Background: It is necessary knowing the large variability of right coronary (RCA) artery specialty for its implications in surgical procedures and clinic events. This variability is usually related to the length, branches quantity, origin and irrigated territories.Objective: To evaluate by direct examination the morphologic expression of RCA in Colombian people.Methods: RCA were measured in 221 fresh hearts by RCA ostium canalization with polyester synthetic resin that was injected in their branches.Results: The caliber of the RCA proximal segment and at the level of the acute angle of the heart was 3.42 ± 0.66 mm and 2.9 ± 0.50 mm, respectively. It ended between crux cordis and the left margin in 75.6% of specimens. Posterior interventricular artery (PIA) reached the inferior third, or the apex, or the anterior interventricular sulcus in 149 (67.4%) cases. Sinoatrial node artery (SNA) originated in the right coronary in 134 (60.6%) cases, 77 (34.9%) from circumflex artery (CxA) and from both in 10 (4.5%). Posterior right diagonal artery (PRDA) was noted in 38 (17.2%) hearts, but only 6% of the sample with long PIA, concomitantly presented the PRDA (P = 0.001). In right dominance SNA were originated from RCA in 54.7% and form CxA in 46.3% (P = 0.06).Conclusions: Caliber of the RCA and its branches is lesser than the majority of previous studies, while the PRDA frequency is slightly higher than the reported in literature.Clinical and pathological scenarios by these variations should be taken into account: hemodynamic procedures, cardiac surgery and arrhythmias from coronary occlusive disease.Descriptors: Coronary Vessels. Coronary Circulation. Atrioventricular Node. Sinoatrial Node. ResumoIntrodução: É necessário conhecer a grande variabilidade da artéria coronária direita (ACD), especialmente por suas implicações nos procedimentos cirúrgicos e eventos clínicos. Esta variabilidade está geralmente relacionada à extensão, à quantidade de ramos, à origem e aos territórios irrigados.Objetivo: Avaliar por exame direto a expressão morfológica da ACD em sujeitos colombianos.Métodos: As ACD foram medidas em 221 corações frescos pela canalização do óstio da ACD com uma resina de poliéster sintético que foi injetada em seus ramos.Resultados: O calibre do segmento proximal da ACD e ao nível do ângulo agudo do coração foi de 3,42 ± 0,66 mm e 2,9 ± 0,50 mm, respectivamente. A ACD terminou entre a crux cordis e a margem esquerda em 75,6% da amostra. Rev Bras Cir Cardiovasc 2011;26(2):230-7 RCA near of the acute margin of the heart and adopt an oblique path on the posterior wall of the right ventricle to reach the middle third of posterior interventricular groove contributing to the irrigation of the lower segment of the diaphragmatic heart face [10][11][12][13]. The branch of the ANA start in the "inverted U" segment of the RCA located in the crux cordis (73%-85%) and the rest coming from the terminal branch of the CxA [14,15].The importance of the cardiac irrigation variability in special the RCA is supported by s...
RESUMEN:Se presenta un raro caso de múltiples variaciones en los miembros superiores de un espécimen cadavérico de 45 años de género masculino, del laboratorio de morfología de la Universidad Industrial de Santander (Bucaramanga-Colombia). Se observó variaciones musculares (presencia bilateral de cabezas adicionales del bíceps braquial y del musculo flexor largo del pulgar, agenesia del palmar largo derecho), nerviosas (anastomosis entre mediano y nervio musculocutáneo, y entre ulnar y mediano al nivel palmar superficial). Adicionalmente, presentó el origen de la arteria radial izquierda desde el segmento superior de la braquial. Estas diversas expresiones morfológicas determinan relevantes implicaciones clínicas y deben tenerse en cuenta en los diferentes abordajes quirúrgicos de los miembros superiores.
Background: The popliteus muscle fulfills a function of rotational stabilizer of the knee. Its particular shape and innervation pattern are the interest of anatomists and surgeons. The aim of this work was characterizing the anatomy and innervation of the popliteus muscle of knees from a sample of mestizo-raced population, predominant in Latin America. Methods: This cross-sectional study was made in 23 knee segments 14 right knees and 9 left knees coming from 14 men and 9 women aged 67 ± 22 years. Results: The popliteus muscle presented a scalene-like triangle shape and its medial base was covered by the superficial expansion of the semimembranosus tendon. The length of its base was 79,2±12,8 mm with a superior and inferior side that measured 58.0±7.4 mm and 101.7±11.7 mm respectively. The popliteus muscle innervation was supplied by the tibial nerve (TN) by the arising of two branches in 22 cases (95.7%). The first branch arose proximal to the inter articular line and presented a length of 91,1 mm. The second branch arose distally to the inter articular line with a length of 48.4±1.3mm. The third was observed in just one case (4.3%) Its length was 108±1.1mm and it arose distally to the inter articular line. Conclusions: The morphological characteristics of the popliteus muscle and its innervation patterns found in our study differ from what was reported in previous studies. The presence of these findings can be considered during the planning of surgical procedures in the posterior aspect of the knee.
The objective of this study was to characterize the communication between ulnar and the median nerve in the superficial palmar region from a sample of mestizo-raced population predominant in Latin America. The superficial palmar regions of 53 fresh cadaveric specimens were evaluated, whom of which underwent necropsy procedure at the Institute of Legal Medicine. Dissection was performed by planes until visualizing the presence of the Communicating Branch (CB) between the digital branches of the ulnar nerve (UN) and the median nerve (MN). Qualitative and morphometric evaluation of the CB was carried out.A CB were observed in 82/ 106 (77.4 %) of the cadaveric specimens studied, of which, 38/53 (71.7 %) were bilateral, 15/53 (28.3 %) unilateral; this being a statistically significant difference (p <0.002). Oblique trajectory of the CB between the fourth and third common digital nerve was observed in 70 (85.4 %) specimens, while the CB with transverse trajectory was found in 7 (8.5 %) regions and in a plexiform form in 5 (6.1 %) cases. The length of the CB was 20.2 ± 5.1 mm and the distances from the upper edge of the flexor retinaculum to the proximal and distal points of the CB were 25 ± 6 mm and 37.4 ± 8.3 mm respectively. The anatomical characteristics of the CB patterns, as well as the morphometric CB findings and their points of reference from the carpal flexor retinaculum, make it possible to delimit a safe area of surgical access in the first-fifth proximal of the palmar region, during the surgical approach of carpal tunnel syndrome.
We describe the patterns of motor branches to the elbow flexors in 106 fresh-frozen cadaveric upper extremities from 53 donors of the Latin American mestizo race. We identified a 20% incidence of an accessory biceps head. The innervation patterns to this accessory head were specifically described and added to the Yang classification as Type IV for the biceps and Type III for the brachialis. The patterns arising from the musculocutaneous nerve to the biceps brachii were of Type I in 69%, Type II in 9%, Type III in 7% and Type IV in 11%, and to the brachialis of Type I in 77%, Type II in 11% and Type III in 9%. In 4%, the branches did not originate from the musculocutaneous nerve. We hypothesize that the branch to the accessory biceps head might be considered as a donor for nerve transfer in selected brachial plexus injuries.
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