Biomedical subjects

Gunther Windisch

Publications and source records attributed to Gunther Windisch.

8 recordsLinked to original sources

PubMed2007

Piriformis muscle: clinical anatomy and consideration of the piriformis syndrome.

Patients with lumbosacral and buttock pain provide tacit support for recognizing the piriformis muscle as a contributing factor to the pain (piriformis syndrome). One hundred and twelve cadaveric specimens were observed to elucidate the anatomical variations of the piriformis muscle referred to the diagnostic and treatment of the piriformis syndrome. The distance between the musculotendinous junction and the insertion was measured and the piriformis categorized into three types: Type A (71, 63.39%): long upper and short lower muscle belly; Type B (40, 35.71%): short upper and long lower muscle belly; Type C (1, 0.9%): fusion of both muscle bellies at the same level. The diameter of the piriformis tendon at the level of the musculotendinous junction ranged from 3 to 9 mm (mean: 6.3 mm). The piriformis showed the following possible fusions with adjacent tendons. In type one (60, 53.57%) a rounded tendon of the piriformis reached the upper border of the greater trochanter. In type two (33, 29.46%) it first joined into the gemellus superior tendon and at last both fused with the obturator internus tendon and inserted into the medial surface of the greater trochanter. A fusion of the piriformis, obturator internus and gluteus medius tendon with the same insertion area as above was observed in type three (15, 13.39%) and finally in type four (4, 3.57%) the tendon fused with the gluteus medius to reach the upper surface of the greater trochanter. Based on this survey anatomical causes for the piriformis syndrome are rare and a more precise workup is necessary to rule out more common diagnosis.

Adult↗

PubMed2007

Anatomic variations of the musculotendinous junction of the soleus muscle and its clinical implications.

The soleus muscle, like the gastrocnemius, is a powerful plantarflexor muscle in the lower limb. The soleus muscle joins the aponeurosis of the gastrocnemius muscle to form the calcaneal (Achilles) tendon. While the basic anatomy of the soleus muscle has been previously described, no study has addressed the anatomical variations of its distal attachment. We found considerable anatomic variation in the distance between this musculotendinous junction and the most proximal point of the proximal edge. This distal measuring point was defined as the most proximal point of the proximal edge of the posterior surface of the calcaneal tuberosity. Eighty human cadaver specimens were preserved according to Thiel's method; we examined one limb from each cadaver, studying 80 lower extremities in total. Following careful dissection of the lower limb, we measured the distance between the distal point of attachment of the soleus muscle fibers (the musculotendinous junction) and the designated measuring point. Our findings were divided into three groups: Group 1 (10 cases, 12.5%), where the distance between the musculotendinous junction and the designated point on the calcaneal tuberosity was between 0 and 1 inches; Group 2 (56 cases, 70%), where the distance was between 1 and 3 inches; and Group 3 (14 cases, 17.5%), where the distance was greater than 3 inches. Detailed knowledge of the anatomic variations of the soleus muscle at its insertion point onto the calcaneal tendon has clinical implications in calcaneal tendon repair following rupture and in the planning of reconstructive surgery using soleus muscle flaps.

Achilles Tendon↗

PubMed2006

A morphometrical study of the medullary cavity of the ulna referred to intramedullary nailing.

Intramedullary fixation is preferred for osteosynthesis in the case of long bone fractures; but the problem of the nails' adjustment to the anatomical needs remains. About 80 cadaveric ulnae were examined to elucidate the curvature of the medullary cavity, the point of varus angulation, the thickness of the radial and ulnar cortical bone and the diameter of the medullary cavity at that point. Furthermore, the point of varus angulation of the posterior border was compared to that of the medullary cavity, to evaluate if it allows any conclusion to the curvature of the medullary cavity. The point of varus angulation of the medullary cavity ranged from 45 to 110 mm (mean 71.02), its angle from 4 to 13.5 grade (mean 8.95). At this point, the thickness of the cortical bone on the radial side was between 2.5 and 7 mm (mean 4.44) and ulnar between 2 and 8 mm (mean 4.37). The diameter ranged from 4 to 10.5 mm (mean 6.96). The point of varus angulation of the posterior border was between 65 and 110 mm (mean 85.88) and differs from that of the medullary cavity observed between 45 and 110 mm (mean 71.02). The point of varus angulation of the posterior border and the medullary cavity differs from 1 to 60 mm and it is found in most cases to be more distal than the point of varus angulation of the medullary cavity so the palpable posterior border allows no reliable conclusion of the curvature of the medullary cavity.

Adult↗

PubMed2006

The pyramidal lobe: clinical anatomy and its importance in thyroid surgery.

The pyramidal lobe could be a source of pitfalls in thyroidectomy, due to its frequency but unreliable preoperative diagnosis on scintigraphic images. Special attention has to be paid to the pyramidal lobe to avoid leavings of residual tissue when complete removal of the thyroid is indicated. Sixty cadaveric specimens were examined with special emphasis to the topographical anatomy and expansion of the pyramidal lobe. A pyramidal lobe was found to be present in 55% of the cadavers (32/58). It was found more frequently in men than in women. In men the median length was 14 mm and in women 29 mm. An accessory thyroid gland was present in one specimen, in four cases the isthmus was missing. The pyramidal lobe branched off more frequently from the left part of the isthmus (16) than from the right (7) or the midline (9). In two cases it originated from the left lobe. Additionally 23 scintigraphic images were analyzed to evaluate the visualization of a pyramidal lobe. Only three of them showed enlargements of the isthmus that could be taken as a pyramidal lobe. Due to its frequency the pyramidal lobe should be regarded as a normal component of the thyroid. It is not reliably diagnosed by scintigraphic imaging because scintigraphy can only give functional information but not morphological one. Therefore the anterior cervical region has to be investigated very carefully during operation in order not to leave residual thyroid tissue in total thyroidectomy.

Adult↗

PubMed2006

The triceps brachii muscle and its insertion on the olecranon.

BACKGROUND: The purpose of this anatomical study was to define the insertion of the tendon of the triceps brachii muscle and the course of the lateral cubital retinaculum (LCR) as an enhancement of the triceps tendon. MATERIAL/METHODS: One hundred cadaver specimens were assessed and the widths of the triceps tendon and the olecranon and the expansion of the LCR were determined. RESULTS: The width of the tendon ranged between 1.9 and 4.2 cm (mean: 2.81) and the width of the olecranon between 1.8-3.8 cm (mean: 2.5). In 65 of the 100 specimens, the width of the tendon was greater than that of the olecranon. The fibers on the medial side inserted exactly on the medial aspect of the olecranon, whereas on the lateral aspect the fibers left the olecranon to reach the posterior border of the ulna. In 28 specimens the olecranon was wider than the tendon of the triceps, and in seven extremities the tendon occupied exactly the whole area of the olecranon. The LCR measured 2.3-7.2 cm (mean: 4.04 cm). CONCLUSIONS: By preserving parts of the triceps tendon on the olecranon and preserving the lateral cubital retinaculum, the extension strength will be maximized, allowing early active elbow motion. Using the triceps brachii muscle for any approach, only the medial aspect might be used as a guideline to reach the olecranon. On the lateral side the fibers of the triceps tendon fan out as the LCR to join into the ulna and the antebrachial fascia.

Adult↗

PubMed2006

Unusual vascularization and nerve supply of the fifth finger.

During a dissection course, an unusual variation in vascularization and nerve supply of the fifth finger of the right hand was found in a 73-year-old human male cadaver. The proper digital palmar artery arose from the superficial branch of the ulnar artery distel to the Guyon's canal. The proper digital palmar artery coursed first palmar to the ulnar nerve then between the abductor minimi and flexor digiti minimi muscles to reach the ulnar side of the fifth finger. Besides this, the ulnar border of the fifth finger was supplied on its palmar side by the dorsal branch of the ulnar nerve, which gave off two tiny twigs for the sensory innervation on the dorsal side of the same finger.

Aged↗

PubMed2004

Herniation of the mylohyoid muscle.

During ultrasound examinations in patients with dysphagia, deficiencies in the mylohyoid muscle with herniation of the sublingual gland were found, which may be mistaken as soft tissue tumors. Between the years 2001 and 2003, 205 half-heads used in dissection courses were examined to determine the location and contents of these gaps. In 25 of these cadaveric specimens, the hiatus (of variable size) appeared as small fissures between the divided fibers of the mylohyoid. In 18 cases (72%), the sublingual gland slipped through these deficiencies and occurred in the front part of the submandibular triangle. From the inferior surface of the muscle, the submental artery also coursed through the separated muscle fibers. The herniations of 7 specimens (28%) were found without any contents, neither with gland perforation nor with a submental artery. The following study points out the spatial relation of the salivary glands to the floor of the mouth and the clinical significance, and some factors referred to the development of herniations are discussed.

Deglutition Disorders↗

PubMed2004

Unusual thyroid gland vascularization.

During a dissection course, an unusual vascularization of the thyroid gland was found in a 69-year-old human male cadaver. On the right side, two arteries from the thyrocervical trunk supplied the lower half of the right lobe of the thyroid gland: the inferior thyroid artery and an additional vessel with a main trunk, found to be split into an upper and lower branch at the level of the longus colli muscle. The upper branch supplied the inferior constrictor pharyngeal muscle and the esophagus, whereas the lower branch coursed, at first, onto the trachea and finally leaving it to anastomose with the inferior thyroid artery.

Aged↗