A communicating branch between the dorsal and superficial ramus of the ulnar nerve (Kaplan's anastomosis): clinical and surgery discussion / Ramo comunicante entre los ramos dorsal y superficial del nervio ulnar (anastomosis de Kaplan): discusión clínica y quirúrgica

The Kaplan´s anastomosis represents the communication between the dorsal and superficial branch of the ulnar nerve distal to ulnar canal. In the present study, a case about this nerve communication, found in a male adult cadaver, is reported. Information about brachial plexus distal anastomosis is fundamental for interpretation of clinical and electrophysiological findings, in order to establish the precise diagnosis of neurological lesions at this level. Its relations with flexor carpi ulnaris muscle's tendon and with pisiform bone exposes it to iatrogenic lesions during surgery.

La anastomosis de Kaplan representa la comunicación entre la rama dorsal y superficial del nervio ulnar distal al canal ulnar. En el presente estudio se informa de un caso de esta comunicación nerviosa, encontrado en un cadáver adulto de sexo masculino. Información sobre el plexo braquial y sus anastomosis distales son fundamentales para la interpretación de los hallazgos clínicos y electrofisiológicos, a fin de establecer el diagnóstico preciso de las lesiones neurológicas a este nivel. Sus relaciones con el tendón del músculo flexor ulnar del carpo, como con el hueso pisiforme, pueden facilitar la ocurrencia de lesiones iatrogénicas durante la cirugía.

Output relations of humeral circumflex arteries and its variations / Relaciones de las arterias circunflejas humerales y sus variaciones

A large range of variability marks the branching pattern of the axillary artery. The knowledge of the anatomical variations and this pattern is essential to diagnostic and therapeutic approaches, including surgery, of the axillary region. The aim of this study was to observe the different possible origins of circumflex humeral arteries and to measure the length and diameter of each vessel. In our study, 24 armpits from adult cadavers (fixed in tamponed formalin 10%) were dissected. The data were analyzed with a digital caliper and the results expressed as Mean ± SD. In majority of specimens, posterior circumflex humeral artery (PCHA) arose from subscapular artery (SSA) (54.16%) and had an average diameter of 3.92±0.41 mm. The anterior circumflex humeral artery was a branch from axillary artery (AA) in the majority of the specimens (62.5%) with an average diameter of 1.83±0.68 mm. Circumflex humeral arteries can arise from SSA, deep brachial artery and AA. The result of this study is an interesting data for origin, length and diameter of these vessels, contributing to the knowledge of these variations occurrence.

Una amplia gama de variabilidad marca el patrón de ramificación de la arteria axilar. El conocimiento de las variaciones anatómicas de este patrón es esencial para enfoques de diagnóstico y terapéuticos, incluyendo la cirugía de la región axilar. El objetivo fue observar los diferentes orígenes posibles de arterias circunflejas humerales y medir la longitud y el diámetro de cada vaso. En el estudio se disecaron 24 axilas de cadáveres adultos (fijados en formalina tamponada al 10%). Los datos se analizaron con un calibrador digital y los resultados se expresaron como Media ± DS. En la mayoría de los especímenes, la arteria circunfleja humeral posterior surgió de la arteria subescapular (ASE) (54,16%) con un diámetro medio de 0,41±3,92 mm. En la mayoría de los especímenes (62,5%), la arteria circunfleja humeral anterior era una rama de la arteria axilar (AA) con un diámetro medio de 0,68±1,83 mm. Las arterias circunflejas humerales pueden surgir de la ASE, de la arteria braquial profunda y AA. El resultado de este estudio es un dato interesante para el origen, la longitud y el diámetro de los vasos, lo que contribuye al conocimiento de la ocurrencia de estas variaciones.

Nutrition and tracheal morphology; does malnutrition lead to characteristics of premature aging? / Nutrición y morfología de la tráquea; ¿puede la desnutrición llevar a características de envejecimiento prematuro?

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Triangle of Brocq and Mouchet: anatomical study in brazilian cadavers and clinical implication

Introduction: The Brocq and Mouchet’s arterio-venous triangle is a well know topographic region that is composed by the intersection of the great cardiac vein (GCV), the circumflex artery (CA) and the anterior interventricular artery (AIA) of the left coronary artery. These structures are located between conus arteriosus and left auricle, on the left side of anterior surface of the heart. Material and methods: Twenty three hearts were dissected and evaluated regarding to Brocq and Mouchet’s arterio-venous triangle at the Department of Morphology of the Fluminense Federal University. All the specimens were dissected in male human cadavers. They were analyzed regarding to their disposition in the triangle and the relations between them. Results: The triangle was found in 20 hearts (86.9%); in the remaining 3 (11.1%) it was not formed. Regarding to the classification of the triangle, the pattern of distribution was as follows: “closed” in 5 (21.7%) hearts, “inferiorly open” in 9 (39.1%) hearts, “superiorly open” in 2 (8.7%) hearts and “completely opened” in 4 (17.4%). Conclusion: Our study may add important information to the anatomy of the heart specifically in brazilian population. These data may have relevant implications regarding to procedures in the heart.