A variant course of the superficial palmar branch of the radial artery.

The objective of this report was to present a case of superficial palmar branch of the radial artery (SPBRA) with a variant course, which to the best of our knowledge, has not been reported in the literature. During anatomical dissections that were carried out in the Department of Anatomy of Suleyman Demirel University School of Medicine to demonstrate the superficial palmar arch, a variation in the course of the SPBRA was noted in the right hand of an adult cadaver. This variant branch ran superficial to, and in contact with, the flexor retinaculum, and ran transversely to join the ulnar artery.

The mechanisms of medial pedicle wall violation: insertion method is as important as correct cannulation of the pedicle.

A cadaver study aims to determine the mechanisms of medial pedicle wall violation after a correct cannulation of the pedicle. The study presents finding out the effect of insertion angle and insertion force on medial wall violation. We used 100 lumbar pedicles of cadavers. Special wooden blocks were produced to simulate a fixed angle fault after a correct pedicle cannulation. Pedicles were divided into 4 groups: 10-degree free drive (group 10), 15-degree free drive (group 15), 10-degree push drive (group 10P), and 15-degree push drive (group 15P). After insertion of pedicle screws, laminectomies were done and the pedicles were evaluated from the inside. Pedicle complications were more in group 10P than group 10 (P = 0.009). Medial wall fracture (P = 0.002) and canal penetration were more in group 15P than group 15 (P = 0.001). Groups 10P and 15P were similar regarding medial wall fractures but canal penetration was significantly higher in group 15P (P = 0.001). Medial wall breaches can happen after correct cannulation of pedicles. Change in insertion angle is one factor but the most important factor is the use of a pushing force while inserting a screw. The pedicle seems to be extremely tolerant to insertion angulation mistakes up to 10 degrees and tends to lead the screw into the correct path spontaneously.

Wet-cupping removes oxidants and decreases oxidative stress.

OBJECTIVES: Wet-cupping therapy is one of the oldest known medical techniques. Although it is widely used in various conditions such as acute\chronic inflammation, infectious diseases, and immune system disorders, its mechanism of action is not fully known. In this study, we investigated the oxidative status as the first step to elucidate possible mechanisms of action of wet cupping. MATERIAL AND METHODS: Wet cupping therapy is implemented to 31 healthy volunteers. Venous blood samples and Wet cupping blood samples were taken concurrently. Serum nitricoxide, malondialdehyde levels and activity of superoxide dismutase and myeloperoxidase were measured spectrophotometrically. RESULTS: Wet cupping blood had higher activity of myeloperoxidase, lower activity of superoxide dismutase, higher levels of malondialdehyde and nitricoxide compared to the venous blood. CONCLUSION: Wet cupping removes oxidants and decreases oxidative stress.

[A rare nerve variation: duplication of the digital nerves in the index finger]. / Nadir bir sinir varyasyonu: Isaret parmagindaki digital sinirlerin duplikasyonu.

We present a 36-year-old male patient who had an anatomic variation in the number of digital nerves in the index finger of the left hand. During flexor tendoplasty for a zone II flexor tendon injury in the index finger, duplication of the radial and ulnar digital nerves was detected at the level of the proximal phalanx, making a total of four digital nerves. Both radial and ulnar digital nerves gave off branches at the level of the metacarpophalangeal joint that ran to the distal index finger. One of digital nerves on the radial side was cut at the level of the proximal phalanx and was treated with neurorrhaphy. Complete sensory recovery in the distal area of the index finger was achieved within a follow-up of six months. Such variations in the digital nerves may lead to insufficient repair if they are gone unnoticed.

Superficial palmar communications between the ulnar and median nerves in Turkish cadavers.

The superficial palmar communicating branch between the ulnar and median nerves, the ramus communicans (RC), has been investigated by anatomical dissections in 30 hands of 15 cadavers in the Turkish population. A communicating branch between the ulnar and median nerves was found in 18 hands (60%). It was classified into 4 types: Type 1-RC emerging from the ulnar 4th common digital nerve (CDN) and uniting with the median 3rd CDN, Type 2-RC emerging from the median 3rd CDN and uniting with the ulnar 4th CDN, Type 3-RC extending horizontally between the 3rd and 4th CDN, Type 4-a plexiform RC formed by multiple twigs. Twelve hands (40%) showed the Type 1 arrangement, one was Type 2 (3.3%), two were Type 3 (6.7%) and three (10%) were Type 4, based on the classification devised by Meals and Shaner ([1983] J Hand Surg Am 8:411-414) and modified by Bas and Kleinert ([1999] J Hand Surg Am 24:1171-1184). Knowledge of the anatomical characteristics of this branch is important for surgical interventions, especially in carpal tunnel release operations.

Size and location of the fetal human ovary.

OBJECTIVE: To determine the development and the localization of the ovaries during the fetal period. MATERIAL AND METHODS: One hundred and fifty-four ovaries obtained from 77 human fetuses aged between 9 and 40 weeks of gestation were used in this study. Firstly, the shapes and the positions of the ovaries were established. Second, the localization of the ovaries with respect to linea terminalis, ureters, and the iliac arteries were determined. Finally, the dimensions and the weight of the ovaries were measured. FINDINGS: In the fetal period, the ovaries were most commonly almond shaped and had an oblique orientation. In the 1st trimester the midpoint of the long axis of the fetal ovaries were at the level of linea terminalis. In the 2nd and 3rd trimester and full-term fetuses, it was observed that the ovaries were not in ovarian fossa, suggesting that descensus ovary was in progression during these times. During the intrauterine period, the ovaries were most commonly located anterior to the ureters and over the common iliac artery, only to migrate to its final location between the internal and external iliac arteries towards the end of the 40th week. CONCLUSION: We found that the ovaries did not assume the position of the adults at the end of the fetal period, rather continued its descent after the birth. We believe our findings about the fetal ovaries will be useful in obstetrics, fetal pathology, and forensic pathology.

Insight into understanding the anatomical and clinical aspects of supernumerary rectus capitis posterior muscles.

Rectus capitis posterior muscles are located in the suboccipital triangle and function in extension and lateral rotation of the head and neck. There are two of these muscles on each side: the rectus capitis posterior major and the rectus capitis posterior minor. This study describes the presence of a third suboccipital muscle in a 55-year-old cadaver. In addition to highlighting the possible relationship between these muscles and cervicogenic headaches or balance in an individual, we also relate this observation to similar musculature in the cat that have been shown to effect crucial functions.

Anatomical variations as potential risk factors for ulnar tunnel syndrome: a cadaveric study.

The aim of this study was to assess the anatomical variations, especially the anomalous muscles passing through Guyon's canal and the fibrous arch forming the piso-hamate hiatus, which may play a role in ulnar tunnel syndrome. We have also focused on the relation of these structures with specific concern to the ulnar nerve. Nineteen embalmed cadavers (37 hands and forearms) were dissected. A fibrous arch extending between the pisiform and the hook of the hamate was observed in 21 hands. In majority of the cases flexor digiti minimi muscle was found to originate only from this arch. An anomalous muscle was disclosed in six hands with four of them passing through the piso-hamate hiatus with the deep branch of the ulnar nerve. In two of four cases, the superficial branch of the ulnar nerve was also accompanying the deep branch of the ulnar nerve beneath the anomalous muscle and through the piso-hamate hiatus. Because these anomalous muscles were generally found to course through the piso-hamate hiatus with the branches of the ulnar nerve, we conclude that the distal portion of the Guyon's canal has a relatively higher risk for ulnar nerve entrapment. We believe that surgeons operating on this region should take into account these various anatomic structures.

Cadaveric observation of an aberrant left subclavian artery: a possible cause of thoracic outlet syndrome.

We report a rare anomaly of the left subclavian artery, coursing through the scalenus anterior muscle, that may cause thoracic outlet syndrome. We also discuss the anatomical basis of the possible diagnostic maneuvers for patients with thoracic outlet syndrome.