Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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A palpation reference line coursing between the superior-most aspect of the iliac crests has been reported to cross the L4 spinous process or L4/L5 intervertebral space in approximately 80% of the population. Comparable data have not been defined for the line coursing between the posterior superior iliac spines (PSIS). The purpose of this study was to compare the anatomical consistency of the PSIS to the iliac crest as landmarks used for spinal palpation. ⋯ The PSIS crossed S2 more frequently than the iliac crest crossed L4 (chi(2) = 12.719, P < or = 0.01). The study findings support the relationship between the PSIS, and the spinous process of S2 is more consistent when compared to the iliac crest and the spinous process of L4. The PSIS reference line may be used to find S2 as a reference standard in validity and reliability palpation studies in the lower lumbar spine.
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Crossed renal ectopia is one of the rarest urinary system anomalies. It is more often seen at autopsy than in clinical practice. Most cases of renal ectopia remain asymptomatic during life and are diagnosed incidentally. ⋯ Both had left-to-right inferior crossed renal ectopia with fusion. Additionally, the first patient had a history of surgery for a recurrent inguinal hernia, whereas the second had crossed fused renal ectopia associated with nephroptosis. Surgeons should be aware of ectopic and fused kidneys to minimize perioperative complications because of the uncertain anatomy.
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The safe and successful performance of a central venous catheterization (CVC) requires a specific knowledge of anatomy in addition to a working knowledge. Misunderstanding the anatomy may result in failure or complications. ⋯ CVC is common practice amongst surgeons, anesthesiologists, and emergency room physicians during the preparations for major surgical procedures such as open-heart surgery, as well as, for intensive care monitoring and rapid restoration of blood volume. Associated with this technique are certain anatomical pitfalls and complications that can be successfully avoided if one possesses a thorough knowledge of the contraindications, regional anatomy, and rationale of the technique.
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Case Reports
Isolated deep peroneal (fibular) nerve palsy in association with primary total hip arthroplasty.
We present two patients suffering isolated deep peroneal (fibular) nerve (DPN) palsies post primary total hip arthroplasty. The consistent factor in both patients was difficulty with initial dislocation and subsequent relocation. Both developed immediate isolated DPN palsies, with loss of dorsiflexion and paraesthesia over the first web space. ⋯ Common peroneal nerve (CPN) palsy is common than due to a number of important anatomical factors. It is thought that the deep and superficial branches of this nerve also exist as discrete fascicles and these same factors make the deep division more frequently affected. Recovery is prolonged and incomplete despite intensive physiotherapy, thus putting emphasis on prevention.
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Although the arachnoid membranes have been known for more than 300 years, the anatomy of the arachnoid membranes has not been studied in detail. This study was performed to explore the microanatomical features of the cranial arachnoid membranes. The arachnoid membranes and cisterns were observed in eight Han Chinese adult human cadaveric brains with an operating microscope, without staining of intracranial structures or injection of colored material into blood vessels. ⋯ On the basis of the arachnoid membranes we identified, the arachnoidal limits of the cisterns were discussed. The microsurgical anatomical research on the arachnoid membranes is a supplement to the anatomical study of the subarachnoid cisterns. The understanding of the topographical features of the arachnoid membranes is valuable to the reasonable dissection of the cisterns and the minimally invasive manipulations during microsurgical procedures.