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At least 19 recordsLinked to original sources

The internal jugular vein maintains its regional anatomy and patency after carotid endarterectomy: a prospective study.

OBJECTIVE: To validate the authors' published surface landmarks for gaining percutaneous access to the internal jugular vein (IJV), and to determine whether these surface landmarks were altered after neck surgery. SUMMARY BACKGROUND DATA: Carotid puncture and pneumothorax continue to be the most frequent mechanical complications of percutaneous IJV venipuncture, particularly when the anterior or posterior approaches are used. The authors' modified technique of IJV venipuncture was associated with a 0.6% complication rate; notably, there were no instances of carotid artery puncture. Determining the accuracy of this method using duplex ultrasound would enhance the technique's applicability and safety. The authors also hypothesized that previous neck surgery would alter the regional anatomy in relation to these surface landmarks for IJV venipuncture. METHODS: The authors prospectively evaluated 417 IJVs in 209 consecutive patients undergoing carotid duplex imaging before and after carotid endarterectomy (CEA). Patients who had undergone CEA were enrolled to investigate the effect of neck surgery on IJV anatomy. The opposite, nonoperated side of the neck served as a control for each patient. The position of the IJV in relation to the surface landmarks, the mobility of the IJV on neck rotation, and the size, patency, and relation of the IJV to the carotid artery were evaluated. RESULTS: Overall accuracy of the surface landmarks for locating the IJV percutaneously was 99% for the control group and 95% for the CEA group. With neck rotation, the IJV was located in a more lateral position in relation to the landmarks that would significantly reduce its accessibility. After neck rotation, it was also noted that the carotid artery moved behind the jugular vein in 85% of the patients in both groups. The mean size of the vein and its patency were similar in both groups. CONCLUSIONS: Duplex imaging validated the accuracy of the surface landmarks for IJV cannulation and documented the adverse effects of neck rotation. IJV anatomy is not altered after CEA.

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Regional anatomy of the term human placenta.

We have studied regional anatomical variability in four term placentae, comparing both whole placental regions and intralobar zones and plates. In addition, we have emphasized the need for careful selection of the area to be sampled, rather than strictly randomized sampling of the whole placenta. A unique contribution is our quantitative data for a number of structures of the several intralobar zones and plates. The data confirm the hypothesis that the area best suited to physiological exchange is the central region parabasal plate. The relative homogeneity of the intralobar zones in this area make it a representative area for sampling for various placental studies.

Capillaries↗

Hypophyseal region--anatomy of the operative approaches.

Landmarks and measurements for the transnasal approach (apertura piriformis, distance to the apertura sinus sphenoidalis) in children and adults are given. Included is the anatomy of the nasal septum, its vessels and nerves. The ostium of the sphenoid sinus, its development, types and dimensions are described. Also shown are the hypophyseal capsule, the hypophyseal vessels and the hypophyseal fossa with its variations and the sella turcica region with its adjacent dural structures (petroclinoid fold, diaphragma sellae, aperture for the internal carotid artery and pituitary cistern). For the intracranial approaches the arterial circle and its branches are important for neurosurgeons. The location, number, width and course of these branches are described. Distances and the most important vessels, which are seen by frontal, frontolateral and pterional approaches, are described.

Arteries↗

Venous drainage architecture of the temporal and parietal regions: anatomy of the superficial temporal artery and vein.

Anatomy of the superficial temporal artery and vein was analyzed with arteriograms, venograms, and arteriovenograms of fresh cadavers that had been injected with contrast medium. The superficial temporal artery always divided into two major branches: the frontal and parietal branches. However, the superficial temporal vein divided into one, two, or three major branches. The distribution area of the major branches of the superficial temporal vein was larger than that of major branches of the superficial temporal artery, and arteriovenograms clearly demonstrated that, except for its proximal portion, the superficial temporal vein was independent of the superficial temporal artery. The frontal and parietal branches of the superficial temporal artery had thin venae comitantes that originated from the proximal portion of the superficial temporal vein, and the venae comitantes gave off branches toward the skin and the underlying soft tissue. Branches to the skin anastomosed with a superficial venous network in the skin layer, which was formed by ramifications of the superficial temporal vein. The venous architecture of the temporal and parietal regions consisted of cutaneous veins and venae comitantes and was basically similar to that of the forearm and scapular region.

Humans↗

Deep and superficial infrapatellar bursae: cadaveric investigation of regional anatomy using magnetic resonance after ultrasound-guided bursography.

OBJECTIVE: To demonstrate the anatomy of the deep and superficial infrapatellar bursae using magnetic resonance (MR) imaging and anatomic correlation in cadavers. DESIGN: MR imaging of the infrapatellar bursae of nine cadaveric knees was performed after ultrasound-guided bursography. The images were compared with those seen on anatomic sectioning. Histologic analysis was obtained in two specimens. RESULTS: The deep infrapatellar bursa (DIB) was visualized in all specimens (n=9) and the superficial infrapatellar bursa (SIB) in five specimens (55%). The mean dimensions of the DIB in the craniocaudal, mediolateral, and anteroposterior planes were respectively 25, 28.7, and 6 mm, and for SIB 19.5, 21.2 and 2.2 mm. A fat apron dividing the DIB was depicted in eight knees (89%). Lateral extension of the DIB beyond the patellar tendon was observed in 100% of cases. Cadaveric analysis depicted a thin septum in the SIB in four of five cases (80%). CONCLUSIONS: The DIB is generally present and extends beyond the lateral margin of the patellar tendon. A fat apron partially separating this structure is usual. The SIB is not an unusual finding and may have a septum separating its compartments.

Aged↗

Radial and ulnar bursae of the wrist: cadaveric investigation of regional anatomy with ultrasonographic-guided tenography and MR imaging.

OBJECTIVE: To demonstrate the anatomy of the radial and ulnar bursae of the wrist using MR and US images. DESIGN: Ultrasonographic-guided tenography of the tendon sheath of flexor pollicis longus (FPL) and the common tendon sheath of the flexor digitorum of the fifth digit (FD5) of ten cadaveric hands was performed, followed by magnetic resonance imaging and gross anatomic correlation. Patterns of communication were observed between these tendon sheaths and the radial and ulnar bursae of the wrist. RESULTS: The tendon sheath of the FPL communicated with the radial bursa in 100% (10/10) of cases, and the tendon sheath of the FD5 communicated with the ulnar bursa in 80% (8/10). Communication of the radial and ulnar bursae was evident in 100% (10/10), and presented an "hourglass" configuration in the longitudinal plane. CONCLUSIONS: The ulnar and radial bursae often communicate. The radial bursa communicates with the FPL tendon sheath, and the ulnar bursa may communicate with the FD5 tendon sheath.

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