Yelda Pinar

A morphometric study on the superficial palmar arch of the hand

The vascular anatomy of the hand is a complex and challenging area and has been the subject of many studies. Knowledge of the vascular patterns and diameters of the hand gained more importance with improvements in microsurgical techniques in reconstructive hand surgery. We evaluated 50 hands (26 left, 24 right) of 26 formalin preserved cadavers to determine the superficial palmar arch, its branches and contributing vessels with special attention to the diameters. The symmetry of the types was also evaluated in detail for the first time in the literature. Measurements were made with the help of a digital caliper. The diameters of the ulnar, radial and median arteries were taken at the level of the wrist while the common palmar digital arteries, hypothenar branches and the superficial palmar branch of the radial artery were measured at their origin. Two types of superficial palmar arch were found and defined as complete (43/50 hands) and incomplete arches (7/50 hands). The complete arches were divided into four subgroups and incomplete arches into three subgroups. Most cases were found at the complete AI group (17 hands). Comparison of the arterial diameters showed the ulnar artery was the dominant vessel of the palm. The diameters of the common palmar digital arteries were not different with regard to complete or incomplete arches and between both sides. It looks safe to sacrifice one of the radial or ulnar arteries in some arterial interventions including radial artery cannulation, radial forearm flap and radial or ulnar artery harvesting for bypass grafting if the arch is complete. But we still recommend the noninvasive tests like modified Allen test or Doppler ultrasonography, before performing an invasive arterial intervention. We propose the radiologists to incorporate the median artery into the Doppler dynamic test in particular the existence or the absence of anastomoses between radial and ulnar arteries.

The anatomical variations of the extensor tendons to the dorsum of the hand.

To lead a quality life, tendon repair must be performed in a trauma causing damage to the extensor tendon of the hand. The aim of this study is to study the structures that can be used as donor tendons. Fifty‐four dissected adult hands were examined to study the pattern of the extensor tendons on the dorsum of the hand. The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius (EIP) tendon which inserted ulnar to the extensor digitorum (ED)‐index; a single ED‐index; a single ED‐middle; a single ED‐ring; an absent ED‐little; a double extensor digiti minimi (EDM), and a single ED‐ring to the little finger. The frequency of the number of tendons is as follows: a single (87.03%) EIP, a single ED‐index (100%), a single (92.6%) ED‐middle, a single (75.9%) ED‐ring, and an absent (68.5%) or a single (24.1%) ED‐little. A double (88.9%) EDM tendons were seen. The thickest type of juncturae tendinum (JT) is found primarily between the ring and little fingers (90%). Suitable excessive tendon and the thickest JT as donor tendon were found in the fourth intermetacarpal space. The present findings, especially the fourth intermetacarpal space, may explain why incisions on the dorsum of the hand should be large and performed with particular care. It is necessary to have a thorough understanding of the arrangements of the multiple extensor muscles and their junctural connections of the hand when tenoplasty or tendon transfer is required. Clin. Anat. 21:652–659, 2008.

The anatomical features and surgical usage of the submental artery

The skin characteristics make the submental region an available flap site for facial and intraoral reconstructions. For this reason, the anatomy of the submental region and the submental artery (SA) has gained in importance recently. The SA branches out from the facial artery at the level of superior edge of the submandibular gland. The SA runs anteromedially below the mandible and superficial to the mylohyoid muscle. It gives off some perforating branches to the overlying platysma and underlying mylohyoid muscle during its course. The terminal branches continue toward the midline, crossing the anterior belly of digastric muscle either superficially or deep, and end at the mental region in general. Some perforating arteries from the terminal branches supply the anterior belly of digastric muscle. This study aimed to describe the anatomical features of the SA and its branches to help in the preparation of submental arterial flaps.

Neuro-arterial relations in the region of the optic canal.

In this paper, we present the results of our investigations on the neuro-arterial relations in the region of the optic canal. A thorough knowledge of the microanatomic features of the ophthalmic artery, optic canal and optic nerve is very important for surgeons approaching lesions of this area. We aimed to extend our present knowledge of the origin of the ophthalmic artery and microsurgical anatomy of the optic canal with exposure of the optic nerve. The optic canal walls and width and height of the orbital and cranial apertures, and thickness of the bony roof of the optic canal were measured on the right and left sides of 57 sphenoid bones, 102 skull bases and 58 fixed adult cadaver heads. The ophthalmic artery originated from the rostromedial circumference of the internal carotid artery in 51.8%, from the medial circumference in 26.2% and the laterobasal circumference in 22% of the specimens. The outer diameter of the ophthalmic artery at its origin was 1.81 ± 0.36 mm on the right and 1.75 ± 0.37 mm on the left side.

The types of talar articular facets and morphometric measurements of the human calcaneus bone on Turkish race

IntroductionThere are three facets over upper side of talocalcaneal joint: anterior talar facet, middle and posterior. Three types of calcaneus that have distinct talar facets were defined as types A, B and C.Materials and methodsA total of 221 calcanei (98 right, 123 left), with unknown gender, were dried and evaluated.ResultsIn our study type B calcaneus (58%) was defined as the most common type, and type A calcaneus (39.3%) as the second most common type. By using facet joint differences and bone measurement, we tried to define calcaneus bone.DiscussionIn many diseases of foot, such as the talocalcaneal artritis and coalition, intraarticular fractures and congenital dysmorphology, flatfood, valgus deformities, the size and shape of the bones, the relationships of the talus and calcaneus with each other and other bones of the foot must be considered for the internal and external fixation and surgical procedures. Type B calcaneus was defined as the most comman type in Turkish race and these results correlate with the ones which were performed on bones of American, Indian and African people, and it was uncorrelated with the results of the researches performed in Europe.

Accessory tendon slip arising from the extensor carpi ulnaris and its importance for wrist pain

OBJECTIVE The anatomical variations of the extensor carpi ulnaris (ECU) muscle can cause a functional impairment of the wrist and the little finger. The aim of this study was to determine the number, thickness and type of accessory tendon arising from the ECU. METHODS The presence of an accessory tendinous slip from the ECU muscle was examined in terms of gross appearance, size, shape, thickness, location and distribution in 54 cadaveric forearms. RESULTS The accessory slips arising from the ECU muscle were observed in three specimens (5.6%) (two left, one right). These slips ran to the ulnar side of the extensor digiti minimi tendon, originated from the head of the ECU, and ended on the extensor apparatus of the fifth finger. The mean width of the tendinous slips was 1.4±0.01 mm. CONCLUSION This anatomic variation of the ECU should be considered in diagnostic and surgical procedures involving the dorsum of the hand. Its clinical importance in the treatment of tenosynovitis and subluxation of joints is also stressed.

Physical attractiveness: analysis of buttocks patterns for planning body contouring treatment

BackgroundAs buttocks region is one of the most characteristic features of the ideal female body figure, the popularity of gluteal region contouring is on the rise. Perception of body form is influenced by its shape and size. Interventions to modify the form of this region are often difficult due to influence. The aim of this study is to investigate the attractiveness of various buttock shapes with the aid of a dedicated software.MethodsStandard personal photographs of the lower body were obtained from 200 healthy volunteers. Linear analyses were made and anatomical perception was calculated according to reference points.ResultsCompared to males, all measurements concerning buttock dimensions were a significantly greater in females. Proportional assessments revealed that in females, the most attractive buttock waist-to-hip ratio was 0.75 from the posterior view. This ratio was 0.85 in males. From the lateral view, the most attractive buttocks have a waist-to-hip ratio of 0.70 in females. Positioning of the lateral prominence at the inferior gluteal fold was rated by 25% of the respondents as the most attractive in males from the posterior view. From the lateral view, the most prominent portion positioned at the midpoint (a 50:50 vertical ratio) was considered the most attractive for females.ConclusionsThese results suggest that utilizing digitalized reference values for a given body region may be an invaluable tool for determination of the correct fat volume, thus individualization of body contouring procedures. With the help of certain software, this research has shown that it is possible to measure the parameters of buttock, which may in turn be used to offer the best solution for any individual in quest for an improved buttocks form. New ideal waist-to-hip ratios of 0.7 update the previous standards.

Characterıstics of Mandibular Incisive canal and Lingual foramen Using Dental Volumetric Tomography (DVT)

OBJECTIVE: To investigate the presence, location and the dimensions of incisive canal and lingual foramen using dental volumetric tomography (DVT). METHODS: Thirty-one dry human mandibles were exposed using a DVT system. Images were examined for the presence of mandibular incisive canal (MIC) and lingual foramina (LF) including their dimensions and anterior-posterior lengths. In addition; labial and lingual diameters and heights of LF was determined. LF were classified with respect to the mental spine as well. RESULTS: MIC was observed in 58% of the images with mean diameter of 2.79mm while the mean length was 2.88mm. Total of 60 LF were observed in 31 mandibles. Twenty eight (47%) of them were located superior while 32 (53%) were located inferior to the genial spines. Only one canal was observed in 30% of the LFs whereas 50% of LFs had two and 20% had three canals. The mean lingual and labial diameters of the LF canals were 0.68mm and 0.63mm respectively. The mean height was 10.57mm and 9.53mm at the lingual and labial sides. CONCLUSION: The MIC, LF and associated neurovascular bundles may show many variations in number, location and size. Therefore, particular evaluation of these structures for each case is recommended.

The evaluation of relationship between body mass index and mental foramen area using computer-aided methods

Objective: Anatomical structure of the mental foramen (MF) is an essential orientation point particularly for implant planning at surgical clinics of dentistry, for genioplasty operations, and plastic surgery. The aim is to determine the influential factors such as the patient age, gender, and body mass index (BMI) on MF anatomy of dental periapical radiograms. Materials and Methods: Our study evaluated the BMI, gender, and age relationship with the calculated areas of the MF based on symmetrically taken 202 periapical dental radiography with a parallel technique of the bottom premolar region of total 101 people ages ranging from 17 to 70 weighing 46–108 kg. Patient age, BMI, and gender were recorded and statistically tested for correlations on the area of the MF. Digital imaging and communications in medicine were measured MF area. Results: Right MF area was measured as 0–20.8 mm2 (mean: 4.98 mm2) and left as 0–17.3 mm2 (4.93 mm2). There was not a difference in the areas of MF between the two sides. Furthermore, it was determined that ANOVA test and BMI, Pearson test with age and gender did not appear to have an effect on MF areas. Only within the obese people, left MF area was significantly different than those with other BMI groups. A negative effect on image quality was found statistically significantly correlated with age and MF. None of the investigated MFs were garbled by any of the investigated influence factors. Conclusion: In incidences in which the anatomical structure of the MF and the areas were crucial; age, gender, height, and weight of the individual were not determinant factors. BMI and MF appeared to have a negative impact.

Increased osseous thickening of the inner surface of the frontal bone.

AIM Increased thickening of the internal surface of the frontal bone (ISFB) was investigated, regarding possible pressure application to the brain tissue and the changes in bone marrow structure. MATERIAL AND METHODS Morphological analysis of the ISFB was carried out in a total of 300 adult skulls. RESULTS Type A, defined as normal appearance, has been detected in 243 cranium. In 57 cranium (19%), increased osseous thickening cases with different appearance were observed. The most frequent examples of osseous thickening were present in nodular types (Types B, C) and diffuse types (Types D, E), (29.8%). In fact, an irregular osseous thickening, which is in the form of plaques, was situated on both sides of the origin of sagittal sulcus. Types B and C were seen as small isolated nodules on the ISFB. In the histological analysis of ISFB, it is determined that the endocranium, normally present in a compact bone structure, changed its lamellar and had a nonwoven immature bone structure, in the areas with the characteristic of increased osseous thickening. The thickening of the diploe gap and increasing lamellar bone tissue in the endocranium revealed an increase in vascularization. CONCLUSION The nodular and widespread form of increased osseous thickening could apply pressure on to dura mater and the brain tissue.