Biomedical subjects
Publications and source records attributed to G L Colborn.
The carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel with very specific signs and symptoms. Anatomical dissection of 156 wrists is presented and then the authors compare their findings with the findings of other investigators. The purpose of this article is not to present results but rather to discuss the anatomic entities involved with the syndrome and to present the open treatment modality.
The carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel with very specific signs and symptoms. Anatomical dissection of 156 wrists is presented and then the authors compare their findings with the findings of other investigators. The purpose of this article is not to present results but rather to discuss the anatomic entities involved with the syndrome and to present the open treatment modality.
The carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel with very specific signs and symptoms. Anatomical dissection of 156 wrists is presented and then the authors compare their findings with the findings of other investigators. The purpose of this article is not to present results but rather to discuss the anatomic entities involved with the syndrome and to present the open treatment modality.
This study examines the incidence of the posterior gastric artery in a series of 75 adult cadavers. We clearly identified the posterior gastric artery in 36 (48%) cadavers as a 1- to 2-mm vessel arising from the cranial border of the splenic artery within 3 cm of the celiac trunk and coursing dorsally to the posterior parietal peritoneum where it forms a fold before supplying the upper part of the posterior gastric wall. Identifying this vessel is difficult during surgery that compromises vascular tributaries of the stomach, and the obscure course and high incidence of this vessel necessitates awareness that, in a 75-85% gastrectomy, the short gastric artery or branches of the left gastric artery should be preserved since the posterior gastric artery will be sacrificed in 13% of these cases.
The anatomy of the left renal vein, especially knowledge of collateral flow, is extremely important to the modern surgeon, since division of the left renal vein is common to many procedures. This study examines the left renal venous drainage system in 20 human cadavers for evidence of collateral flow and anomalies. Ten cadavers underwent dissection of the tissues surrounding the left renal vein, except for the left suprarenal and left gonadal veins, and 10 did not. Water and methylene blue were injected into the left renal vein to check for extravasation, and the veins were subsequently divided. There was no evidence of additional tributaries off the left renal vein as no extravasation occurred, and opening of the left gonadal and left suprarenal veins did not reveal any direct connections to the inferior vena cava. Thus, this experiment did not demonstrate evidence of a systemic collateral flow system draining the left kidney once the left renal vein was divided. Anomalies of the left renal venous drainage system occurred in six of 20 (30%) of cadavers, with one anomaly of the left renal vein itself (5%) manifested as a supernumerary left renal vein. The other anomalies included bifurcation of the gonadal vein, bifurcation of the suprarenal vein, the inferior phrenic vein draining into the left renal vein distal to the superior mesenteric artery, and the presence of a lumbar vein draining into the left renal vein in two cadavers. The lumbar veins may perhaps represent a normal variant.
Long before the Christian era, the duodenum was named and its function in controlling gastric emptying was conjectured. It received almost no further attention until the Eighteenth century when its relation to the bile and pancreatic ducts became know. The embryogenesis of the duodenum and the histological features of the organ are described as well as the gross movements that explain the mature relations of the duodenum to the surrounding structures. The "sphincters" of the duodenum are mentioned and evaluated.
The second part of this monograph on the duodenum describes the muscular and mucosal changes observed at the gastroduodenal junction. The structure of the duodenal wall and details of the intramural portion of the common bile and pancreatic ducts are described, together with the surgical anatomy of the four parts of the duodenum. The arterial supply, the venous and lymphatic drainage, and the innervations are described from the surgeon's point of view.
Duodenal pathology includes various developmental malformations and acquired lesions. This report provides brief descriptions of various congenital anomalies of the duodenum, including stenosis and atresia, annular pancreas and ectopic duodenal pancreatic tissue, megaduodenum, duodenal diverticula, preduodenal portal vein, and paraduodenal fossae. Acquired lesions, such as duodenal ulcer, tumors, vascular compression, and duodenal trauma are also described.
This is the last part of our efforts to present, if possible, the duodenum in toto as an anatomical and surgical entity. For all practical purposes, Part 4 is a short presentation of the anatomy involved in mobilization and exposure of the duodenum from a surgical standpoint with specific applications. A table with most of the anatomical complications of duodenal surgery is also included.
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The anatomy of the inguinal region is enigmatic and confusing. Among the many structures involved in hernial repair are the iliopubic tract, the transversus abdominis aponeurosis and the transversalis fascia, the transversalis crura and sling, and the inguinal canal. There is still much disagreement among surgeons and anatomists about the existence, structure, and function of these anatomic entities.