Anatomical illustrations have gradual changed since their inception. The pioneers of the field have initially used pencil drawings, followed by line illustrations, colored illustrations, two dimensional and three-dimensional illustrations, and it grew up to virtual reality. Recent studies have observed their benefit in teaching anatomy, especially for providing spatial orientation of various structures and complex topics such as middle ear, pterygopalatine fossa, where dissection cannot offer much comprehension. Drawing software such as Illustrator and Photoshop have revolutionized the image quality in anatomy textbooks. Adobe Illustrator comprises many useful tools to draw anatomical diagrams such as pen tool, pencil tool, paint brush tool, text tool. It has various paper sizes to choose and different formats of files to create vector-based images. The drawing hardware such as Wacom Cintiq, Apple iPad Pro with pencil enhances the experience with drawing software.
Anterior cruciate ligament injury is commonly seen in sports related trauma. Complete tear requires surgical reconstruction. During postoperative rehabilitation, because of arthrogenic muscle inhibition (AMI), the quadriceps muscle remains inactive and has reduced contraction. Various strategies were aimed at treating this AMI and/or improve quadriceps strength such as open chain (OKC) and closed chain kinetic (CKC) exercises, blood flow resistance training (BFRT), cryotherapy, and transcutaneous nerve stimulation (TENS). Of all these, CKC was better than OKC in improving the range of movements, weight bearing exercises provided quicker return to physical activity. Cryotherapy was found to be an effective way to counter AMI and improve knee function and reduce the pain. The BFRT and TENS were found to be ineffective. Single legged hop test at six months postoperatively was found to be reliable predictor of the quadriceps function at one year. Electromechanical dynamometry is the gold standard machine to assess the knee extension and provide exercise, handheld dynamometry is easy to use. Leg press, leg extension machine are other machines used to provide exercises.
The anterior cruciate ligament is an important structure maintaining knee stability. ACL injuries are very commonly seen. They cause substantial effect in the younger population, mainly seen in sports injuries either by contact or non-contact mode, affects productivity and physical activity after injury, causes economic burden of surgeries and rehabilitation and post-operative complications. They fail to heal owing to various factors such as a low number of cells, poor vascularity, the inhibitory effect of synovial fluid. Newer approaches to surgeries are evolving to provide better treatment. Hence, a review will enrich the understanding of the pattern of ACL injuries and its application in novel ways of surgical repair.
To describe a complex case of anomalous kidneys involving right early division of renal artery, left accessory renal artery, bilateral upper polar arteries and bilateral extrarenal calyces. This is a very rare case documented having these four anomalies together. The variations were observed during routine anatomical dissection in a male cadaver at department of anatomy, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, IndiaDuring dissection, multiple anatomical variations involving the structures at the hilum of right kidney were found. Right kidney showed early division of renal artery (RRA) 1.4 cm close to aorta. Left kidney showed accessory renal artery (LARA) 5 mm above origin of main renal artery (LRA), running obliquely entering the hilum. Two polar arteries were seen entering upper pole on right kidney as well as left kidney (RUPA1, RUPA2, LUPA1, LUPA2). Extrarenal calyces were observed to be present in both the kidneys, two on the right and three on the left. The variations observed are of importance as multiple anomalies are present in a single cadaver. They are of significance during surgical procedures like renal transplantation, aortic surgeries and in radiological interpretation.
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