The anterolateral ligament: A cadaveric study in fetuses.

The aim of this study was to determine the presence and morphology of the anterolateral ligament (ALL) of the knee in a sample of fetuses. We hypothesized that the ALL is present in sample fetuses and its origin is not related to repetitive stresses throughout life. Forty fresh-frozen knees from cadaveric fetuses were dissected using a standard technique. The ALL and other structures in the anterolateral compartment of the knee were identified. The details of the femoral and tibial attachments, course and relationships with anatomical structures of the ALL were identified, recorded, and quantitatively characterized. The ALL was identified in 100% of the dissected knees. We found three anatomical patterns regarding the femoral attachment: (1) Proximal and posterior to the fibular collateral ligament (55%); (2) Together with the fibular collateral ligament (25%); and (3). Anterior and distal to it (20%). The ALL was extracapsular with an oblique course attaching into the anterolateral aspect of the tibia, midway between the midpoint of Gerdy's tubercle and the fibular head. The ALL has a strong attachment to the lateral meniscus, creating two fascicles: proximal or meniscofemoral and distal or meniscotibial. The ALL is a constant, extracapsular anatomical structure in the anterolateral compartment of the knee, present from the later prenatal period of life. Its morphology shows three different patterns of femoral attachment in relation to the fibular collateral ligament position, a strong attachment in the lateral meniscus, and a constant tibial attachment. Clin. Anat. 30:625-634, 2017. © 2017 Wiley Periodicals, Inc.

Anatomic mapping of the collateral branches of the external carotid artery with regard to daily clinical practice.

BACKGROUND: To identify the anatomical variations of the main branches of the external carotid artery (lingual, facial, occipital, ascending pharyngeal and sternocleidomastoid), giving information about the calibers and origins with the aim of creating a new classification useful in clinical practice. MATERIAL AND METHODS: 193 human embalmed body-donors were dissected. The data collected were analyzed using the Chi² test. The results of previous studies were reviewed. RESULTS: The majority of the anterior arterial branches (superior thyroid, facial and lingual artery) were observed with an independent origin, respectively, classified as pattern I (80.83%, 156/193). In 17.62% (34/193) a linguofacial trunk, pattern II, has been observed, only in 1,04% (2/193) a thyrolingual trunk, pattern III, has been found and in one case (1/193, 0.52%) one thyrolinguofacial trunk, pattern IV, was found. Depending on the posterior branches (occipital and ascending pharyngeal), four different types could be determined: type a, the posterior arteries originated independently, type b, the posterior arteries originated in a common trunk, type c, the ascending pharyngeal artery was absent, type d, the occipital artery was absent. CONCLUSION: Anatomical variations in these arteries are relevant in daily clinical practice due to growing applications, e.g., in Interventional Radiology techniques. Knowledge of these anatomical references could help clinicians in the interpretation of the carotid system.

The bronchial segmentation and its anatomical variations. A clinical-anatomic and bronchoscopy study.

The development in interventional respiratory medicine entails the need of bronchial anatomical knowledge, whose variations assume their greatest importance nowadays. The aim of this study was to describe the frequency of these variations and to analyze the bronchial lengths, barely registered before in literature. This observational descriptive study (from June 2018 until April 2019) was conducted in a sample of 17 pairs of lungs, which were dissected and measured at the Cadaver Donation Centre (Universidad Complutense, Madrid), and a second sample of 50 bronchoscopies, performed at the San Carlos Clinic Hospital, which were analyzed during the procedure. Our results show that there are no significant differences in the incidence of variations by sex in any of both samples, and neither in the average length of any bronchus by sex nor lobar pattern. Left main bronchus presents the longest length and left upper lobe bronchus the shortest. The highest percentage of variations is contained in the right lower lobe (25.4%), and the most frequent variation in the subsuperior bronchus (B*) (19.4%). The middle lobe and the left lower lobe present the lowest percentage of variations (11.9%). Only 37.3% of the pairs of lungs/patients did not have any anatomical variation in the general sample. Despite of the small size of the sample, results show a high percentage of variations and a minority of completely normal pairs of lungs, which invites us to reflect about the probable high prevalence of variations in the general population. Further studies with greater samples are needed to confirm our hypothesis.

Overview of the History of the Cranial Nerves: From Galen to the 21st Century.

Throughout history the description and classification of the cranial nerves has been linked to the development and characteristics of anatomy and the role that it played as a tool in providing rationality to medicine, together with social, cultural, religious, and philosophical factors. Anatomists were interested in the cranial nerves, but they disagreed on their number and their paths. We can divide the history of the cranial nerves into three different periods: the first, early or macroscopic period; the second or microscopic period; and the third period or ontogenesis and genoarchitecture. The main aim of this article is to show how the description and knowledge of the cranial nerves were developed in the course of these three periods, and to highlight the main changes produced and the factors related to these changes. We describe how the first period was mainly focused on establishing the definition, number and paths of the cranial nerves, through contributions ranging from Galen's studies in the second century to Sömmerring's Doctoral Dissertation in 1778 that described 12 cranial nerves for the first time. Then, the microscopic period was concentrated on the identification of the real nuclei of origin of the different cranial nerves located in the brain stem. Finally came the third period, or ontogenesis and genoarchitecture of the rhombecephalic and mesencephalic cranial nerve nuclei. Anat Rec, 302:381-393, 2019. © 2018 Wiley Periodicals, Inc.