Nader Wafae

Morphometry of the human bicipital groove (sulcus intertubercularis)

BACKGROUND The bicipital groove is located between the greater and lesser tubercles at the proximal extremity of the humerus and extends inferiorly. Citations that anatomic variations of the groove could give rise to sliding of the biceps brachii muscle tendon led us to initiate a morphometric study on this groove. MATERIALS AND METHODS The study was done on 50 dry humeral bones from adults of both genders and from both sides. A digital caliper rule was used to measure the length, thickness and width of the bicipital groove and the humerus. The angles of the bicipital groove were measured with a goniometer. RESULTS The average length of the groove was 8.1 cm and it corresponded to 25.2% of the length of the humerus. The width at the midpoint of the groove was 10.1 mm and corresponded to 49.7% to 54.5% of the width of the humerus. The depth was 4.0 mm and corresponded to 18.8% of the depth of the humerus. The mean angle formed by the groove lips was 106 degrees . CONCLUSION This study confirmed the variability of the measurements presented by the groove in relation to all the aspects considered. LEVEL OF EVIDENCE Basic Science.

The recurrent laryngeal nerve in relation to the inferior constrictor muscle of the pharynx.

The point of penetration of the recurrent laryngeal nerve into the larynx is recognized as the most frequent site of injury to the nerve during surgical procedures of the thyroid gland. The anatomical relationships of 25 right and left recurrent laryngeal nerves in 25 anatomical blocks from formalin‐fixed human corpses have been studied.

Anatomical Indicators of Dominance between the Coronary Arteries of Dogs

En los corazones humanos la dominancia coronaria es derecha. Sin embargo, no encontramos referencias en la literatura sobre los indicadores de esta dominancia en perros. Utilizamos 30 corazones de perros de ambos sexos y raza mixta, fijados en formaldeido al 10%. Las ramas de las arterias coronarias fueron disecadas con especial atencion a los niveles considerados como referencias. En 96,7% de los corazones, la rama circunfleja de la arteria coronaria izquierda excedio o llego a la crux cordis. La arteria interventricular subsinuosa, termino antes de llegar al apice en 21 casos, en el apice en 5 casos y despues del apice en 4 casos. La arteria interventricular paraconal, termino antes de llegar al apice en 2 casos, en el apice en 11 casos y despues del apice en 17 casos. La region del apice del corazon estaba irrigada por ramas de la arteria coronaria izquierda a traves de la rama interventricular paraconal o a traves de los dos ramas interventriculares. La longitud media y el numero de ramas ventriculares de la arteria coronaria izquierda son mas grandes que las ramas de la arteria coronaria derecha. La rama interventricular subsinuosa es una rama de la rama circunfleja de la arteria coronaria izquierda. En los corazones de los perros, sin embargo, la dominancia es izquierda. La norma de dominancia en los perros es diferente de la norma de dominancia en humanos encontrada en la literatura.

Analysis on the Incidence of the Fibularis Quartus Muscle Using Magnetic Resonance Imaging

Objective. Quantify the presence of the fibularis quartus muscle and correlate it with the individuals sex and concomitant presence of the fibularis tertius muscle. Materials and Methods. We evaluated 211 magnetic resonance examinations (43.13% men and 56.87% women) on the ankle and hindfoot, produced between 2009 and 2011. Results. The fourth fibularis muscle was found to be present in 7.62% of the examinations and 75% of these also contained the fibularis tertius muscle. Conclusion. The incidence of the fourth fibularis muscle is variable; moreover, its incidence does not depend on the individuals gender or the presence of the fibularis tertius muscle.

Estudo anatômico das artérias coronárias de suínos Landrace

The experimental use of coronary arteries of swine to study drug action for clinical and surgical application is an important tool. For this anatomic study about coronary arteries, thirty hearts of Landrace pigs, of both sexes, 5 to 6 months old, weighing 80 to 110 kg, were fixed in 10% formalin. The coronary arteries and their branches were dissected until the visible ramifications. There was one left coronary artery, with length of 0.4-1.2cm, giving off 2 (80%) or 3 (20%) branches. The paraconal interventricular branch, with length of 10-16cm, emitted 16-25 branches, 52.3% for the right ventricle and 47.7% for the left ventricle. The circumflex branch, with length of 7-15cm, emitted 4-13 branches, 55.6% for the left ventricle and 44.4% for the left atrium. There was one right coronary artery, with length of 7.5-11.5cm, which emitted 12-21 branches, 57.4% for the right ventricle and 42.6% for the right atrium. The subsinuosus interventricular branch, length of 3-11cm, emitted 9-22 branches, 50.9% for the right ventricle and 49.1% for the left ventricle. The number of branches of the paraconal interventricular branch and the number of branches of the subsinuosus interventricular branch was similar for both ventricles. The results obtained in the present study compared with the literature indicate that the distribution of the coronary branches in swine and in humans is similar.

Anatomy of the septomarginal trabecula in goat hearts.

Our aim in this study was to examine the right septomarginal trabecula of goats regarding the frequency, origin course of the septal and free component, attachment to the papillaris magnus muscle and size . The material used consisted in 32 hearts from non-pedigree goats of both sexes, preserved in 10% formalin. The right septomarginal trabecula was present in all hearts. It could also present a prominence in the form of a cord in the septum before detaching and going towards the wall or the papillary muscle. We called this a septal component and found it in 69% of all hearts studied. In the remaining specimens, the exit of the septomarginal trabecula was abrupt, without presenting a septal component. It could be attached solely to the papillaris magnus muscle or to the papillary muscle and the ventricle wall, originated in the cranial third of the septum, and was attached to the middle third of the papillary muscle or its caudal third. Its free part, from the septum to the papillaris magnus muscle, ranged in length from 1.3 cm to 2.6 cm. The mean value was 1.7 cm, and the most frequent values were 1.9 and 1.5 cm. In conclusion, in goats, the septomarginal trabecula is a constant and invariable structure.

Neurovascular Pedicles of the Tibialis Anterior Muscle in Children

La importancia del musculo tibial anterior en cirugias de transposicion ortopedica en ninos, asi como en casos de mielomeningocele, fundamenta su estudio respecto a sus pediculos neurovasculares. El estudio se realizo en 34 miembros inferiores de cadaveres de ninos de un ano o menos de edad. Se observo que el musculo tibial anterior presentaba con frecuencia 7 a 10 ramas arteriales (52,4%). En 97,1% de los casos estos ramos eran derivados de la arteria tibial anterior. En dos casos, la arteria tibial anterior estaba ausente y el musculo suplio su irrigacion con la arteria fibular. En relacion a la entrada de las ramas, 39,7% lo hacen en el tercio superior del musculo. El tercio medio recibe 40,1% de las ramas y el tercio inferior recibe 20,2% de ellas. El nervio fibular profundo es la fuente principal de inervacion, en 91,2% de los casos provee 2 a 4 ramos para el musculo, de ellos el 46,2% termina en el tercio superior y el 43% en el tercio medio. Con mayor frecuencia, existen dos pediculos neurovasculares supliendo el tercio superior y uno supliendo el tercio medio del musculo tibial anterior

Bilateral Duplication of Gonadal Veins: a Case Report

La duplicacion de las venas gonadales es mas comun en el lado izquierdo, con pocos casos bilaterales. El proposito de este reporte fue describir el caso de una duplicacion bilateral de las venas gonadales, dos de las cuales desembocaban en la vena cava inferior. El vaso proximo del margen medial del rinon tenia un diametro de 2,68mm y una longitud de 64,41 mm. La segunda vena tenia un diametro de 1,43 mm y una longitud de 73,76 mm. Los dos vasos desembocaban en la vena renal izquierda. La primera vena tenia un diametro de 2,7 mm y estaba a 21,8 mm del margen medial del rinon. La otra tenia un diametro de 1,64 mm y se se localizaba a 35,13 mm del margen medial del rinon. La presencia de variaciones donde se produce el drenaje de los vasos gonadales tiene importancia clinica para la comprension del origen del varicocele y la recurrencia del mismo, despues de procedimientos quirurgicos.

Angiographic study of the arterial supply to the palatine mucoperiosteum

Studies on the arterial supply of dog palatal mucoperiosteum have contributed to the success of surgical procedures on the hard palate of humans. We decided to undertake a more detailed anatomical study of the arterial supply of the canine palate. 15 male dogs of the species Canis familiaris were used. Contrast solution (barium sulfate) was injected into the palatal arterial system, followed by the removal of the dogs palate together with its mucoperiosteum. To obtain good radiographic imaging of the arterial network of the palatal mucoperiosteum, decalcification of the palatal bone was carried out. X-ray images were taken by a mammography X-ray machine set for 23 kV and 10 mA. The X-ray images showed that the mucoperiosteal arterial network is composed of a left and a right major artery which enters the mucoperiosteum through the left and right foramen, respectively. Anastomoses were observed between these two major arteries along their path from the posterior to the anterior regions of the mucoperiosteum. These anastomoses always occurred at the palatal transversal crests. The statistical study of the collected data showed that, for the posterior third of the palate, there is a proportionality between the number of the arterial derivations from the two major arteries and the mucoperiosteal area. The X-ray images also showed that the middle third of the palate is the least supplied with arterial derivations.

VARIACIONES DE LAS COMUNICACIONES LINFATICO-VENOSAS EN LA FOSA SUPRACLAVICULAR IZQUIERDA DEL HOMBRE

Considerando la importancia clinica y quirurgica de las comunicaciones linfaticovenosas, poco descritas en la region cervical, presentamos y analizamos variaciones de estas comunicaciones, las que fueron observadas despues de la diseccion de la fosa supraclavicular izquierda de 34 cadaveres en la Disciplina de Anatomia Descriptiva y Topografica de la Universidade Federal de Sao Paulo-Escola Paulista de Medicina, Brasil. Encontramos dos casos (5,9 %) de vasos linfaticos que desembocaban en la vena subclavia izquierda, proximo del angulo yugulo-subclavio. En ambos casos, estaba presente el conducto toracico desembocando en el lugar habitual. Los estudios anatomicos de estas variaciones son importantes, ya que su conocimiento ayuda a evitar secuelas despues de la realizacion de procedimientos quirurgicos en la region cervical permitiendo, ademas, aportar detalles sobre las vias linfaticas de esa region