Descriptive and topographical analysis of the labyrinthine artery in human fetuses.

Hearing or/and balance impairments may be caused by disorders of the labyrinthine artery (LA) and their branches. Most findings regarding the LA anatomy have been acquired through investigation of the cerebellopontine angle (CPA) in animal or adult human specimens. Eighty-eight CPAs and LAs of human fetuses were investigated using angio-techniques and microdissections. We found 15 intricate forms of distribution of LA. The LA usually originated from the extra-meatus loop in the anterior inferior cerebellar artery (AICA). The distribution of its terminal branches was 53.42% uni-arterial, 44.31% bi-arterial, and 2.27% tri-arterial systems. In the uni-arterial system, the LA described an anterior superior path to the cochlear nerve (CN) and originated its terminal branches in the gap between CN and the inferior part of the vestibular nerve. In the bi-arterial system, the anterior LA was located anterior and superior to the CN while the posterior LA appeared posterosuperior to the superior part of the vestibular nerve. In the tri-arterial system, the terminal branches originated directly from the AICA loop. Our results provide anatomical support to explain how compressions in the LA branches inside the internal acoustic meatus, as evoked by Schwannomas in the VII and VIII nerves, can lead to hearing and balance loss. The zone of the posterior vestibular nerve appeared to be a "safe area" for invasive procedures in these specimens.

Stumbling corrective reaction elicited by mechanical and electrical stimulation of the saphenous nerve in walking mice.

The ability to walk around in a natural environment requires the capacity to cope with unexpected obstacles that may disrupt locomotion. One such mechanism is called the stumbling corrective reaction (SCR) that enables animals to step over obstacles that would otherwise disturb the progression of swing movement. Here we use in vivo motion analysis and physiological recording techniques to describe the SCR in mice. We show that SCR can be elicited consistently in mice during locomotion by inserting an obstacle along the path of leg movement during swing phase. Furthermore, we show that the same behavior can be elicited if the saphenous nerve, a cutaneous nerve that would detect contact of the leg with an object, is stimulated electrically. This suggests that cutaneous afferent feedback is sufficient to elicit SCR. We further show that the SCR is phase dependent, occurring only with stimulation during swing phase, but not during early stance. During SCR elicited by either method, the foot is lifted higher to clear the object by flexing the knee, via the semitendinosus muscle, and ankle joint, by tibialis anterior contraction. The tibialis anterior also exhibits a brief extension before flexion onset. Our data provide a detailed description of SCR in mice and will be crucial for future research that aims to identify the interneurons of the premotor network controlling SCR and its neuronal mechanisms by combining motion analysis, electrophysiology and mouse genetics.

An alternative didactic, functional and topographic systematization of the spinal muscles.

Back muscles are commonly described in a topographically-oriented manner without necessarily following morphological criteria. In this manner, non-standard terms may be employed which convey incorrect morphological concepts and demanding more time from both faculty and students to transmit knowledge. We propose a classification system for spinal muscles incorporating morphological concepts with the goal of facilitating knowledge transfer and suggest the term "spinal muscles". Those muscles were systematically divided and classified in seven strata from anterior to posterior: vertebro-appendicular (VA), transversarium (Tr), deep post-transversarium (DPT), middle post-transversarium (MPT), superficial post-transversarium (SPT), deep spino-appendicular (DSA) and superficial spino-appendicular (SSA). Besides topography and function, this system incorporates innervation and embryological origins of each muscle. The extrinsic (VA, DSA, SSA) or intrinsic (Tr, DPT, MPT, SPT) nature of these muscles in relation to the spine and also the topographic relationship to the transverse process is represented in this system. Specific areas of functional, nervous and developmental transition exist on Tr and DPT strata due to being adjacent to extrinsic strata. We believe this system represents a more modern and concise teaching strategy for back muscles which may be employed partially or fully within any program. We envision its full version may be particularly useful in postgraduate medical training for specialties dealing with the spinal column such as neurosurgery, orthopedic surgery and physical medicine and rehabilitation.

Accessory soleus muscle: a case report and clinical applicability.

Variations in leg muscle are uncommon. Literature on this subject is scarce, but when those variations are reported they may cause alterations in joint mechanics or cause some discomfort in the leg and foot. The accessory soleus muscle (ASM) is considered an unusual anatomical variation, with an incidence of 0.5-6.0% in the population through studies in cadavers. During routine preparation of study material in the dissection room of the anatomy laboratory of the Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória/ES - Brazil, an ASM was found in the right inferior limb of a male cadaver fixed in 10% formalin. This supernumerary muscle was 3 cm wide, 9 cm long and 1 cm thick in its most voluminous part, in typical penniform fibers arrangement. It was located in the posteromedial region of the ankle, anterior to the Achilles tendon and posterior to the deep muscles of the leg compartment. Its anterior face covered the tibial nerve and the posterior tibial vessels, while its lower half was covered by the flexor retinaculum into the tarsal tunnel. Reports in the literature show possible compression of a neurovascular bundle because of its intimal position within the tarsal tunnel, which could result in ischemic compartment syndrome.

Eficiência do treino de marcha em suporte parcial de peso no equilíbrio de pacientes hemiparéticos / Effect of gait training with body weight support in hemiparetic patients balance

O suporte parcial de peso (SPP) foi utilizado pela primeira vez em âmbitos clínicos nos anos 80. Acredita-se que essa terapia promova melhora da marcha em pacientes com seqüela de Acidente Vascular Encefálico (AVE). Investigamos a importância do treino de marcha na esteira elétrica com SPP nesses pacientes. Sete pacientes com diagnóstico clínico de hemiparesia ou hemiplegia foram submetidos aleatoriamente a um protocolo de treinamento em esteira elétrica em SPP (Experimental, n = 4), ou ao tratamento tradicional sem SPP (Controle, n = 3) por 20 sessões, para avaliar o equilíbrio. Observou-se melhora estatisticamente significante no equilíbrio avaliado pela escala de BERG no Grupo Experimental (p = 0,003). Mais estudos são necessários para elucidar os resultados obtidos...

The Body Weight Support (BWS) was used for the first time in clinical studies by the 80s. It is believed that this therapy promotes improvement of gait in patients with Stroke sequel. We investigated the importance of gait training in treadmill with BWS in those patients. Seven patient with clinical diagnosis of hemiparesis or hemiplegia were randomly submitted toa treadmill training protocol with BWS, (Experimental, n=4), or to traditional approach without BWS (Control, n=3) for 20 sessions to balance evaluation. The balance evaluation by BERG scale showed significant improves on experimental group (p = 0,003). Further investigations should be conducted in order to elucidate those data obtained...

The connective tissue of the adductor canal--a morphological study in fetal and adult specimens.

The adductor canal is a conical or pyramid-shaped pathway that contains the femoral vessels, saphenous nerve and a varying amount of fibrous tissue. It is involved in adductor canal syndrome, a claudication syndrome involving young individuals. Our objective was to study modifications induced by aging on the connective tissue and to correlate them to the proposed pathophysiological mechanism. The bilateral adductor canals and femoral vessels of four adult and five fetal specimens were removed en bloc and analyzed. Sections 12 microm thick were obtained and the connective tissue studied with Sirius Red, Verhoeff, Weigert and Azo stains. Scanning electron microscopy (SEM) photomicrographs of the surfaces of each adductor canal were also analyzed. Findings were homogeneous inside each group. The connective tissue of the canal was continuous with the outer layer of the vessels in both groups. The pattern of concentric, thick collagen type I bundles in fetal specimens was replaced by a diffuse network of compact collagen bundles with several transversal fibers and an impressive content of collagen III fibers. Elastic fibers in adults were not concentrated in the thick bundles but dispersed in line with the transversal fiber system. A dynamic compression mechanism with or without an evident constricting fibrous band has been proposed previously for adductor canal syndrome, possibly involving the connective tissue inside the canal. The vessels may not slide freely during movement. These age-related modifications in normal individuals may represent necessary conditions for this syndrome to develop.

Influência da complacência arterial na capacidade física de indivíduos idosos / Arterial compliance effects on physical capacity of elderly subjects

O enrijecimento arterial é um fator de risco independente para doença cardiovascular, podendo se agravar com a idade e sendo atenuado pelo exercício físico principalmente em idosos. O objetivo deste estudo foi correlacionar à capacidade física de indivíduos idososcom a Velocidade de Onda de Pulso (VOP). Para tanto, foi avaliada a complacência dos grandes vasos de pacientes do sexo masculino obtido através da medida da VOP com o aparelho COMPLIOR II. O nível de capacidade física foi obtido com o teste de esforço submáximo (teste de caminhada de 6 minutos). Nossos dados sugerem que a rigidez arterial aumenta com a idade, que esta rigidez esta intimamente ligada ao nível de aptidão cardiorrespiratória e que este pode sugestivamente influenciar na prevenção do enrijecimento arterial.

The arterial stiffness is an independent cardiovascular risk factor of aging, whichcould be measure by the Pulse Wave Velocity (PWV). The aim of this study was correlate the physical capacity of aging men to the PWV. In order to measure arterial compliance of greatvessels in aging males we used a COMPLIOR II equipment to determine PWV. Physical capacity levels were obtained by 6 minutes walking test. Our data suggest that arterial stiffnessincrease by the age, and it is intimately close to the level of cardiorespiratory fitness. The results also indicate that effects of physical capacity has some influence on the prevention of arterial stiffness.