Differences and similarities in muscle architecture of fibularis longus and brevis-An observational descriptive cross-sectional and feasibility study.

Background: The fibularis longus (FL) muscle is larger in volume than fibularis brevis (FB) and is therefore claimed to be the stronger evertor of the two. Clinical observation of FL and FB tendon rupture show that injury to the FB has a serious negative effect on hindfoot eversion. This implies that the FB is the stronger and more important evertor.

Surgical applied anatomy: alive and kicking.

Background: Contention exists amongst anatomists, clinicians and surgeons about how much anatomical knowledge medical students need, although what is taught should be aligned with current surgical practice. The aim of this study was to explore the scope of recent advances in applied anatomy as highlighted in the ANZ Journal of Surgery in each of the surgical specialties.

Methods: The 2018 volume of the ANZ Journal of Surgery was narrowed to 254 articles by applying the search term 'anatomy'.

Outcomes of prenatally diagnosed solitary functioning kidney during early life.

Objective: To evaluate outcomes of congenital solitary functioning kidney (SFK) in early childhood.

Study Design: A retrospective study of 32 children diagnosed in utero with SFK owing to unilateral renal agenesis or multicystic dysplastic kidney and followed for 1 to 11.5 years.

Emerging roles of microRNA in the embryo-endometrium cross talk.

Embryo implantation requires a reciprocal interaction between the blastocyst and endometrium and is associated with complex regulatory mechanisms. Since their discovery, microRNAs have become prominent regulatory candidates, providing missing links for many biological pathways. In recent years, microRNAs have been implicated as one of the important players in the regulation of multiple physiological functions of the endometrium.

Gastrocsoleus recession techniques: an anatomical and biomechanical study in human cadavers.

Lengthening of the conjoined tendon of the gastrocnemius aponeurosis and soleus fascia is frequently used in the treatment of equinus deformities in children and adults. The Vulpius procedure as described in most orthopaedic texts is a division of the conjoined tendon in the shape of an inverted V. However, transverse division was also described by Vulpius and Stoffel, and has been reported in some clinical studies.

Lengthening of the gastrocnemius-soleus complex: an anatomical and biomechanical study in human cadavers.

Background: Lengthening of the gastrocnemius-soleus complex is frequently performed for equinus deformity. Many techniques have been described, but there is uncertainty regarding the precise details of some surgical procedures.

Methods: The surgical anatomy of the gastrocnemius-soleus complex was investigated, and standardized approaches were developed for the procedures described by Baumann, Strayer, Vulpius, Baker, Hoke, and White.

Biomechanics of medial hamstring lengthening.

Background: Medial hamstring lengthening is frequently used to correct contractures in neuromuscular conditions such as cerebral palsy. Surgical techniques vary considerably and little is known about the lengthening characteristics of muscle-tendon-units after surgical intervention.

Methods: A randomized trial was performed on paired cadaver medial hamstring muscle-tendon-units comparing 'High' (proximal) versus 'Low' (distal) lengthening procedures.

Anatomy and pathophysiology of the pleura and pleural space.

Pleural effusions are most often secondary to an underlying condition and may be the first sign of the underlying pathologic condition. The balance between the hydrostatic and oncotic forces dictates pleural fluid homeostasis. The parietal pleura has a more significant role in pleural fluid homeostasis.

[Trial of labor after two cesarean sections: the policy in Israel and four years experience].

Introduction: Trial of vaginal birth after caesarean is considered acceptable after one caesarean section. However, trial of vaginal birth after more than one caesarean section is still unaccepted by most clinicians. Birth rates in Israel are within the highest in the western world and many women are interested in a trial of labor after two previous caesarean sections.

The effects of intramuscular tenotomy on the lengthening characteristics of tibialis posterior: high versus low intramuscular tenotomy.

Background: Lengthening of soft-tissue contractures is frequently required in children with a wide variety of congenital and acquired deformities. However, little is known about the biomechanics of surgical procedures which are commonly used in contracture surgery, or if variations in technique may have a bearing on surgical outcomes. We investigated the hypothesis that the site of intramuscular tenotomy (IMT) within the muscle-tendon-unit (MTU) of the tibialis posterior (TP) would affect the lengthening characteristics.

Anomalies of the flexor carpi ulnaris: clinical case report and cadaveric study.

Flexor carpi ulnaris (FCU) is an ever-present muscle of the anterior flexor compartment of the forearm. Variations of FCU are uncommon, with additional slips or heads of muscles described, and only one reported case of an accessory muscle. We describe a unique clinical case report in which an accessory FCU was identified and describe the findings of 5,000 cadaveric dissections of the forearm, performed as part of an ongoing institutional study of anatomical variations.

The place of anatomy in medical education: AMEE Guide no 41.

This Guide, a combined work by three authors from different countries, provides perspectives into the history of teaching gross anatomy, briefly, from the earliest of times, through to a detailed examination of curricula in both traditional didactic approaches and Problem-Based Learning (PBL) curricula. The delivery of a module within a curriculum in tertiary education is interplay between the content (knowledge and skills) of a subject, the teaching staff involved, the students and their approaches to learning, and the philosophy underpinning the delivery of the learning material. The work is divided into sections that deal with approaches to learning anatomy from the perspective of students, to delivery of the content of the curriculum by lecturers, including the assessment of knowledge, and itemises the topics that could be considered important for an appropriate anatomy module in an integrated course, delivered in a way that emphasises clinical application.

Review article: anatomical considerations for ultrasound guidance for regional anesthesia of the neck and upper limb.

Purpose: The purpose of this narrative review is to describe an anatomical approach for residents-in-training and anesthesiologists who are learning techniques of ultrasound-guided regional anesthesia of the neck and upper limb.

Sources: Relevant articles relating anatomy and anatomical variation to the emerging practice of ultrasound-guided regional anesthesia for the neck and upper limb were sourced via both Medline and PubMed databases. Also, our approach to teaching ultrasound technique has developed from using anatomical resources and cadaveric workshops.

The anatomy of the distal vagina: towards unity.

Introduction: Factual presentations of sexual anatomy are required for educational purposes, for clinical and more general communication about sexual matters. To date, unambiguous, accurate and objective images with appropriate labeling to enhance specificity in communication have been lacking.

Aim: The aim of this presentation is to provide a comprehensive overview of anatomy of the distal vagina.

Do we need dissection in an integrated problem-based learning medical course? Perceptions of first- and second-year students.

Background: The introduction of a problem-based learning (PBL) curriculum at the School of Medicine of the University of Melbourne has necessitated a reduction in the number of lectures and limited the use of dissection in teaching anatomy. In the new curriculum, students learn the anatomy of different body systems using PBL tutorials, practical classes, pre-dissected specimens, computer-aided learning multimedia and a few dissection classes. The aims of this study are: (1) to assess the views of first- and second-year medical students on the importance of dissection in learning about the anatomy, (2) to assess if students' views have been affected by demographic variables such as gender, academic background and being a local or an international student, and (3) to assess which educational tools helped them most in learning the anatomy and whether dissection sessions have helped them in better understanding anatomy.

Undiagnosed fracture in a common foot variant: the biphalangeal little toe.

The biphalangeal little toe is an anatomical anomaly that has been previously well described in the early anatomical literature. But, as is the case with many anomalies, there is a lack of awareness of it amongst current clinicians. We report the case of a fracture through the distal phalanx of the little toe, with a delay in the diagnosis due to confusion over the X-ray findings.

Transverse sinus septum: a new aetiology of idiopathic intracranial hypertension?

A venographic cryptic stenosis at the junction of middle and lateral third of the transverse sinus has been observed in patients suffering from idiopathic intracranial hypertension. After reviewing the anatomical and embryological literature of the transverse sinus, 20 transverse sinuses were explored (in a pilot study of 10 human cadavers) in order to determine the anatomical basis of this stenosis. The presence of septa of varying sizes was observed.

The subpectoral pacemaker implant: it isn't what it seems!

The traditional pulse generator implantation site lies subcutaneous on the fascia of the pectoralis major muscle. This article describes a subpectoral pocket approach, which on anatomic investigation is actually "intrapectoral" and offers a much improved cosmetic result with the potential advantage of less erosion. In the authors' experience with over 1000 initial pacemaker implants and pulse generator replacements, the potential concerns of neurovascular and muscular damage have not been realized.

Anatomy of the pudendal nerve and its terminal branches: a cadaver study.

Background: This study documents the anatomy of the pudendal nerve, which has a major role in maintaining faecal continence. Unexpected faecal incontinence can develop following perineal surgery even when the anal sphincters are not damaged. In addition, injury to the pudendal nerve might be encountered during pelvic procedures such as a sacrospinous colpopexy.