Contribution of embryology in the understanding of cervical venous system anatomy within and around the transverse foramen: a review of the classical literature.

Anatomic arrangement of venous system within the transverse foramen is a controversial topic among authors. Precise knowledge of this arrangement is necessary in imaging where vertebral artery dissection is suspected, as well as in surgical approaches of cervical spine. This knowledge objective cannot be achieved without a prerequisite knowledge of primitive venous system.

[Anatomic study and CT angiography with 3D reconstructions of the pulmonary arterial tree].

Aim Of The Study: To prove in vivo and on cadaveric lungs, the constancy of the collateral type of distribution for the right and left pulmonary arteries as described in classical books and modern studies; to estimate the frequency of the main branches observed and define an arterial tree of reference set up with the most common branches for reading the CT pulmonary angiographies.

Patients And Methods: Sixty three-dimensional reconstructions of pulmonary arterial trees (right: 30; left: 30) using the Volume Rendering Technique (VRT) performed from CT angiographic studies of 30 patients without bronchial, arterial or pulmonary pathology. Dissection of 16 pulmonary arteries from eight fresh cadavers injected with latex.

The island hemisoleus flap on distal vascular pedicle: anatomical bases and clinical applications.

The coverage of skin defects of the ankle and of the distal fourth of the leg remains a difficult problem despite progress in reconstructive surgery. The aim of our study was to establish an arterial map of the lateral head of the soleus muscle, to compare it with the existing data in order to investigate the possibility of raising a fibular artery-based pedicle island reverse flow flap. It has the theoretical advantage over its medial counterpart of sparing the main arterial axis of the leg and foot.

Greater trochanter displacements after Charnley's trochanterotomy, during passive hip movements: a real-time 3D cadaveric approach.

Non-unions of greater trochanter (GT) fractures or osteotomies are the source of frequent complications. Two muscles are involved in the genesis of such non-unions, the gluteus medius and the gluteus minimus. Literature says that, during hip flexion, their terminal insertions on the faces of the GT generate an anterior translation of the GT responsible for contact loosening and healing defect.

[Transmaxillary approach to the skull base: surgical anatomy and guidelines].

Background: A surgical and anatomic approach to the skull base using the transmaxillary route is presented. This route is well-known and used for a long time for sinus conditions.

Method: This study was performed on injected cadavers.

[Numerical variants and congenital fusions of carpal bones].

The number of carpal bones may be increased or decreased by the fact of anatomical variants or true congenital anomalies. Numerical increment arises from additional or from split bones. Over twenty accessory carpal bones have been described but the commonest are the os centrale carpi, the os radiale externum, the triangular bone and the styloideum bone.

The morphometric study of the sacrospinal and sacrotuberal ligaments correlated with the morphometry of the pelvis.

Perineal neuralgias may be considered as nerve entrapment syndromes, which have been anatomically poorly studied. The pudendal nerve could be compressed between the sacrospinal and the sacrotuberal ligaments. This study tries to find a correlation between the pelvis and the lumbosacral junction morphometry, and sacrospinal and sacrotuberal ligaments morphometry.

[Right-sided duplication of the inferior vena cava].

An infrarenal duplication of the inferior vena cava with both channels lying on the right side of the aorta was fortuitously found during an abdominal Computed Tomography performed on a 52 year-old woman. Only two same cases seem to be reported in the literature. This very uncommon abnormality probably results from persistence of the infra-renal part of the right subcardinal vein.

[Persistence of the stapedial artery: three cases].

The authors report three cases of persistence of the stapedial artery, discovered by computed tomography examination. For two cases, a clinical symptomatology was present but probably related to the association with an aberrant carotid artery in the middle ear; the only case of isolated persistence of the stapedial artery was asymptomatic. Direct visualisation of the abnormal artery was possible on the C.

Two rare anomalies of the left renal vein.

Two uncommon anatomical variations of the left renal vein were found on dissected specimens: a circumaortic venous ring and a retro-aortic bifid left renal vein. The first anomaly results from a persistence of the embryonic renal venous collar. The second one would be related to a particular pattern of left inferior vena cava.

Dorsal pancreas agenesis: computed tomography appearance with three-dimensional volume rendering reconstruction.

We report a case of a very rare congenital variant consisting in a dorsal (or left) pancreas agenesis due to the lack of development of the dorsal embryonic bud of the gland. This variant is characterized using helical computed tomography (CT). Three-dimensional (3D) computed tomography reconstruction, especially using the volume rendering technique, is very helpful for assessing this entity, which it is important to recognize due to its potential clinical implication (diabetes mellitus).

Pedicle island flaps of latissimus dorsi. Applications in surgical repair of ruptures of the rotator cuff.

There are considerable problems in repair of major ruptures of the rotator cuff tendons particularly those of the supra and infraspinatus mm. The Gerber technique only transfers the tendinous insertion of the latissimus dorsi onto the greater tuberosity in massive cuff ruptures. We have extended this approach.

Celiac-bimesenteric trunk: anatomic and radiologic description--case report.

The authors report the case of a 39-year-old man with a common origin of three arteries-the celiac, superior mesenteric, and inferior mesenteric arteries-that has not been described previously in the literature, to their knowledge. This variant, which they call the celiac-bimesenteric trunk, is documented with a selective angiogram, and an embryologic explanation is offered.

[Ultrasonic features of congenital anomalies of the gallbladder].

Congenital anomalies of the gallbladder (GB) correspond to the ultimate manifestation of the wide range of anatomical variations that may affect the GB. Anomalies may be numerical: duplication, accessory GB, and, rarely, agenesis. Anomalies of position are more common: ectopic GB, floating or wandering GB.

[Anatomic variability and congenital anomalies of the gallbladder: ultrasonographic study of 1823 patients].

The authors report the results from the ultrasonographic exploration of the gallbladder performed on 1823 patients. They found morphologic variations and abnormalities in more than 33% of gallbladders, topographic ones in about 3.5% of observations and only 3 cases of real duplication of the gallbladder.

Arterial and neural relations at the posterior and lateral aspects of the medullo-spinal junction.

The authors report the results of a series of 59 microdissections of the region of the foramen magnum. These dissections were made under the strict conditions of a surgical approach using an operating microscope. The major anatomic structures of the medullo-spinal junction are arranged mainly at its lateral aspect.

Anatomical basis of a fascio-cutaneous pedicle flap based on the infero-lateral collateral artery of the leg.

An anatomical study of 30 cases has been performed on the vascularisation of the distal third of the antero-lateral compartment of the leg, with particular reference to the relations of the infero-lateral collateral artery of the anterior tibial artery, the perforating branch of the peroneal artery, and the antero-lateral malleolar artery. A fascio-cutaneous pedicle flap based on the infero-lateral collateral artery is described noting that the superior, anterior, and posterior limits are similar to those of the lateral supramalleolar flap of Masquelet. The inferior limit of this new flap is 15 mm distal to the site of emergence of the perforating branch of the peroneal artery.

The "anatomic" view of the suprarenals in medical imaging.

Based on coordinates derived from three series of anatomic sections, the authors propose a view for tomographic investigation, applicable in MRI and ultrasound, which reconstructs the ideal image of the suprarenal gland in its quadrilateral as described by Testut. This "anatomic" view is 45 degrees vertical and oblique, intermediate between the sagittal and frontal views, which it can advantageously replace. A new aspect of suprarenal tomography, recalling the image of a triskele, is described in the context of this view.

Thoracoscopic dissection of the esophagus in human cadavers.

A technique for thoracoscopic dissection of the esophagus is described which gives a large and magnified view of the pleural cavity, the mediastinum, and the esophagus. This technique was developed on human cadavers which gives excellent technical resources for learning and practicing endoscopic surgical anatomy of the esophagus. It avoids the need to change the position of the patient to perform a total thoracoabdominal esophagectomy via a triple surgical approach.

[Juxta- or trans-condylar lateral extension of the posterior suboccipital approach. Anatomical study, surgical aspects].

In order to improve the surgical approach to tumors and aneurysms of the anterior or antero-lateral aspect of the foramen magnum, some authors have proposed a lateral extension of the posterior sub-occipital approach to the occipital condyle including in some cases its partial or complete resection. The evaluation of this close medio-condylar or trans-condylar suboccipital approach has been performed on eight coloured-latex injected specimens in the conditions of a microsurgical operation. The extra- and intradural steps have been studied so as to define the optimal position of the patient's head and the surgeon and to precise the accessible anatomical structures: Vertebral artery (and its control), Cranial nerves IX, X, XI & XII, Posterior-inferior cerebellar artery and collaterals, Vertebro-basilar junction, antero-lateral aspect of the brain stem and spinal cord.

Anatomical basis of neurotisation of the median nerve in the hand by the radial nerve.

The sensory sequelae after lesions of the median nerve cause difficulties in treatment since few sensory transfers are available. Neurotisation of the median by sensory branches of the radial nerve have aroused little interest although they have already been used by some authors after anastomosis at the wrist or through the first or second interosseous spaces. Based on what was originally a purely anatomic study, our interest was directed to the possibilities of performing more distal neurotisation for the treatment of sensory disorders of limited extent.

Measurements of the normal lumbar spinal canal by computed tomography. Segmental study of L3-L4 and L4-L5 related to the height of the subject.

Computed tomography measurements of the main diameters and cross section areas of the lumbar vertebral canal and the lower end of the dural sac at the L3-L4 and L4-L5 levels were made in 34 young male adults who were free of symptoms. This study shows a statistically significant correlation between the height of the subject and the cross sectional area of the canal and the dural sac, and the interpedicular diameter. The determination of regression coefficients enabled an estimate to be made of the mean values of these parameters in relation to height, the actual values having a normal distribution around these means.

[Value of x-ray computed tomography in evaluating the operability of esophageal cancer. Results of a prospective study].

The authors report their results of a prospective double-blind study of 35 patients with squamous cell carcinoma of the esophagus conducted between February 1987 and February 1988. As all the patients were operated upon, we were able to define diagnostic accuracy (DA) of CT in determining the upper pole of the tumour, position of the tumour, invasion of trachea and bronchi, aorta, left auricle, vertebral column, pleura, pericardium and also abdominal invasion or thoracic lymph node. CT scanning slightly improved pre-operative evaluation of resectability of tumours when compared with routine barium swallow, abdominal US and bronchoscopy.

The venous hilum of the testis and epididymis: anatomic aspect.

The venous return from the testis is effected by 3 venous pathways: the pampiniform plexus gathrs the centripetal and centrifugal paths of the testis with the marginal vein of the epididymis; the deferential vein accompanies the ductus deferens; and the cremasteric vein travels more superficially between the internal and external spermatic fasciae on its way to the inferior epigastric vein. At the caudal pole of the testicle these different pathways form such close connections as to constitute a real vascular junction.