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PURPOSE: This investigation aimed to study the types of external occipital protuberance (EOP) with special reference to Type 3 (spine type). Detailed information will be useful for clinicians to manage occipital headaches or issues related to the biomechanics of the neck and for accurate radiological interpretations. METHODS: Thirty-one dry intact cadaveric skulls were studied for EOP classification. In Type III EOP cases, the size of EOP was noticed using different modalities and compared. The superior nuchal lines and external occipital crest were observed for their prominence and any variation. RESULTS: 42% of the skulls belong to Type 1, 51.5% to Type 2, and 6.5% to Type 3 EOP. Superior nuchal lines and external occipital crest were more prominent in Types 2 and 3 EOP. In Type 3 EOP cases, the mean length, width, and thickness of the spine as measured directly on the skull were 16.63 mm; 20.1 mm, and 7.82 mm respectively, the same as radiograph findings. CT examination revealed the average volume as 0.95 cm3. Out of two Type 3 EOP cases, the spine with larger values for its size was having a lesser volume value in CT. CONCLUSIONS: Plain lateral radiography is a reliable method to measure the length and thickness of spinous EOP. However, more values of these parameters for morphometry of the EOP spine do not mean more volume of EOP and vice versa. Detailed information regarding the occurrence of occipital spur and its morphology will be of great importance to neurosurgeons, sports, physicians, emergency departments, and radiologists.
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Cabeça , Osso Occipital , Humanos , Osso Occipital/diagnóstico por imagem , Osso Occipital/anatomia & histologia , Pescoço , Vértebras Cervicais/cirurgia , RadiografiaRESUMO
PURPOSE: Recurrent laryngeal nerve (RLN) is the most critical structure in terms of intricacy. Anatomic variations of the nerve may further make thyroid surgery cumbersome. The present study was undertaken to provide comprehensive knowledge about the soundness of commonly used anatomical landmarks such as Berry's ligament (BL), tracheo-esophageal groove (TEG), inferior thyroid artery (ITA), and the midpoint of the posterior border of the thyroid gland in the identification of the nerve intraoperatively. METHODS: Thirty adult cadavers were dissected to identify the RLN in the neck and to locate it in relation to the aforementioned anatomical landmarks. RESULTS: The RLN/BL relationship: RLN was most often located superficial to the BL (88.3%), followed by deep to the BL in 8.4%, and piercing the BL in 3.3% of cases, respectively. The RLN/TEG relationship: the RLN was located inside the TEG in most cases (71.7%), followed by RLN lying outside the TEG in 28.3%. Outside the groove, it was most commonly found lateral to the TEG (64.7%). RLN/ITA relationship: the nerve was passing deep to the artery in most of the cases (65%), followed by superficial (30%) and rarely (5%) in-between the branches. RLN/ midpoint posterior border of thyroid relationship: In 57 (95%) cases, RLN was coursing in the area posterior to the midpoint of the posterior border of the gland with an average distance of 4.95 ± 2.23 mm ranging between 2.21 and 12.1 mm. CONCLUSIONS: Both the BL and TEG are potentially crucial for safeguarding RLN. Although in results, BL turns out to be more consistent than TEG, we propose the utilization of both these anatomical landmarks together for complication-free neck surgeries. Furthermore, the midpoint of the posterior border of the thyroid turns out to be the single most consistent landmark for identifying RLN during partial thyroidectomy.
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Nervo Laríngeo Recorrente , Glândula Tireoide , Adulto , Humanos , Glândula Tireoide/cirurgia , Glândula Tireoide/irrigação sanguínea , Nervo Laríngeo Recorrente/anatomia & histologia , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Artéria Subclávia , CadáverRESUMO
COVID-19 pandemic has created a lot of turmoil in medical teaching, the magnitude of impact is many folds in the subject of anatomy, as it is practical based. A major challenge for anatomy teachers is to replicate the experience of practical exposures. These exposures range from cadaveric dissection to demonstration of bones, museum specimens, and histology slides, where they will have interactive communication with students, and thus help in the enhancement of communication and clinical skills among them. In recent days, anatomy teachers throughout the globe started using various advanced technology to make the teaching-learning session more interesting. In pre-pandemic era, usage of such advancements in information and communication technology was a 'choice'. But pandemic has changed the situation drastically, what was a 'choice' earlier is now an 'obligation.' Presently although infection rate is low, vaccination rate is high, most of the medical schools re-opened for usual offline teaching, still body donation is all time low making the situation 'back to square one'. Keeping such unprecedented situations in mind, we need to incorporate various innovative educational technologies in day-to-day teaching-learning methodologies.
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Anatomia , COVID-19 , Educação de Graduação em Medicina , Estudantes de Medicina , Anatomia/educação , Currículo , Tecnologia Educacional , Humanos , Pandemias , SARS-CoV-2 , EnsinoRESUMO
PURPOSE: Due to COVID-19 pandemic, Thanks giving ceremony to cadaver was different this year in two ways: the students were partially exposed to cadaveric dissections (for 7 months) and later learned Anatomy via online classes due to lockdown (for 5 months) and secondly it was not feasible to gather for the ceremony so virtual platform was preferred. The purpose of this study was to discern the gratitude for cadaver and to recognize the importance of cadaveric dissection from the reflection of students who experienced hybrid anatomy learning amidst COVID-19. METHODS: The study was conducted on 48 first year medical students who were admitted to the college in August 2019 and were willing to participate. An online invitation was sent to students to participate in virtual thanks giving to cadaver ceremony on the last day of their anatomy class (August 2020). RESULTS: Though the students partially studied gross anatomy with the aid of dissections on the cadaver; however, they expressed respect and gratitude to the silent mentor in the form of a card, poem, drawing or paragraph and shared it via google classroom platform. The students wished if they could continue their anatomy course in dissection hall as paused due to COVID-19 pandemic. CONCLUSIONS: Reflection of these students may mark impact on future anatomy students who may or may not get the chance for dissections. The thanks-giving gesture will also help to bind medical science and humanity especially during the crisis of pandemic.
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Anatomia/educação , COVID-19/prevenção & controle , Dissecação/ética , Educação de Graduação em Medicina/ética , Estudantes de Medicina/psicologia , Anatomia/ética , Temas Bioéticos , COVID-19/epidemiologia , COVID-19/transmissão , Cadáver , Controle de Doenças Transmissíveis/normas , Currículo , Educação a Distância/ética , Educação a Distância/métodos , Educação de Graduação em Medicina/métodos , Humanismo , Humanos , Aprendizagem , Pandemias/prevenção & controle , RespeitoRESUMO
PURPOSE: Injury to the radial nerve is not an uncommon phenomenon in fracture displacement of distal humerus and its operative management as the nerve is immobile and superficial at its point of entry into the anterior compartment and in close proximity to humerus. Such injuries can be reduced by defining a 'safe area' for the radial nerve in relation to the triceps aponeurosis in the distal humerus. METHODS: Radial nerve was dissected in 40 arms and distance of the nerve from triceps aponeurosis was measured at five sites; first one at the level of proximal or medial apex of aponeurosis, followed by four sites along its lateral border. These distances were analyzed to identify its location and to define a 'safe area' in relation to the triceps aponeurosis in the distal humerus. RESULTS: In majority of cases (67.50%), the point of entry of radial nerve into anterior compartment was at the level of proximal or medial apex at a mean distance of 2.11 ± 0.31 cm. The mean distance of radial nerve from the lateral border of triceps aponeurosis was 1.98 ± 0.60 cm with a range of 1.00-2.50 cm. The closest distance between the nerve and the aponeurosis was found to be 1.00 cm at the level of distal or lateral apex. CONCLUSION: The relationship between radial nerve and triceps aponeurosis is constant and easily reproducible. It is suggested that the rectangular zone immediately adjoining the lateral border of aponeurosis (< 1.00 cm) can be considered "safe" for soft tissue dissection while surgically approaching distal humeral fractures.
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Aponeurose/anatomia & histologia , Fraturas do Úmero/cirurgia , Músculo Esquelético/anatomia & histologia , Traumatismos dos Nervos Periféricos/prevenção & controle , Nervo Radial/anatomia & histologia , Pontos de Referência Anatômicos , Cadáver , Feminino , Humanos , Fraturas do Úmero/complicações , Úmero/lesões , Úmero/inervação , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/efeitos adversos , Procedimentos Ortopédicos/métodos , Traumatismos dos Nervos Periféricos/etiologia , Nervo Radial/lesõesRESUMO
PURPOSE: During this forced down-time of COVID-19 pandemic, shift to virtual anatomy education is the solitary solution to support the learning of students. The purpose of this study was to understand the visible and invisible potential challenges being faced by the 1st year medical and dental students while attending digital anatomy classes. METHODS: The present study was conducted on 81st year medical and dental students who were admitted to their respective college in August 2019 and were willing to participate in the study. A multiple choice close-ended questionnaire regarding their opinion on virtual classes was designed and feedback was taken from the students. RESULTS: Majority (65%) of the students agreed that they missed their traditional anatomy learning i.e., dissection courses, face to face lectures and interaction with mentors. The students strongly felt the lack of confidence and difficulty in the topics completed without dissections, models, microscopic slides and other modalities. 83% felt lack of proper gadgets, high-band width and strong internet connections, a potential barrier in their digital learning. Lack of self-motivation was felt by 69% students. CONCLUSIONS: The current situation of anatomy education is not intentional, and is not the long term silver bullet solution for a visual subject like anatomy. Though learners face a lot of challenges, however, a shift to online must be supported at this time of health crisis. As the digital learning may go for indefinite period, the feedback of students may be helpful for relevant and timely modifications in digital anatomy education.
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Anatomia/educação , COVID-19/prevenção & controle , Educação em Odontologia/métodos , Educação a Distância/métodos , Educação de Graduação em Medicina/métodos , COVID-19/epidemiologia , COVID-19/transmissão , Controle de Doenças Transmissíveis/normas , Currículo/estatística & dados numéricos , Dissecação/educação , Educação em Odontologia/normas , Educação em Odontologia/estatística & dados numéricos , Educação a Distância/normas , Educação a Distância/estatística & dados numéricos , Educação de Graduação em Medicina/normas , Educação de Graduação em Medicina/estatística & dados numéricos , Humanos , Índia/epidemiologia , Aprendizagem , Pandemias/prevenção & controle , Satisfação Pessoal , Estudantes de Odontologia/psicologia , Estudantes de Odontologia/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricosRESUMO
Proficiency in surface anatomy knowledge plays a pivotal role in fostering complication-free and efficacious clinical practice across a wide spectrum of healthcare specialties. This comprehensive understanding and adept utilization of surface anatomy principles serve as the linchpin for deciphering normal anatomical structures within medical imaging and the aptitude to articulate the topographical attributes, visual characteristics, and interrelations of palpable anatomical entities. Despite the advent of advanced direct visualization techniques, such as ultrasound guidance, which assist in interventional procedures, clinicians have not relinquished the indispensable requirement for pertinent surface anatomy knowledge to ensure the successful and secure execution of procedures. Regrettably, evidence-based surface anatomy remains an underemphasized facet in the pedagogy of anatomical sciences. The current narrative review underscores the various methodologies employed in imparting surface anatomy education to students. However, it is noteworthy that no singular, unequivocal best practice has emerged for the teaching and acquisition of surface anatomy knowledge. Therefore, as custodians of anatomical education, there is a pressing need to innovate and amalgamate contemporary pedagogical approaches with state-of-the-art technologies to furnish students with evidence-based surface anatomy insights, thereby enhancing comprehension, retention, and the lasting utility of this essential domain of medical knowledge.
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[This corrects the article DOI: 10.7759/cureus.43153.].
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Art and drawing have a well-established history with the teaching and learning of anatomy, as symbolized by Leonardo Da Vinci's Vitruvian Man. However, its efficacy relatively declined in modern anatomy education. The purpose of this study was to survey students' views regarding the "anatomy Rangoli-making activity" and to discern if this art form may be implicated in anatomy education. In this group activity, the basic anatomical drawing of the specific structure was made on the floor, and then the different structures in the illustration were filled with relevant powdered Rangoli colors. The present study was conducted on seventy-eight first-year medical students who were willing to participate in the study. A mixed questionnaire regarding their opinion on the "anatomy Rangoli-making activity" was designed and feedback was taken from the students. The majority of the students replied that the Rangoli-making activity was interesting, promoted team spirit, and improved confidence to draw and understand the concept of the diagrams. The students agreed that it is an innovative method of anatomy learning. Almost 99% of students suggested incorporating such art activities in anatomy learning for future students. The enthusiastic response of the students to this activity is encouraging to introduce such art base activities in anatomy education and learning. Future multicenter studies on this learning method may be planned to check its efficacy.
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Background:Renal size can be affected by various causal elements such as age, sex, and demographic characteristics. It is crucial for medical professionals to consider these factors when making clinical decisions. The purpose of this investigation was to establish normograms for renal measurements and explore their association with the anthropometric variables in the natives of Northern India. Methods:A total of 105 individuals with presumed healthy kidneys were enrolled in the present study. Kidney length, width and parenchymal thickness were measured, and data were analysed to identify potential differences related to age, gender and side. Correlation analysis was conducted to examine the relationship between kidney measurements and body biometrics, including body height, body weight, body mass index (BMI) and body surface area (BSA). Results:Mean values for kidney length, width and parenchymal thickness in the 209 kidneys analysed were as follows: right kidney - length 10.65 ± 1.34 cm, width 4.5 ± 0.42 cm and parenchymal thickness 0.91 ± 0.16 cm; left kidney - length 10.7 ± 1.69 cm, width 4.78 ± 1.26 cm and parenchymal thickness 0.76 ± 0.40 cm. Thickness showed significant differences between the right and left kidneys. No significant differences in renal parameters were found between males and females. Analysis based on age groups revealed an increase in renal length and thickness with advancing age, while width decreased in the middle age group (31-40 years) and then increased. Weak positive correlations were observed between kidney parameters and body height, body weight, BSA, and BMI. Conclusion:Renal parameters can vary among different populations depending on age, demographic characteristics, and ethnicity. Therefore, relying on commonly cited values for renal sonographic interpretation or clinical decision-making may not be appropriate. Interpreting renal measurements should be based on reference data specific to the studied population.
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Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory bowel diseases that have been associated with nonalcoholic fatty liver disease (NAFLD). This systematic review aimed to examine whether Crohn's disease confers a greater risk for nonalcoholic fatty liver disease compared to ulcerative colitis. A comprehensive search of electronic databases from January 2000 to May 2023 was conducted to identify observational studies investigating the association between Crohn's disease or ulcerative colitis and nonalcoholic fatty liver disease. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 checklist ensured transparent reporting, and the Newcastle-Ottawa Scale was used to assess study quality. Data synthesis revealed higher nonalcoholic fatty liver disease prevalence among Crohn's disease patients compared to ulcerative colitis patients across regions. Ten studies published between 2016 and 2022, encompassing a total of 4164 participants from three continents, were included in the review. The median proportion of Crohn's disease patients with nonalcoholic fatty liver disease was 37.22% (range: 10.95-53.80%), while it was 27.55% (range: 8.60-46.20%) for ulcerative colitis patients. Subgroup analysis by region confirmed CD's higher NAFLD risk. Median proportions for CD patients who developed NAFLD from North America, Europe, and Asia were 25.97% (range: 14.6-37.33%), 47.01% (range: 14.2-53.8%), and 20.78% (range: 10.95-30.6%), respectively, and the median proportion of persons with UC who developed NAFLD in studies from North America, Europe, and Asia were 17.28% (range: 8.6-25.96%), 37.70% (range: 25.64-46.20%), and 19.52% (range: 10.14-28.90%), respectively. Variations suggest differing mechanisms, disease features, and therapeutics. Transmural inflammation in Crohn's disease may increase metabolic abnormalities, including nonalcoholic fatty liver disease. Geographic differences in lifestyle, genetics, and environmental variables may also contribute. This review demonstrates that Crohn's disease patients face a higher nonalcoholic fatty liver disease risk than ulcerative colitis patients, emphasizing the need for early monitoring and prevention. Further studies are warranted to understand mechanisms and develop tailored management approaches.
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This narrative review summarizes the principal findings of observational studies, systematic reviews, and meta-analyses on diet and dietary patterns' role in the risk of pancreatic cancer. Etiologically pancreatic cancer is multifactorial. Evidence exists of an association between nutrients, dietary patterns, and pancreatic cancer. An extensive literature search was conducted on PubMed, Cochrane, and Google Scholar. A thorough search of articles published in English till May 2023 and related to the review was performed. The relationship between all macronutrients, micronutrients, and various dietary patterns with the risk of pancreatic cancer was assessed. It is concluded that a diet high in nutrients like red and processed meat, refined sugars, saturated and monounsaturated fats, alcohol, copper, and a Western dietary pattern can increase the likelihood of pancreatic cancer. Contrary to this, a diet consisting of fruits, vegetables, appropriate quantities of vitamins and minerals, and a Mediterranean dietary pattern is associated with a decreased risk of pancreatic cancer.
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People with type 2 diabetes mellitus have a greater risk of developing cardiovascular problems. Since cardiovascular diseases are a major cause of mortality all over the world, we need to find more efficient measures to control this risk in the diabetes population in addition to conventional glycemic control. In this systematic review, we aim to explore the latest findings on the cardiovascular effects of glucagon-like peptide-1 (GLP-1) agonists and dual GLP-1/glucose-dependent insulinotropic peptide (GIP) agonists in patients with type 2 diabetes mellitus. We conducted a comprehensive literature search using PubMed and Google Scholar as the main sources for data collection. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations for conducting this review. The outcomes of interest included mortality due to cardiovascular causes, non-fatal myocardial infarction, stroke, effects on cardiovascular risk factors, heart failure, and development of arrhythmias. After thorough literature screening and quality analysis, 14 articles were finally included for qualitative synthesis. GLP-1 receptor agonists appeared to be effective in reducing the risk of cardiovascular mortality, myocardial infarction, and stroke. They were found to reduce the risk of composite major adverse cardiovascular event (MACE) outcomes by 12-14% when compared to placebo. Their role in preventing heart failure and arrhythmias is uncertain, and further trials are needed to confirm the same. The cardiovascular outcomes of GLP-1/GIP dual agonists are currently under investigation. Studies completed to date show that they do not increase the risk of cardiovascular disease when compared to placebo.
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Childhood obesity is a global public health problem with significant implications for the health and well-being of children. The prevalence of childhood obesity is increasing every decade, making it a recognized public health concern. This systematic review aims to explore and evaluate the impact of school-based interventions on reducing pediatric obesity among school-aged children. A systematic review of literature according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 was conducted. Google Scholar, PubMed, and Cochrane were the databases used. After screening for bias, inclusion and exclusion criteria, and quality, 27 studies were included in the systematic review, and data were synthesized. The results show that physical activity reduces obesity and improves cardiovascular health. The nutritional change reduces the risk of obesity more than physical activity alone. When blended, the two provide the most benefits for participants. Motivation, self-efficacy, and behavioral change could help maintain the improvements. Schools should adopt a blend of physical activity and nutritional change to reduce prevent, reduce, and manage obesity.
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This systematic review aims to examine the racial disparities and outcomes of percutaneous coronary interventions (PCIs) in patients above 65 years in America. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020 and includes a comprehensive search strategy, study selection, data extraction, and quality assessment. The search strategy identified 10 relevant articles that were included in the review. The findings indicate that racial disparities exist in access to PCI, door-to-balloon (DTB) time, procedure utilization, and outcomes among elderly patients. African American and Hispanic patients were found to experience longer door-to-balloon time and lower rates of PCI utilization compared to White patients. Moreover, racial and ethnic minorities had worse clinical outcomes, including higher mortality rates and increased risk of major adverse cardiovascular events. The review also highlights the impact of Medicaid expansion on reducing disparities in access, treatment, and outcomes for patients with acute myocardial infarction (AMI). However, limitations in data availability and representation of racial and ethnic minorities in clinical trials were identified. The discussion section provides a robust analysis of the findings, exploring potential underlying factors contributing to the observed disparities. The review concludes that addressing racial disparities in PCI outcomes among elderly patients is crucial for achieving equitable healthcare delivery and improving cardiovascular health outcomes in America.
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Novel cancer therapies have revolutionized the management of various cancers. An immune checkpoint inhibitor (ICI) is one of these antitumor medications. ICIs, which are immune therapies, enhance the immune system's capacity to fight cancer cells. Based on the receptors that they inhibit, such as PD-1, PD-L1, and CTLA-4, ICIs are subdivided. Although this class of drugs is extremely beneficial for cancer patients, their adverse effects can be fatal. Multiple organs, such as the cardiovascular system, may be impacted by immune-related adverse effects (irAEs). These cardiotoxic irAEs can occur at a rate of up to 1% and can be fatal. Myocarditis is the most prevalent of all cardiotoxicities. The purpose of this systematic review is to assess the seriousness of myocarditis, the most prevalent cardiotoxicity of ICIs, and the importance of screening. We chose studies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria. Therefore, from 2018 to 2023, we gathered articles from databases such as PubMed, ScienceDirect, Web of Science, the Cochrane Library, and Google Scholar. Of the 665 studies identified based on various screening methods and quality assessment tools, 13 were selected for inclusion in the study. This study shows that although the risk of myocarditis in ICI therapy is low and the majority of cases are asymptomatic or mild, some cases can be deadly and disastrous, and physicians should be aware that if myocarditis is suspected based on clinical symptoms, troponin, electrocardiogram, and echocardiogram, treatment should be initiated accordingly.
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The anatomical variations of the brachial plexus in humans have clinical significance for surgeons, radiologists, and anatomists. In a study of 60 brachial plexuses, four trunked brachial plexuses were encountered in three limbs (two female and one male), all of them being post fixed and on left side of cadavers. The third trunk in all these limbs gave rise to two anterior divisions (upper and lower) and one posterior division. In two limbs belonging to the female sex, the upper anterior division joined with the anterior division of the second trunk to form the lateral cord while its lower anterior division joined with the anterior division of the fourth trunk to form the medial cord. In the sole male limb, along with the third trunk, the fourth trunk also divided into upper and lower anterior divisions. Upper anterior divisions of the third and fourth trunks joined to form the medial root of the median nerve while lower anterior divisions joined to form the ulnar nerve. No medial cord was formed as such. Further, it is inferred that in postfixed brachial plexus, there is a tendency to failure on part of T1 and T2 to join C8 which continues as the third trunk while T1 and T2 continue as the fourth trunk. Since it was seen in all postfixed brachial plexuses of the present study, it is emphasized to be given a place in the textbooks of anatomy or to conduct a study on a larger database.
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Plexo Braquial/anormalidades , Plexo Braquial/anatomia & histologia , Cadáver , Feminino , Humanos , Masculino , Nervo Mediano/anatomia & histologia , Nervo Ulnar/anatomia & histologiaRESUMO
AIM: To examine the variations in number, size, and shape of foramina transversaria (FTs) of cervical vertebrae, and to discuss their clinical importance. MATERIAL AND METHODS: The FTs of 200 dry cervical vertebrae (C3?C7) from 40 spines were studied for the presence of variations in their number (single, double, or triple), size, and shape. The foramina were classified according to their shape depending upon the direction of their main diameter. RESULTS: Accessory foramina were found in 40 cervical vertebrae. Bilateral accessory foramina were slightly more common than a unilateral accessory foramen. Accessory foramina occurred in a particular pattern, with incidence increasing with descending order of cervical vertebrae, and were most commonly found in C7. The mean values of the anteroposterior and transverse FT diameters on the right side were 4.96 ± 1.08 and 5.68 ± 1.20 mm, respectively, and on the left side were 5.07 ± 1.12 and 5.76 ± 1.29 mm, respectively. The difference was not statistically significant. FTs with very small diameter ( < 3.5 mm) were found mostly in C7 followed by C5 and C6. Five types of shape were noted. Type 1 was predominant on the right side, whereas type 4 was predominant on the left side. CONCLUSION: Differences in number (duplication), size, and shape of the FTs are not uncommon phenomena. Anatomical knowledge of FT variations is surgically pertinent, as in such conditions the vertebral artery may become twisted or deformed and result in vertebrobasilar insufficiency. Morphometric measurements from this study may be useful in interpreting radiographic images of the cervical spine obtained using computed tomography or cervical angiograms.
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Vértebras Cervicais , Artéria Vertebral , Angiografia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The human paracentral lobule (PCL) is the medial continuation of the precentral and postcentral gyri. It has important functional area related to the lower limb and perineum. Its visible surface that corresponds to magnetic resonance imaging scout images varies in morphology, so it requires exact data. Studies related to such data are rare. With such a facile, we studied the morphology and morphometry of PCL. MATERIALS AND METHODS: Fifty formalin-fixed adult human brains dissected in the midsagittal plane were used in this study. First, the morphological types of PCL and its boundary were determined, followed by morphometry of its extrasulcal surface using digital vernier calipers. Measurements were done along the anteroposterior axis (length) and vertical axis (height). In addition to that, the extent of motor and sensory area into PCL was also measured. RESULTS: Three distinct morphological types of PCL were found: continuous (2%), partially segmented (91%), and completely segmented type (7%). In completely segmented type, a short transitional lobulolimbic gyrus was also found in three cases. The mean extrasulcal surface of the left PCL was significantly larger, both in males (left 10.67 cm2 vs. right 8.80 cm2) and in females (left 8.80 cm2 vs. right 6.99 cm2). Irrespective of gender and sidedness, motor area was significantly larger than the sensory area. CONCLUSION: Reported data will be useful in diagnosis and treatment of diseases affecting the human PCL. Variations in the distribution of sensorimotor cortex over PCL may help further assessment of hemispheric lateralization and the location of central sulcus as a reliable indicator of cytoarchitectonic borders.
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Purpose Precise knowledge about clinically observed bony orbital aging is needed for surgical planning for acceptable cosmetic results. The effect of age and gender on the facial skeleton and orbital aperture has been appreciated earlier, but its quantification remains ignored. The purpose of this study was to evaluate age- and sex-related changes in the shape of the orbital aperture and construct a reference data set for the aging phenomenon in Indians. Methods Two hundred digital radiographs (Water's/frontal view) of the skull, obtained for various reasons, were evaluated. The radiographs comprised 107 males and 93 females aged between 10 and 60 years (10-59 years). Orbital shape, height/width, and interorbital/biorbital distances were noted, and orbital indices (OIs) were calculated. Orbital parameters thus obtained were compared between right and left sides and males and females. The relation of the parameters with age and gender was analyzed. Results Four types of orbits, round (33.5%), elliptical (30.5%), rectangular (27.5%), and square (9.5%), were noted in the study population. The average value of height and width of the right orbit was found to be higher than that of the left (p > 0.05). Male patients had higher (p > 0.05) and wider (p > 0.05) orbits than females. The right OI (81.55 ± 5.30) was higher than the left (80.75 ± 4.80) (p > 0.05). When comparatively evaluated between gender, both orbits were found to be of the microseme type with a mere difference (p > 0.05). The average interorbital/biorbital distance was 1.27 ± 2.11 and 9.78 ± 4.40 cm, respectively, without any gender difference. No significant relation was found between the age change and the parameters defined (p > 0.05), except in one age group (10-19 years). Conclusions Orbital dimensions showed no association with age and gender except in one age group (10-19 years); a pubertal growth spurt in females might be causing this phenomenon. The morphometric data may be useful in forensic anthropology and better planning for reconstructive surgeries in the orbito-maxillary region.