant surface markings, and analyzed correlations between these variables and age or gender. While many common surface markings in Iranians were consistent with the evidence-based literature, there were some differences. In relation to the corresponding segments of the vertebral column, the superior vena cava formation and the lower border of the pleura adjacent to the vertebral column and right kidney tended to be at higher levels in adult Iranians than a Caucasian population. There were also discrepancies between the Iranian population and commonly-referenced medical textbooks and recent evidence-based literature concerning the vertebral levels of the diaphragmatic openings of the esophagus, aorta, and inferior vena cava. This study emphasizes the need to consider evidence-based reappraisals of surface anatomy to guide clinical practice. Much of our current knowledge of surface anatomy is based on older studies of cadavers rather than living people, and does not take ethnic and individual variations into consideration. © 2015 Wiley Periodicals, Inc.

  13. Why relevance theory is relevant for lexicography

    DEFF Research Database (Denmark)

    Bothma, Theo; Tarp, Sven


    This article starts by providing a brief summary of relevance theory in information science in relation to the function theory of lexicography, explaining the different types of relevance, viz. objective system relevance and the subjective types of relevance, i.e. topical, cognitive, situational...... that is very important for lexicography as well as for information science, viz. functional relevance. Since all lexicographic work is ultimately aimed at satisfying users’ information needs, the article then discusses why the lexicographer should take note of all these types of relevance when planning a new...... dictionary project, identifying new tasks and responsibilities of the modern lexicographer. The article furthermore discusses how relevance theory impacts on teaching dictionary culture and reference skills. By integrating insights from lexicography and information science, the article contributes to new...


    African Journals Online (AJOL)

    in body size and jaw force are thought to reduce competition for food between ...... through the water and prey is taken by surprise or actively pursued (Van ..... differences in limb and axial anatomy probably exist among the four South African.

  15. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... of a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product that claims to treat or cure cancer? According to the Federal Trade Commission, consumers should ...

  16. Understanding Colds: Anatomy of the Nose (United States)

    ... Complications Special Features References Common Cold Understanding Colds Anatomy of the Nose The nose contains shelf-like ... white). Soft tissue, such as the eye, is gray. The maxillary sinus of adults has a volume ...

  17. Cochlear anatomy: CT and MR imaging

    International Nuclear Information System (INIS)

    Martinez, Manuel; Bruno, Claudio; Martin, Eduardo; Canale, Nancy; De Luca, Laura; Spina, Juan C. h


    The authors present a brief overview of the normal cochlear anatomy with CT and MR images in order to allow a more complete identification of the pathological findings in patients with perceptive hipoacusia. (author)

  18. Ecological anatomy of some hydrophytes in Nigeria

    African Journals Online (AJOL)



    Jul 20, 2009 ... tissues and counter stained in Aniline Blue to increase contrast. Sections were viewed with microscope equipped with the ocular eye-piece at 100 x magnification. .... the relationship between anatomy, ecology and evolution.

  19. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... a Cancer Treatment Scam Anatomy of a Cancer Treatment Scam January 19, 2012 Curious about a product ... and should not stop or delay their conventional treatment. Category: Scam Watch Health Download File Related Videos ...

  20. Bone Conduction: Anatomy, Physiology, and Communication

    National Research Council Canada - National Science Library

    Henry, Paula; Letowski, Tomasz R


    .... This report combines results of an extensive literature review of the anatomy and physiology of human hearing, theories behind the mechanisms of bone conduction transmission, devices for use in bone...

  1. Anatomy Ontology Matching Using Markov Logic Networks

    Directory of Open Access Journals (Sweden)

    Chunhua Li


    Full Text Available The anatomy of model species is described in ontologies, which are used to standardize the annotations of experimental data, such as gene expression patterns. To compare such data between species, we need to establish relationships between ontologies describing different species. Ontology matching is a kind of solutions to find semantic correspondences between entities of different ontologies. Markov logic networks which unify probabilistic graphical model and first-order logic provide an excellent framework for ontology matching. We combine several different matching strategies through first-order logic formulas according to the structure of anatomy ontologies. Experiments on the adult mouse anatomy and the human anatomy have demonstrated the effectiveness of proposed approach in terms of the quality of result alignment.

  2. Endoscopic Endonasal Anterior Skull Base Surgery: A Systematic Review of Complications During the Past 65 Years. (United States)

    Borg, Anouk; Kirkman, Matthew A; Choi, David


    Endoscopic skull base surgery is becoming more popular as an approach to the anterior skull base for tumors and cerebrospinal fluid (CSF) fistulae. It offers the advantages of better cosmesis and improved quality of life after surgery. We reviewed the complication rates reported in the literature. A literature search was performed in the electronic database Ovid MEDLINE (1950 to August 25, 2015) with the search item "([Anterior] AND Skull base surgery) AND endoscopic." We identified 82 relevant studies that included 7460 cases. An average overall complication rate of 17.1% (range 0%-68.0%) and a mortality rate of 0.4% (0%-10.0%) were demonstrated in a total of 82 studies that included 7460 cases. The average CSF leak rate for all studies was 8.9% (0%-40.0%) with meningiomas and clival lesions having the greatest CSF leak rates. The most frequent benign pathology encountered was pituitary adenomas (n = 3720, 49.8% of all cases) and the most frequent malignant tumor was esthesioneuroblastoma (n = 120, 1.6% of all cases). Studies that included only CSF fistula repairs had a lower average total complication rate (12.9%) but a greater rate of meningitis compared with studies that reported mixed pathology (2.4% vs. 1.3%). A trend towards a lower total complication rate with increasing study size was observed. The endoscopic approach is an increasingly accepted technique for anterior skull base tumor surgery and is associated with acceptable complication rates. Increasing experience with this technique can decrease rates of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Radiological anatomy of the groin region

    International Nuclear Information System (INIS)

    Berg, J.C. van den; Valois, J.C. de; Go, P.M.N.Y.H.; Rosenbusch, G.


    The purpose of this paper is to give an overview of the anatomy of the inguinal region, and to discuss the value of various imaging modalities in the diagnosis of groin hernias. After description of the gross anatomy of the groin, attention is focused on the anatomic features of conventional herniography, US, CT, and MRI. Advantages, disadvantages, and accuracy of each technique is discussed briefly. (orig.)

  4. External and internal anatomy of third molars. (United States)

    Guerisoli, D M; de Souza, R A; de Sousa Neto, M D; Silva, R G; Pécora, J D


    The external and internal anatomy of 269 third molars (155 maxillary and 114 mandibular) were studied. The teeth were measured, classified according to their root number and shape and the internal anatomy was observed by the use of diaphanization. A great anatomical variability was found, with the presence of up to 5 roots in maxillary third molars and 3 roots in mandibular third molars. The number of root canals followed the same pattern.

  5. Renal anatomy as applied to uroradiologic interventions

    International Nuclear Information System (INIS)

    Coleman, C.C.; Castaneda-Zuniga, W.; Miller, R.P.; Amplatz, K.


    Through the experience at the University of Minnesota with over 650 stone removals and over 1,000 percutaneous nephrostomies and ureteral manipulations, the authors developed an approach to the urinary system that has minimized their complication rate and maximized their successes. The exhibit demonstrates the salient anatomic relationships of the kidney with respect to urologic interventions. The kidney's position within the body, lobar anatomy, arterial anatomy, relationship to the ribs and pleura, and relationship to adjacent organs are shown

  6. Normal distal pulmonary vein anatomy

    Directory of Open Access Journals (Sweden)

    Wiesława Klimek-Piotrowska


    Full Text Available Background. It is well known that the pulmonary veins (PVs, especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants.Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated.Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%, followed by the common ostium for the left superior and the inferior PVs (4.44%. Mean diameters of PV ostia (for the classical pattern were: left superior = 13.8 ± 2.9 mm; left inferior = 13.3 ± 3.4 mm; right superior = 14.3 ± 2.9 mm; right inferior = 13.7 ± 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 ± 4.1 mm. The mean ostium-to-last-tributary (closest to the atrium distances were: left superior = 15.1 ± 4.6 mm; left inferior = 13.5 ± 4.0 mm; right superior = 11.8 ± 4.0 mm; right inferior = 11.0 ± 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances.Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs.

  7. Combined Endoscopic Transorbital and Endonasal Repair of High Flow Orbital Apex/Middle Fossa Cerebrospinal Fluid Leak with a Nasoseptal Flap. (United States)

    Lucke-Wold, Brandon; Mendez, Gustavo; Cua, David; Akins, Paul; Gillham, Haley; Ciporen, Jeremy


    High flow orbital apex or middle fossa cerebrospinal fluid (CSF) leaks can be life threatening and complex to repair. These leaks associated with large dural defects are most commonly repaired with an open temporalis muscle patch or free flaps, but these flaps do not always stop the leak. A 65-year-old patient presented two years after orbital exenteration and radiation for squamous cell carcinoma. He developed multi-organism meningitis and pneumocephalus secondary to a large high-flow orbital apex/middle fossa CSF leak. To repair the leak, a combined endoscopic transorbital/endonasal approach with pedicled nasospetal flap and dermis fat graft was used. We describe the unique endoscopic technique that was used to treat the life threatening high flow orbital apex/middle fossa CSF leak. The technique allowed the use of the transposed pedicled flap, which is an alternative to the free flap in controlling CSF leak. Cisternogram post-operatively and clinical exam confirmed resolution of CSF leak. Although a critically ill patient at admission with a modified Rankin scale (MRS) of 5, he was discharged home on continued IV antibiotic therapy with a MRS of 3. Endoscopic evaluation at three months after treatment showed the effectiveness of the flap and he continued to improve clinically. This is the first case to describe a combined endoscopic transorbital and endonasal repair of high flow orbital apex/middle fossa CSF leak with a pedicled nasoseptal flap. These techniques can be utilized during initial reconstruction after orbital exenteration or as a salvage flap.

  8. Systematic Review of Ossicular Chain Anatomy: Strategic Planning for Development of Novel Middle Ear Prostheses. (United States)

    Kamrava, Brandon; Roehm, Pamela C


    Objective To systematically review the anatomy of the ossicular chain. Data Sources Google Scholar, PubMed, and otologic textbooks. Review Methods A systematic literature search was performed on January 26, 2015. Search terms used to discover articles consisted of combinations of 2 keywords. One keyword from both groups was used: [ ossicular, ossicle, malleus, incus, stapes] and [ morphology, morphometric, anatomy, variation, physiology], yielding more than 50,000 hits. Articles were then screened by title and abstract if they did not contain information relevant to human ossicular chain anatomy. In addition to this search, references of selected articles were studied as well as suggested relevant articles from publication databases. Standard otologic textbooks were screened using the search criteria. Results Thirty-three sources were selected for use in this review. From these studies, data on the composition, physiology, morphology, and morphometrics were acquired. In addition, any correlations or lack of correlations between features of the ossicular chain and other features of the ossicular chain or patient were noted, with bilateral symmetry between ossicles being the only important correlation reported. Conclusion There was significant variation in all dimensions of each ossicle between individuals, given that degree of variation, custom fitting, or custom manufacturing of prostheses for each patient could optimize prosthesis fit. From published data, an accurate 3-dimensional model of the malleus, incus, and stapes can be created, which can then be further modified for each patient's individual anatomy.

  9. Deep learning relevance

    DEFF Research Database (Denmark)

    Lioma, Christina; Larsen, Birger; Petersen, Casper


    train a Recurrent Neural Network (RNN) on existing relevant information to that query. We then use the RNN to "deep learn" a single, synthetic, and we assume, relevant document for that query. We design a crowdsourcing experiment to assess how relevant the "deep learned" document is, compared...... to existing relevant documents. Users are shown a query and four wordclouds (of three existing relevant documents and our deep learned synthetic document). The synthetic document is ranked on average most relevant of all....

  10. What Do the Public Know about Anatomy? Anatomy Education to the Public and the Implications (United States)

    Taylor, Adam M.; Diggle, Peter; Wessels, Quenton


    Public knowledge of the anatomical "self" is lacking and evidence points towards a growing need for anatomy education to the wider public. The public were offered the opportunity to learn human anatomy and complete an anatomical knowledge survey afterwards. Sixty-three participants volunteered to attempt to place 20 anatomical structures…

  11. Tomographic diagnosis and relevant aspects of otosclerosis

    International Nuclear Information System (INIS)

    Gaiotti, Juliana Oggioni; Gomes, Natalia Delage; Costa, Ana Maria Doffemond; Villela, Caroline Laurita Batista Couto; Moreira, Wanderval; Diniz, Renata Lopes Furletti Caldeira


    A literature review and pictorial essay were developed to discuss the importance of knowing the main findings and locations of otosclerosis at multidetector computed tomography (MDCT). The authors performed a retrospective review of cases of otosclerosis diagnosed in their institution by means of high resolution multidetector computed tomography. Otosclerosis corresponds to otic capsule dysplasia characterized by metabolic derangement of its endochondral layer. Such condition constitutes a relevant cause of sensorineural hearing loss, affecting about 7% to 10% of the general population. The diagnosis is usually clinical, but imaging methods play a significant role in the anatomical detailing, differential diagnosis, surgical planning and evaluation of postoperative complications. Among such methods, the relevance of MDCT is highlighted. Radiologists should be familiar with the MDCT findings of otosclerosis, as well as with the temporal bone anatomy to assist in the appropriate clinical management of this disease. (author)

  12. Tomographic diagnosis and relevant aspects of otosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Gaiotti, Juliana Oggioni; Gomes, Natalia Delage; Costa, Ana Maria Doffemond; Villela, Caroline Laurita Batista Couto; Moreira, Wanderval; Diniz, Renata Lopes Furletti Caldeira, E-mail: [Hospital Mater Dei-Mater Imagem, Belo Horizonte, MG (Brazil)


    A literature review and pictorial essay were developed to discuss the importance of knowing the main findings and locations of otosclerosis at multidetector computed tomography (MDCT). The authors performed a retrospective review of cases of otosclerosis diagnosed in their institution by means of high resolution multidetector computed tomography. Otosclerosis corresponds to otic capsule dysplasia characterized by metabolic derangement of its endochondral layer. Such condition constitutes a relevant cause of sensorineural hearing loss, affecting about 7% to 10% of the general population. The diagnosis is usually clinical, but imaging methods play a significant role in the anatomical detailing, differential diagnosis, surgical planning and evaluation of postoperative complications. Among such methods, the relevance of MDCT is highlighted. Radiologists should be familiar with the MDCT findings of otosclerosis, as well as with the temporal bone anatomy to assist in the appropriate clinical management of this disease. (author)

  13. Attitudes and views of medical students toward anatomy learnt in the preclinical phase at King Khalid University

    Directory of Open Access Journals (Sweden)

    Mohammed A Kemeir


    Full Text Available Objective: The objective of the present study was to determine the views and attitude of clinical medical students toward gross anatomy courses taught to them in preclinical years and their relevance to their medical practice. Materials and Methods: A structured questionnaire of 16 items was distributed to 146 clinical students. The study group included both genders (104 males and 42 females. A total of 121 students (83% responded to the questionnaire. Results: The responses obtained in relation to the clarity of the anatomy course outline its impact on their ability to think and solve problems, develop their skills as members of a team, and its relevance to their clinical practice and their ability to engage in common clinical practices were negative. Conclusion : There is an urgent need to redesign the anatomy curriculum in King Khalid University in order to enable the graduates to deliver adequate health care to the community.

  14. Anatomy, histochemistry and immunohistochemistry of the olfactory subsystems in mice

    Directory of Open Access Journals (Sweden)

    Arthur William Barrios


    Full Text Available The four regions of the murine nasal cavity featuring olfactory neurons were studied anatomically and by labelling with lectins and relevant antibodies with a view to establishing criteria for the identification of olfactory subsystems that are readily applicable to other mammals. In the main olfactory epithelium and the septal organ the olfactory sensory neurons (OSNs are embedded in quasi-stratified columnar epithelium; vomeronasal OSNs are embedded in epithelium lining the medial interior wall of the vomeronasal duct and do not make contact with the mucosa of the main nasal cavity; and in Grüneberg’s ganglion a small isolated population of OSNs lies adjacent to, but not within, the epithelium. With the exception of Grüneberg’s ganglion, all the tissues expressing olfactory marker protein (OMP (the above four nasal territories, the vomeronasal and main olfactory nerves, and the main and accessory olfactory bulbs are also labelled by Lycopersicum esculentum agglutinin, while Ulex europaeus agglutinin I labels all and only tissues expressing Gi2 (the apical sensory neurons of the vomeronasal organ, their axons, and their glomerular destinations in the anterior accessory olfactory bulb. These staining patterns of UEA-I and LEA may facilitate the characterization of olfactory anatomy in other species. A 710-section atlas of the anatomy of the murine nasal cavity has been made available on line.

  15. The use of porcine corrosion casts for teaching human anatomy. (United States)

    Eberlova, Lada; Liska, Vaclav; Mirka, Hynek; Tonar, Zbynek; Haviar, Stanislav; Svoboda, Milos; Benes, Jan; Palek, Richard; Emingr, Michal; Rosendorf, Jachym; Mik, Patrik; Leupen, Sarah; Lametschwandtner, Alois


    In teaching and learning human anatomy, anatomical autopsy and prosected specimens have always been indispensable. However, alternative methods must often be used to demonstrate particularly delicate structures. Corrosion casting of porcine organs with Biodur E20 ® Plus is valuable for teaching and learning both gross anatomy and, uniquely, the micromorphology of cardiovascular, respiratory, digestive, and urogenital systems. Assessments of casts with a stereomicroscope and/or scanning electron microscope as well as highlighting cast structures using color coding help students to better understand how the structures that they have observed as two-dimensional images actually exist in three dimensions, and students found using the casts to be highly effective in their learning. Reconstructions of cast hollow structures from (micro-)computed tomography scans and videos facilitate detailed analyses of branching patterns and spatial arrangements in cast structures, aid in the understanding of clinically relevant structures and provide innovative visual aids. The casting protocol and teaching manual we offer can be adjusted to different technical capabilities and might also be found useful for veterinary or other biological science classes. Copyright © 2017 Elsevier GmbH. All rights reserved.

  16. OCT imaging of craniofacial anatomy in xenopus embryos (Conference Presentation) (United States)

    Deniz, Engin; Jonas, Stephan M.; Griffin, John; Hooper, Michael C.; Choma, Michael A.; Khokha, Mustafa K.


    The etiology of craniofacial defects is incompletely understood. The ability to obtain large amounts of gene sequence data from families affected by craniofacial defects is opening up new ways to understand molecular genetic etiological factors. One important link between gene sequence data and clinical relevance is biological research into candidate genes and molecular pathways. We present our recent research using OCT as a nondestructive phenotyping modality of craniofacial morphology in Xenopus embryos, an important animal model for biological research in gene and pathway discovery. We define 2D and 3D scanning protocols for a standardized approach to craniofacial imaging in Xenopus embryos. We define standard views and planar reconstructions for visualizing normal anatomy and landmarks. We compare these views and reconstructions to traditional histopathology using alcian blue staining. In addition to being 3D, nondestructive, and having much faster throughout, OCT can identify craniofacial features that are lost during traditional histopathological preparation. We also identify quantitative morphometric parameters to define normative craniofacial anatomy. We also note that craniofacial and cardiac defects are not infrequently present in the same patient (e.g velocardiofacial syndrome). Given that OCT excels at certain aspects of cardiac imaging in Xenopus embryos, our work highlights the potential of using OCT and Xenopus to study molecular genetic factors that impact both cardiac and craniofacial development.

  17. An anatomy memorial tribute: fostering a humanistic practice of medicine. (United States)

    Vora, A


    Medical students' first "patients" are the individuals who donate their bodies for laboratory dissection, and these first lessons of medicine serve as a model for the doctor-patient relationship. An Anatomy Memorial Tribute was initiated by students at Mount Sinai School of Medicine to honor these donors. Students and faculty shared music, art, and readings of original poetry and prose. The event facilitated dialogue about attitudes and feelings with regards to death and dying. Controversial issues included anonymity versus identification of donors and the appropriateness of professionals showing emotion in public. The feedback from both students and faculty participants in the event was overwhelmingly positive. Students wrote that the tribute provided a sense of closure for their dissection experience and reinvolved them in shaping their education; faculty indicated that it was appropriate. Memorial tributes are a first step toward fostering the personal growth and emotional preparation required for competent and compassionate patient care. To encourage a humanistic approach to medical education, faculty have the opportunity to participate in such tributes, facilitate sensitive use of language in the anatomy laboratory, and expand the broader medical school curriculum in relation to death and dying. Medical students may expand the concept of memorial tributes and enhance their professional growth in this area by sharing information, ideas, and experiences through national organizations such as the Humanistic Medicine Group of the American Medical Students Association. The capacity of physicians to effectively serve patients facing the end of life is particularly relevant in the setting of palliative medicine.

  18. Pain. Part 2a: Trigeminal Anatomy Related to Pain. (United States)

    Renton, Tara; Egbuniwe, Obi


    In order to understand the underlying principles of orofacial pain it is important to understand the corresponding anatomy and mechanisms. Paper 1 of this series explains the central nervous and peripheral nervous systems relating to pain. The trigeminal nerve is the 'great protector' of the most important region of our body. It is the largest sensory nerve of the body and over half of the sensory cortex is responsive to any stimulation within this system. This nerve is the main sensory system of the branchial arches and underpins the protection of the brain, sight, smell, airway, hearing and taste, underpinning our very existence. The brain reaction to pain within the trigeminal system has a significant and larger reaction to the threat of, and actual, pain compared with other sensory nerves. We are physiologically wired to run when threatened with pain in the trigeminal region and it is a 'miracle' that patients volunteer to sit in a dental chair and undergo dental treatment. Clinical Relevance: This paper aims to provide the dental and medical teams with a review of the trigeminal anatomy of pain and the principles of pain assessment.

  19. Anatomy of the ward round.

    LENUS (Irish Health Repository)

    O'Hare, James A


    The ward round has been a central activity of hospital life for hundreds of years. It is hardly mentioned in textbooks. The ward round is a parade through the hospital of professionals where most decision making concerning patient care is made. However the traditional format may be intimidating for patients and inadequate for communication. The round provides an opportunity for the multi-disciplinary team to listen to the patient\\'s narrative and jointly interpret his concerns. From this unfolds diagnosis, management plans, prognosis formation and the opportunity to explore social, psychological, rehabilitation and placement issues. Physical examination of the patient at the bedside still remains important. It has been a tradition to discuss the patient at the bedside but sensitive matters especially of uncertainty may better be discussed elsewhere. The senior doctor as round leader must seek the input of nursing whose observations may be under-appreciated due to traditional professional hierarchy. Reductions in the working hours of junior doctors and shortened length of stay have reduced continuity of patient care. This increases the importance of senior staff in ensuring continuity of care and the need for the joint round as the focus of optimal decision making. The traditional round incorporates teaching but patient\\'s right to privacy and their preferences must be respected. The quality and form of the clinical note is underreported but the electronic record is slow to being accepted. The traditional multi-disciplinary round is disappearing in some centres. This may be regrettable. The anatomy and optimal functioning of the ward round deserves scientific scrutiny and experimentation.

  20. Constructive, collaborative, contextual, and self-directed learning in surface anatomy education

    NARCIS (Netherlands)

    Bergman-de Bres, E.M.; Sieben, J.M.; Smailbegovic, I.; Bruin, A. de; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der


    Anatomy education often consists of a combination of lectures and laboratory sessions, the latter frequently including surface anatomy. Studying surface anatomy enables students to elaborate on their knowledge of the cadaver's static anatomy by enabling the visualization of structures, especially

  1. Detailed sectional anatomy of the spine

    International Nuclear Information System (INIS)

    Rauschning, W.


    Morphologic studies on the human spine constitute a special challenge because of the spine's complex topographic anatomy and the intimate relationship between the supporting skeleton and the contiguous soft tissues (muscles, discs, joint capsules) as well as the neurovascular contents of the spinal canal and intervertebral foramina. The improving resolution and multiplanar image reformatting capabilities of modern CT scanners call for accurate anatomic reference material. Such anatomic images should be available without distortion, in natural colors, and in considerable detail. The images should present the anatomy in the correct axial, sagittal, and coronal planes and should also be sufficiently closely spaced so as to follow the thin cuts of modern CT scanners. This chapter details one of several recent attempts to correlate gross anatomy with the images depicted by high-resolution CT. The methods of specimen preparation, sectioning, and photographing have been documented elsewhere

  2. Anatomy and histology of the sacroiliac joints. (United States)

    Egund, Niels; Jurik, Anne Grethe


    The anatomy of joints provides an important basis for understanding the nature and imaging of pathologic lesions and their imaging appearance. This applies especially to the sacroiliac (SI) joints, which play a major role in the diagnosis of spondyloarthritis. They are composed of two different joint portions, a cartilage-covered portion ventrally and a ligamentous portion dorsally, and thus rather complex anatomically. Knowledge of anatomy and the corresponding normal imaging findings are important in the imaging diagnosis of sacroiliitis, especially by MR imaging. A certain distinction between the two joint portions by MR imaging is only obtainable by axial slice orientation. Together with a perpendicular coronal slice orientation, it provides adequate anatomical information and thereby a possibility for detecting the anatomical site of disease-specific characteristics and normal variants simulating disease. This overview describes current knowledge about the normal macroscopic and microscopic anatomy of the SI joints. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Cloud-Based Evaluation of Anatomical Structure Segmentation and Landmark Detection Algorithms : VISCERAL Anatomy Benchmarks


    Jimenez-del-Toro, Oscar; Muller, Henning; Krenn, Markus; Gruenberg, Katharina; Taha, Abdel Aziz; Winterstein, Marianne; Eggel, Ivan; Foncubierta-Rodriguez, Antonio; Goksel, Orcun; Jakab, Andres; Kontokotsios, Georgios; Langs, Georg; Menze, Bjoern H.; Fernandez, Tomas Salas; Schaer, Roger


    Variations in the shape and appearance of anatomical structures in medical images are often relevant radiological signs of disease. Automatic tools can help automate parts of this manual process. A cloud-based evaluation framework is presented in this paper including results of benchmarking current state-of-the-art medical imaging algorithms for anatomical structure segmentation and landmark detection: the VISCERAL Anatomy benchmarks. The algorithms are implemented in virtual machines in the ...

  4. Retention of anatomy knowledge by student radiographers

    International Nuclear Information System (INIS)

    Hall, A. Susanne; Durward, Brian R.


    Introduction: Anatomy has long been regarded as an integral part of the core curriculum. However, anecdotal evidence suggests that long-term retention of anatomy knowledge may be deficient. This study aims to evidence whether student radiographers demonstrate the same level of knowledge of anatomy after a period of time has elapsed and to correlate to approaches to learning and studying. Methodology: A repeated measures design was utilised to measure retention of anatomy knowledge for both MCQs and short-response answers to a Practical Radiographic Anatomy Examination; alpha value p < 0.05. Fifty-one students from levels 2 and 3 were retested after a time lapse of 10 and 22 months respectively. The students were not aware that their knowledge was being retested. Approaches to learning and studying were measured using the ASSIST inventory. Results: Statistical analysis found no difference in performance on MCQ assessment, in either the combined sample or levels 2 and 3 separately, from baseline to retention occasions; average retention rate being 99%. However, a statistical difference in performance on PRAE assessment was found, with level 2 experiencing a larger reduction in scores; retention rate of 67% compared to level 3 at 77%. The students perceived themselves to be principally strategic in their approach to learning and studying but no strong relationships were found when correlated to test scores. Conclusion: The student radiographers in this study demonstrated varied anatomy retention rates dependent on assessment method employed and time interval that had elapsed. It is recommended that diverse teaching and assessment strategies are adopted to encourage a deeper approach to learning and studying.

  5. SLAP lesions: Anatomy, clinical presentation, MR imaging diagnosis and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Debra [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); MedRay Imaging and Fraser Health Authority, Vancouver, BC (Canada)], E-mail:; Mohana-Borges, Aurea; Borso, Maya; Chung, Christine B. [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)


    ABSTRACT: Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.

  6. Cross-sectional anatomy for computed tomography

    International Nuclear Information System (INIS)

    Farkas, M.L.


    This self-study guide recognizes that evaluation and interpretation of CT-images demands a firm understanding of both cross-sectional anatomy and the principles of computed tomography. The objectives of this book are: to discuss the basic principles of CT, to stress the importance of cross-sectional anatomy to CT through study of selected cardinal transverse sections of head, neck, and trunk, to explain orientation and interpretation of CT-images with the aid of corresponding cross-sectional preparations

  7. Anatomy, normal variants, and basic biomechanics

    International Nuclear Information System (INIS)

    Berquist, T.H.; Johnson, K.A.


    This paper reports on the anatomy and basic functions of the foot and ankle important to physicians involved in imaging procedures, clinical medicine, and surgery. New radiographic techniques especially magnetic resonance imaging, provide more diagnostic information owing to improved tissue contrast and the ability to obtain multiple image planes (axial, sagittal, coronal, oblique). Therefore, a thorough knowledge of skeletal and soft tissue anatomy is even more essential. Normal variants must also be understood in order to distinguish normal from pathologic changes in the foot and ankle. A basic understanding of biomechanics is also essential for selecting the proper diagnostic techniques

  8. Anatomy and imaging of the normal meninges. (United States)

    Patel, Neel; Kirmi, Olga


    The meninges are an important connective tissue envelope investing the brain. Their function is to provide a protective coating to the brain and also participate in the formation of blood-brain barrier. Understanding their anatomy is fundamental to understanding the location and spread of pathologies in relation to the layers. It also provides an insight into the characteristics of such pathologies when imaging them. This review aims to describe the anatomy of the meninges, and to demonstrate the imaging findings of specific features.

  9. Microvascular anatomy of the cerebellar parafloccular perforating space. (United States)

    Sosa, Pablo; Dujovny, Manuel; Onyekachi, Ibe; Sockwell, Noressia; Cremaschi, Fabián; Savastano, Luis E


    The cerebellopontine angle is a common site for tumor growth and vascular pathologies requiring surgical manipulations that jeopardize cranial nerve integrity and cerebellar and brainstem perfusion. To date, a detailed study of vessels perforating the cisternal surface of the middle cerebellar peduncle-namely, the paraflocculus or parafloccular perforating space-has yet to be published. In this report, the perforating vessels of the anterior inferior cerebellar artery (AICA) in the parafloccular space, or on the cisternal surface of the middle cerebellar peduncle, are described to elucidate their relevance pertaining to microsurgery and the different pathologies that occur at the cerebellopontine angle. Fourteen cadaveric cerebellopontine cisterns (CPCs) were studied. Anatomical dissections and analysis of the perforating arteries of the AICA and posterior inferior cerebellar artery at the parafloccular space were recorded using direct visualization by surgical microscope, optical histology, and scanning electron microscope. A comprehensive review of the English-language and Spanish-language literature was also performed, and findings related to anatomy, histology, physiology, neurology, neuroradiology, microsurgery, and endovascular surgery pertaining to the cerebellar flocculus or parafloccular spaces are summarized. A total of 298 perforating arteries were found in the dissected specimens, with a minimum of 15 to a maximum of 26 vessels per parafloccular perforating space. The average outer diameter of the cisternal portion of the perforating arteries was 0.11 ± 0.042 mm (mean ± SD) and the average length was 2.84 ± 1.2 mm. Detailed schematics and the surgical anatomy of the perforating vessels at the CPC and their clinical relevance are reported. The parafloccular space is a key entry point for many perforating vessels toward the middle cerebellar peduncle and lateral brainstem, and it must be respected and protected during surgical approaches to the

  10. Ocular anatomy in medieval arabic medicine. A review. (United States)

    Laios, Konstantinos; Moschos, Marilita M; George, Androutsos


    In medieval Arabic medicine Ophthalmology had a central role. Ocular anatomy was described in many ophthalmological treatises of the physicians of the time. These physicians followed the doctrines of Galen according ocular anatomy, nevertheless their contribution to the history of ocular anatomy was the presentation of ocular anatomical sketches in their manuscripts for the fist time in medical history.

  11. Learning of Cross-Sectional Anatomy Using Clay Models (United States)

    Oh, Chang-Seok; Kim, Ji-Young; Choe, Yeon Hyeon


    We incorporated clay modeling into gross anatomy and neuro-anatomy courses to help students understand cross-sectional anatomy. By making clay models, cutting them and comparing cut surfaces to CT and MR images, students learned how cross-sectional two-dimensional images were created from three-dimensional structure of human organs. Most students…

  12. Magnetic resonance imaging anatomy of the anal canal

    International Nuclear Information System (INIS)

    Kashyap, P.; Bates, N.


    The anatomy of the anal canal is complex but well demonstrated by MRI. Understanding the anatomy is a prerequisite for determining the true site and the extent of pathology, especially for surgical workup. In this article, the MRI anatomy of the anal canal has been displayed using highlighted MRI images and line diagrams. Copyright (2004) Blackwell Science Pty Ltd

  13. Guidelines for Standard Photography in Gross and Clinical Anatomy (United States)

    Barut, Cagatay; Ertilav, Hakan


    Photography has a widespread usage in medicine and anatomy. In this review, authors focused on the usage of photography in gross and clinical anatomy. Photography in gross and clinical anatomy is not only essential for accurate documentation of morphological findings but also important in sharing knowledge and experience. Photographs of cadavers…

  14. Medical Students' Perception of Problem Areas in Anatomy ...

    African Journals Online (AJOL)

    The ranges of problems were extensive; neuro-anatomy in gross anatomy, slide review in histology, and cardiovascular embryology were amongst the most highlighted areas of concern. Most students attributed the problems in gross anatomy to difficulty with accessing the area during dissection and inability to grasp the ...

  15. Computer assisted surgical anatomy mapping : applications in surgical anatomy research, tailor-made surgery and presonalized teaching

    NARCIS (Netherlands)

    A.L.A. Kerver (Anton)


    markdownabstractThis thesis presents a novel anatomy mapping tool named Computer Assisted Surgical Anatomy Mapping (CASAM). It allows researchers to map complex anatomy of multiple specimens and compare their location and course. Renditions such as safe zones or danger zones can be visualized,

  16. Two-Year Community: Human Anatomy Software Use in Traditional and Online Anatomy Laboratory Classes: Student-Perceived Learning Benefits (United States)

    Kuyatt, Brian L.; Baker, Jason D.


    This study evaluates the effectiveness of human anatomy software in face-to-face and online anatomy laboratory classes. Cognitive, affective, and psychomotor perceived learning was measured for students using Pearson Education's Practice Anatomy Laboratory 2.0 software. This study determined that student-perceived learning was significantly…

  17. Systematic wood anatomy of the Rosaceae

    NARCIS (Netherlands)

    Zhang, Shu-Yin


    The wood anatomy of the Rosaceae is surveyed and analysed, based on the study of 280 species (c. 500 specimens) belonging to 62 genera from different parts of the world. Eighteen wood anatomical characters have been used for a phenetic and phylogenetic classification. In the phenetic classification,

  18. [Computer technologies in teaching pathological anatomy]. (United States)

    Ponomarev, A B; Fedorov, D N


    The paper gives experience with personal computers used at the Academician A.L. Strukov Department of Pathological Anatomy for more than 20 years. It shows the objective necessity of introducing computer technologies at all stages of acquiring skills in anatomical pathology, including lectures, students' free work, test check, etc.

  19. Cardiac anatomy and physiology: a review. (United States)

    Gavaghan, M


    This article reviews the normal anatomy and physiology of the heart. Understanding the normal anatomic and physiologic relationships described in this article will help perioperative nurses care for patients who are undergoing cardiac procedures. Such knowledge also assists nurses in educating patients about cardiac procedures and about activities that can prevent, reverse, or improve cardiac illness.

  20. Digital interactive learning of oral radiographic anatomy. (United States)

    Vuchkova, J; Maybury, T; Farah, C S


    Studies reporting high number of diagnostic errors made from radiographs suggest the need to improve the learning of radiographic interpretation in the dental curriculum. Given studies that show student preference for computer-assisted or digital technologies, the purpose of this study was to develop an interactive digital tool and to determine whether it was more successful than a conventional radiology textbook in assisting dental students with the learning of radiographic anatomy. Eighty-eight dental students underwent a learning phase of radiographic anatomy using an interactive digital tool alongside a conventional radiology textbook. The success of the digital tool, when compared to the textbook, was assessed by quantitative means using a radiographic interpretation test and by qualitative means using a structured Likert scale survey, asking students to evaluate their own learning outcomes from the digital tool. Student evaluations of the digital tool showed that almost all participants (95%) indicated that the tool positively enhanced their learning of radiographic anatomy and interpretation. The success of the digital tool in assisting the learning of radiographic interpretation is discussed in the broader context of learning and teaching curricula, and preference (by students) for the use of this digital form when compared to the conventional literate form of the textbook. Whilst traditional textbooks are still valued in the dental curriculum, it is evident that the preference for computer-assisted learning of oral radiographic anatomy enhances the learning experience by enabling students to interact and better engage with the course material. © 2011 John Wiley & Sons A/S.

  1. Modelling vocal anatomy's significant effect on speech

    NARCIS (Netherlands)

    de Boer, B.


    This paper investigates the effect of larynx position on the articulatory abilities of a humanlike vocal tract. Previous work has investigated models that were built to resemble the anatomy of existing species or fossil ancestors. This has led to conflicting conclusions about the relation between

  2. Anatomy, Medical Education, and Human Ancestral Variation (United States)

    Strkalj, Goran; Spocter, Muhammad A.; Wilkinson, A. Tracey


    It is argued in this article that the human body both in health and disease cannot be fully understood without adequately accounting for the different levels of human variation. The article focuses on variation due to ancestry, arguing that the inclusion of information pertaining to ancestry in human anatomy teaching materials and courses should…

  3. Thoracic radiographic anatomy in goats | Makungu | Tanzania ...

    African Journals Online (AJOL)

    The aim of this study was to describe the normal radiographic anatomy of the thorax of small East African goats as a reference for clinical use. Radiography of the thorax was performed under general anaesthesia in 10 healthy small East African goats. Right lateral (RL), left lateral (LL), dorsoventral (DV) and ventrodorsal ...

  4. Testing to Enhance Retention in Human Anatomy (United States)

    Logan, Jessica M.; Thompson, Andrew J.; Marshak, David W.


    Recent work in cognitive psychology has shown that repeatedly testing one's knowledge is a powerful learning aid and provides substantial benefits for retention of the material. To apply this in a human anatomy course for medical students, 39 fill-in-the-blank quizzes of about 50 questions each, one for each region of the body, and four about the…

  5. Wood anatomy of the Blakeeae (Melastomataceae)

    NARCIS (Netherlands)

    Koek-Noorman, J.; Hogeweg, P.; Maanen, van W.H.M.; Welle, ter B.J.H.


    The present paper deals with the wood anatomy of the Blakeeae (Melastomataceae). Generic descriptions of the secondary xylem of Blakea, Topobea, and Huilaea are given and compared with data on 16 genera of the Miconieae. Numerical pattern detection was undertaken. The results confirm our preliminary

  6. Anatomy of a Cancer Treatment Scam

    Medline Plus

    Full Text Available ... Competition Matters Tech@FTC Comment Policy Contests IoT Home Inspector Challenge Robocalls: Humanity Strikes Back DetectaRobo Zapping ... File Documents in Adjudicative Proceedings You are here Home » News & Events » Audio/Video » Anatomy of a Cancer ...

  7. Anatomy and Physiology. Revised Teacher Edition. (United States)

    Hartman, Danene; And Others

    This curriculum guide contains 14 units of instruction for a course in anatomy and physiology for surgical technology students. The units cover the following topics: (1) organization of the body; (2) cells, tissues, and membranes; (3) integumentary system; (4) skeletal system; (5) muscular system; (6) nervous system; (7) special sense organs; (8)…

  8. The functional anatomy of the ureterovesical junction

    NARCIS (Netherlands)

    Thomson, A. S.; Dabhoiwala, N. F.; Verbeek, F. J.; Lamers, W. H.


    To obtain a new insight into the anti-reflux mechanism of the ureterovesical junction by studying the topographical anatomy of the juxta- and intravesical ureter and its relationship to the surrounding bladder musculature. Fresh pig bladders were fixed, frozen and serially sectioned. Enzyme

  9. Anatomy and Physiology of the Small Bowel. (United States)

    Volk, Neil; Lacy, Brian


    Comprehension of small intestine physiology and function provides a framework for the understanding of several important disease pathways of the gastrointestinal system. This article reviews the development, anatomy and histology of the small bowel in addition to physiology and digestion of key nutrients. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Anatomy and physiology of genital organs - women. (United States)

    Graziottin, Alessandra; Gambini, Dania


    "Anatomy is destiny": Sigmund Freud viewed human anatomy as a necessary, although not a sufficient, condition for understanding the complexity of human sexual function with a solid biologic basis. The aim of the chapter is to describe women's genital anatomy and physiology, focusing on women's sexual function with a clinically oriented vision. Key points include: embryology, stressing that the "female" is the anatomic "default" program, differentiated into "male" only in the presence of androgens at physiologic levels for the gestational age; sex determination and sex differentiation, describing the interplay between anatomic and endocrine factors; the "clitoral-urethral-vaginal" complex, the most recent anatomy reading of the corpora cavernosa pattern in women; the controversial G spot; the role of the pelvic floor muscles in modulating vaginal receptivity and intercourse feelings, with hyperactivity leading to introital dyspareunia and contributing to provoked vestibulodynia and recurrent postcoital cystitis, whilst lesions during delivery reduce vaginal sensations, genital arousability, and orgasm; innervation, vessels, bones, ligaments; and the physiology of women's sexual response. Attention to physiologic aging focuses on "low-grade inflammation," genital and systemic, with its impact on women sexual function, especially after the menopause, if the woman does not or cannot use hormone replacement therapy. © 2015 Elsevier B.V. All rights reserved.

  11. Fostering Improved Anatomy and Physiology Instructor Pedagogy (United States)

    Mattheis, Allison; Jensen, Murray


    Despite widespread calls for reform in undergraduate science, technology, engineering, and mathematics education, effecting lasting change in instructor practice is challenging to achieve. This article describes the results of a 2-yr research study that involved efforts to develop the pedagogical expertise of a group of anatomy and physiology…

  12. Surgical anatomy of the nail apparatus.

    NARCIS (Netherlands)

    Haneke, E.


    Nail surgery is an integral part of dermatologic surgery. An in-depth knowledge of the anatomy, biology, physiology, and gross pathology of the entire nail unit is essential. In particular, knowledge of nail histopathology is necessary to perform diagnostic nail biopsies and other nail procedures

  13. The Use of Three Dimensional Printed Interactive Models and a Digital Anatomy Case Study to Improve Medical Student Understanding of Pelvic and Perineal Anatomy (United States)

    Solis, Laura de Jesus

    The anatomy of the pelvis and perineum is especially complex for novice students. In the Language of Medicine Module (Gross Anatomy and Embryology), medical students are expected to learn a high volume of material in a short time. The study of these regions is especially challenging due to the limited visibility of structures and difficulty of dissection. Understanding of the spatial relationships of the pelvic and perineal structures is important to acquire the foundational knowledge for future clinical application. Traditional methods such as dissection, prosected specimens, peer teaching, and radiological images are used at UT Health San Antonio to teach these regions. Emerging three dimensional technologies applied in computer based models and printed physical models serve as alternative ways to teach Anatomy. This study examines the effectiveness of adding two active learning methods that use these technologies to teach the anatomy of the pelvis and perineum in the Language of Medicine module, as assessed by exam performance and a satisfaction survey. The learning methods included female pelvic and perineal printed models with simulated anatomical contents made with arts and crafts material, and a digital anatomy case study using BodyVizRTM. In 2016, 220 medical students in four groups (A-D) rotated between demonstrations on prosected cadavers and interactive sessions with each 3D learning tool. Student exam performance was assessed as the percentage of points obtained on select written and practical exam questions relevant to the anatomy of the pelvis and perineum. Across four years, practical exam performance for all relevant pelvic and perineal tags (structures tagged with a string or pin) shows a consistent decline of averages from 2013 (83%) to 2015 (75.7%). This decline was slightly reversed in 2016 (76.6%) following the integration of the 3D learning tools. The analysis of the obturator internus muscle tag, a tag included in the practical exams across

  14. "Digit anatomy": a new technique for learning anatomy using motor memory. (United States)

    Oh, Chang-Seok; Won, Hyung-Sun; Kim, Kyong-Jee; Jang, Dong-Su


    Gestural motions of the hands and fingers are powerful tools for expressing meanings and concepts, and the nervous system has the capacity to retain multiple long-term motor memories, especially including movements of the hands. We developed many sets of successive movements of both hands, referred to as "digit anatomy," and made students practice the movements which express (1) the aortic arch, subclavian, and thoracoacromial arteries and their branches, (2) the celiac trunk, superior mesenteric artery and their branches, and formation of the portal vein, (3) the heart and the coronary arteries, and (4) the brachial, lumbar, and sacral plexuses. A feedback survey showed that digit anatomy was helpful for the students not only in memorizing anatomical structures but also in understanding their functions. Out of 40 students, 34 of them who learned anatomy with the help of digit anatomy were "very satisfied" or "generally satisfied" with this new teaching method. Digit anatomy that was used to express the aortic arch, subclavian, and thoracoacromial arteries and their branches was more helpful than those representing other structures. Although the movements of digit anatomy are expected to be remembered longer than the exact meaning of each movement, invoking the motor memory of the movement may help to make relearning of the same information easier and faster in the future. Copyright © 2011 American Association of Anatomists.

  15. Anatomy meets dentistry! Linking anatomy and clinical practice in the preclinical dental curriculum

    Directory of Open Access Journals (Sweden)

    Nicole Rafai


    Full Text Available Abstract Background Establishing a strong link early on between preclinical coursework and the clinical context is necessary for students to be able to recognize the practical relevance of the curriculum during their preclinical anatomical courses and to transfer knowledge more easily. Our objective was to enhance the clinical relevance of a preclinical anatomy course for second-year medical students of dentistry by implementing an interdisciplinary skills training course on “Palpation of the Head and Neck Muscles” and to measure the learning outcomes. Methods For the curricular development of the expanded course module, Kern’s 6-step approach was applied including subjective evaluation. We used a peer-teaching format supported by an e-learning application. A randomized control study measured effects of the two components (skills training, e-module on learning outcomes. Four learning methods were compared: (1 lecture, (2 lecture + e-module, (3 lecture + skills training, (4 lecture + skills training + e-module. An objective structured clinical examination (OSCE was used to measure and compare learning outcomes. Results The two-way variance analysis demonstrated that participation in the skills training had a statistically significant effect on the OSCE results (p = 0.0007. Students who participated in the skills training did better (φ 107.4 ± 14.4 points than students who only attended the lecture (φ 88.8 ± 26.2 points. Students who used the e-module but did not attend the skills training earned a slightly but not significantly higher average number of points (φ 91.8 ± 31.3 points than those who only attended the lecture. The learning outcomes of the skills training were again significantly increased when the training was combined with the e-module (φ 121.8 ± 21.8 points, thus making it the ideal method for achieving the learning objectives defined in this study. Conclusions The “Palpation of

  16. Gigantism treated by pure endoscopic endonasal approach in a case of McCune-Albright syndrome with sphenoid fibrous dysplasia: a case report. (United States)

    Sharifi, Guive; Jalessi, Maryam; Sarvghadi, Farzaneh; Farhadi, Mohammad


    McCune-Albright syndrome (MAS) is an uncommon polyostotic manifestation of fibrous dysplasia in association with at least one endocrinopathy that is mostly associated with precocious puberty and hyperpigmented skin macules named café-au-lait spots. We present an atypical manifestation of McCune-Albright syndrome in a 19-year-old man with the uncommon association of polyostotic fibrous dysplasia and gigantism in the absence of café-au-lait spots and precocious puberty. He presented with a height increase to 202 cm in the previous 3 years, which had become more progressive in the few months prior. Physical examination revealed only a mild facial asymmetry; however, a computed tomography (CT) scan discovered vast areas of voluminous bones with ground-glass density and thickening involving the craniofacial bones and skull base. Magnetic resonance imaging (MRI) found a right stalk shift of the pituitary with a 20 mm pituitary adenoma. We describe the diagnostic and endoscopic endonasal transsphenoidal approach for excision of the tumor. Georg Thieme Verlag KG Stuttgart · New York.

  17. The history of anatomy in Persia. (United States)

    Shoja, Mohammadali M; Tubbs, R Shane


    The study of human anatomy can be found throughout the rich history of Persia. For thousands of years, morphological descriptions derived from this part of the world have contributed to and have helped form our current anatomical knowledge base. In this article we review the major influential Persian periods and the individuals who have contributed to the development of anatomy. We have divided the history of Persia into five eras: (1) the period of the Elamites, Medes, early Persians and Babylonians (10th millennium to 6th century BC); (2) following the establishment of the Persian Empire (6th century BC) to the 7th century AD; (3) after the Islamic conquest of Persia to the ascendency of Baghdad (7th to 13th century AD); (4) from the Mongol invasion of Persia to the foundations of modern anatomy (13th to 18th century AD); and (5) modern Persia/Iran (18th century AD to present). Evidence indicates that human dissection was commonplace in the first era, which led to a disciplined practice of surgery in the centuries leading to the foundation of the Persian Empire. By the emergence of Zoroastrianism in the Persian Empire, the microcosm theory was widely used to understand internal anatomy in relation to the external universe. The world's first cosmopolitan university and hospital were built in Gondishapur, south-western Persia, in the third century AD. Greek and Syriac knowledge influenced the second era. With the gradual ruin of Gondishapur and the foundation of Baghdad following the Islamic conquest of Persia (637-651 AD), a great movement took place, which led to the flourishing of the so-called Middle Age or Islamic Golden Age. Of the influential anatomists of this period, Mesue (777-857 AD), Tabbari (838-870 AD), Rhazes (865-925 AD), Joveini (?-983 AD), Ali ibn Abbas (930-994 AD), Avicenna (980-1037 AD) and Jorjani (1042-1137 AD) all hailed from Persia. There is evidence in the Persian literature as to the direct involvement of these scholars in human

  18. Procedure Oriented Torsional Anatomy of the Forearm for Spasticity Injection. (United States)

    Chiou-Tan, Faye; Cianca, John; John, Joslyn; Furr-Stimming, Erin; Pandit, Sindhu; Taber, Katherine H


    : This is the second in a series of articles related to the concept of "torsional" anatomy. The objective of this article is to provide musculoskeletal ultrasound (MSKUS) anatomy of the forearm in the position of hemispastic flexion as a reference relevant to needle procedures. The MSKUS images were obtained in a healthy human subject. Marker dots were placed over common injection sites in the forearm for spasticity. The MSKUS probe was centered over each dot to obtain a cross-sectional view. A pair of MSKUS images was recorded for each site: the first in anatomic neutral and second in hemiparetic spastic position. The images were compared side to side. In addition, a video recording was made at each site to track the movement of the muscles and nerves during internal rotation. The pronator teres (PT) rotated medially and the brachialis and biceps tendon rotated in view. In addition, the median nerve became more superficial. The flexor carpi radialis rotated medially and was replaced by PT and the median nerve. The flexor carpi ulnaris and flexor digitorum profundus rotated medially and were replaced by the flexor carpi radialis, PT and median nerve. The flexor digitorum superficialis was replaced by the brachioradialis, extensor carpi radialis brevis, and radial nerve. The brachioradialis was replaced by the extensor carpi radialis brevis and extensor digitorum communis. Intended muscle targets rotate out of view and injection range. These are replaced by other muscles and nerves that could inadvertently be injected. This potentially could result in both increased complications and decreased efficacy of the procedure. It is hoped that this series of images will increase the accuracy and safety of needle placement for spasticity injections in the forearm.

  19. On Feature Relevance in Image-Based Prediction Models: An Empirical Study

    DEFF Research Database (Denmark)

    Konukoglu, E.; Ganz, Melanie; Van Leemput, Koen


    Determining disease-related variations of the anatomy and function is an important step in better understanding diseases and developing early diagnostic systems. In particular, image-based multivariate prediction models and the “relevant features” they produce are attracting attention from the co...

  20. Making Deferred Taxes Relevant

    NARCIS (Netherlands)

    Brouwer, Arjan; Naarding, Ewout


    We analyse the conceptual problems in current accounting for deferred taxes and provide solutions derived from the literature in order to make International Financial Reporting Standards (IFRS) deferred tax numbers value-relevant. In our view, the empirical results concerning the value relevance of

  1. Parsimonious relevance models

    NARCIS (Netherlands)

    Meij, E.; Weerkamp, W.; Balog, K.; de Rijke, M.; Myang, S.-H.; Oard, D.W.; Sebastiani, F.; Chua, T.-S.; Leong, M.-K.


    We describe a method for applying parsimonious language models to re-estimate the term probabilities assigned by relevance models. We apply our method to six topic sets from test collections in five different genres. Our parsimonious relevance models (i) improve retrieval effectiveness in terms of

  2. Overview of radiological anatomy and topography

    International Nuclear Information System (INIS)

    Mohamed Ali Abdul Khader


    This chapter introduces the reader to the examination of the most common radiographs of the body that will be encountered by the x-ray operator. The discussion of the radiograph begins with a review of the anatomy and functions of the region. This is followed by a description of the normal anatomy that is imaged in the radiographs. The subjects discussed are follows - Skeleton; Axial Skeleton, Skull: functions, radiographic appearance. Vertebral Column, Thoracic Cage (Sternum and Ribs), The Chest Radiograph, Appendicular Skeleton, Shoulder Girdle and Upper Arm. Radiological Appearance of the Elbow, Radiological Appearance of the Wrist and Hand, Pelvic Girdle and Lower Limbs, Innominate (hip bones) Radiological Appearance of the Pelvis, Lower Extremities, Joints, Classification, Radiological Appearance of the Knee, Radiological Appearance of the Ankle and Foot, Systems and Cavities of the Body, Cranial Cavity, Thoracic Cavity, Abdominal Cavity, Pelvic Cavity

  3. Understanding chest radiographic anatomy with MDCT reformations

    Energy Technology Data Exchange (ETDEWEB)

    Sussmann, A.R. [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States); Ko, J.P., E-mail: jane.ko@nyumc.or [Department of Radiology, Thoracic Imaging, NYU Langone Medical Center, New York, NY (United States)


    Chest radiograph interpretation requires an understanding of the mediastinal reflections and anatomical structures. Computed tomography (CT) improves the learning of three-dimensional (3D) anatomy, and more recently multidetector CT (MDCT) technology has enabled the creation of high-quality reformations in varying projections. Multiplanar reformations (MPRs) of varying thickness in the coronal and sagittal projections can be created for direct correlation with findings on frontal and lateral chest radiographs, respectively. MPRs enable simultaneous visualization of the craniocaudal extent of thoracic structures while providing the anatomic detail that has been previously illustrated using cadaveric specimens. Emphasis will be placed on improving knowledge of mediastinal anatomy and reflections including edges, lines, and stripes that are visible on chest radiographs.

  4. Fetal anatomy revealed with fast MR sequences. (United States)

    Levine, D; Hatabu, H; Gaa, J; Atkinson, M W; Edelman, R R


    Although all the imaging studies in this pictorial essay were done for maternal rather than fetal indications, fetal anatomy was well visualized. However, when scans are undertaken for fetal indications, fetal motion in between scout views and imaging sequences may make specific image planes difficult to obtain. Of the different techniques described in this review, we preferred the HASTE technique and use it almost exclusively for scanning pregnant patients. The T2-weighting is ideal for delineating fetal organs. Also, the HASTE technique allows images to be obtained in 430 msec, limiting artifacts arising from maternal and fetal motion. MR imaging should play a more important role in evaluating equivocal sonographic cases as fast scanning techniques are more widely used. Obstetric MR imaging no longer will be limited by fetal motion artifacts. When complex anatomy requires definition in a complicated pregnant patient, MR imaging should be considered as a useful adjunct to sonography.

  5. Pocket atlas of MRI body anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Berquist, T.H.; Ehman, R.L.; May, G.R.


    This book is a guide to the anatomy of extracranial organs as seen in magnetic resonance images. This collection of 96 magnetic resonance images, accompanied by explanatory line drawings, covers all the major organs of the body- shoulder and humerus; elbow and forearm; hand and wrist; chest; abdomen; pelvis; thigh; knee; calf; and ankle. The images are displayed in the axial, coronal, and sagittal planes, enabling radiologists to quickly review coronal and sagittal anatomy as it applies to routine MRI practice. Special emphasis is placed on the extremities, where spatial resolution, coronal and sagittal planes, and soft tissue contrast provide important anatomic detail. Each MRI image is carefully labeled - using numbers with legends at the top of the page - to highlight key anatomic features. Where applicable, special parameters and positioning are noted below the images. Accompanying each image is a line drawing demonstrating the level and plane of the image.

  6. Patellofemoral anatomy and biomechanics: current concepts (United States)



    The patellofemoral joint, due to its particular bone anatomy and the numerous capsuloligamentous structures and muscles that act dynamically on the patella, is considered one of the most complex joints in the human body from the biomechanical point of view. The medial patellofemoral ligament (MPFL) has been demonstrated to contribute 60% of the force that opposes lateral displacement of the patella, and MPFL injury results in an approximately 50% reduction in the force needed to dislocate the patella laterally with the knee extended. For this reason, recent years have seen a growing interest in the study of this important anatomical structure, whose aponeurotic nature has thus been demonstrated. The MPFL acts as a restraint during motion, playing an active role under conditions of laterally applied stress, but an only marginal role during natural knee flexion. However, it remains extremely difficult to clearly define the anatomy of the MPFL and its relationships with other anatomical structures. PMID:25606512

  7. Interoperability between phenotype and anatomy ontologies. (United States)

    Hoehndorf, Robert; Oellrich, Anika; Rebholz-Schuhmann, Dietrich


    Phenotypic information is important for the analysis of the molecular mechanisms underlying disease. A formal ontological representation of phenotypic information can help to identify, interpret and infer phenotypic traits based on experimental findings. The methods that are currently used to represent data and information about phenotypes fail to make the semantics of the phenotypic trait explicit and do not interoperate with ontologies of anatomy and other domains. Therefore, valuable resources for the analysis of phenotype studies remain unconnected and inaccessible to automated analysis and reasoning. We provide a framework to formalize phenotypic descriptions and make their semantics explicit. Based on this formalization, we provide the means to integrate phenotypic descriptions with ontologies of other domains, in particular anatomy and physiology. We demonstrate how our framework leads to the capability to represent disease phenotypes, perform powerful queries that were not possible before and infer additional knowledge.

  8. Alterations in physiology and anatomy during pregnancy. (United States)

    Tan, Eng Kien; Tan, Eng Loy


    Pregnant women undergo profound anatomical and physiological changes so that they can cope with the increased physical and metabolic demands of their pregnancies. The cardiovascular, respiratory, haematological, renal, gastrointestinal and endocrine systems all undergo important physiological alterations and adaptations needed to allow development of the fetus and to allow the mother and fetus to survive the demands of childbirth. Such alterations in anatomy and physiology may cause difficulties in interpreting signs, symptoms, and biochemical investigations, making the clinical assessment of a pregnant woman inevitably confusing but challenging. Understanding these changes is important for every practicing obstetrician, as the pathological deviations from the normal physiological alterations may not be clear-cut until an adverse outcome has resulted. Only with a sound knowledge of the physiology and anatomy changes can the care of an obstetric parturient be safely optimized for a better maternal and fetal outcome. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Complementing anatomy education using three-dimensional anatomy mobile software applications on tablet computers. (United States)

    Lewis, T L; Burnett, B; Tunstall, R G; Abrahams, P H


    Anatomy has traditionally been a cornerstone of medical education, which has been taught via dissection and didactic lectures. The rising prevalence of mobile tablet technology means medical software applications ("apps") play an increasingly important role in medical education. The applications highlighted in this article will aid anatomical educators to identify which are the most useful in clinical, academic, and educational environments. These have been systematically identified by downloading all applications with keywords related to anatomy and then carrying out qualitative assessment. Novel anatomy applications from developers such as Visible Body, 3D4Medical, and Pocket Anatomy allow students to visualize and manipulate complex anatomical structures using detailed 3D models. They often contain additional content including clinical correlations and a range of media from instructional videos to interactive quiz functions. The strength of tablet technology lies in its ability to consolidate and present anatomical information to the user in the most appropriate manner for their learning style. The only question mark remains over the level of detail and accuracy of these applications. Innovative medical educators who embrace tablet technology will find that anatomy applications serve as a useful learning tool when used in conjunction with existing teaching setups. Copyright © 2013 Wiley Periodicals, Inc.

  10. Anatomy education environment measurement inventory: A valid tool to measure the anatomy learning environment. (United States)

    Hadie, Siti Nurma Hanim; Hassan, Asma'; Ismail, Zul Izhar Mohd; Asari, Mohd Asnizam; Khan, Aaijaz Ahmed; Kasim, Fazlina; Yusof, Nurul Aiman Mohd; Manan Sulong, Husnaida Abdul; Tg Muda, Tg Fatimah Murniwati; Arifin, Wan Nor; Yusoff, Muhamad Saiful Bahri


    Students' perceptions of the education environment influence their learning. Ever since the major medical curriculum reform, anatomy education has undergone several changes in terms of its curriculum, teaching modalities, learning resources, and assessment methods. By measuring students' perceptions concerning anatomy education environment, valuable information can be obtained to facilitate improvements in teaching and learning. Hence, it is important to use a valid inventory that specifically measures attributes of the anatomy education environment. In this study, a new 11-factor, 132-items Anatomy Education Environment Measurement Inventory (AEEMI) was developed using Delphi technique and was validated in a Malaysian public medical school. The inventory was found to have satisfactory content evidence (scale-level content validity index [total] = 0.646); good response process evidence (scale-level face validity index [total] = 0.867); and acceptable to high internal consistency, with the Raykov composite reliability estimates of the six factors are in the range of 0.604-0.876. The best fit model of the AEEMI is achieved with six domains and 25 items (X 2  = 415.67, P education environment in Malaysia. A concerted collaboration should be initiated toward developing a valid universal tool that, using the methods outlined in this study, measures the anatomy education environment across different institutions and countries. Anat Sci Educ 10: 423-432. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  11. Clinical anatomy of the subserous layer: An amalgamation of gross and clinical anatomy. (United States)

    Yabuki, Yoshihiko


    The 1998 edition of Terminologia Anatomica introduced some currently used clinical anatomical terms for the pelvic connective tissue or subserous layer. These innovations persuaded the present author to consider a format in which the clinical anatomical terms could be reconciled with those of gross anatomy and incorporated into a single anatomical glossary without contradiction or ambiguity. Specific studies on the subserous layer were undertaken on 79 Japanese women who had undergone surgery for uterine cervical cancer, and on 26 female cadavers that were dissected, 17 being formalin-fixed and 9 fresh. The results were as follows: (a) the subserous layer could be segmentalized by surgical dissection in the perpendicular, horizontal and sagittal planes; (b) the segmentalized subserous layer corresponded to 12 cubes, or ligaments, of minimal dimension that enabled the pelvic organs to be extirpated; (c) each ligament had a three-dimensional (3D) structure comprising craniocaudal, mediolateral, and dorsoventral directions vis-á-vis the pelvic axis; (d) these 3D-structured ligaments were encoded morphologically in order of decreasing length; and (e) using these codes, all the surgical procedures for 19th century to present-day radical hysterectomy could be expressed symbolically. The establishment of clinical anatomical terms, represented symbolically through coding as demonstrated in this article, could provide common ground for amalgamating clinical anatomy with gross anatomy. Consequently, terms in clinical anatomy and gross anatomy could be reconciled and compiled into a single anatomical glossary. © 2015 Wiley Periodicals, Inc.

  12. The Journal of Anatomy: origin and evolution. (United States)

    Morriss-Kay, Gillian


    The Journal of Anatomy was launched 150 years ago as the Journal of Anatomy and Physiology, in an age when anatomy and physiology were not regarded as separate disciplines. European science in general was advancing rapidly at the time (it was 7 years after publication of Darwin's Origin of Species), and the recent demise of the Natural History Review meant that there was no English language publication covering these subjects. The founding editors were George Murray Humphry of Cambridge and William Turner of Edinburgh, together with Alfred Newton of Cambridge and Edward Perceval Wright of Dublin (the last two served only for a year). The pivotal event leading to the Journal's foundation was the 1866 meeting of the British Association, at which Humphry delivered the 'Address in Physiology' (printed in the first issue). Turner, who was also present at the 1866 British Association meeting, remained as a member of the editorial team for 50 years and was a major contributor of Journal articles. The title was changed to Journal of Anatomy in October 1916, when it was taken under the wing, in terms of both management and ownership, by the Anatomical Society. This article reviews the early years of the Journal's publication in more detail than later years because of the historical interest of this less familiar material. The subject matter, which has remained surprisingly consistent over the years, is illustrated by examples from some notable contributions. The evolution of illustration techniques is surveyed from 1866 to the present day; the final section provides brief summaries of all of the chief editors. © 2016 Anatomical Society.

  13. Congenital Heart Defects and Coronary Anatomy


    Mawson, John B.


    Coronary artery anomalies are a well recognized feature of many cardiac malformations and have been catalogued in a number of reviews. This overview concentrates on 1) the interplay between congenital heart defects and coronary morphogenesis, examining how some of the embryology fits with the experiments of nature encountered in clinical practice; and 2) the influence of coronary anatomy on patient management. This overview uses, as examples, pulmonary atresia with intact ventricular septum, ...

  14. Clinical anatomy of the periocular region. (United States)

    Shams, Pari N; Ortiz-Pérez, Santiago; Joshi, Naresh


    The aims of this article are twofold: (1) to provide the facial plastic surgeon with a comprehensive and up-to-date overview of periocular anatomy including the brow, midface, and temporal region and (2) to highlight important anatomical relationships that must be appreciated in order to achieve the best possible functional and aesthetic surgical outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Exercises in anatomy: the normal heart. (United States)

    Anderson, Robert H; Sarwark, Anne; Spicer, Diane E; Backer, Carl L


    In the first of our exercises in anatomy, created for the Multimedia Manual of the European Association of Cardiothoracic Surgery, we emphasized that thorough knowledge of intracardiac anatomy was an essential part of the training for all budding cardiac surgeons, explaining how we had used the archive of congenitally malformed hearts maintained at Lurie Children's Hospital in Chicago to prepare a series of videoclips, demonstrating the salient features of tetralogy of Fallot. In this series of videoclips, we extend our analysis of the normal heart, since for our initial exercise we had concentrated exclusively on the structure of the right ventricular outflow tract. We begin our overview of normal anatomy by emphasizing the need, in the current era, to describe the heart in attitudinally appropriate fashion. Increasingly, clinicians are demonstrating the features of the heart as it is located within the body. It is no longer satisfactory, therefore, to describe these components in a 'Valentine' fashion, as continues to be the case in most textbooks of normal or cardiac anatomy. We then emphasize the importance of the so-called morphological method, which states that structures within the heart should be defined on the basis of their own intrinsic morphology, and not according to other parts, which are themselves variable. We continue by using this concept to show how it is the appendages that serve to distinguish between the atrial chambers, while the apical trabecular components provide the features to distinguish the ventricles. We then return to the cardiac chambers, emphasizing features of surgical significance, in particular the locations of the cardiac conduction tissues. We proceed by examining the cardiac valves, and conclude by providing a detailed analysis of the septal structures. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  16. The anatomy of Japan's postwar economic development.


    Tsao, Hsiung Yuan


    Approved for public release; distribution is unlimited This thesis examines the anatomy of postwar Japanese economic development. It is illustrated by the reform and reconstruction era (1945-52) and those factors which caused the Japanese economy to grow during the 1953-73 period. Furthermore, on the basis of Japanese economic successes, the role of the Japanese in world affairs again became important. However, due to the world experiencing economic inflation and an oil shock after 1974, t...

  17. Student Perceptions of Sectional CT/MRI Use in Teaching Veterinary Anatomy and the Correlation with Visual Spatial Ability: A Student Survey and Mental Rotations Test. (United States)

    Delisser, Peter J; Carwardine, Darren


    Diagnostic imaging technology is becoming more advanced and widely available to veterinary patients with the growing popularity of veterinary-specific computed tomography (CT) and magnetic resonance imaging (MRI). Veterinary students must, therefore, be familiar with these technologies and understand the importance of sound anatomic knowledge for interpretation of the resultant images. Anatomy teaching relies heavily on visual perception of structures and their function. In addition, visual spatial ability (VSA) positively correlates with anatomy test scores. We sought to assess the impact of including more diagnostic imaging, particularly CT/MRI, in the teaching of veterinary anatomy on the students' perceived level of usefulness and ease of understanding content. Finally, we investigated survey answers' relationship to the students' inherent baseline VSA, measured by a standard Mental Rotations Test. Students viewed diagnostic imaging as a useful inclusion that provided clear links to clinical relevance, thus improving the students' perceived benefits in its use. Use of CT and MRI images was not viewed as more beneficial, more relevant, or more useful than the use of radiographs. Furthermore, students felt that the usefulness of CT/MRI inclusion was mitigated by the lack of prior formal instruction on the basics of CT/MRI image generation and interpretation. To be of significantly greater use, addition of learning resources labeling relevant anatomy in tomographical images would improve utility of this novel teaching resource. The present study failed to find any correlation between student perceptions of diagnostic imaging in anatomy teaching and their VSA.

  18. Radiological anatomy for FRCR. Pt. 1

    International Nuclear Information System (INIS)

    Borg, Philip; Alvi, Abdul Rahman


    The new FRCR part 1 Anatomy examination comprises 20 cases/images, with five questions about each. The cases are labelled 01 to 20 and the five questions are labelled (a) to (e). The authors have set out to emulate this format by gathering 200 cases which, from their experience, are representative of the cases on which candidates will be tested. The book consists of 10 tests with 20 cases each, and 5 stem questions each. The answers, along with an explanation and tips, accompany each test at the end of the chapter. This will help candidates to identify the level of anatomical knowledge expected by the Royal College of Radiologists. The aim of this book is not to replace the already available literature in radiological anatomy, but to complement it as a revision guide. Whereas radiological anatomy atlases and textbooks provide images with labels for every possible identifiable structure in an investigation, the cases in this book have only 5 labels, simulating the exam. (orig.)

  19. A radiographic study of pediatric ulnar anatomy. (United States)

    Cravino, Mattia; Oni, Julius K; Sala, Debra A; Chu, Alice


    The adult ulna has a unique bony architecture that has been described in the literature, but, to the best of our knowledge, the ulnar anatomy in children has not been described. We examined 75 anteroposterior (AP) and 64 lateral radiographs (29 were bilateral) of 50, 0.5- to 11-year-old, healthy children's forearms. On AP radiographs, the total ulnar length, the ulnar proximal angle, the ulnar distal angle, and the distance between each angle from the tip of the triceps insertion; and, on lateral radiographs, the ulnar length and bow deviation were measured. The correlation between age and radiographic measurements, differences based on sex, differences compared with adults' measurements, and interobserver/intraobserver reliability were assessed. Age had a very strong/strong positive correlation with length/distance measurements on both AP and lateral radiographs. Only AP ulnar distal angle was significantly different between sexes (females > males). Compared with the adult ulnar studies, the AP proximal angle in children is significantly smaller and the location of this angle is significantly more distal. Interobserver and intraobserver reliability were very good for length/distance measurements on AP and lateral radiographs. The knowledge of pediatric ulnar anatomy could be helpful in the treatment of forearm deformities due to multiple hereditary exostosis and osteogenesis imperfecta, and in the treatment of ulnar fractures, particularly in Monteggia variants, where restoration of the correct forearm anatomy is essential to obtain good clinical and functional results. Study of diagnostic test, Level II.

  20. Tinjauan Anatomi Layout Halaman Republika Epaper

    Directory of Open Access Journals (Sweden)

    Suprayitno Suprayitno


    Full Text Available Communities are increasingly familiar with Internet technology became one of the reasons for the rapid growth of digital newspaper in Indonesia. The ability of the media presents news in brief, fast, accessible and inexpensive form the basis of high growth of consumer interest in digital newspaper / electronic. Technological developments, triggering changes to the newspaper that had shaped the physical print later developed in digital form. In principle, newspaper print and digital newspapers contain messages or the same news, namely providing information to readers about the actual and weighted, as well as other light information that is entertainment. Review the anatomy of the digital newspaper layout is a study to trace and explore what and how the anatomy of a newspaper page layout, at least to provide information and understanding of the anatomy of the layouts in outline. Process layout in the digital version is no different from print media, which distinguishes its output only. In the process to any design layout of a medium, a designer is still expected to possess and master the basic principles such as layout hierarchy, emphasis, balance, and unity. 

  1. Tomographic anatomy of the vena cava and renal veins: features relevant to vena cava filter placement

    Directory of Open Access Journals (Sweden)

    Thiago Melo do Espírito Santo


    Full Text Available BACKGROUND: There is a growing demand for invasive procedures involving the inferior vena cava, in particular for placement of vena cava filters. It is not always easy to identify the more distal renal vein with cavography, for safe release of filters. OBJECTIVES: To determine parameters for the relationships between the renal veins and the infrarenal vena cava and their corresponding vertebral bodies, their relationships with biotype and the occurrence of anatomic variations, the relationships between vertebral bodies and the bifurcation of the common iliac veins and the distance from this bifurcation to the outflow of the more distal renal vein, with reference to placement of vena cava filters. METHODS: A total of 150 abdominal computed tomography scans conducted from October to November 2011 were analyzed and classified according to the biotype exhibited (using Charpy's angle. Scans were performed at MEDIMAGEM and analyzed at the Integrated Vascular Surgery Service, both part of Hospital da Beneficência Portuguesa in São Paulo, Brazil. RESULTS: In 127 of the 150 scans analyzed (84.66%, the more distal renal vein emerged between the first lumbar intervertebral space (L1-L2 and the body of L2, irrespective of patient biotype. Just 23 patients (15.33% exhibited a more distal renal vein with outflow below the body of L2, i.e. in the projection of the space between L2 and L3. CONCLUSIONS: The radiological correlation between the confluence of the more distal renal vein and vertebral bodies exhibits little variation, irrespective of the biotype of the patient.

  2. Behavioral Relevance of Species-Specific Vasotocin Anatomy in Gregarious Finches

    Directory of Open Access Journals (Sweden)

    Aubrey M Kelly


    Full Text Available Despite substantial species differences in the vasotocin/vasopressin (VT/VP circuitry of the medial bed nucleus of the stria terminalis (BSTm and lateral septum (LS; a primary projection target of BSTm VT/VP cells, functional consequences of this variation are poorly known. Previous experiments in the highly gregarious zebra finch (Estrildidae: Taeniopygia guttata demonstrate that BSTm VT neurons promote gregariousness in a male-specific manner and reduce anxiety in both sexes. However, in contrast to the zebra finch, the less gregarious Angolan blue waxbill (Estrildidae: Uraeginthus angolensis exhibits fewer VT-immunoreactive cells in the BSTm as well as differences in receptor distribution across the LS subnuclei, suggesting that knockdown of VT production in the BSTm would produce behavioral effects in Angolan blue waxbills that are distinct from zebra finches. Thus, we here quantified social contact, gregariousness (i.e. preference for the larger of two groups, and anxiety-like behavior following bilateral antisense knockdown of VT production in the BSTm of male and female Angolan blue waxbills. We find that BSTm VT neurons promote social contact, but not gregariousness (as in male zebra finches, and that antisense effects on social contact are significantly stronger in male waxbills than in females. Knockdown of BSTm VT production has no effect on anxiety-like behavior. These data provide novel evidence that species differences in the VT/VP circuitry arising in the BSTm are accompanied by species-specific effects on affiliation behaviors.

  3. Kant on anatomy and the status of the life sciences. (United States)

    Olson, Michael J


    This paper contributes to recent interest in Kant's engagement with the life sciences by focusing on one corner of those sciences that has received comparatively little attention: physical and comparative anatomy. By attending to remarks spread across Kant's writings, we gain some insight into Kant's understanding of the disciplinary limitations but also the methodological sophistication of the study of anatomy and physiology. Insofar as Kant highlights anatomy as a paradigmatic science guided by the principle of teleology in the Critique of the Power of Judgment, a more careful study of Kant's discussions of anatomy promises to illuminate some of the obscurities of that text and of his understanding of the life sciences more generally. In the end, it is argued, Kant's ambivalence with regard to anatomy gives way to a pessimistic conclusion about the possibility that anatomy, natural history, and, by extension, the life sciences more generally might one day become true natural sciences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Stereopsis, Visuospatial Ability, and Virtual Reality in Anatomy Learning


    Luursema, Jan-Maarten; Vorstenbosch, Marc; Kooloos, Jan


    A new wave of virtual reality headsets has become available. A potential benefit for the study of human anatomy is the reintroduction of stereopsis and absolute size. We report a randomized controlled trial to assess the contribution of stereopsis to anatomy learning, for students of different visuospatial ability. Sixty-three participants engaged in a one-hour session including a study phase and posttest. One group studied 3D models of the anatomy of the deep neck in full stereoptic virtual ...

  5. Culturally Relevant Cyberbullying Prevention


    Phillips, Gregory John


    In this action research study, I, along with a student intervention committee of 14 members, developed a cyberbullying intervention for a large urban high school on the west coast. This high school contained a predominantly African American student population. I aimed to discover culturally relevant cyberbullying prevention strategies for African American students. The intervention committee selected video safety messages featuring African American actors as the most culturally relevant cyber...

  6. MR imaging of brain surface structures: Surface anatomy scanning

    International Nuclear Information System (INIS)

    Katada, K.; Koga, S.; Asahina, M.; Kanno, T.; Asahina, K.


    Preoperative evaluation of brain surface anatomy, including cortical sulci and veins, relative to cerebral and cerebellar lesions is an important subject for surgeons. Until now, no imaging modality existed that allowed direct visualization of brain surface anatomy. A new MR imaging technique (surface anatomy scanning) was developed to visualize brain surface structures. The technique uses a spin-echo pulse sequence with long repetition and echo times, thick sections and a surface coil. Cortical sulci, fissures, veins, and intracranial lesions were clearly identified with this technique. Initial clinical results indicate that surface anatomy scanning is useful for lesion localization and for detailed evaluation of cortical and subcortical lesions

  7. Comparison of endoscopic endonasal and bifrontal craniotomy approaches for olfactory groove meningiomas: A matched pair analysis of outcomes and frontal lobe changes on MRI. (United States)

    de Almeida, John R; Carvalho, Felipe; Vaz Guimaraes Filho, Francisco; Kiehl, Tim-Rasmus; Koutourousiou, Maria; Su, Shirley; Vescan, Allan D; Witterick, Ian J; Zadeh, Gelareh; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A; Gentili, Fred; Snyderman, Carl H


    We compare the outcomes and postoperative MRI changes of endoscopic endonasal (EEA) and bifrontal craniotomy (BFC) approaches for olfactory groove meningiomas (OGM). All patients who underwent either BFC or EEA for OGM were eligible. Matched pairs were created by matching tumor volumes of an EEA patient with a BFC patient, and matching the timing of the postoperative scans. The tumor dimensions, peritumoral edema, resectability issues, and frontal lobe changes were recorded based on preoperative and postoperative MRI. Postoperative fluid-attenuated inversion recovery (FLAIR) hyperintensity and residual cystic cavity (porencephalic cave) volume were compared using univariable and multivariable analyses. From a total of 70 patients (46 EEA, 24 BFC), 10 matched pairs (20 patients) were created. Three patients (30%) in the EEA group and two (20%) in the BFC had postoperative cerebrospinal fluid leaks (p=0.61). Gross total resections were achieved in seven (70%) of the EEA group and nine (90%) of the BFC group (p=0.26), and one patient from each group developed a recurrence. On postoperative MRI, there was no significant difference in FLAIR signal volumes between EEA and BFC approaches (6.9 versus 13.3 cm(3); p=0.17) or in porencephalic cave volumes (1.7 versus 5.0 cm(3); p=0.11) in univariable analysis. However, in a multivariable analysis, EEA was associated with less postoperative FLAIR change (p=0.02) after adjusting for the volume of preoperative edema. This study provides preliminary evidence that EEA is associated with quantifiable improvements in postoperative frontal lobe imaging. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. The endoscopic endonasal approach is not superior to the microscopic transcranial approach for anterior skull base meningiomas-a meta-analysis. (United States)

    Muskens, Ivo S; Briceno, Vanessa; Ouwehand, Tom L; Castlen, Joseph P; Gormley, William B; Aglio, Linda S; Zamanipoor Najafabadi, Amir H; van Furth, Wouter R; Smith, Timothy R; Mekary, Rania A; Broekman, Marike L D


    In the past decade, the endonasal transsphenoidal approach (eTSA) has become an alternative to the microsurgical transcranial approach (mTCA) for tuberculum sellae meningiomas (TSMs) and olfactory groove meningiomas (OGMs). The aim of this meta-analysis was to evaluate which approach offered the best surgical outcomes. A systematic review of the literature from 2004 and meta-analysis were conducted in accordance with the PRISMA guidelines. Pooled incidence was calculated for gross total resection (GTR), visual improvement, cerebrospinal fluid (CSF) leak, intraoperative arterial injury, and mortality, comparing eTSA and mTCA, with p-interaction values. Of 1684 studies, 64 case series were included in the meta-analysis. Using the fixed-effects model, the GTR rate was significantly higher among mTCA patients for OGM (eTSA: 70.9% vs. mTCA: 88.5%, p-interaction OGM (p-interaction = 0.33). CSF leak was significantly higher among eTSA patients for both OGM (eTSA: 25.1% vs. mTCA: 10.5%, p-interaction OGM resection (p-interaction = 0.10). Mortality was not significantly different between eTSA and mTCA patients for both TSM (p-interaction = 0.14) and OGM resection (p-interaction = 0.88). Random-effect models yielded similar results. In this meta-analysis, eTSA was not shown to be superior to mTCA for resection of both OGMs and TSMs.

  9. Atlas of fetal sectional anatomy with ultrasound and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Isaacson, G.; Mintz, M.C.; Crelin, E.S.


    Here is an atlas of sectional anatomy for the fetus featuring correlated anatomy and imaging, transverse coronal and sagittal views, a guide to development of the brain, cardiac anatomy in standard plans of study and, over 280 illustrations

  10. Evaluation of an innovative hands-on anatomy-centered ultrasound curriculum to supplement graduate gross anatomy education. (United States)

    Royer, Danielle F; Kessler, Ross; Stowell, Jeffrey R


    Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre- and post-course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post-course, students reported significantly higher (P education and to students' future careers remained positive after the course. End-of-semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy-centered ultrasound curriculum significantly increased confidence with and knowledge of US among non-medical anatomy students with limited prior training. Non-medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US. Anat Sci Educ 10: 348-362. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  11. "Anatomy lesson of Frederik Ruysch" of 1670: a tribute to Ruysch's contributions to lymphatic anatomy

    NARCIS (Netherlands)

    Ijpma, Frank F. A.; van Gulik, Thomas M.


    Frederick Ruysch was one of the most prominent Dutch physicians of the seventeenth and eighteenth centuries. For more than 65 years, he was the Praelector Anatomiae (Lecturer of Anatomy) of the Amsterdam Guild of Surgeons. During his career, he conducted many dissections at the guild's theatre to

  12. The perceived importance of anatomy and neuroanatomy in the practice of speech-language pathology. (United States)

    Martin, Kate; Bessell, Nicola J; Scholten, Ingrid


    The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum. © 2013 American Association of Anatomists.

  13. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT

    International Nuclear Information System (INIS)

    Ooijen, Peter M.A. van; Dorgelo, Joost; Oudkerk, Matthijs; Zijlstra, Felix


    Early identification and evaluation of relatively frequent anomalous coronary anatomy is quite relevant because of the occurrence of sudden cardiac death or related symptoms of myocardial ischemia. Selective coronary angiography (CAG) is invasive, expensive and cannot always provide the required information adequately. Recently, non-invasive imaging techniques such as magnetic resonance imaging and multidetector-row computed tomography (MDCT) have been shown to provide a good anatomical view of the coronary artery tree. This study aims to demonstrate the value of 16-MDCT for evaluation of anomalous coronary anatomy. In 13 patients scanned using 16-MDCT, six different coronary anomalies were diagnosed [two absent left main, one single vessel left coronary artery (LCA), three LCA originating from the right (two with interarterial course), six right coronary artery originating from the left, one double left anterior descending (LAD)]. Mean diagnostic quality, recorded by two observers using a 5-point scale (1= non-diagnostic to 5= excellent diagnostic quality), resulted in a mean score of 3.73 (SD 1.19) without any non-diagnostic result. MDCT offers an accurate diagnostic modality to visualize the origin and course of anomalous coronary arteries by a three-dimensional display of anatomy. Shortcomings in CAG can be overcome by the use of contrast-enhanced MDCT. (orig.)

  14. Experiences with dissection courses in human anatomy: a comparison between Germany and Ethiopia. (United States)

    Bekele, Assegedech; Reissig, Dieter; Löffler, Sabine; Hinz, Andreas


    Dissection courses in human anatomy are laborious, and new teaching tools have become available. Therefore, some universities intend to reduce the dissection course. Furthermore, little is known about dissection courses in African universities. The aim of this study is to compare the students' experiences with and evaluations of the dissection courses in two universities: Leipzig (Germany) and Gondar (Ethiopia). Since the Gondar Medical College was founded in cooperation with the Leipzig University in 1978, the anatomy courses in both universities follow roughly the same rules. A structured questionnaire was used to assess the dissection courses from the students' point of view. The sample of students consisted of 109 German and 124 Ethiopian first year undergraduate medical students. Most students in both countries (94% in Germany and 82% in Ethiopia) judge the dissection course to be highly relevant compared to other courses. Perceived health hazards associated with dissection of the cadaver show significant differences between Germany (14%) and Ethiopia (44%). Most students had normal feelings again at the end of the dissection course. Further similarities and differences between the courses in Germany and Ethiopia are described. Dissection courses are highly appreciated also in Africa. The high degree of affirmation of the dissection courses should be taken into consideration when discussing modifications of gross anatomy curriculum or changes in the teacher to student ratio. Copyright © 2010 Elsevier GmbH. All rights reserved.

  15. A reappraisal of pediatric thoracic surface anatomy. (United States)

    Fischer, Nicholas J; Morreau, Jonty; Sugunesegran, Ramanen; Taghavi, Kiarash; Mirjalili, S Ali


    Accurate knowledge of surface anatomy is fundamental to safe clinical practice. A paucity of evidence in the literature regarding thoracic surface anatomy in children was identified. The associations between surface landmarks and internal structures were meticulously analyzed by reviewing high quality computed tomography (CT) images of 77 children aged from four days to 12 years. The results confirmed that the sternal angle is an accurate surface landmark for the azygos-superior vena cava junction in a plane through to the level of upper T4 from birth to age four, and to lower T4 in older children. The concavity of the aortic arch was slightly below this plane and the tracheal and pulmonary artery bifurcations were even lower. The cardiac apex was typically at the 5 th intercostal space (ICS) from birth to age four, at the 4 th ICS and 5 th rib in 4-12 year olds, and close to the midclavicular line at all ages. The lower border of the diaphragm was at the level of the 6 th or 7 th rib at the midclavicular line, the 7 th ICS and 8 th rib at the midaxillary line, and the 11 th thoracic vertebra posteriorly. The domes of the diaphragm were generally flatter and lower in children, typically only one rib level higher than its anterior level at the midclavicular line. Diaphragm apertures were most commonly around the level of T9, T10, and T11 for the IVC, esophagus and aorta, respectively. This is the first study to provide an evidence-base for thoracic surface anatomy in children. Clin. Anat. 30:788-794, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. A reappraisal of adult abdominal surface anatomy. (United States)

    Mirjalili, S Ali; McFadden, Sara L; Buckenham, Tim; Stringer, Mark D


    Descriptions of clinically important surface landmarks often vary between and within contemporary anatomical texts. The aim of this study was to investigate the surface anatomy of major abdominal vessels, kidneys, spleen, gastroesophageal junction, and duodenojejunal flexure in living adults using computed tomography (CT). After excluding patients with distorting space-occupying lesions, scoliosis, abnormal lordosis, and obvious visceromegaly, 108 abdominal CT scans of supine adults (mean age 60 years, range 18-97 years; 64 female) at end tidal inspiration were available for analysis by dual consensus reporting. Intra-observer agreement was assessed by repeat blind assessment of a random sample of scans. The vertebral level of the aortic bifurcation and almost all of its major branches, and the origin of the inferior vena cava were consistent with current descriptions. Important differences from contemporary descriptions of surface anatomy were as follows: the renal arteries were most commonly at the L1 vertebral level (left 55%, right 43%); the midpoint of the renal hila was most frequently at L2 (left 68%, right 40%); the 11th rib was a posterior relation of the left kidney in only 28% of scans; and the spleen was most frequently located between the 10th and 12th ribs (48%) with its long axis in line with the 11th rib (55%). Although the majority of vascular surface landmarks are consistent with standard descriptions, the surface anatomy of the kidneys, renal arteries, and spleen needs to be revised in accordance with observations using modern imaging techniques in vivo. Copyright © 2012 Wiley Periodicals, Inc.

  17. The subscapularis: anatomy, injury, and imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morag, Yoav; Jamadar, David A.; Dong, Qian; Jacobson, Jon A. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Miller, Bruce [University of Michigan, Department of Orthopaedics, Ann Arbor, MI (United States)


    The subscapularis is the largest and most powerful of the rotator cuff muscles and fulfills an important role in glenohumeral movement and stability. The spectrum and implications of subscapularis muscle or tendon injury differ from injury to other rotator cuff components because of its unique structure and function. Diagnosing subscapularis injury is clinically difficult and assessment of subscapularis integrity may be limited during arthroscopy or open surgery. Diagnostic imaging plays an important part in diagnosing and evaluating the extent of subscapularis injury. The radiologist should be aware of the anatomy of the subscapularis, the variations in muscle or tendon injury, and the potential implications for treatment and prognosis. (orig.)

  18. Computer tomographic anatomy of the neck

    International Nuclear Information System (INIS)

    Koenig, R.


    The structures in the neck which can be recognised by computer tomography, and their course, is described. The cartilagenous larynx and trachea, the oesophagus, thyroid, sternocleidomastoid muscle, common carotid arteries and internal jugular veins can be recognised regularly. In addition, one can identify smaller muscles, vessels and nerves, such as the sterno-hyoid, omo-hyoid, anterior and medial scalenus muscles, the superior and inferior thyroid arteries and the suprascapular, internal thoracic and vertebral arteries, the thyro-cervical trunk and the vagus and phrenic nerves. An accurate knowledge of the anatomy is essential for the recognition of enlarged parathyroid glands. (orig.) [de

  19. An imaging atlas of human anatomy

    International Nuclear Information System (INIS)

    Weir, J.; Abrahams, P.H.


    The atlas presents pictures obtained by the various imaging techniques, showing the normal anatomy of the various body regions in healthy adults. The pictures are the major information given, accompanying texts are reduced to captions giving the Latin names of important anatomic details or a brief introduction each to the fundamental characteristics of the imaging methods used, as e.g. angiography, computerized tomography, magnetic resonance imaging, and ultrasonography. The atlas is a key source of reference and a guide in interpreting radiographs. The material is arranged in chapters according to the body regions of interest: Head, neck, brain; spine and spinal cord; upper extremities; thorax; abdomen; pelvis; lower extremities. (UWA) [de

  20. Interactive videodisk atlas of knee anatomy

    International Nuclear Information System (INIS)

    McEnery, K.W.; Woods, J.W.; Glenn, W.F.; Rauschning, W.


    An interactive, computer-assisted atlas of knee anatomy has been developed. MR and CT images from normal volunteers and cryomicrotomed anatomic images were recorded on a laser viodeodisk. Computer software allows movement through the knee and correlation of radiographic images in the coronal, axial, and sagittal planes. Computer graphics are superimposed on the videodisk images. A high-resolution color graphics, touch-screen monitor is included in the computer system. Learning modules allow for rapid identification of specific structure by touching their location on the screen. Computer-created testing modules are available that provide for self-assessment

  1. The subscapularis: anatomy, injury, and imaging

    International Nuclear Information System (INIS)

    Morag, Yoav; Jamadar, David A.; Dong, Qian; Jacobson, Jon A.; Miller, Bruce


    The subscapularis is the largest and most powerful of the rotator cuff muscles and fulfills an important role in glenohumeral movement and stability. The spectrum and implications of subscapularis muscle or tendon injury differ from injury to other rotator cuff components because of its unique structure and function. Diagnosing subscapularis injury is clinically difficult and assessment of subscapularis integrity may be limited during arthroscopy or open surgery. Diagnostic imaging plays an important part in diagnosing and evaluating the extent of subscapularis injury. The radiologist should be aware of the anatomy of the subscapularis, the variations in muscle or tendon injury, and the potential implications for treatment and prognosis. (orig.)

  2. Computer tomographic anatomy of the neck

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, R.


    The structures in the neck which can be recognised by computer tomography, and their course, is described. The cartilagenous larynx and trachea, the oesophagus, thyroid, sternocleidomastoid muscle, common carotid arteries and internal jugular veins can be recognised regularly. In addition, one can identify smaller muscles, vessels and nerves, such as the sterno-hyoid, omo-hyoid, anterior and medial scalenus muscles, the superior and inferior thyroid arteries and the suprascapular, internal thoracic and vertebral arteries, the thyro-cervical trunk and the vagus and phrenic nerves. An accurate knowledge of the anatomy is essential for the recognition of enlarged parathyroid glands.

  3. The Limits to Relevance (United States)

    Averill, M.; Briggle, A.


    Science policy and knowledge production lately have taken a pragmatic turn. Funding agencies increasingly are requiring scientists to explain the relevance of their work to society. This stems in part from mounting critiques of the "linear model" of knowledge production in which scientists operating according to their own interests or disciplinary standards are presumed to automatically produce knowledge that is of relevance outside of their narrow communities. Many contend that funded scientific research should be linked more directly to societal goals, which implies a shift in the kind of research that will be funded. While both authors support the concept of useful science, we question the exact meaning of "relevance" and the wisdom of allowing it to control research agendas. We hope to contribute to the conversation by thinking more critically about the meaning and limits of the term "relevance" and the trade-offs implicit in a narrow utilitarian approach. The paper will consider which interests tend to be privileged by an emphasis on relevance and address issues such as whose goals ought to be pursued and why, and who gets to decide. We will consider how relevance, narrowly construed, may actually limit the ultimate utility of scientific research. The paper also will reflect on the worthiness of research goals themselves and their relationship to a broader view of what it means to be human and to live in society. Just as there is more to being human than the pragmatic demands of daily life, there is more at issue with knowledge production than finding the most efficient ways to satisfy consumer preferences or fix near-term policy problems. We will conclude by calling for a balanced approach to funding research that addresses society's most pressing needs but also supports innovative research with less immediately apparent application.

  4. Relevant Subspace Clustering

    DEFF Research Database (Denmark)

    Müller, Emmanuel; Assent, Ira; Günnemann, Stephan


    Subspace clustering aims at detecting clusters in any subspace projection of a high dimensional space. As the number of possible subspace projections is exponential in the number of dimensions, the result is often tremendously large. Recent approaches fail to reduce results to relevant subspace...... clusters. Their results are typically highly redundant, i.e. many clusters are detected multiple times in several projections. In this work, we propose a novel model for relevant subspace clustering (RESCU). We present a global optimization which detects the most interesting non-redundant subspace clusters...... achieves top clustering quality while competing approaches show greatly varying performance....

  5. Improved understanding of human anatomy through self-guided radiological anatomy modules. (United States)

    Phillips, Andrew W; Smith, Sandy G; Ross, Callum F; Straus, Christopher M


    To quantifiably measure the impact of self-instructed radiological anatomy modules on anatomy comprehension, demonstrated by radiology, gross, and written exams. Study guides for independent use that emphasized structural relationships were created for use with two online radiology atlases. A guide was created for each module of the first year medical anatomy course and incorporated as an optional course component. A total of 93 of 96 eligible students participated. All exams were normalized to control for variances in exam difficulty and body region tested. An independent t-test was used to compare overall exam scores with respect to guide completion or incompletion. To account for aptitude differences between students, a paired t-test of each student's exam scores with and without completion of the associated guide was performed, thus allowing students to serve as their own controls. Twenty-one students completed no study guides; 22 completed all six guides; and 50 students completed between one and five guides. Aggregate comparisons of all students' exam scores showed significantly improved mean performance when guides were used (radiology, 57.8% [percentile] vs. 45.1%, P < .001; gross, 56.9% vs. 46.5%, P = .001; written, 57.8% vs. 50.2%, P = .011). Paired comparisons among students who completed between one and five guides demonstrated significantly higher mean practical exam scores when guides were used (radiology, 49.3% [percentile] vs. 36.0%, P = .001; gross, 51.5% vs. 40.4%, P = .005), but not higher written scores. Radiological anatomy study guides significantly improved anatomy comprehension on radiology, gross, and written exams. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

  6. Comparisons between the attitudes of medical and dental students toward the clinical importance of gross anatomy and physiology. (United States)

    Olowo-Ofayoku, Anthony; Moxham, Bernard John


    Marked changes are occurring within both the medical and dental curricula and new ways of teaching the basic sciences have been devised and traditional methods (e.g., dissection for gross anatomy and of bench-based animal preparations for physiology) are increasingly no longer the norm. Although there is much anecdotal evidence that students are not in favor of such changes, there is little evidence for this based on quantitative analyses of students' attitudes. Using Thurstone and Chave attitude analyses, we assessed the attitudes of first year medical and dental students at Cardiff University toward gross anatomy and physiology in terms of their perceived clinical importance. In addition, we investigated the appropriateness ("fitness for purpose") of teaching methodologies used for anatomy and physiology. The hypotheses tested recognized the possibility that medical and dental students differed in their opinions, but that they had a preference to being taught gross anatomy through the use of dissection and had no preference for physiology teaching. It was found that both medical and dental students displayed positive attitudes toward the clinical relevance of gross anatomy and that they preferred to be taught by means of dissection. Although both medical and dental students displayed positives attitudes toward the clinical relevance of physiology, this was greater for the medical students. Both medical and dental students showed a preference for being taught physiology through didactic teaching in small groups but the medical students also appreciated being taught by means of practicals. Overall, this study highlights the expectations that students have for the basic science foundation teaching within their professional training and signals a preference for being taught experientially/practically. Differences were discerned between medical and dental students that might reflect the direct association between systems physiology and pathophysiology and the

  7. [Specific features of surgical anatomy of the subhyoid region with special reference to tracheostomy]. (United States)

    Chernykh, A V; Mashkova, T A; Nerovnyĭ, A I; Maleev, Iu V


    Peculiarities of thyroid gland linear dimensions, volume, shape, and topographical features were investigated using the morphological material obtained from 426 human corpses of either gender with a view to using this information for planning and performing tracheostomy in residents of the Central Chernozem region, Russia. The study yielded new data on surgical anatomy of additional muscles of the subhyoid region, thyroid isthmus and pyramidal lobe. Rare and previously unknown variants of anatomical structure of the anterior cervical area are described that may play the role of risk factors of postoperative complications of tracheostomy. Relevant recommendations are provided for practicing otorhinolaryngologists.

  8. Using generalizability analysis to estimate parameters for anatomy assessments: A multi-institutional study. (United States)

    Byram, Jessica N; Seifert, Mark F; Brooks, William S; Fraser-Cotlin, Laura; Thorp, Laura E; Williams, James M; Wilson, Adam B


    With integrated curricula and multidisciplinary assessments becoming more prevalent in medical education, there is a continued need for educational research to explore the advantages, consequences, and challenges of integration practices. This retrospective analysis investigated the number of items needed to reliably assess anatomical knowledge in the context of gross anatomy and histology. A generalizability analysis was conducted on gross anatomy and histology written and practical examination items that were administered in a discipline-based format at Indiana University School of Medicine and in an integrated fashion at the University of Alabama School of Medicine and Rush University Medical College. Examination items were analyzed using a partially nested design s×(i:o) in which items were nested within occasions (i:o) and crossed with students (s). A reliability standard of 0.80 was used to determine the minimum number of items needed across examinations (occasions) to make reliable and informed decisions about students' competence in anatomical knowledge. Decision study plots are presented to demonstrate how the number of items per examination influences the reliability of each administered assessment. Using the example of a curriculum that assesses gross anatomy knowledge over five summative written and practical examinations, the results of the decision study estimated that 30 and 25 items would be needed on each written and practical examination to reach a reliability of 0.80, respectively. This study is particularly relevant to educators who may question whether the amount of anatomy content assessed in multidisciplinary evaluations is sufficient for making judgments about the anatomical aptitude of students. Anat Sci Educ 10: 109-119. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  9. Ligament of the head of femur: A comprehensive review of its anatomy, embryology, and potential function. (United States)

    Perumal, Vivek; Woodley, Stephanie J; Nicholson, Helen D


    The functional significance of the ligament of the head of femur (LHF), or ligamentum teres has often been debated. Having gained recent attention in clinical practice, it is suggested to partly provide some mechanical stability to the hip joint. However, the anatomy of this ligament is not well studied. This paper systematically reviews the anatomy of the LHF with the aim of exploring our current understanding of this structure and identifying any gaps in knowledge regarding its morphology and function. A systematic search of Medline, Embase, ProQuest, Web of Science, and Scopus databases was undertaken and relevant data extracted, analyzed. A total of 69 references were obtained, that included 53 full text articles, three published abstracts, and 13 textbooks. Many publications related to clinical studies (n = 11) rather than gross anatomy (n = 7), with one report on variation of the LHF. Considerable inconsistency in the naming and description of the LHF morphology was observed. Variable attachment sites were reported except for the acetabular notch, transverse acetabular ligament, and the femoral fovea. Presence and patency of the ligamental arteries supplying the head of the femur and their exact location were variably described and were often incomplete. The LHF is believed to be taught in extreme hip adduction, but there is little evidence to support this. In conclusions, further investigation of the anatomy of the LHF is recommended, particularly to clarify its mechanical role, innervation, and vascular contribution to the developing and adult femur, so to better inform clinical practice. © 2015 Wiley Periodicals, Inc.

  10. Medical Student Perceptions of Radiology Use in Anatomy Teaching (United States)

    Murphy, Kevin P.; Crush, Lee; O'Malley, Eoin; Daly, Fergus E.; Twomey, Maria; O'Tuathaigh, Colm M. P.; Maher, Michael M.; Cryan, John F.; O'Connor, Owen J.


    The use of radiology in the teaching of anatomy to medical students is gaining in popularity; however, there is wide variation in how and when radiology is introduced into the curriculum. The authors sought to investigate students' perceptions regarding methods used to depict and teach anatomy and effects of integrated radiology instruction on…

  11. The Anatomy Lecture Then and Now: A Foucauldian Analysis (United States)

    Friesen, Norm; Roth, Wolff-Michael


    Although there are many points of continuity, there are also a number of changes in the pedagogical form of the anatomy lecture over the longue durée, over centuries of epistemic change, rather than over years or decades. The article begins with an analysis of the physical and technical arrangements of the early modern anatomy lecture, showing how…

  12. The anatomy lessons of the Amsterdam Guild of Surgeons

    NARCIS (Netherlands)

    IJpma, F.F.A.


    Mandatory lessons in anatomy, taught by the praelector anatomiae (lecturer in anatomy) of the Amsterdam Guild of Surgeons, were an important part of the surgical training starting in the 16th century. We describe how surgeons were trained approximately 350 years ago at the Surgeons’ Guild. The role

  13. Medical Students' Perspective on Current and Future Training in Anatomy

    NARCIS (Netherlands)

    Triepels, C.P.R.; Koppes, D.M.; Kuijk, S.M.J. Van; Popeijus, H.E.; Lamers, W.H.; Gorp, T. Van; Futterer, J.J.; Kruitwagen, R.; Notten, K.J.B.


    Gaining sufficient knowledge of anatomy is an important part of medical education. Factors that influence how well students learn anatomical structures include available sources, learning time and study assistance. This study explores the attitude of medical students with regard to studying anatomy

  14. Anatomy in Occupational Therapy Program Curriculum: Practitioners' Perspectives (United States)

    Schofield, Katherine Anne


    Anatomy education is undergoing significant transformation. It is unknown whether changes are in accordance with occupational therapy (OT) practice needs. The purpose of this pilot study was to survey OT clinicians to determine their perspectives on the value of anatomy in OT curricula, and anatomical knowledge required for practice. In addition…

  15. YouTube: An Emerging Tool in Anatomy Education (United States)

    Jaffar, Akram Abood


    The use of online social networks in medical education can remodel and enhance anatomy teaching and learning; one such network is the video-sharing site YouTube. Limited research in the literature exists on the use of YouTube as a platform for anatomy education. The aim of this study is to assess student's perceptions and patterns of usage of this…

  16. Anatomy Education for the YouTube Generation (United States)

    Barry, Denis S.; Marzouk, Fadi; Chulak-Oglu, Kyrylo; Bennett, Deirdre; Tierney, Paul; O'Keeffe, Gerard W.


    Anatomy remains a cornerstone of medical education despite challenges that have seen a significant reduction in contact hours over recent decades; however, the rise of the "YouTube Generation" or "Generation Connected" (Gen C), offers new possibilities for anatomy education. Gen C, which consists of 80% Millennials, actively…

  17. Human Anatomy: Let the Students Tell Us How to Teach (United States)

    Davis, Christopher R.; Bates, Anthony S.; Ellis, Harold; Roberts, Alice M.


    Anatomy teaching methods have evolved as the medical undergraduate curriculum has modernized. Traditional teaching methods of dissection, prosection, tutorials and lectures are now supplemented by anatomical models and e-learning. Despite these changes, the preferences of medical students and anatomy faculty towards both traditional and…

  18. The art of human anatomy: Renaissance to 21st century. (United States)

    Van Hee, Robrecht; Wells, F C; Ballestriero, Roberta; Richardson, Ruth; Mazzarello, Paolo; Cani, Valentina; Catani, Marco


    This session examines the relationship between the art and science of anatomy from the time of Vesalius to the present with particular emphasis on the role of the medical artist and the changing nature of anatomical illustration over the last five centuries. Pivotal changes in the art of anatomy will be examined including the evolution of media and brain imaging from Golgi to Geschwind.

  19. Stereopsis, Visuospatial Ability, and Virtual Reality in Anatomy Learning

    NARCIS (Netherlands)

    Luursema, J.M.; Vorstenbosch, M.A.; Kooloos, J.G.M.


    A new wave of virtual reality headsets has become available. A potential benefit for the study of human anatomy is the reintroduction of stereopsis and absolute size. We report a randomized controlled trial to assess the contribution of stereopsis to anatomy learning, for students of different

  20. The mouse-human anatomy ontology mapping project. (United States)

    Hayamizu, Terry F; de Coronado, Sherri; Fragoso, Gilberto; Sioutos, Nicholas; Kadin, James A; Ringwald, Martin


    The overall objective of the Mouse-Human Anatomy Project (MHAP) was to facilitate the mapping and harmonization of anatomical terms used for mouse and human models by Mouse Genome Informatics (MGI) and the National Cancer Institute (NCI). The anatomy resources designated for this study were the Adult Mouse Anatomy (MA) ontology and the set of anatomy concepts contained in the NCI Thesaurus (NCIt). Several methods and software tools were identified and evaluated, then used to conduct an in-depth comparative analysis of the anatomy ontologies. Matches between mouse and human anatomy terms were determined and validated, resulting in a highly curated set of mappings between the two ontologies that has been used by other resources. These mappings will enable linking of data from mouse and human. As the anatomy ontologies have been expanded and refined, the mappings have been updated accordingly. Insights are presented into the overall process of comparing and mapping between ontologies, which may prove useful for further comparative analyses and ontology mapping efforts, especially those involving anatomy ontologies. Finally, issues concerning further development of the ontologies, updates to the mapping files, and possible additional applications and significance were considered. DATABASE URL:

  1. Comparative leaf anatomy of Kokoona and Lophopetalum (Celastraceae)

    NARCIS (Netherlands)

    Jansen, W.T.; Baas, P.


    The leaf anatomy of Kokoona and Lophopetalum is described in detail. Separation of the two genera as effectuated by Hou (1963) is supported by differences in vascular anatomy of the distal end of the petiole, which is invariably more complex in Lophopetalum than in Kokoona. Other differential

  2. Systematic wood anatomy of the tribe Guettardeae (Rubiaceae)

    NARCIS (Netherlands)

    Welle, ter B.J.H.; Loureiro, A.A.; Lisboa, P.L.B.; Koek-Noorman, J.


    Systematic wood anatomy of the tribe Guettardeae (Rubiaceae). The wood anatomy of nearly all genera of the Guettardeae (Rubiaceae, Guettardoideae) has been examined, and in this respect the tribe is heterogeneous. Suggestions are made for a delimitation of the tribe. Guettarda, Bobea, Antirhea,

  3. Anatomy Education in Namibia: Balancing Facility Design and Curriculum Development (United States)

    Wessels, Quenton; Vorster, Willie; Jacobson, Christian


    The anatomy curriculum at Namibia's first, and currently only, medical school is clinically oriented, outcome-based, and includes all of the components of modern anatomical sciences i.e., histology, embryology, neuroanatomy, gross, and clinical anatomy. The design of the facilities and the equipment incorporated into these facilities were directed…

  4. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

  5. Student Perceptions to Teaching Undergraduate Anatomy in Health Sciences (United States)

    Anderton, Ryan S.; Chiu, Li Shan; Aulfrey, Susan


    Anatomy and physiology teaching has undergone significant changes to keep up with advances in technology and to cater for a wide array of student specific learning approaches. This paper examines perceptions towards a variety of teaching instruments, techniques, and innovations used in the delivery and teaching of anatomy and physiology for health…

  6. Anatomy of the female reproductive system of Rusa deer ( Rusa ...

    African Journals Online (AJOL)

    The study aims to present baseline data on the reproductive anatomy of a poorly known tropical deer species, Rusa deer (Rusa timorensis). The anatomy of female reproductive system is described using seven uniparous hinds, aged between four and eight years. The various reproductive structures were studied via ...

  7. The normal anatomy of the pulmonary hili on computed tomography

    International Nuclear Information System (INIS)

    Stark, P.


    The diagnosis of abnormalities in the hili by computed tomography may be difficult. A thorough knowledge of normal cross-sectional anatomy is necessary. The hilar anatomy on cross sections is described in detail and illustrated by appropriate cuts. (orig.) [de

  8. Is Information Still Relevant? (United States)

    Ma, Lia


    Introduction: The term "information" in information science does not share the characteristics of those of a nomenclature: it does not bear a generally accepted definition and it does not serve as the bases and assumptions for research studies. As the data deluge has arrived, is the concept of information still relevant for information…

  9. Anatomy of the patent foramen ovale for the interventionalist. (United States)

    McKenzie, Jeff A; Edwards, William D; Hagler, Donald J


    Patent foramen ovale (PFO) is an interatrial communication whose management is controversial. Several manufacturers have submitted protocols for Food and Drug Administration (FDA) approval of their PFO closure device. The purpose of this study was to define anatomy relevant to percutaneous PFO closure, validate the clinical observation that most PFOs contain little tissue rim at the aorta, comment on proposed closure guidelines, and to discuss approaches to PFO closure. From the Mayo Clinic Tissue Registry, five normal hearts with PFO were selected from each sex from the first 10 decades of life (n = 100). Measurements (mm) included PFO length, diameter, and distance from FO-superior vena cava (SVC) and FO-aortic annulus (AoAn). Patient age, weight, and height were obtained from autopsy reports, and body surface area (BSA) was calculated. PFO length and diameter increased with age (P = 0.029 and 0.001, respectively), and FO-SVC and FO-AoAn increased with BSA (P women than men (P = 0.028). Using current sizing guidelines, 66% (CI = 56-75%) of the 100 patients would have been excluded from device closure, and only 31% could have received the smallest (18 mm) device. Our results suggest that the proposed device closure guidelines may result in inappropriate device sizing. In addition to excluding suitable candidates, strict application of the guidelines could also result in incomplete closure or device embolization. Suggestions for modification of the guidelines and options for device closure are discussed.

  10. Measuring medical students' motivation to learning anatomy by cadaveric dissection. (United States)

    Abdel Meguid, Eiman M; Khalil, Mohammed K


    Motivation and learning are inter-related. It is well known that motivating learners is clearly a complex endeavor, which can be influenced by the educational program and the learning environment. Limited research has been conducted to examine students' motivation as a method to assess the effectiveness of dissection in medical education. This study aimed to assess and analyze students' motivation following their dissection experience. A 29-item survey was developed based on the Attention, Relevance, Confidence, and Satisfaction model of motivation. Descriptive statistics were undertaken to describe students' motivation to the dissection experience. T-test and ANOVA were used to compare differences in motivational scores between gender and educational characteristics of students. Dissection activities appear to promote students' motivation. Gender difference was statistically significant as males were more motivated by the dissection experience than females. Comparison between students with different knowledge of anatomy was also significantly different. The study is an important step in the motivational design to improve students' motivation to learn. The outcome of this study provides guidance to the selection of specific strategies to increase motivation by generating motivational strategies/tactics to facilitate learning. Anat Sci Educ 10: 363-371. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  11. Japanese Neurosurgeons and Microsurgical Anatomy: A Historical Review (United States)



    Research in microneurosurgical anatomy has contributed to great advances in neurosurgery in the last 40 years. Many Japanese neurosurgeons have traveled abroad to study microsurgical anatomy and played major roles in advancing and spreading the knowledge of anatomy, overcoming their disadvantage that the cadaver study has been strictly limited inside Japan. In Japan, they initiated an educational system for surgical anatomy that has contributed to the development and standardization of Japanese neurosurgery. For example, the Japanese Society for Microsurgical Anatomy started an annual educational meeting in the middle of 1980s and published its proceedings in Japanese every year for approximately 20 years. These are some of the achievements that bring worldwide credit to Japanese neurosurgeons. Not only should Japanese neurosurgeons improve their educational system but they should also contribute to the international education in this field, particularly in Asia. PMID:25797782

  12. Fostering improved anatomy and physiology instructor pedagogy. (United States)

    Mattheis, Allison; Jensen, Murray


    Despite widespread calls for reform in undergraduate science, technology, engineering, and mathematics education, effecting lasting change in instructor practice is challenging to achieve. This article describes the results of a 2-yr research study that involved efforts to develop the pedagogical expertise of a group of anatomy and physiology instructors at the college level. Data were collected through a series of individual interviews that included the use of the Teacher Beliefs Inventory questionnaire (23) along with observations onsite in participants' college classrooms and at process-oriented guided inquiry learning (POGIL) curriculum writing workshops. Findings indicated attitudinal shifts on the part of participants from teacher-centered to more student-centered pedagogy and supported the benefits of long-term professional development for instructors. Here, we documented the successful progress of these professors as they participated in a curriculum development process that emphasized student-centered teaching with the goal of promoting broader change efforts in introductory anatomy and physiology. Copyright © 2014 The American Physiological Society.

  13. Personalized augmented reality for anatomy education. (United States)

    Ma, Meng; Fallavollita, Pascal; Seelbach, Ina; Von Der Heide, Anna Maria; Euler, Ekkehard; Waschke, Jens; Navab, Nassir


    Anatomy education is a challenging but vital element in forming future medical professionals. In this work, a personalized and interactive augmented reality system is developed to facilitate education. This system behaves as a "magic mirror" which allows personalized in-situ visualization of anatomy on the user's body. Real-time volume visualization of a CT dataset creates the illusion that the user can look inside their body. The system comprises a RGB-D sensor as a real-time tracking device to detect the user moving in front of a display. In addition, the magic mirror system shows text information, medical images, and 3D models of organs that the user can interact with. Through the participation of 7 clinicians and 72 students, two user studies were designed to respectively assess the precision and acceptability of the magic mirror system for education. The results of the first study demonstrated that the average precision of the augmented reality overlay on the user body was 0.96 cm, while the results of the second study indicate 86.1% approval for the educational value of the magic mirror, and 91.7% approval for the augmented reality capability of displaying organs in three dimensions. The usefulness of this unique type of personalized augmented reality technology has been demonstrated in this paper. © 2015 Wiley Periodicals, Inc.

  14. Cardiovascular anatomy and physiology in the female. (United States)

    Wingate, S


    Important differences in male and female cardiovascular anatomy and physiology may account for many of the gender differences seen in various cardiac disease states. Predominant influences on female disease manifestations include (1) women's smaller body size, hence smaller hearts and smaller coronary vessels and (2) women's fluctuating levels of estrogen throughout their lifespan. Understanding these critical anatomic and physiologic differences allows the clinician to better predict and plan care for women. For example, knowing that women generally have a smaller body surface area than men allows one to better understand why men have higher creatine kinase (CK) values than do women--an important distinction when interpreting these values in the acute care setting. The fact that women's hearts and coronary vessels are generally smaller than men's also helps one understand why women have a higher in-hospital mortality than men post-coronary artery bypass graft surgery (see article by Allen in this issue for more detailed information on revascularization). These are only a few examples of the many opportunities that acute care nurses have to integrate their knowledge of anatomy and physiology into proactive planning for their female cardiac patients.

  15. Anatomy and function: PET-CT. (United States)

    Kajander, Sami; Saraste, Antti; Ukkonen, Heikki; Knuuti, Juhani


    CT coronary angiography and perfusion PET form an attractive combination to study coronary artery lesions and their consequences in patients with coronary artery disease. Whereas CT provides non-invasive assessment of coronary lumen and wall, PET perfusion is a reliable method for the evaluation of myocardial flow. CT, although very capable of ruling out significant coronary artery disease, is less than satisfactory in assessing the actual significance of the detected lesions. PET imaging, despite its excellent sensitivity, fails to describe the exact anatomy of the epicardial vessels. By fusing image data from these two modalities, lesions can be accurately correlated with their physiological or anatomical counterparts. Hybrid PET-CT devices, now in wide clinical use, allow such fusion in a one-stop-shop study. Although still seeking its place in clinical scenarios, growing evidence suggests that hybrid PET-CT imaging of coronary anatomy and myocardial perfusion can accurately - and non-invasively - assess the existence and degree of coronary artery disease.

  16. Virtual Reality Educational Tool for Human Anatomy. (United States)

    Izard, Santiago González; Juanes Méndez, Juan A; Palomera, Pablo Ruisoto


    Virtual Reality is becoming widespread in our society within very different areas, from industry to entertainment. It has many advantages in education as well, since it allows visualizing almost any object or going anywhere in a unique way. We will be focusing on medical education, and more specifically anatomy, where its use is especially interesting because it allows studying any structure of the human body by placing the user inside each one. By allowing virtual immersion in a body structure such as the interior of the cranium, stereoscopic vision goggles make these innovative teaching technologies a powerful tool for training in all areas of health sciences. The aim of this study is to illustrate the teaching potential of applying Virtual Reality in the field of human anatomy, where it can be used as a tool for education in medicine. A Virtual Reality Software was developed as an educational tool. This technological procedure is based entirely on software which will run in stereoscopic goggles to give users the sensation of being in a virtual environment, clearly showing the different bones and foramina which make up the cranium, and accompanied by audio explanations. Throughout the results the structure of the cranium is described in detailed from both inside and out. Importance of an exhaustive morphological knowledge of cranial fossae is further discussed. Application for the design of microsurgery is also commented.

  17. Microsurgical anatomy of the abducens nerve. (United States)

    Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L


    The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. Copyright © 2012 Wiley Periodicals, Inc.

  18. Perceptions of cadaveric dissection in anatomy teaching. (United States)

    Naz, Saima; Nazir, Ghazala; Iram, Samia; Mohammad, Malik; Umair; Qari, Iftikhar Hussain; Mohammad, Shaheen


    Anatomy professors world over are lamenting about medical students' lack of interest in dissections and its diminishing utilisation in medical studies. The objective of our study was to find out the reasons why some of the Pakistani medical students were avoiding dissections. We conducted this study in 5 medical colleges of Pakistan from Dec 2010-Oct 2011. Questionnaires were prepared and administered to more than 500 Pakistani medical students, at least 6 months after their first cadaver dissecting session. Mostly 1st and 2nd year medical students participated in this study. Around 43% students have actually performed dissections in some form, whereas around 57% had never touched the cadaver. Further evaluation of these results revealed that out of 57% of students, 45% avoided dissection due to bad smell of formaldehyde, 37% due to moral/ethical grounds, 22% due to low motivation and respect of human body, 19.4% due to anxiety, 18.6% due to religious reason, 16% due to fear, asthma and emotional reaction, 9.4% due to toxic chemical, 8.6% due to laziness and 7% due to nightmares. In spite of availability of required number of cadavers in all 5 medical colleges and a clear realisation amongst the students that dissecting cadaver is an effective way of learning anatomy; majority of students were not very keen and had therefore not performed dissection even once.

  19. Historical development of modern anatomy education in Japan. (United States)

    Sakai, Tatsuo


    Medical schools at the beginning of Meiji era were diverse, both in regard to their founders and their methods of education, frequently employing foreign teachers of various nationalities. In 1871, German teachers were appointed to organize medical education at the medical school of the University of Tokyo. The anatomical education at the school was conducted by German teachers, i.e. Miller (1871-1873), Dönitz (1873-1877), Gierke (1877-1880) and Disse (1880-1885), followed by Koganei, who returned from the study in Germany. At the first meeting of Japanese Association ofAnatomists in 1893 [Meiji 26], the Japanese anatomy teachers met together and most of them were graduates of the University of Tokyo or fellows of its anatomy department. Before 1877 [Meiji 10], the anatomy books were mainly translated from English books, and foreign teachers of various nationalities were employed in many medical schools in Japan. After 1877 [Meiji 10], the anatomy books based on the lectures by German teachers at the University of Tokyo were published. The anatomy books after 1887 [Meiji 20] were written based on German books, and the German anatomical terms were utilized. After 1905 [Meiji 38], the original Japanese anatomy books appeared, employing international anatomical terms. In the Meiji 10s the anatomy teachers and anatomy textbooks spread from the University of Tokyo to the medical schools in Japan as the number of medical schools increased temporally. In the Meiji 20s the five national and three public medical schools in addition to the University of Tokyo provided substantial anatomy education including dissection course. Even in the early Meiji 20s these medical schools supplied only half of the newly licensed doctors, and the others were supplied through the national examination after preparatory education at private medical schools without opportunity of substantial anatomy education including dissection course.

  20. Designing Anatomy Program in Modern Medical Curriculum: Matter of Balance (United States)

    Grković, Ivica; Marinović Guić, Maja; Košta, Vana; Poljičanin, Ana; Čarić, Ana; Vilović, Katarina


    Aim To evaluate the structure of the anatomy program in the first year medical curriculum of University of Split School of Medicine by comparing it with the recommendations by the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) and the Terminologia Anatomica (TA); we also quantitatively evaluated the organization of teaching material in contemporary topographical anatomy textbooks and matched them with the AACA recommendations, TA, and the curriculum of the anatomy course taught at Medical School in Split, Croatia. Methods TA, official recommendations of the AACA, 6 contemporary anatomy textbooks, and the structure of the anatomy course were analyzed for the proportion of the terms or text devoted to standard topographical regions of the body. The findings were correlated using Spearman ρ test. Results The curriculum outline correlated both with the AACA recommendations (Spearman ρ = 0.83, P = 0.015) and TA (Spearman ρ = 0.73, P = 0.046). Textbooks contained 8 distinct sections, 7 allocated to topographic anatomy regions and 1 to general anatomy concepts and principles. The structure of all textbooks correlated significantly with the course curriculum. However, 4 out of 6 textbooks did not correlate with TA and only a single textbook showed significant correlation with the AACA recommendations. Conclusion Anatomy textbooks vary in the amount of text dedicated to different parts of topographical anatomy and are not quite concordant with curriculum recommendations and standard anatomical terminology. Planning the structure of an anatomy course should not be based on a single book or recommendation but on evidence. PMID:19260144

  1. Learning Anatomy through Thiel- vs. Formalin-Embalmed Cadavers: Student Perceptions of Embalming Methods and Effect on Functional Anatomy Knowledge (United States)

    Kennel, Larissa; Martin, David M. A.; Shaw, Hannah; Wilkinson, Tracey


    Thiel-embalmed cadavers, which have been adopted for use in anatomy teaching in relatively few universities, show greater flexibility and color retention compared to formalin-embalmed cadavers, properties which might be considered advantageous for anatomy teaching. This study aimed to investigate student attitudes toward the dissection experience…

  2. Anatomy learning styles and strategies among Jordanian and Malaysian medical students: the impact of culture on learning anatomy. (United States)

    Mustafa, Ayman G; Allouh, Mohammed Z; Mustafa, Intisar G; Hoja, Ibrahim M


    The study aims to investigate anatomy learning styles and strategies of Jordanian and Malaysian medical students at the Jordan University of Science and Technology. The study is a cross-sectional questionnaire-based study. Students' responses for the questionnaire were numerically coded, and the results were analyzed to reveal statistically significant differences between Jordanian and Malaysian students. The results showed that Jordanian medical students were less interested in using cadavers in learning anatomy than Malaysian medical students. However, similar to their Malaysian counterparts, they prefer to employ other tools to learn anatomy like plastinated models and Internet-based resources. In addition to the aforementioned tools, Malaysian students were more interested in using cross-sectional images and making their own revision cards. Both Jordanian and Malaysian medical students were more interested in learning anatomy through clinical cases, and by system rather than by region. Moreover, it was revealed that Jordanian medical students learn anatomy more efficiently when they formulate a general view of a particular topic. Both Jordanian and Malaysian medical students also relied on reciting definitions and memorizing facts to learn anatomy. The study also reported significant differences between Jordanian and Malaysian students' perspectives on learning anatomy. The findings of the study suggest that Jordanian and Malaysian medical students posses different cultures of learning. Jordanian anatomy instructors need to consider these different learning cultures when they prepare their instructional methods and teaching materials to fulfill the educational needs of their culturally diverse students.

  3. An exploration of the factors that contribute to learning satisfaction of first-year anatomy and physiology students. (United States)

    Eagleton, Saramarie


    Lecturers have reverted to using a "blended" approach when teaching anatomy and physiology. Student responses as to how this contributes to their learning satisfaction were investigated using a self-administered questionnaire. The questionnaire consisted of closed- and open-ended questions that were based on three determinants of learning satisfaction: perceived course learnability, learning community support, and perceived learning effectiveness. Regarding course learnability, students responded positively on questions regarding the relevance of the subject for their future careers. However, students identified a number of distractions that prevented them from paying full attention to their studies. As far as learning community support was concerned, respondents indicated that they were more comfortable asking a peer for support if they were unsure of concepts than approaching the lecturing staff. Most of the students study in their second language, and this was identified as a stumbling block for success. There was a difference in opinion among students regarding the use of technology for teaching and learning of anatomy and physiology. From students' perceptions regarding learning effectiveness, it became clear that students' expectations of anatomy and physiology were unrealistic; they did not expect the module to be so comprehensive. Many of the students were also "grade oriented" rather than "learning oriented" as they indicated that they were more concerned about results than "owning" the content of the module. Asking students to evaluate aspects of the teaching and learning process have provided valuable information to improve future offerings of anatomy and physiology. Copyright © 2015 The American Physiological Society.

  4. Clinical anatomy and significance of the thoracic intervertebral foramen: A cadaveric study and review of the literature. (United States)

    Gkasdaris, Grigorios; Tripsianis, Grigorios; Kotopoulos, Konstantinos; Kapetanakis, Stylianos


    The literature is lacking information on the anatomy and the osseous dimensions of the thoracic intervertebral foramen (IVF). We describe the anatomy of the broader area, and we proceed with morphometric data of the vertebrae and the foramina. Depiction of these features is provided with imaging and illustrations. The purpose of this paper is to survey and present the anatomy of the foramen as a whole and provide baseline statistical data. We review relevant literature, and we present data obtained from skeletal samples of known population and sex. One hundred and nineteen thoracic vertebrae of ten cadaveric spines from the prefecture of Eastern Macedonia and Thrace, Greece, were selected. Statistical analysis measuring the vertical height and the foraminal width of each vertebra was made in accordance with sex. No statistically important differences referring to the descriptive data of both sexes were found. However, statistically, important positive correlation between the vertebral height and the foraminal width was observed, especially for men. The components of the foramen including arteries and veins passing through or neighboring it, and the spinal nerves and roots are described and depicted. The osseous thoracic IVF reveals a glimpse of the in vivo structure and alterations of its width may be present in back pain and other degenerative diseases. Although it is crucial for surgeries and other interventional procedures of the thoracic spine, little is known about the precise anatomy and dimensions of this anatomical landmark.

  5. Clinical anatomy and significance of the thoracic intervertebral foramen: A cadaveric study and review of the literature

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    Grigorios Gkasdaris


    Full Text Available Introduction: The literature is lacking information on the anatomy and the osseous dimensions of the thoracic intervertebral foramen (IVF. We describe the anatomy of the broader area, and we proceed with morphometric data of the vertebrae and the foramina. Depiction of these features is provided with imaging and illustrations. The purpose of this paper is to survey and present the anatomy of the foramen as a whole and provide baseline statistical data. Materials and Methods: We review relevant literature, and we present data obtained from skeletal samples of known population and sex. One hundred and nineteen thoracic vertebrae of ten cadaveric spines from the prefecture of Eastern Macedonia and Thrace, Greece, were selected. Statistical analysis measuring the vertical height and the foraminal width of each vertebra was made in accordance with sex. Results: No statistically important differences referring to the descriptive data of both sexes were found. However, statistically, important positive correlation between the vertebral height and the foraminal width was observed, especially for men. The components of the foramen including arteries and veins passing through or neighboring it, and the spinal nerves and roots are described and depicted. Conclusions: The osseous thoracic IVF reveals a glimpse of the in vivo structure and alterations of its width may be present in back pain and other degenerative diseases. Although it is crucial for surgeries and other interventional procedures of the thoracic spine, little is known about the precise anatomy and dimensions of this anatomical landmark.

  6. Patient specific anatomy: the new area of anatomy based on computer science illustrated on liver. (United States)

    Soler, Luc; Mutter, Didier; Pessaux, Patrick; Marescaux, Jacques


    Over the past century, medical imaging has brought a new revolution: internal anatomy of a patient could be seen without any invasive technique. This revolution has highlighted the two main limits of current anatomy: the anatomical description is physician dependent, and the average anatomy is more and more frequently insufficient to describe anatomical variations. These drawbacks can sometimes be so important that they create mistakes but they can be overcome through the use of 3D patient-specific surgical anatomy. In this article, we propose to illustrate such improvement of standard anatomy on liver. We first propose a general scheme allowing to easily compare the four main liver anatomical descriptions by Takasaki, Goldsmith and Woodburne, Bismuth and Couinaud. From this general scheme we propose four rules to apply in order to correct these initial anatomical definitions. Application of these rules allows to correct usual vascular topological mistakes of standard anatomy. We finally validate such correction on a database of 20 clinical cases compared to the 111 clinical cases of a Couinaud article. Out of the 20 images of the database, we note a revealing difference in 14 cases (70%) on at least one important branch of the portal network. Only six cases (30%) do not present a revealing difference between both labellings. We also show that the right portal fissure location on our 20 cases defined between segment V and VI of our anatomical definition is well correlated with the real position described by Couinaud on 111 cases, knowing that the theoretical position was only found in 46 cases out of 111, i.e., 41.44% of cases with the non-corrected Couinaud definition. We have proposed a new anatomical segmentation of the liver based on four main rules to apply in order to correct topological errors of the four main standard segmentations. Our validation clearly illustrates that this new definition corrects the large amount of mistakes created by the current

  7. Genotoxic damage in pathology anatomy laboratory workers exposed to formaldehyde

    International Nuclear Information System (INIS)

    Costa, Solange; Coelho, Patricia; Costa, Carla; Silva, Susana; Mayan, Olga; Silva Santos, Luis; Gaspar, Jorge; Teixeira, Joao Paulo


    Formaldehyde (FA) is a chemical traditionally used in pathology and anatomy laboratories as a tissue preservative. Several epidemiological studies of occupational exposure to FA have indicated an increased risk of nasopharyngeal cancers in industrial workers, embalmers and pathology anatomists. There is also a clear evidence of nasal squamous cell carcinomas from inhalation studies in the rat. The postulated mode of action for nasal tumours in rats was considered biologically plausible and considered likely to be relevant to humans. Based on the available data IARC, the International Agency for Research on Cancer, has recently classified FA as a human carcinogen. Although the in vitro genotoxic as well as the in vivo carcinogenic potentials of FA are well documented in mammalian cells and in rodents, evidence for genotoxic effects and carcinogenic properties in humans is insufficient and conflicting thus remains to be more documented. To evaluate the genetic effects of long-term occupational exposure to FA a group of 30 Pathological Anatomy laboratory workers was tested for a variety of biological endpoints, cytogenetic tests (micronuclei, MN; sister chromatid exchange, SCE) and comet assay. The level of exposure to FA was evaluated near the breathing zone of workers, time weighted average of exposure was calculated for each subject. The association between the biomarkers and polymorphic genes of xenobiotic metabolising and DNA repair enzymes was also assessed. The mean level of exposure was 0.44 ± 0.08 ppm (0.04-1.58 ppm). MN frequency was significantly higher (p = 0.003) in the exposed subjects (5.47 ± 0.76) when compared with controls (3.27 ± 0.69). SCE mean value was significantly higher (p < 0.05) among the exposed group (6.13 ± 0.29) compared with control group (4.49 ± 0.16). Comet assay data showed a significant increase (p < 0.05) of TL in FA-exposed workers (60.00 ± 2.31) with respect to the control group (41.85 ± 1.97). A positive correlation was

  8. Clinical Relevance of Adipokines

    Directory of Open Access Journals (Sweden)

    Matthias Blüher


    Full Text Available The incidence of obesity has increased dramatically during recent decades. Obesity increases the risk for metabolic and cardiovascular diseases and may therefore contribute to premature death. With increasing fat mass, secretion of adipose tissue derived bioactive molecules (adipokines changes towards a pro-inflammatory, diabetogenic and atherogenic pattern. Adipokines are involved in the regulation of appetite and satiety, energy expenditure, activity, endothelial function, hemostasis, blood pressure, insulin sensitivity, energy metabolism in insulin sensitive tissues, adipogenesis, fat distribution and insulin secretion in pancreatic β-cells. Therefore, adipokines are clinically relevant as biomarkers for fat distribution, adipose tissue function, liver fat content, insulin sensitivity, chronic inflammation and have the potential for future pharmacological treatment strategies for obesity and its related diseases. This review focuses on the clinical relevance of selected adipokines as markers or predictors of obesity related diseases and as potential therapeutic tools or targets in metabolic and cardiovascular diseases.

  9. Information Needs/Relevance


    Wildemuth, Barbara M.


    A user's interaction with a DL is often initiated as the result of the user experiencing an information need of some kind. Aspects of that experience and how it might affect the user's interactions with the DL are discussed in this module. In addition, users continuously make decisions about and evaluations of the materials retrieved from a DL, relative to their information needs. Relevance judgments, and their relationship to the user's information needs, are discussed in this module. Draft

  10. Volumetric visualization of anatomy for treatment planning

    International Nuclear Information System (INIS)

    Pelizzari, Charles A.; Grzeszczuk, Robert; Chen, George T. Y.; Heimann, Ruth; Haraf, Daniel J.; Vijayakumar, Srinivasan; Ryan, Martin J.


    Purpose: Delineation of volumes of interest for three-dimensional (3D) treatment planning is usually performed by contouring on two-dimensional sections. We explore the usage of segmentation-free volumetric rendering of the three-dimensional image data set for tumor and normal tissue visualization. Methods and Materials: Standard treatment planning computed tomography (CT) studies, with typically 5 to 10 mm slice thickness, and spiral CT studies with 3 mm slice thickness were used. The data were visualized using locally developed volume-rendering software. Similar to the method of Drebin et al., CT voxels are automatically assigned an opacity and other visual properties (e.g., color) based on a probabilistic classification into tissue types. Using volumetric compositing, a projection into the opacity-weighted volume is produced. Depth cueing, perspective, and gradient-based shading are incorporated to achieve realistic images. Unlike surface-rendered displays, no hand segmentation is required to produce detailed renditions of skin, muscle, or bony anatomy. By suitable manipulation of the opacity map, tissue classes can be made transparent, revealing muscle, vessels, or bone, for example. Manually supervised tissue masking allows irrelevant tissues overlying tumors or other structures of interest to be removed. Results: Very high-quality renditions are produced in from 5 s to 1 min on midrange computer workstations. In the pelvis, an anteroposterior (AP) volume rendered view from a typical planning CT scan clearly shows the skin and bony anatomy. A muscle opacity map permits clear visualization of the superficial thigh muscles, femoral veins, and arteries. Lymph nodes are seen in the femoral triangle. When overlying muscle and bone are cut away, the prostate, seminal vessels, bladder, and rectum are seen in 3D perspective. Similar results are obtained for thorax and for head and neck scans. Conclusion: Volumetric visualization of anatomy is useful in treatment

  11. Imaging of jaw with dental CT software program: Normal Anatomy

    International Nuclear Information System (INIS)

    Kim, Myong Gon; Seo, Kwang Hee; Jung, Hak Young; Sung, Nak Kwan; Chung, Duk Soo; Kim, Ok Dong; Lee, Young Hwan


    Dental CT software program can provide reformatted cross-sectional and panoramic images that cannot be obtained with conventional axial and direct coronal CT scan. The purpose of this study is to describe the method of the technique and to identify the precise anatomy of jaw. We evaluated 13 mandibles and 7 maxillae of 15 subjects without bony disease who were being considered for endosseous dental implants. Reformatted images obtained by the use of bone algorithm performed on GE HiSpeed Advantage CT scanner were retrospectively reviewed for detailed anatomy of jaw. Anatomy related to neurovascular bundle(mandibular foramen, inferior alveolar canal, mental foramen, canal for incisive artery, nutrient canal, lingual foramen and mylohyoid groove), muscular insertion(mylohyoid line, superior and inferior genial tubercle and digastric fossa) and other anatomy(submandibular fossa, sublingual fossa, contour of alveolar process, oblique line, retromolar fossa, temporal crest and retromolar triangle) were well delineated in mandible. In maxilla, anatomy related to neurovascular bundle(greater palatine foramen and groove, nasopalatine canal and incisive foramen) and other anatomy(alveolar process, maxillary sinus and nasal fossa) were also well delineated. Reformatted images using dental CT software program provided excellent delineation of the jaw anatomy. Therefore, dental CT software program can play an important role in the preoperative assessment of mandible and maxilla for dental implants and other surgical conditions

  12. Occurrence and evolutionary inferences about Kranz anatomy in Cyperaceae (Poales

    Directory of Open Access Journals (Sweden)



    Full Text Available ABSTRACT Cyperaceae is an angiosperm family with the greatest diversity of species with Kranz anatomy. Four different types of Kranz anatomy (chlorocyperoid, eleocharoid, fimbristyloid and rhynchosporoid have been described for this angiosperm family, and the occurrence and structural characteristics of these types are important to trace evolutionary hypotheses. The purpose of this study was to examine the available data on Cyperaceae Kranz anatomy, emphasizing taxonomy, geographic distribution, habitat and anatomy, to infer the potential origin of the Kranz anatomy in this family. The results showed that the four types of Kranz anatomy (associated with C4 photosynthesis in Cyperaceae emerged numerous times in unrelated phylogenetic groups. However, the convergence of these anatomical types, except rhynchosporoid, was observed in certain groups. Thus, the diverse origin of these species might result from different environmental pressures that promote photorespiration. Greater variation in occurrence of Kranz anatomy and anatomical types was observed inEleocharis, whose emergence of the C4 pathway was recent compared with other genera in the family, and the species of this genus are located in aquatic environments.

  13. Locomotion and basicranial anatomy in primates and marsupials. (United States)

    Villamil, Catalina I


    There is ongoing debate in paleoanthropology about whether and how the anatomy of the cranium, and especially the cranial base, is evolving in response to locomotor and postural changes. However, the majority of studies focus on two-dimensional data, which fails to capture the complexity of cranial anatomy. This study tests whether three-dimensional cranial base anatomy is linked to locomotion or to other factors in primates (n = 473) and marsupials (n = 231). Results indicate that although there is a small effect of locomotion on cranial base anatomy in primates, this is not the case in marsupials. Instead, facial anatomy likely drives variation in cranial base anatomy in both primates and marsupials, with additional roles for body size and brain size. Although some changes to foramen magnum position and orientation are phylogenetically useful among the hominoids, they do not necessarily reflect locomotion or positional behavior. The interplay between locomotion, posture, and facial anatomy in primates requires further investigation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Variability and reliability of the vastus lateralis muscle anatomy. (United States)

    D'Arpa, Salvatore; Toia, Francesca; Brenner, Erich; Melloni, Carlo; Moschella, Francesco; Cordova, Adriana


    The aims of this study are to investigate the variability of the morphological and neurovascular anatomy of the vastus lateralis (VL) muscle and to describe the relationships among its intramuscular partitions and with the other muscles of the quadriceps femoris. Clinical implications in its reliability as a flap donor are also discussed. In 2012, the extra- and intramuscular neurovascular anatomy of the VL was investigated in 10 cadaveric lower limbs. In three specimens, the segmental arterial pedicles were injected with latex of different colors to point out their anastomotic connections. The morphological anatomy was investigated with regard to the mutual relationship of the three muscular partitions and the relation of the VL with the other muscles of the quadriceps femoris. The VL has a segmental morphological anatomy. However, the fibers of its three partitions interconnect individually and with the other bellies of the quadriceps femoris, particularly, in several variable portions with the vastus intermedius and mainly in the posterior part of the VL. The lateral circumflex femoral artery and its branches have variable origin, but demonstrate constant segmental distribution. Intramuscular dissection and colored latex injections show a rich anastomotic vascular network among the three partitions. Moderate variability exists in both the myological and the neurovascular anatomy of the VL. Despite this variability, the anatomy of the VL always has a constant segmental pattern, which makes the VL a reliable flap donor. Detailed knowledge of the VL anatomy could have useful applications in a broad clinical field.

  15. Spatial abilities and anatomy knowledge assessment: A systematic review. (United States)

    Langlois, Jean; Bellemare, Christian; Toulouse, Josée; Wells, George A


    Anatomy knowledge has been found to include both spatial and non-spatial components. However, no systematic evaluation of studies relating spatial abilities and anatomy knowledge has been undertaken. The objective of this study was to conduct a systematic review of the relationship between spatial abilities test and anatomy knowledge assessment. A literature search was done up to March 20, 2014 in Scopus and in several databases on the OvidSP and EBSCOhost platforms. Of the 556 citations obtained, 38 articles were identified and fully reviewed yielding 21 eligible articles and their quality were formally assessed. Non-significant relationships were found between spatial abilities test and anatomy knowledge assessment using essays and non-spatial multiple-choice questions. Significant relationships were observed between spatial abilities test and anatomy knowledge assessment using practical examination, three-dimensional synthesis from two-dimensional views, drawing of views, and cross-sections. Relationships between spatial abilities test and anatomy knowledge assessment using spatial multiple-choice questions were unclear. The results of this systematic review provide evidence for spatial and non-spatial methods of anatomy knowledge assessment. Anat Sci Educ 10: 235-241. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  16. Dental CT: examination technique, radiation load and anatomy; Dental-CT: Untersuchungstechnik, Strahlenbelastung und Anatomie

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    Lenglinger, F.X.; Muhr, T. [AKH Wels (Austria). Inst. fuer Radiologie; Krennmair, G. [Praxis fuer Zahn-, Mund- und Kieferheilkunde und Implantologie, Marchtrenk (Austria)


    Traditionally oral surgeons and dentists have evaluated the jaws using intraoral films and panoramic radiographs. The involvement of radiologists has been limited. In the past few years dedicated CT-software-programs developed to evaluate dental implant patients have provided a new look at the jaws. The complex anatomy is described and identified on human skulls and on axial, panoramic, and cross-sectional images. With this anatomic description Dental-CT-scans are used to demonstrate the anatomy of maxilla and the mandible. An overview of the technique of Dental-CT is provided, furthermore the radiation dose of different organs is explained. Suggestions to reduce these doses by simple modifications of the recommended protocols are given. (orig.) [German] Die Einfuehrung im Bereich der Computertomographiesoftware (Dental-CT) ermoeglicht dem Radiologen zusaetzlich zu den ueblichen, von den Zahnaerzten durchgefuehrten Roentgenuntersuchungen eine ueberlagerungs- und verzerrungsfreie Darstellung des Ober- und Unterkiefers. In der Implantologie ist mit dieser Darstellung eine exakte Planung moeglich. Weiterhin haben sich Duennschicht-CT-Untersuchungen auch bei der Abklaerung von Zysten, Tumoren, Frakturen, tiefen Parodontitiden und retinierten Zaehnen bewaehrt. In dieser Zeit wird ein Ueberblick ueber die Anatomie, die Untersuchungstechnik des Dental-CT und die auftretende Strahlenbelastung gegeben. Basierend auf rezente Literaturangaben kann eine Reduktion der absorbierten Dosis bei gleichbleibender Bildqualitaet durch einfache Protokollmodifikationen erzielt werden. (orig.)

  17. Arthroscopic anatomy of the subdeltoid space

    Directory of Open Access Journals (Sweden)

    Michael J. Salata


    Full Text Available From the first shoulder arthroscopy performed on a cadaver in 1931, shoulder arthroscopy has grown tremendously in its ability to diagnose and treat pathologic conditions about the shoulder. Despite improvements in arthroscopic techniques and instrumentation, it is only recently that arthroscopists have begun to explore precise anatomical structures within the subdeltoid space. By way of a thorough bursectomy of the subdeltoid region, meticulous hemostasis, and the reciprocal use of posterior and lateral viewing portals, one can identify a myriad of pertinent ligamentous, musculotendinous, osseous, and neurovascular structures. For the purposes of this review, the subdeltoid space has been compartmentalized into lateral, medial, anterior, and posterior regions. Being able to identify pertinent structures in the subdeltoid space will provide shoulder arthroscopists with the requisite foundation in core anatomy that will be required for challenging procedures such as arthroscopic subscapularis mobilization and repair, biceps tenodesis, subcoracoid decompression, suprascapular nerve decompression, quadrangular space decompression and repair of massive rotator cuff tears.

  18. Clinical anatomy of fecal incontinence in women. (United States)

    Kadam-Halani, Priyanka K; Arya, Lily A; Andy, Uduak U


    Fecal incontinence is a devastating condition that has a severe impact on quality of life. This condition disproportionately affects women and its incidence is increasing with the aging United States population. Fecal continence is maintained by coordination of a functioning anal sphincter complex, intact sensation of the anorectum, rectal compliance, and the ability to consciously control defecation. Particularly important are the puborectalis sling of the levator ani muscle complex and intact innervation of the central and peripheral nervous systems. An understanding of the intricate anatomy required to maintain continence and regulate defecation will help clinicians to provide appropriate medical and surgical management and diminish the negative impact of fecal incontinence. In this article, we describe the anatomic and neural basis of fecal continence and normal defecation as well as changes that occur with fecal incontinence in women. Clin. Anat. 30:901-911, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Anatomy and physiology of the esophagus. (United States)

    Gavaghan, M


    Modern diagnosis and treatment of esophageal disease is a result of progress in assessing the anatomy and physiology of the esophagus, as well as refinements in anesthetic and surgical techniques. Esophageal carcinoma spreads rapidly and metastasizes easily. The tendency for early spread and the absence of symptoms result in late diagnosis that reduces treatment options and cure rates. Lifestyle (i.e., use of alcohol and tobacco), nutritional deficiencies, ingestion of nitrosamines, and mutagen-inducing fungi are blamed for cancer of the esophagus. Other pathologic conditions (e.g., achalasia, Barrett's epithelium, gastric reflux, hiatal hernia) are potential contributors to the development of carcinoma. Nurses are in key positions to identify the existence of factors contributing to premalignant or malignant lesions and to educate patients and make the appropriate referrals.

  20. Scapulothoracic Anatomy and Snapping Scapula Syndrome

    Directory of Open Access Journals (Sweden)

    Rachel M. Frank


    Full Text Available The scapulothoracic articulation is a sliding junction between the deep aspect of the scapula and thoracic rib cage at the levels of ribs 2 through 7. Motion at this articulation is dynamically stabilized by a variety of muscular attachments, allowing for controlled positioning of the glenoid to assist in glenohumeral joint function. A thorough understanding of the complex anatomic relationships, including the various muscles, and bursa, is critical to the evaluation of patients presenting with scapulothoracic disorders. The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. The purpose of this review is to discuss the anatomy of the scapulothoracic articulation with an emphasis on the pathology associated with snapping scapula syndrome.

  1. Distal radioulnar joint: functional anatomy, including pathomechanics. (United States)

    Haugstvedt, J R; Langer, M F; Berger, R A


    The distal radioulnar joint allows the human to rotate the forearm to place the hand in a desired position to perform different tasks, without interfering with the grasping function of the hand. The ulna is the stable part of the forearm around which the radius rotates; the stability of the distal radioulnar joint is provided by the interaction between ligaments, muscles and bones. The stabilizing structures are the triangular fibrocartilage complex, the ulnocarpal ligament complex, the extensor carpi ulnaris tendon and tendon sheath, the pronator quadratus, the interosseous membrane and ligament, the bone itself and the joint capsule. The purpose of this review article is to present and illustrate the current understanding of the functional anatomy and pathomechanics of this joint.

  2. Anatomi Kurikulum Pendidikan Agama Islam di Sekolah

    Directory of Open Access Journals (Sweden)

    Marliana Marliana


    Full Text Available Anatomy of curriculum is described as the components that must be present in every curriculum that can be used for the learning process. They are objectives of the curriculum, materials of teaching, contents of the curriculum, strategies or methods, media and evaluation and improvement of teaching. These components are interconnected to one another. Each component has a content which is very important for the continuity of the curriculum. One of the most important parts of the curriculum is procces of learning as an empowering or enable the students. Thus, the need for active and participatory interaction between students and academic material or with a certain situation so that matter can be transformed into the learning experience of students.

  3. Gross anatomy education for South African undergraduate physiotherapy students. (United States)

    Shead, Dorothy A; Roos, Ronel; Olivier, Benita; Ihunwo, Amadi O


    Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

  4. Arthroscopic knee anatomy in young achondroplasia patients (United States)

    del Pilar Duque Orozco, M.; Record, N. C.; Rogers, K. J; Bober, M. B.; Mackenzie, W. G.; Atanda, A.


    Abstract Purpose Achondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy. Methods Records of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed. Bony, cartilaginous and ligamentous changes were noted. The trochlea sulcus angle was measured from intra-operative arthroscopic images. Results A total of 12 knee arthroscopies in nine patients were performed. The mean age at surgery was 16.9 years (12 to 22). In all patients, the indication for surgery was knee pain and/or mechanical symptoms that were refractory to non-operative treatment. Three anatomical variations involving the distal femur were found in all knees: a deep femoral trochlea; a high A-shaped intercondylar notch; and a vertically oriented anterior cruciate ligament. The average trochlea sulcus angle measured 123°. Pathology included: synovial plica (one knee); chondral lesions (three knees); discoid lateral meniscus (11 knees); and meniscal tears (six knees). All patients were pain-free and returned to normal activity at final follow-up. Conclusion Children with achondroplasia have characteristic distal femur anatomy noted during knee arthroscopy. These variations should be considered normal during knee arthroscopy in these patients. Arthroscopic findings confirmed previous MRI findings within this specific population with the addition of a deep trochlear groove which was not previously reported. PMID:28828058

  5. Forearm interosseous membrane imaging and anatomy. (United States)

    McGinley, Joseph C; Roach, Neil; Gaughan, John P; Kozin, Scott H


    To determine the regional thickness variation of the interosseous membrane (IOM) along the forearm and validate magnetic resonance imaging of the IOM with laser micrometry. Axial thickness measurements of 12 cadaver forearms were obtained using magnetic resonance imaging (MRI) at radial, central, and ulnar locations. The specimens were dissected, and IOM thickness measured using a laser micrometer. MRI and laser measurements of the main and oblique IOM bundles were compared. An axial thickness profile was plotted versus forearm length, and radial, central, and ulnar positions were compared. The main bundle thickness was 2.18+/-0.20 mm using laser micrometry, which was not significantly different from MRI measurements (1.86+/-0.25 mm, p=0.11, power = 0.84). The dorsal oblique bundle thickness was not significantly different between measurement methods (2.93+/-0.77 mm and 3.30+/-1.64 mm using laser micrometry and MRI respectively, p=0.75, power = 0.04). Both methods demonstrated a progressive increase in thickness proximally within the forearm. MRI measurements demonstrated a significantly greater thickness increase in the radial location compared to the central location (slope = 2.26 and 1.05, r(2)=0.31 and 0.12 respectively, p0.05). Our findings describe the varying IOM anatomy using MRI, and determined the location of the clinically important IOM fiber bundles. This study confirms the accuracy of MR imaging of the IOM by comparison with a laser micrometer, and demonstrates the thickness variation along the forearm. This information may be used to identify changes in IOM anatomy with both acute IOM injury and chronic fiber attenuation.

  6. Forearm interosseous membrane imaging and anatomy

    Energy Technology Data Exchange (ETDEWEB)

    McGinley, Joseph C. [Temple University, School of Medicine, Philadelphia, Pennsylvania (United States); Roach, Neil [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania (United States); Gaughan, John P. [Temple University, Department of Biostatistics, Philadelphia, Pennsylvania (United States); Kozin, Scott H. [Shriners Hospitals for Children, Pediatric Hand and Upper Extremity Surgery, Philadelphia (United States); Temple University, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania (United States)


    To determine the regional thickness variation of the interosseous membrane (IOM) along the forearm and validate magnetic resonance imaging of the IOM with laser micrometry. Axial thickness measurements of 12 cadaver forearms were obtained using magnetic resonance imaging (MRI) at radial, central, and ulnar locations. The specimens were dissected, and IOM thickness measured using a laser micrometer. MRI and laser measurements of the main and oblique IOM bundles were compared. An axial thickness profile was plotted versus forearm length, and radial, central, and ulnar positions were compared. The main bundle thickness was 2.18{+-}0.20 mm using laser micrometry, which was not significantly different from MRI measurements (1.86{+-}0.25 mm, p=0.11, power = 0.84). The dorsal oblique bundle thickness was not significantly different between measurement methods (2.93{+-}0.77 mm and 3.30{+-}1.64 mm using laser micrometry and MRI respectively, p=0.75, power = 0.04). Both methods demonstrated a progressive increase in thickness proximally within the forearm. MRI measurements demonstrated a significantly greater thickness increase in the radial location compared to the central location (slope = 2.26 and 1.05, r{sup 2}=0.31 and 0.12 respectively, p<0.05). The ulnar slope was not significantly different from zero (r{sup 2}=0.02, p>0.05). Our findings describe the varying IOM anatomy using MRI, and determined the location of the clinically important IOM fiber bundles. This study confirms the accuracy of MR imaging of the IOM by comparison with a laser micrometer, and demonstrates the thickness variation along the forearm. This information may be used to identify changes in IOM anatomy with both acute IOM injury and chronic fiber attenuation. (orig.)

  7. Forearm interosseous membrane imaging and anatomy

    International Nuclear Information System (INIS)

    McGinley, Joseph C.; Roach, Neil; Gaughan, John P.; Kozin, Scott H.


    To determine the regional thickness variation of the interosseous membrane (IOM) along the forearm and validate magnetic resonance imaging of the IOM with laser micrometry. Axial thickness measurements of 12 cadaver forearms were obtained using magnetic resonance imaging (MRI) at radial, central, and ulnar locations. The specimens were dissected, and IOM thickness measured using a laser micrometer. MRI and laser measurements of the main and oblique IOM bundles were compared. An axial thickness profile was plotted versus forearm length, and radial, central, and ulnar positions were compared. The main bundle thickness was 2.18±0.20 mm using laser micrometry, which was not significantly different from MRI measurements (1.86±0.25 mm, p=0.11, power = 0.84). The dorsal oblique bundle thickness was not significantly different between measurement methods (2.93±0.77 mm and 3.30±1.64 mm using laser micrometry and MRI respectively, p=0.75, power = 0.04). Both methods demonstrated a progressive increase in thickness proximally within the forearm. MRI measurements demonstrated a significantly greater thickness increase in the radial location compared to the central location (slope = 2.26 and 1.05, r 2 =0.31 and 0.12 respectively, p 2 =0.02, p>0.05). Our findings describe the varying IOM anatomy using MRI, and determined the location of the clinically important IOM fiber bundles. This study confirms the accuracy of MR imaging of the IOM by comparison with a laser micrometer, and demonstrates the thickness variation along the forearm. This information may be used to identify changes in IOM anatomy with both acute IOM injury and chronic fiber attenuation. (orig.)

  8. The anatomy of the hip abductor muscles. (United States)

    Flack, N A M S; Nicholson, H D; Woodley, S J


    The anatomy of the hip abductors has not been comprehensively examined, yet is important to understanding function and pathology in the gluteal region. For example, pathology of the hip abductor muscle-tendon complexes can cause greater trochanteric pain syndrome, and may be associated with gluteal atrophy and fatty infiltration. The purpose of this study was to investigate the detailed morphology of gluteus medius (GMed), gluteus minimus (GMin), and tensor fascia lata (TFL), and determine whether the muscles comprised anatomical compartments. The gluteal region from 12 cadavers was dissected and data collected on attachment sites, volume, fascicular and tendinous anatomy, and innervation. Three sites of GMed origin were identified (gluteal fossa, gluteal aponeurosis, and posteroinferior edge of the iliac crest) and the distal tendon had lateral and posterior parts. GMed was the largest in volume (27.6 ± 11.6 cm(3); GMin 14.1 ± 11.1 cm(3); TFL 1.8 ± 0.8 cm(3)). Fascicles of GMin originated from the gluteal fossa, inserting onto the deep surface of its distal tendon and the hip joint capsule. TFL was encapsulated in the fascia lata, having no bony attachment. Primary innervation patterns varied for GMed, with three or four branches supplying different regions of muscle. Distinct secondary nerve branches entered four regions of GMin; no differential innervation was observed for TFL. On the basis of architectural parameters and innervation, GMed, and GMin each comprise of four compartments but TFL is a homogenous muscle. It is anticipated that these data will be useful for future clinical and functional studies of the hip abductors. Copyright © 2013 Wiley Periodicals, Inc.

  9. Xeroradiographic anatomy of the equine digit and metacarpophalangeal region

    International Nuclear Information System (INIS)

    Smallwood, J.E.; Holladay, S.D.


    The purpose of the project was to use xeroradiography to provide a reference for radiographic anatomy of the equine digit and metacarpophalangeal region. The left foredigits and metacarpophalangeal joints of a mature horse and a 30-day-old foal were radiographed, using xeroradiographic techniques. Fifteen xeroradiographs, illustrating standard projections of each area, were selected and appropriately labeled to demonstrate normal radiographic anatomy of these regions. These xeroradiographs have been used successfully for several years to teach radiographic anatomy of these areas to first-year veterinary students at North Carolina State University

  10. Magnetic resonance imaging (MRI) in obstetrics. II. Fetal anatomy. (United States)

    Powell, M C; Worthington, B S; Buckley, J M; Symonds, E M


    Magnetic resonance imaging (MRI) was performed in 36 patients at between 10 and 38 weeks gestation to determine the fetal anatomy that could be identified at different gestations. Fetal motion significantly degraded the image quality in the first and second trimesters, but in the final trimester fetal anatomy was clearly demonstrated. T2 weighted sequences showed the fetal brain and lungs to have a high signal intensity. Shorter TR leading to a T1 weighting gave better resolution of the overall anatomy. MRI has revealed the potential for assessment of lung maturity and the growth-retarded fetus.

  11. Anatomy and Histology of the Human and Murine Prostate. (United States)

    Ittmann, Michael


    The human and murine prostate glands have similar functional roles in the generation of seminal fluid to assist in reproduction. There are significant differences in the anatomy and histology of murine and human prostate and knowledge of the normal anatomy and histology of the murine prostate is essential to interpreting changes in genetically engineered mouse models. In this review, the normal anatomy and histology of both human and mouse prostate will be described. Copyright © 2018 Cold Spring Harbor Laboratory Press; all rights reserved.

  12. [Relevant public health enteropathogens]. (United States)

    Riveros, Maribel; Ochoa, Theresa J


    Diarrhea remains the third leading cause of death in children under five years, despite recent advances in the management and prevention of this disease. It is caused by multiple pathogens, however, the prevalence of each varies by age group, geographical area and the scenario where cases (community vs hospital) are recorded. The most relevant pathogens in public health are those associated with the highest burden of disease, severity, complications and mortality. In our country, norovirus, Campylobacter and diarrheagenic E. coli are the most prevalent pathogens at the community level in children. In this paper we review the local epidemiology and potential areas of development in five selected pathogens: rotavirus, norovirus, Shiga toxin-producing E. coli (STEC), Shigella and Salmonella. Of these, rotavirus is the most important in the pediatric population and the main agent responsible for child mortality from diarrhea. The introduction of rotavirus vaccination in Peru will have a significant impact on disease burden and mortality from diarrhea. However, surveillance studies are needed to determine the impact of vaccination and changes in the epidemiology of diarrhea in Peru following the introduction of new vaccines, as well as antibiotic resistance surveillance of clinical relevant bacteria.

  13. Other relevant biological papers

    International Nuclear Information System (INIS)

    Shimizu, M.


    A considerable number of CRESP-relevant papers concerning deep-sea biology and radioecology have been published. It is the purpose of this study to call attention to them. They fall into three general categories. The first is papers of general interest. They are mentioned only briefly, and include text references to the global bibliography at the end of the volume. The second are papers that are not only mentioned and referenced, but for various reasons are described in abstract form. The last is a list of papers compiled by H.S.J. Roe specifically for this volume. They are listed in bibliographic form, and are also included in the global bibliography at the end of the volume


    Morphological differences between old growth and sapling (Pseudotsuga menziesii, (Mirb.) Franco) Douglas fir trees may extend to differences in needle anatomy. We used microscopy with image analysis to compare and quantify anatomical parameters in cross-sections of previous year...

  15. the anatomy of pelvic corona mortis vessles in black africans

    African Journals Online (AJOL)

    , Moi University, P. O. Box ... This vascular anastomosis is also at risk during ilionguinal approach to the acetabulum (7). A medial approach for pelvic osteotomies for acetabular dysplasia ..... Gray's Anatomy 39th Edition , section 7 abdomen.

  16. Innovative taught MSc in Medical Visualisation and Human Anatomy. (United States)

    Clunie, Lauren; Livingstone, Daniel; Rea, Paul M


    A relatively new, fully accredited MSc in Medical Visualisation and Human Anatomy, is now offered through a joint collaboration with the Laboratory of Human Anatomy, University of Glasgow and the Digital Design Studio, Glasgow School of Art. This degree combines training in digital technologies and intensive human anatomy training as a result of a long-standing successful partnership between these two esteemed institutes. The student also has to complete a research dissertation which encompasses both the digital perspective and a related medical, dental, surgical, veterinary (comparative anatomy) or life science specialty to enhance development in the digital field for a variety of specialties. This article discusses the background in development of this degree, the course structure and the career prospects and destinations for graduates of this unique degree programme.

  17. Delaware Anatomy: With Linguistic, Social, and Medical Aspects (United States)

    Miller, Jay


    Presents the comprehensive partonomy of anatomy in Unami Lenape or Delaware as provided by a modern Unami specialist. The primary referent is the human body, but some comparative terms referring to animals and plants are also provided. (CHK)

  18. Growth regulators, DNA content and anatomy in vitro -cultivated ...

    African Journals Online (AJOL)

    Growth regulators, DNA content and anatomy in vitro -cultivated Curcuma longa ... Shoots were inoculated in MS culture medium with the addition of 30 g/L of sucrose ... flow cytometry, utilizing two reference standards, green pea, and tomato.

  19. Evaluation of anatomy comic strips for further production and applications (United States)

    Shin, Dong Sun; Kim, Dae Hyun; Park, Jin Seo; Jang, Hae Gwon


    The corresponding author of the study has been sketching comic strips to explain anatomy in a humorous manner. All the anatomy comic strips, including those in Korean (650 episodes) and English (451 episodes), can be viewed on the homepage ( Such comic strips were created with the aim of assisting medical students. However, their impact was unknown, and therefore, we surveyed the students' responses. We noted that anatomy grades were better in the students who read the comic strips. The comics helped the trainees chat with individuals with and without a medical background. The authors also considered comments on the problems with the comic strips and attempted to find solutions. The episodes are being currently used and further produced for educational purposes. To support this effort, the readers' valuable opinions will be continuously collected and assessed. PMID:24179697

  20. Evaluation of anatomy comic strips for further production and applications. (United States)

    Shin, Dong Sun; Kim, Dae Hyun; Park, Jin Seo; Jang, Hae Gwon; Chung, Min Suk


    The corresponding author of the study has been sketching comic strips to explain anatomy in a humorous manner. All the anatomy comic strips, including those in Korean (650 episodes) and English (451 episodes), can be viewed on the homepage ( Such comic strips were created with the aim of assisting medical students. However, their impact was unknown, and therefore, we surveyed the students' responses. We noted that anatomy grades were better in the students who read the comic strips. The comics helped the trainees chat with individuals with and without a medical background. The authors also considered comments on the problems with the comic strips and attempted to find solutions. The episodes are being currently used and further produced for educational purposes. To support this effort, the readers' valuable opinions will be continuously collected and assessed.

  1. Historical perspective-Anatomy down the ages in Australasia; lessons for the future. (United States)

    Flack, Natasha Ams; Nicholson, Helen D


    Is anatomy a dying discipline? This article explores the history and current state of human anatomy in Australasia, and considers the changing nature of the discipline, and possibilities for the future. A web-based search of all tertiary institutions in Australasia was performed to identify which taught anatomy. Those identified were invited to provide further information about postgraduate student numbers, external courses and public outreach. Forty-one institutions across Australasia teach anatomy. There are seven identifiable anatomy departments and nine disciplines of anatomy. From 1900 to 2014, the number of medical schools has increased (from 4 to 20), however a concomitant increase in the number of anatomy departments (2014, n = 7) was not observed. Twenty-one institutions, without medical schools, currently teach anatomy but none have a stand-alone anatomy department. Anatomy is taught in more than 18 different undergraduate and postgraduate programs. From the 28 institutions that provided current data, 310 postgraduate research students were identified. Predominantly, they came from longer-established institutions with an identifiable anatomy department. Similarly, those with anatomy departments/disciplines offered external professional courses. Many institutions engaged in public outreach. The evidence suggests that anatomy is alive and possibly even growing in Australasia. However, the structures around the discipline and the students who are learning anatomy are changing. Our challenge is to prepare the next generation of anatomy faculty to be both researchers and teachers. © 2015 Wiley Periodicals, Inc.

  2. Are medical students being taught anatomy in a way that best prepares them to be a physician?

    DEFF Research Database (Denmark)

    Meral Savran, Mona; Tranum-Jensen, Jørgen; Frost Clementsen, Paul


    was assessed by administering the tests to clinical consultants, anatomy teachers, and pre-course medical students. Post-course medical students took both tests to explore the focus of the course, i.e., whether it facilitated clinical reasoning. RESULTS: The pre-course students scored significantly lower than...... the teachers and post-course students on both tests and lower than the consultants on the consultants' test (P students (P ... tests). The post-course students scored significantly lower on the consultants' test (P = 0.001) and significantly higher on the teachers' test (P = 0.02) than the consultants. CONCLUSIONS: This study demonstrates poor performances by medical students on a test containing clinically relevant anatomy...

  3. Ultrasonography of the lower extremity veins: Anatomy and basic approach

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum [Dept. of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)


    Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography.

  4. Computed tomography of the sacrum: 1. normal anatomy

    International Nuclear Information System (INIS)

    Whelan, M.A.; Gold, R.P.


    The sacrum of a disarticulated pelvis was scanned with a Pfizer 0450 computed tomographic scanner using contiguous 5 mm sections to display the normal computed tomographic anatomy of the sacrum. These anatomic sections were then compared with normal sacrums. In analyzing the computed tomographic anatomy, emphasis was placed on the central canal and sacral foramina, in that these landmarks are important in determining not only the presence but also the type of pathology involving the sacrum

  5. Vesalius, Röntgen and the origins of Modern Anatomy. (United States)

    Thomas, Adrian M K


    The discovery of X-rays in 1895 by Wilhelm Conrad Röntgen transformed our understanding of both the physical world and our understanding of ourselves. Traditional anatomy as shown by Andreas Vesalius was learnt from dissection of the supine deceased body. Radiology showed anatomy in the living in a manner previously not possible, and has transformed our anatomical understanding, particularly of human growth and variation.

  6. Symbolic modeling of human anatomy for visualization and simulation (United States)

    Pommert, Andreas; Schubert, Rainer; Riemer, Martin; Schiemann, Thomas; Tiede, Ulf; Hoehne, Karl H.


    Visualization of human anatomy in a 3D atlas requires both spatial and more abstract symbolic knowledge. Within our 'intelligent volume' model which integrates these two levels, we developed and implemented a semantic network model for describing human anatomy. Concepts for structuring (abstraction levels, domains, views, generic and case-specific modeling, inheritance) are introduced. Model, tools for generation and exploration and applications in our 3D anatomical atlas are presented and discussed.

  7. Re-living anatomy: medical student use of lecture capture


    Diss, L; Sharp, A; Scott, F; Moore, L; Daniel, P; Memon, S; Smith, C


    Lecture capture resources have become common place within UK Higher education to enhance and support learning in addition to the tradition lecture. These resources can be particularly useful for medical students in anatomy teaching where time dedicated to anatomy within the curriculum has been reduced compared to previous generations(1).\\ud \\ud This study aimed to investigate how lecture capture aided student learning Qualitative feedback was also collected in view to further improve the reso...

  8. Inside out: modern imaging techniques to reveal animal anatomy.


    Henrik Lauridsen; Kasper Hansen; Tobias Wang; Peter Agger; Jonas L Andersen; Peter S Knudsen; Anne S Rasmussen; Lars Uhrenholt; Michael Pedersen


    Animal anatomy has traditionally relied on detailed dissections to produce anatomical illustrations, but modern imaging modalities, such as MRI and CT, now represent an enormous resource that allows for fast non-invasive visualizations of animal anatomy in living animals. These modalities also allow for creation of three-dimensional representations that can be of considerable value in the dissemination of anatomical studies. In this methodological review, we present our experiences using MRI,...

  9. Unusual anatomy of maxillary central incisor with two roots


    T S Ashwini Shivakumar; Saleem Makandar; Ajay Kadam


    Introduction: Knowledge of root canal morphology is essential for successful endodontic therapy. Failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment. Case Report: This case report describes the successful endodontic treatment of the maxillary central incisor with unusual anatomy of two roots and two root canals. A 23-year-old male patient was referred for dental consultation with discoloration of the maxillary right central incisor with periapical les...

  10. Ultrasonography of the lower extremity veins: Anatomy and basic approach

    International Nuclear Information System (INIS)

    Lee, Dong Kyu; Ahn, Kyung Sik; Kang, Chang Ho; Cho, Sung Bum


    Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography

  11. Spatiotemporal patterns, triggers and anatomies of seismically detected rockfalls

    Directory of Open Access Journals (Sweden)

    M. Dietze


    Full Text Available Rockfalls are a ubiquitous geomorphic process and a natural hazard in steep landscapes across the globe. Seismic monitoring can provide precise information on the timing, location and event anatomy of rockfalls, which are parameters that are otherwise hard to constrain. By pairing data from 49 seismically detected rockfalls in the Lauterbrunnen Valley in the Swiss Alps with auxiliary meteorologic and seismic data of potential triggers during autumn 2014 and spring 2015, we are able to (i analyse the evolution of single rockfalls and their common properties, (ii identify spatial changes in activity hotspots (iii and explore temporal activity patterns on different scales ranging from months to minutes to quantify relevant trigger mechanisms. Seismic data allow for the classification of rockfall activity into two distinct phenomenological types. The signals can be used to discern multiple rock mass releases from the same spot, identify rockfalls that trigger further rockfalls and resolve modes of subsequent talus slope activity. In contrast to findings based on discontinuous methods with integration times of several months, rockfall in the monitored limestone cliff is not spatially uniform but shows a systematic downward shift of a rock mass release zone following an exponential law, most likely driven by a continuously lowering water table. Freeze–thaw transitions, approximated at first order from air temperature time series, account for only 5 out of the 49 rockfalls, whereas 19 rockfalls were triggered by rainfall events with a peak lag time of 1 h. Another 17 rockfalls were triggered by diurnal temperature changes and occurred during the coldest hours of the day and during the highest temperature change rates. This study is thus the first to show direct links between proposed rockfall triggers and the spatiotemporal distribution of rockfalls under natural conditions; it extends existing models by providing seismic observations of the

  12. Human anatomy: let the students tell us how to teach. (United States)

    Davis, Christopher R; Bates, Anthony S; Ellis, Harold; Roberts, Alice M


    Anatomy teaching methods have evolved as the medical undergraduate curriculum has modernized. Traditional teaching methods of dissection, prosection, tutorials and lectures are now supplemented by anatomical models and e-learning. Despite these changes, the preferences of medical students and anatomy faculty towards both traditional and contemporary teaching methods and tools are largely unknown. This study quantified medical student and anatomy faculty opinion on various aspects of anatomical teaching at the Department of Anatomy, University of Bristol, UK. A questionnaire was used to explore the perceived effectiveness of different anatomical teaching methods and tools among anatomy faculty (AF) and medical students in year one (Y1) and year two (Y2). A total of 370 preclinical medical students entered the study (76% response rate). Responses were quantified and intergroup comparisons were made. All students and AF were strongly in favor of access to cadaveric specimens and supported traditional methods of small-group teaching with medically qualified demonstrators. Other teaching methods, including e-learning, anatomical models and surgical videos, were considered useful educational tools. In several areas there was disharmony between the opinions of AF and medical students. This study emphasizes the importance of collecting student preferences to optimize teaching methods used in the undergraduate anatomy curriculum. © 2013 American Association of Anatomists.

  13. Anatomy education for the YouTube generation. (United States)

    Barry, Denis S; Marzouk, Fadi; Chulak-Oglu, Kyrylo; Bennett, Deirdre; Tierney, Paul; O'Keeffe, Gerard W


    Anatomy remains a cornerstone of medical education despite challenges that have seen a significant reduction in contact hours over recent decades; however, the rise of the "YouTube Generation" or "Generation Connected" (Gen C), offers new possibilities for anatomy education. Gen C, which consists of 80% Millennials, actively interact with social media and integrate it into their education experience. Most are willing to merge their online presence with their degree programs by engaging with course materials and sharing their knowledge freely using these platforms. This integration of social media into undergraduate learning, and the attitudes and mindset of Gen C, who routinely creates and publishes blogs, podcasts, and videos online, has changed traditional learning approaches and the student/teacher relationship. To gauge this, second year undergraduate medical and radiation therapy students (n = 73) were surveyed regarding their use of online social media in relation to anatomy learning. The vast majority of students had employed web-based platforms to source information with 78% using YouTube as their primary source of anatomy-related video clips. These findings suggest that the academic anatomy community may find value in the integration of social media into blended learning approaches in anatomy programs. This will ensure continued connection with the YouTube generation of students while also allowing for academic and ethical oversight regarding the use of online video clips whose provenance may not otherwise be known. © 2015 American Association of Anatomists.

  14. Accessory left gastric artery: angiographic anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Soo; Lim, Hyung Guhn; Kim, Hong Soo; Jeon, Doo Sung [Presbyterian Medical Center, Chunju (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Soon Young [Myongji Hospital, College of Medicine, Kwandong University, Seoul (Korea, Republic of)


    To evaluate the angiographic anatomy of the accessory left gastric artery (accLGA). We evaluated the angiographic findings of the accLGA in 50 patients (Angiostar; Siemens, Erlangen, Germany). Performing celiac and selective angiography in 50 and 34 patients, respectively. By means of celiac angiography, (1) site of origin, (2) anatomical course, (3) diameter, (4) degree of tortuosity, and (5) distal tapering were evaluated, while selective angiography was used to determine (1) arterial branching, (2) area of blood supply, and (3) patterns of gastric wall stain. Celiac angiography showed that the accLGA arose from the left hepatic artery (LHA) in 45 cases (90%) and from the proper hepatic artery in five (10%). If the accLGA arose from the LHA, its origin entirely depended on the branching pattern of the latter. It always arose from the lateral branch of the LHA furthest to the left and uppermost, and proximal to its umbilical point. The most common anatomical course of the accLGA, seen in 27 cases (54%), was between the S2 and S3 segmental branch. The diameter and degree of tortuosity of the accLGA were similar to those of adjacent intrahepatic branches in 21 (42%) and 33 cases (66%), respectively. The degree of tapering was less than that of adjacent intrahepatic vessel in 28 (56%). Selective angiography demonstrated esophageal branching of the acc LGA in 27 cases (79%), inferior phrenic arterial branching in three (9%), a mediastinal branch in one (3%), and hypervascularity of the lung in one (3%). In 15 cases (44%), bifurcation of the accLGA was recognized. The vascular territory of the accLGA was the gastric fundus together with the distal esophagus in 21 cases (62%), mainly the gastric fundus in six (18%), and mainly the distal esophagus in four (12%). The pattern of gastric mucosal stain was curvilinear wall in 31 cases (91%) and nodular in three (9%). A knowledge of the angiographic anatomy of the accLGA facilitates accurate recognition of this artery on

  15. Interactive radiological anatomy eLearning solution for first year medical students: Development, integration, and impact on learning. (United States)

    Webb, Alexandra Louise; Choi, Sunhea


    A technology enhanced learning and teaching (TELT) solution, radiological anatomy (RA) eLearning, composed of a range of identification-based and guided learning activities related to normal and pathological X-ray images, was devised for the Year 1 nervous and locomotor course at the Faculty of Medicine, University of Southampton. Its effectiveness was evaluated using a questionnaire, pre- and post-tests, focus groups, summative assessment, and tracking data. Since introduced in 2009, a total of 781 students have used RA eLearning, and among them 167 Year 1 students in 2011, of whom 116 participated in the evaluation study. Students enjoyed learning (77%) with RA eLearning, found it was easy to use (81%) and actively engaged them in their learning (75%), all of which were associated to the usability, learning design of the TELT solution and its integration in the curriculum; 80% of students reported RA eLearning helped their revision of anatomy and 69% stated that it facilitated their application of anatomy in a clinical context, both of which were associated with the benefits offered by the learning and activities design. At the end of course summative assessment, student knowledge of RA eLearning relevant topics (mean 80%; SD ±16) was significantly better as compared to topics not relevant to RA eLearning (mean 63%; SD ±15) (mean difference 18%; 95% CI 15% to 20%; P < 0.001). A well designed and integrated TELT solution can be an efficient method for facilitating the application, integration, and contextualization of anatomy and radiology to create a blended learning environment. © 2013 American Association of Anatomists.

  16. User perspectives on relevance criteria

    DEFF Research Database (Denmark)

    Maglaughlin, Kelly L.; Sonnenwald, Diane H.


    , partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance......This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant...... matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially...

  17. Learning anatomy through Thiel- vs. formalin-embalmed cadavers: Student perceptions of embalming methods and effect on functional anatomy knowledge. (United States)

    Kennel, Larissa; Martin, David M A; Shaw, Hannah; Wilkinson, Tracey


    Thiel-embalmed cadavers, which have been adopted for use in anatomy teaching in relatively few universities, show greater flexibility and color retention compared to formalin-embalmed cadavers, properties which might be considered advantageous for anatomy teaching. This study aimed to investigate student attitudes toward the dissection experience with Thiel- compared to formalin/ethanol-embalmed cadavers. It also aimed to determine if one embalming method is more advantageous in terms of learning functional anatomy through the comparison of student anterior forearm functional anatomy knowledge. Student opinions and functional anatomy knowledge were obtained through use of a questionnaire from students at two medical schools, one using Thiel-, and one using more traditional formalin/ethanol-embalmed cadavers. Both the Thiel group and the formalin group of students were surveyed shortly after completing an anterior forearm dissection session. Significant differences (P-values <0.01) in some attitudes were found toward the dissection experience between cohorts using Thiel- vs. formalin-embalmed cadavers. The Thiel group of students felt more confident about recognizing anatomy in the living individual, found it easier to identify and dissect anatomical structures, and indicated more active exploration of functional anatomy due to the retained flexibility of the cadaver. However, on testing, no significant difference in functional anatomy knowledge was found between the two cohorts. Overall, although Thiel embalming may provide an advantageous learning experience in some investigated areas, more research needs to be carried out, especially to establish whether student perception is based on reality, at least in terms of structure identification. Anat Sci Educ 11: 166-174. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

  18. Resident perceptions of anatomy education: a survey of medical school alumni from two different anatomy curricula and multiple medical specialties. (United States)

    Bohl, Michael A; Gest, Thomas R


    In 2004, the University of Michigan Medical School reduced its gross anatomy curriculum. To determine the effect of this reduction on resident perceptions of their clinical preparedness, we surveyed alumni that included residents from the original and new shortened curricula. A Likert-scale survey was sent to four classes of alumni. Respondents were compared in old curriculum (OC) and new curriculum (NC) groups, surgical specialty (SS) and nonsurgical specialty (NS) groups, and subgroups of SS and NS were compared for differences between OC and NC. Mean response scores were compared using independent samples T-tests. As a single population (n = 110), respondents felt their anatomy education prepared them well for residency, that a more robust anatomy curriculum would be helpful, that dissection was important to their residency preparation, and that a 4th year anatomy elective was effective in expanding their anatomy education and preparing them for residency. No significant difference existed between OC and NC groups, neither as a whole nor as SS and NS subgroups. The SS group felt dissection was more important to their residency preparation than the NS group (P = 0.001) and that a more robust anatomy curriculum would have better prepared them for residency (P = 0.001). Thirty percent of SS respondents who did not take a 4th year elective commented that they wish they had. Fourth year anatomy electives were highly valued by residents, and respondents felt that they should be offered to students as a way of revisiting anatomy following the 1st year of clinical training. Copyright © 2011 American Association of Anatomists.

  19. Gross Anatomy classroom and dissection laboratory. An ethnographic approach to the study of human anatomy

    Directory of Open Access Journals (Sweden)

    María Belén López Castro


    Full Text Available The academic areas that rely on university chairs articulate teaching and research in particular ways. The aim of this paper is to describe the ways in which knowledge about the body is built from the work of the laboratories of dissection, without losing sight of its articulation with the anatomy lessons as a regular signature. From an ethnographic perspective, the proposal is to focus in the interventions over the dead body in the dissection laboratory based on the object of didactic transposition of the class.

  20. Anatomy of an online misinformation network.

    Directory of Open Access Journals (Sweden)

    Chengcheng Shao

    Full Text Available Massive amounts of fake news and conspiratorial content have spread over social media before and after the 2016 US Presidential Elections despite intense fact-checking efforts. How do the spread of misinformation and fact-checking compete? What are the structural and dynamic characteristics of the core of the misinformation diffusion network, and who are its main purveyors? How to reduce the overall amount of misinformation? To explore these questions we built Hoaxy, an open platform that enables large-scale, systematic studies of how misinformation and fact-checking spread and compete on Twitter. Hoaxy captures public tweets that include links to articles from low-credibility and fact-checking sources. We perform k-core decomposition on a diffusion network obtained from two million retweets produced by several hundred thousand accounts over the six months before the election. As we move from the periphery to the core of the network, fact-checking nearly disappears, while social bots proliferate. The number of users in the main core reaches equilibrium around the time of the election, with limited churn and increasingly dense connections. We conclude by quantifying how effectively the network can be disrupted by penalizing the most central nodes. These findings provide a first look at the anatomy of a massive online misinformation diffusion network.

  1. Neuroembryology and functional anatomy of craniofacial clefts

    Directory of Open Access Journals (Sweden)

    Ewings Ember


    Full Text Available The master plan of all vertebrate embryos is based on neuroanatomy. The embryo can be anatomically divided into discrete units called neuromeres so that each carries unique genetic traits. Embryonic neural crest cells arising from each neuromere induce development of nerves and concomitant arteries and support the development of specific craniofacial tissues or developmental fields. Fields are assembled upon each other in a programmed spatiotemporal order. Abnormalities in one field can affect the shape and position of developing adjacent fields. Craniofacial clefts represent states of excess or deficiency within and between specific developmental fields. The neuromeric organization of the embryo is the common denominator for understanding normal anatomy and pathology of the head and neck. Tessier′s observational cleft classification system can be redefined using neuroanatomic embryology. Reassessment of Tessier′s empiric observations demonstrates a more rational rearrangement of cleft zones, particularly near the midline. Neuromeric theory is also a means to understand and define other common craniofacial problems. Cleft palate, encephaloceles, craniosynostosis and cranial base defects may be analyzed in the same way.

  2. Normal CT anatomy of the spine

    International Nuclear Information System (INIS)

    Quiroga, O.; Matozzi, F.; Beranger, M.; Nazarian, S.; Salamon, G.; Gambarelli, J.


    To analyse the anatomo-radiological correlation of the spine and spinal cord, 22 formalized, frozen anatomical specimens corresponding to different regions of the spinal column (8 cervical, 5 dorsal, and 9 lumbar) were studied by CT scans on axial, sagittal and coronal planes and by contact radiography after they were cut into anatomical slices in order to clarify the normal CT anatomy of the spinal column. The results obtained from CT patient scans, performed exclusively on the axial plane, were compared with those obtained from the anatomical specimens (both CT and contrast radiography). High resolution CT programs were used, enabling us to obtain better individualization of the normal structures contained in the spinal column. Direct sagittal and coronal sections were performed on the specimens in order to get further anatomo-radiological information. Enhanced CT studies of the specimens were also available because of the air already present in the subarachnoid spaces. Excellent visualization was obtained of bone structures, soft tissue and the spinal cord. High CT resolution of the spine appeares to be an excellent neuroradiological procedure to study the spine and spinal cord. A metrizamide CT scan is, however, necessary when a normal unenhanced CT scan is insufficient for diagnosis and when the spinal cord is not clearly visible, as often happens at the cervical level. Clinical findings are certainly very useful to ascertain the exact CT level and to limit the radiation exposure. (orig.)

  3. Tinjauan Anatomi Klinik dan Manajemen Bell's Palsy

    Directory of Open Access Journals (Sweden)

    Nur Mujaddidah


    Full Text Available Bell's Palsy is a peripheral facial nerve weakness (facial nerve with acute onset on one side of the face. This condition causes the inability of the patient to move half of his face consciously (volunter on the affected side. The Bell's Palsy incidence is 20-30 cases out of 100.000 people and accounts for 60-70% of all cases of unilateral facial paralysis. The disease is self-limited, but causes great suffering for patients who are not treated properly. Controversy in the management is still debated, and the cause is still unknown. The underlying hypothesis is ischemic, vascular, viral, bacterial, hereditary, and immunologic. Therapy done so far is to improve facial nerve function and healing process. The management of the therapy used will be closely related to the structure of the anatomy and its functions and associated abnormalities. The modalities of Bell's Palsy therapy are with corticosteroids and antivirals, facial exercises, electrostimulation, physiotherapy and decompression operations. Approximately 80-90% of patients with Bell's palsy recover completely within 6 months, even in 50-60% of cases improved within 3 weeks. Approximately 10% experienced persistent facial muscle asymmetry, and 5% experienced severe sequelae, and 8% of cases were recurrent.

  4. Functional anatomy and biomechanics of the carpus

    International Nuclear Information System (INIS)

    Schmitt, R.


    The wrist is an exceedingly complex structure composed of several joints and a dedicated ligamentous system. Its functional principles allow a wide range of carpal motion and make the wrist remarkably resistant to external stress forces: The proximal carpal row serves as an intercalated link interposed between the static elements of both the forearm and the distal carpal row. Like a flexible placeholder, the proximal row synchronously adapts to the spatial and temporal requirements of the wrist. There are synergistic movement patterns including simultaneous flexion of the proximal row as the wrist is deviated radially and simultaneous extension during ulnar deviation. Together with pronosupination of the radioulnar joints, the combined radial/ulnar inclination and flexion/extension enable spherical, out-of-plane movements of the hand. Carpal function is best explained by the ''model of a ring under tension.'' This review addresses the anatomy and the biomechanics of the wrist and illustrates systematic image analysis by using carpal lines and angles as well as indices of carpal height. (orig.) [de

  5. Anatomy of a Security Operations Center (United States)

    Wang, John


    Many agencies and corporations are either contemplating or in the process of building a cyber Security Operations Center (SOC). Those Agencies that have established SOCs are most likely working on major revisions or enhancements to existing capabilities. As principle developers of the NASA SOC; this Presenters' goals are to provide the GFIRST community with examples of some of the key building blocks of an Agency scale cyber Security Operations Center. This presentation viII include the inputs and outputs, the facilities or shell, as well as the internal components and the processes necessary to maintain the SOC's subsistence - in other words, the anatomy of a SOC. Details to be presented include the SOC architecture and its key components: Tier 1 Call Center, data entry, and incident triage; Tier 2 monitoring, incident handling and tracking; Tier 3 computer forensics, malware analysis, and reverse engineering; Incident Management System; Threat Management System; SOC Portal; Log Aggregation and Security Incident Management (SIM) systems; flow monitoring; IDS; etc. Specific processes and methodologies discussed include Incident States and associated Work Elements; the Incident Management Workflow Process; Cyber Threat Risk Assessment methodology; and Incident Taxonomy. The Evolution of the Cyber Security Operations Center viII be discussed; starting from reactive, to proactive, and finally to proactive. Finally, the resources necessary to establish an Agency scale SOC as well as the lessons learned in the process of standing up a SOC viII be presented.

  6. Microscopic functional anatomy: Integumentary system: Chapter 17 (United States)

    Elliott, Diane G.; Ostrander, Gary K.


    Many of the features of the fish integument can only be observed microscopically. Because there are over 20,000 living fishes, mostly higher bony fishes (teleosts), a great diversity exists in the microscopic anatomy of the integument. This chapter presents several examples from varied taxonomic groups to illustrate the variation in morphological features. As in all vertebrate epidermis, the fundamental structural unit is the epithelial cell. This is the only constant feature, as a great diversity of cell types exists in the various fish taxa. Some of these include apocrine mucous cells and a variety of other secretory cells, ionocytes, sensory cells, and wandering cells such as leukocytes. The dermis consists essentially of two sets of collagen fibers arranged in opposing geodesic spirals around the body. The dermis of most fishes is divided into two major layers. The upper (outer) layer, the stratum spongiosum or stratum laxum, is a loose network of connective tissue, whereas the lower layer, the stratum compactum, is a dense layer consisting primarily of orthogonal collagen bands. There are also specialized dermal elements such as chromatophores scales, and fin rays.

  7. Interactive Anatomy-Augmented Virtual Simulation Training. (United States)

    Aebersold, Michelle; Voepel-Lewis, Terri; Cherara, Leila; Weber, Monica; Khouri, Christina; Levine, Robert; Tait, Alan R


    Traditionally, clinical psychomotor skills are taught through videos and demonstration by faculty which does not allow for the visualization of internal structures and anatomical landmarks that would enhance the learner skill performance. Sophomore and junior nursing students attending a large Midwestern Institution (N=69) participated in this mixed methods study. Students demonstrated their ability to place a nasogastric tube (NGT) after being randomly assigned to usual training (Control group) or an iPad anatomy-augmented virtual simulation training module (AR group). The ability of the participants to demonstrate competence in placing the NGT was assessed using a 17-item competency checklist. After the demonstration, students completed a survey to elicit information about students' level of training, prior experience with NGT placement, satisfaction with the AR technology, and perceptions of AR as a potential teaching tool for clinical skills training. The ability to correctly place the NGT through all the checklist items was statistically significant in the AR group compared with the control group (P = 0.011). Eighty-six percent of participants in the AR group rated AR as superior/far superior to other procedural training programs to which they had been exposed, whereas, only 5.9% of participants in the control group rated the control program as superior/far superior (P < 0.001). Overall the AR module was better received compared with the control group with regards to realism, identifying landmarks, visualization of internal organs, ease of use, usefulness, and promoting learning and understanding.

  8. Charcoal anatomy of Brazilian species. I. Anacardiaceae. (United States)

    Gonçalves, Thaís A P; Scheel-Ybert, Rita


    Anthracological studies are firmly advancing in the tropics during the last decades. The theoretical and methodological bases of the discipline are well established. Yet, there is a strong demand for comparative reference material, seeking for an improvement in the precision of taxonomic determination, both in palaeoecological and palaeoethnobotanical studies and to help preventing illegal charcoal production. This work presents descriptions of charcoal anatomy of eleven Anacardiaceae species from six genera native to Brazil (Anacardium occidentale, Anacardium parvifolium, Astronium graveolens, Astronium lecointei, Lithrea molleoides, Schinus terebenthifolius, Spondias mombin, Spondias purpurea, Spondias tuberosa, Tapirira guianensis, and Tapirira obtusa). They are characterized by diffuse-porous wood, vessels solitary and in multiples, tyloses and spiral thickenings sometimes present; simple perforation plates, alternate intervessel pits, rounded vessel-ray pits with much reduced borders to apparently simple; parenchyma paratracheal scanty to vasicentric; heterocellular rays, some with radial canals and crystals; septate fibres with simple pits. These results are quite similar to previous wood anatomical descriptions of the same species or genera. Yet, charcoal identification is more effective when unknown samples are compared to charred extant equivalents, instead of to wood slides.

  9. Charcoal anatomy of Brazilian species. I. Anacardiaceae

    Directory of Open Access Journals (Sweden)


    Full Text Available ABSTRACT Anthracological studies are firmly advancing in the tropics during the last decades. The theoretical and methodological bases of the discipline are well established. Yet, there is a strong demand for comparative reference material, seeking for an improvement in the precision of taxonomic determination, both in palaeoecological and palaeoethnobotanical studies and to help preventing illegal charcoal production. This work presents descriptions of charcoal anatomy of eleven Anacardiaceae species from six genera native to Brazil (Anacardium occidentale, Anacardium parvifolium, Astronium graveolens, Astronium lecointei, Lithrea molleoides, Schinus terebenthifolius, Spondias mombin, Spondias purpurea, Spondias tuberosa, Tapirira guianensis, and Tapirira obtusa. They are characterized by diffuse-porous wood, vessels solitary and in multiples, tyloses and spiral thickenings sometimes present; simple perforation plates, alternate intervessel pits, rounded vessel-ray pits with much reduced borders to apparently simple; parenchyma paratracheal scanty to vasicentric; heterocellular rays, some with radial canals and crystals; septate fibres with simple pits. These results are quite similar to previous wood anatomical descriptions of the same species or genera. Yet, charcoal identification is more effective when unknown samples are compared to charred extant equivalents, instead of to wood slides.

  10. [Anatomy and pathogenesis of diverticular disease]. (United States)

    Wedel, T; Böttner, M


    Although diverticular disease is one of the most frequent gastrointestinal disorders the pathogenesis is not yet sufficiently clarified. The aim is to define the anatomy and pathogenesis of diverticular disease considering the risk factors and description of structural and functional alterations of the bowel wall. This article gives an appraisal of the literature, presentation and evaluation of classical etiological factors, analysis and discussion of novel pathogenetic concepts. Colonic diverticulosis is defined as an acquired out-pouching of multiple and initially asymptomatic pseudodiverticula through muscular gaps in the colon wall. Diverticular disease is characterized by diverticular bleeding and/or inflammatory processes (diverticulitis) with corresponding complications (e.g. abscess formation, fistula, covered and open perforation, peritonitis and stenosis). Risk factors for diverticular disease include increasing age, genetic predisposition, congenital connective tissue diseases, low fiber diet, high meat consumption and pronounced overweight. Alterations of connective tissue cause a weakening of preformed exit sites of diverticula and rigidity of the bowel wall with reduced flexibility. It is assumed that intestinal innervation disorders and structural alterations of the musculature induce abnormal contractile patterns with increased intraluminal pressure, thereby promoting the development of diverticula. Moreover, an increased release of pain-mediating neurotransmitters is considered to be responsible for persistent pain in chronic diverticular disease. According to the present data the pathogenesis of diverticular disease cannot be attributed to a single factor but should be considered as a multifactorial event.

  11. Anatomy of an online misinformation network (United States)

    Wang, Lei; Jiang, Xinwen; Flammini, Alessandro; Ciampaglia, Giovanni Luca


    Massive amounts of fake news and conspiratorial content have spread over social media before and after the 2016 US Presidential Elections despite intense fact-checking efforts. How do the spread of misinformation and fact-checking compete? What are the structural and dynamic characteristics of the core of the misinformation diffusion network, and who are its main purveyors? How to reduce the overall amount of misinformation? To explore these questions we built Hoaxy, an open platform that enables large-scale, systematic studies of how misinformation and fact-checking spread and compete on Twitter. Hoaxy captures public tweets that include links to articles from low-credibility and fact-checking sources. We perform k-core decomposition on a diffusion network obtained from two million retweets produced by several hundred thousand accounts over the six months before the election. As we move from the periphery to the core of the network, fact-checking nearly disappears, while social bots proliferate. The number of users in the main core reaches equilibrium around the time of the election, with limited churn and increasingly dense connections. We conclude by quantifying how effectively the network can be disrupted by penalizing the most central nodes. These findings provide a first look at the anatomy of a massive online misinformation diffusion network. PMID:29702657

  12. Anatomy of an online misinformation network. (United States)

    Shao, Chengcheng; Hui, Pik-Mai; Wang, Lei; Jiang, Xinwen; Flammini, Alessandro; Menczer, Filippo; Ciampaglia, Giovanni Luca


    Massive amounts of fake news and conspiratorial content have spread over social media before and after the 2016 US Presidential Elections despite intense fact-checking efforts. How do the spread of misinformation and fact-checking compete? What are the structural and dynamic characteristics of the core of the misinformation diffusion network, and who are its main purveyors? How to reduce the overall amount of misinformation? To explore these questions we built Hoaxy, an open platform that enables large-scale, systematic studies of how misinformation and fact-checking spread and compete on Twitter. Hoaxy captures public tweets that include links to articles from low-credibility and fact-checking sources. We perform k-core decomposition on a diffusion network obtained from two million retweets produced by several hundred thousand accounts over the six months before the election. As we move from the periphery to the core of the network, fact-checking nearly disappears, while social bots proliferate. The number of users in the main core reaches equilibrium around the time of the election, with limited churn and increasingly dense connections. We conclude by quantifying how effectively the network can be disrupted by penalizing the most central nodes. These findings provide a first look at the anatomy of a massive online misinformation diffusion network.

  13. Temporomandibular Joint Anatomy Assessed by CBCT Images

    Directory of Open Access Journals (Sweden)

    Silvia Caruso


    Full Text Available Aim. Since cone beam computed tomography (CBCT has been used for the study of craniofacial morphology, the attention of orthodontists has also focused on the mandibular condyle. The purpose of this brief review is to summarize the recent 3D CBCT images of mandibular condyle. Material and Methods. The eligibility criteria for the studies are (a studies aimed at evaluating the anatomy of the temporomandibular joint; (b studies performed with CBCT images; (c studies on human subjects; (d studies that were not clinical case-reports and clinical series; (e studies reporting data on children, adolescents, or young adults (data from individuals with age ≤ 30 years. Sources included PubMed from June 2008 to June 2016. Results. 43 full-text articles were initially screened for eligibility. 13 full-text articles were assessed for eligibility. 11 articles were finally included in qualitative synthesis. The main topics treated in the studies are the volume and surface of the mandibular condyle, the bone changes on cortical surface, the facial asymmetry, and the optimum position of the condyle in the glenoid fossa. Conclusion. Additional studies will be necessary in the future, constructed with longitudinal methodology, especially in growing subjects. The limits of CBCT acquisitions are also highlighted.

  14. The deep lymphatic anatomy of the hand. (United States)

    Ma, Chuan-Xiang; Pan, Wei-Ren; Liu, Zhi-An; Zeng, Fan-Qiang; Qiu, Zhi-Qiang


    The deep lymphatic anatomy of the hand still remains the least described in medical literature. Eight hands were harvested from four nonembalmed human cadavers amputated above the wrist. A small amount of 6% hydrogen peroxide was employed to detect the lymphatic vessels around the superficial and deep palmar vascular arches, in webs from the index to little fingers, the thenar and hypothenar areas. A 30-gauge needle was inserted into the vessels and injected with a barium sulphate compound. Each specimen was dissected, photographed and radiographed to demonstrate deep lymphatic distribution of the hand. Five groups of deep collecting lymph vessels were found in the hand: superficial palmar arch lymph vessel (SPALV); deep palmar arch lymph vessel (DPALV); thenar lymph vessel (TLV); hypothenar lymph vessel (HTLV); deep finger web lymph vessel (DFWLV). Each group of vessels drained in different directions first, then all turned and ran towards the wrist in different layers. The deep lymphatic drainage of the hand has been presented. The results will provide an anatomical basis for clinical management, educational reference and scientific research. Copyright © 2018 Elsevier GmbH. All rights reserved.

  15. Clinical anatomy as practiced by ancient Egyptians. (United States)

    Loukas, Marios; Hanna, Michael; Alsaiegh, Nada; Shoja, Mohammadali M; Tubbs, R Shane


    Egypt is famously known for its Nile and pyramids, yet not many people know that Egypt made possible the origin of the anatomical sciences. Several ancient papyri guide us through the Egyptians' exploration of the human body and how they applied anatomical knowledge to clinical medicine to the best of their knowledge. It is through records, such as the Edwin Smith, Ebers, and Kahun papyri and other literature detailing the work of the Egyptian embalmers, physicians, and Greek anatomists, that we are able to take a glimpse into the evolution of the anatomical sciences from 3000 B.C. to 250 B.C. It is through the Egyptian embalmer that we were able to learn of some of the first interactions with human organs and their detailed observation. The Egyptian physician's knowledge, being transcribed into the Ebers and Edwin Smith papyri, enabled future physicians to seek reference to common ailments for diagnosing and treating a variety of conditions ranging from head injuries to procedures, such as trans-sphenoidal surgery. In Alexandria, Herophilus, and Erasistratus made substantial contributions to the anatomical sciences by beginning the practice of human dissection. For instance, Herophilus described the anatomy of the heart valves along with Erasistratus who demonstrated how blood was prevented from flowing retrograde under normal conditions. Hence, from various records, we are able to unravel how Egypt paved the road for study of the anatomical sciences. Copyright © 2011 Wiley-Liss, Inc.

  16. Muscular anatomy of the human ventricular folds. (United States)

    Moon, Jerald; Alipour, Fariborz


    Our purpose in this study was to better understand the muscular anatomy of the ventricular folds in order to help improve biomechanical modeling of phonation and to better understand the role of these muscles during phonatory and nonphonatory tasks. Four human larynges were decalcified, sectioned coronally from posterior to anterior by a CryoJane tape transfer system, and stained with Masson's trichrome. The total and relative areas of muscles observed in each section were calculated and used for characterizing the muscle distribution within the ventricular folds. The ventricular folds contained anteriorly coursing thyroarytenoid and ventricularis muscle fibers that were in the lower half of the ventricular fold posteriorly, and some ventricularis muscle was evident in the upper and lateral portions of the fold more anteriorly. Very little muscle tissue was observed in the medial half of the fold, and the anterior half of the ventricular fold was largely devoid of any muscle tissue. All 4 larynges contained muscle bundles that coursed superiorly and medially through the upper half of the fold, toward the lateral margin of the epiglottis. Although variability of expression was evident, a well-defined thyroarytenoid muscle was readily apparent lateral to the arytenoid cartilage in all specimens.

  17. Comparative and Developmental Anatomy of Cardiac Lymphatics

    Directory of Open Access Journals (Sweden)

    A. Ratajska


    Full Text Available The role of the cardiac lymphatic system has been recently appreciated since lymphatic disturbances take part in various heart pathologies. This review presents the current knowledge about normal anatomy and structure of lymphatics and their prenatal development for a better understanding of the proper functioning of this system in relation to coronary circulation. Lymphatics of the heart consist of terminal capillaries of various diameters, capillary plexuses that drain continuously subendocardial, myocardial, and subepicardial areas, and draining (collecting vessels that lead the lymph out of the heart. There are interspecies differences in the distribution of lymphatic capillaries, especially near the valves, as well as differences in the routes and number of draining vessels. In some species, subendocardial areas contain fewer lymphatic capillaries as compared to subepicardial parts of the heart. In all species there is at least one collector vessel draining lymph from the subepicardial plexuses and running along the anterior interventricular septum under the left auricle and further along the pulmonary trunk outside the heart and terminating in the right venous angle. The second collector assumes a different route in various species. In most mammalian species the collectors run along major branches of coronary arteries, have valves and a discontinuous layer of smooth muscle cells.

  18. Bronchial arteries: anatomy, function, hypertrophy, and anomalies. (United States)

    Walker, Christopher M; Rosado-de-Christenson, Melissa L; Martínez-Jiménez, Santiago; Kunin, Jeffrey R; Wible, Brandt C


    The two main sources of blood supply to the lungs and their supporting structures are the pulmonary and bronchial arteries. The bronchial arteries account for 1% of the cardiac output but can be recruited to provide additional systemic circulation to the lungs in various acquired and congenital thoracic disorders. An understanding of bronchial artery anatomy and function is important in the identification of bronchial artery dilatation and anomalies and the formulation of an appropriate differential diagnosis. Visualization of dilated bronchial arteries at imaging should alert the radiologist to obstructive disorders that affect the pulmonary circulation and prompt the exclusion of diseases that produce or are associated with pulmonary artery obstruction, including chronic infectious and/or inflammatory processes, chronic thromboembolic disease, and congenital anomalies of the thorax (eg, proximal interruption of the pulmonary artery). Conotruncal abnormalities, such as pulmonary atresia with ventricular septal defect, are associated with systemic pulmonary supply provided by aortic branches known as major aortopulmonary collaterals, which originate in the region of the bronchial arteries. Bronchial artery malformation is a rare left-to-right or left-to-left shunt characterized by an anomalous connection between a bronchial artery and a pulmonary artery or a pulmonary vein, respectively. Bronchial artery interventions can be used successfully in the treatment of hemoptysis, with a low risk of adverse events. Multidetector computed tomography helps provide a vascular road map for the interventional radiologist before bronchial artery embolization. RSNA, 2015

  19. Comparison of traditional methods with 3D computer models in the instruction of hepatobiliary anatomy. (United States)

    Keedy, Alexander W; Durack, Jeremy C; Sandhu, Parmbir; Chen, Eric M; O'Sullivan, Patricia S; Breiman, Richard S


    This study was designed to determine whether an interactive three-dimensional presentation depicting liver and biliary anatomy is more effective for teaching medical students than a traditional textbook format presentation of the same material. Forty-six medical students volunteered for participation in this study. Baseline demographic information, spatial ability, and knowledge of relevant anatomy were measured. Participants were randomized into two groups and presented with a computer-based interactive learning module comprised of animations and still images to highlight various anatomical structures (3D group), or a computer-based text document containing the same images and text without animation or interactive features (2D group). Following each teaching module, students completed a satisfaction survey and nine-item anatomic knowledge post-test. The 3D group scored higher on the post-test than the 2D group, with a mean score of 74% and 64%, respectively; however, when baseline differences in pretest scores were accounted for, this difference was not statistically significant (P = 0.33). Spatial ability did not statistically significantly correlate with post-test scores for the 3D group or the 2D group. In the post-test satisfaction survey the 3D group expressed a statistically significantly higher overall satisfaction rating compared to students in the 2D control group (4.5 versus 3.7 out of 5, P = 0.02). While the interactive 3D multimedia module received higher satisfaction ratings from students, it neither enhanced nor inhibited learning of complex hepatobiliary anatomy compared to an informationally equivalent traditional textbook style approach. . Copyright © 2011 American Association of Anatomists.

  20. The thoracolumbar fascia: anatomy, function and clinical considerations (United States)

    Willard, F H; Vleeming, A; Schuenke, M D; Danneels, L; Schleip, R


    In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall. The superficial lamina of the posterior layer of the TLF (PLF) is dominated by the aponeuroses of the latissimus dorsi and the serratus posterior inferior. The deeper lamina of the PLF forms an encapsulating retinacular sheath around the paraspinal muscles. The middle layer of the TLF (MLF) appears to derive from an intermuscular septum that developmentally separates the epaxial from the hypaxial musculature. This septum forms during the fifth and sixth weeks of gestation. The paraspinal retinacular sheath (PRS) is in a key position to act as a ‘hydraulic amplifier’, assisting the paraspinal muscles in supporting the lumbosacral spine. This sheath forms a lumbar interfascial triangle (LIFT) with the MLF and PLF. Along the lateral border of the PRS, a raphe forms where the sheath meets the aponeurosis of the transversus abdominis. This lateral raphe is a thickened complex of dense connective tissue marked by the presence of the LIFT, and represents the junction of the hypaxial myofascial compartment (the abdominal muscles) with the paraspinal sheath of the epaxial muscles. The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF. At the base of the lumbar spine all of the layers of the TLF fuse together into a thick composite that attaches firmly to the posterior superior iliac spine