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1

A study on the morphology of the popliteus muscle and arcuate popliteal ligament

100%

Paraskevas G., Papaziogas B., Kitsoulis P., Spanidou S.

Folia Morphologica

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2006

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tom 65

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nr 4

381-384

The aim of this study was to investigate the origins and morphological features of the popliteus muscle in cadavers. In a sample of 40 lower limbs taken from cadavers the exact morphological features of the popliteus muscle were examined. In 100% of the cases studied we noticed, apart from the known femoral origin from the lateral femoral epicondyle, a fibular origin from the styloid process of the head of the fibula directed obliquely and blending with the main femoral origin, forming the arms of a Y-shaped structure. In all the cases a capsular origin was presented, while in 91.67% an origin lateral to it from the superior border of the posterior horn of the lateral meniscus was found. The capsular and meniscal origins formed the base of the Y-shaped structure that corresponded to the known arcuate ligament. We consider that the additional origins of the popliteus muscle form the arcuate ligament, which is not a distinct anatomical structure as it is described in traditional anatomical textbooks. In addition, we have analysed the exact morphological features of the capsular, fibular and meniscal origins of the popliteal muscle.

2

Anatomic variability in the relation between the retromandibular vein and the facial nerve: a case report, literature review and classification

100%

Piagkou M., Tzika M., Paraskevas G., Natsis K.

Folia Morphologica

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2013

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tom 72

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nr 4

Knowledge of anatomic variations concerning head and neck veins is important to surgeons performing interventions in these regions, as well as to radiologists. The retromandibular vein is used as a guide to expose the facial nerve branches inside the parotid gland, during parotid surgery and open reduction of mandibular condyle fractures. It is also used as a landmark for localisation of the nerve and compartmentalisation of parotid gland lesions preoperatively, during computed tomography, magnetic resonance imaging and sonography. In this paper, the anomalous retromandibular vein’s course on the left side of a male cadaver is described. The vein was formed around the nerve, while the maxillary vein travelled medial to the facial nerve branches and superficial to the superficial temporal vein. Interestingly, the facial nerve temporofacial division crossed again the superficial temporal vein upwards, forming a “nerve fork”. The incidence of the reported variability of the relationship between the retromandibular vein and the facial nerve are discussed with a detailed literature review. Accordingly, the typical deep position of the retromandibular vein in relation to the facial nerve is estimated to 88.17% to all sides. Furthermore, an updated classification system is proposed, including 4 types and subtypes. (Folia Morphol 2013; 72, 4: 371–375)

3

Co - existence of os acromiale with suprascapular osseous bridge: a case report and review of the literature

88%

Paraskevas G., Raikos A., Lazos L., Economou Z., Natsis K.

Folia Morphologica

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2009

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tom 68

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nr 2

We report on a very rare case of co-existence of os acromiale with suprascapular osseous bridge in a dry scapula. The frequency of os acromiale alone ranges from 1.3 to 15%, while the frequency of suprascapular osseous bridge varies between 0.036% and 12.5%. We review the relative literature and emphasize the fact that such knowledge is important for a physician in order to avoid misdiagnosis of an acromion fracture and lytic lesion of the scapula. (Folia Morphol 2009; 68, 2: 109–112)

4

High origin of a superficial ulnar artery arising from the axillary artery: anatomy, embryology, clinical significance and a review of the literature

88%

Natsis K., Papadopoulou A. L., Paraskevas G., Totlis T., Tsikaras P.

Folia Morphologica

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2006

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tom 65

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nr 4

400-405

The superficial ulnar artery (SUA) is an ulnar artery of high origin that lies superficially in the forearm. Its reported frequency ranges from 0.17% to 2%. During anatomical dissection in our department we observed a unilateral case of SUA in a 75-year-old white male human cadaver. It originated from the right axillary artery at the level of the junction of the two median nerve roots and followed a looping course, crossing over the lateral root of the median nerve and running lateral to it in the upper and middle thirds of the arm, whereas in the inferior third of the arm the SUA crossed over the median nerve and ran medially to it. In the cubital fossa, it passed superficially over the medial side of the ulnar aponeurosis and coursed subcutaneously in the ulnar side of the forearm superficially to the forearm flexor muscles. In the hand the SUA anastomosed with the superficial palmar branch of the radial artery, creating the superficial palmar arch. Additionally, it participated in the development of the deep palmar arch. The axillary artery, after the origin of the SUA, continued as the brachial artery and divided into the radial and common interosseous arteries in the cubital fossa. The normal ulnar artery was absent. No muscular or other arterial variations were observed in this cadaver. The embryological interpretation of this variation is difficult and it may arise as a result of modifications to the normal pattern of capillary vessel maintenance and regression. The existence of a SUA is undoubtedly of interest to the clinician as well as to the anatomist. This report presents a case of unilateral SUA along with a review of the literature, embryological explanation and analysis of its clinical significance.

5

The persistence of the sciatic artery

88%

Paraskevas G., Papaziogas B., Gigis J., Mylonas A., Gigis P.

Folia Morphologica

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2004

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tom 63

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nr 4

The persistent sciatic artery (PSA) is a rare anatomical variant where the internal iliac artery and the axial artery of the embryo provide the major supply of the lower limb, the superficial femoral artery being usually poorly developed or absent. We describe an extremely large right PSA in a 79-year-old male cadaver during a medical gross anatomy course, with simultaneous existence of a hypoplastic superficial and deep femoral artery. The PSA, which was a continuation of the anterior division of the right internal iliac artery, entered the buttock through the greater sciatic foramen situated in the gluteal region laterally to the sciatic nerve and in the mid thigh medially to the same nerve, becoming in the popliteal fossa the popliteal artery. Neither the superficial nor the deep femoral artery had communication with the popliteal artery. Because the PSA in our study was the only blood supply to the lower limb, we present the embryologic origins and the clinical anatomy of this artery.

6

Abnormal location of the papilla of Vater: a cadaveric study

76%

Paraskevas G., Papaziogas B., Natsis K., Katsinelos P., Gigis P., Atmatzidis K.

Folia Morphologica

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2005

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tom 64

|

nr 1

51-53

We report a case of a male cadaver aged 72 years with an ectopic location of the papilla of Vater. The ectopic papilla was situated at the supero-posterior border of the 3rd portion of the duodenum at a distance of 0.9 cm from the limit of the 2nd and 3rd portions of the duodenum. The frequency of this anomaly fluctuates between 0 and 11.83% and when the papilla is located distal to its usual position the usual location is in the proximal 2 cm of the 3rd part of the duodenum. We refer to the possible difference in the papilla’s location between patients and cadavers and call attention to the differential diagnosis with spontaneous or surgical fistulae.

7

A rare case of bilateral supernumerary heads of sternocleidomastoid muscle and its clinical impact

76%

Natsis K., Asouchidou I., Vasileiou M., Papathanasiou E., Noussios G., Paraskevas G.

Folia Morphologica

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2009

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tom 68

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nr 1

The sternocleidomastoid muscle (SCM) functions as a landmark for physicians such as anatomists, orthopaedic surgeons, neurosurgeons, and anaesthesiologists, who intervene in the minor supraclavicular fossa located at the base of the neck. The variability of SCM anatomy may cause complications while trying to access the vital elements that are located in the minor supraclavicular fossa. This study aims to present a case of supernumerary heads of the sternocleidomastoid muscle and to discuss its clinical significance. The cervical region of an elderly male cadaver was dissected and the findings were recorded and photographed. On both sides, the SCM muscle had an additional sternal head, and simultaneously there were three additional clavicular heads, four in total. These additional heads, the sternal and the clavicular, reduced the interval between them causing significant stenosis of the minor supraclavicular fossa. Sternocleidomastoid muscle variations with regard to the number of its heads are very rare in the literature, but this variation may cause severe complications. The minor supraclavicular fossa is important for anaesthesiologists because of the anterior central venous catheterization approach. Physicians should be aware of this anatomical variation in order to prevent complications. (Folia Morphol 2009; 68, 1: 52–54)

8

Cadaveric-biomechanical study on medial retinaculum: its stabilising role for the patella against lateral dislocation

76%

Mitrogiannis L., Barbouti A., Kanavaros P., Paraskevas G., Kitsouli A., Mitrogiannis G., Kitsoulis P.

Folia Morphologica

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2018

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tom 77

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nr 4

Background: The aim of this study was to analyse the biomechanical role of medial retinaculum, as a stabilising factor against lateral patellar dislocation. Materials and methods: This cadaveric-biomechanical study included the patellae of 10 cadaveric knees, which were surgically exposed and the medial retinaculum of each one was located. A stable 24.51 N force was applied to the four parts of the quadriceps, and an increasing lateral displacing force was applied to the patella, up to 5 mm dislocation. The study was repeated for 0°, 45°, and 90° of knee flexion, with the medial retinaculum intact and dissected. The Wilcoxon signed rank test was used for data analysis. A p value < 0.05 was considered as statistical significant. Results: After the dissection of medial retinaculum, the lateral displacement force was lower at every angle of knee flexion (p = 0.005, p = 0.007, p = 0.005, respectively). The lateral displacement force increased as the flexion angle increased (p = 0.005), regardless of medial retinaculum integrity. Conclusions: Medial retinaculum acts as a stabilising factor for the patella, against its lateral dislocation in lower flexion angles. Therefore, methods of surgical reinforcement or repair of medial retinaculum could provide protection against recurrent patellar dislocation. (Folia Morphol 2018; 77, 4: 742–747)

9

Morphological study of the calcaneofibular ligament in cadavers

76%

Kitsoulis P., Marini A., Pseftinakou A., Iliou K., Galani V., Paraskevas G.

Folia Morphologica

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2011

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tom 70

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nr 3

The aim of the present study was to investigate the anatomical and morphological characteristics and the maximum elongation of the calcaneofibular ligament (CFL) in cadavers. In a sample of 72 cadaveric lower limbs the mean values of length, width, thickness, and angle with the sagittal plane were recorded for the CFL. The mean ligament’s length was 31.8 mm, and the mean width and thickness were 4.4 mm and 1.5 mm respectively. The mean angle with the sagittal plane was 51.11°. In 72.2% of the lower limbs studied, the ligament presented one band, while 22.2% and 5.6% of them were two-banded and three-banded respectively. A common origin with the anterior talofibular ligament (TFL) was found in 24 of the feet (33%). There were also 4 cases in which the anterior TFL was absent. Finally, we measured the maximal elongation of the ligament during extreme inversion and simultaneous dorsal flexion and found it to be 2.88 mm on average. We noticed and statistically verified that women presented a greater elongation compared to men. A precise knowledge of the origin, insertion, direction, and morphology of CFL is critical for ligament injuries in ankle sprains and during ankle reconstruction. Ligament elasticity plays an important role in the range of ankle motion and ligament shearing. Male and female ankle joints differ in several anthropometric characteristics and thus the genre differences in ligament elongation are of great interest. (Folia Morphol 2011; 70, 3: 180–184)

10

Persistent median artery in the carpal tunnel: anatomy, embryology, clinical significance, and review of the literature

76%

Natsis K., Iordache G., Gigis I., Kyriazidou A., Lazaridis N., Noussios G., Paraskevas G.

Folia Morphologica

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2009

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tom 68

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nr 4

193-200

The median artery usually regresses after the eighth week of intrauterine life, but in some cases it persists into adulthood. The persistent median artery (PMA) passes through the carpal tunnel of the wrist, accompanying the median nerve. During anatomical dissection in our department, we found two unilateral cases of PMA originating from the ulnar artery. In both cases the PMA passed through the carpal tunnel, reached the palm, and anastomosed with the ulnar artery, forming a medio-ulnar type of superficial palmar arch. In addition, in both cases we observed a high division of the median nerve before entering the carpal tunnel. Such an artery may result in several complications such as carpal tunnel syndrome, pronator syndrome, or compression of the anterior interosseous nerve. Therefore, the presence of a PMA should be taken into consideration in clinical practice. This study presents two cases of PMA along with an embryological explanation, analysis of its clinical significance, and a review of the literature. The review of the literature includes cases observed during surgical procedures or anatomical dissections. Cases observed by means of imaging techniques were not included in the study. (Folia Morphol 2009; 68, 4: 193–200)

11

An accessory middle scalene muscle causing thoracic outlet syndrome

76%

Paraskevas G., Loannidis O., Papaziogas B., Natsis K., Spanidou S., Kitsoulis P.

Folia Morphologica

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2007

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tom 66

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nr 3

The aim of our study is to present a very rare accessory middle scalene muscle, leading to thoracic outlet syndrome. In particular, a muscular bundle was discovered on a male cadaver connecting the middle portion of the middle scalene muscle with the anterior scalene muscle insertion to Lisfranc’s tubercle. This triangular accessory muscle and, especially, its sharp medial border compressed the middle and lower trunk of the brachial plexus and the subclavian artery. This anomaly is of great importance because it emphasises the fact that it is not primarily the anterior scalene muscle that produces symptoms of thoracic outlet syndrome but the anterior displacement of the middle scalene muscle or its accessory muscular bands. We also present the relative international literature and the clinical significance of our finding.

12

Excavated type of rhomboid fossa of the clavicle: a radiological study

64%

Paraskevas G., Natsis K., Spanidou S., Tzaveas A., Kitsoulis P., Raikos A., Papaziogas B., Anastasopoulos N.

Folia Morphologica

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2009

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tom 68

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nr 3

The excavated type of rhomboid fossa of the clavicle is a relatively neglected anatomical structure that can potentially cause diagnostic problems. Its unilateral occurrence may be confused by the physician as avascular necrosis, osteomyelitis, or even a tumour. We studied 80 routine chest radiographs and identified the clavicles with excavated type of rhomboid fossa. The sex, sidedness, and handedness were recorded. An excavated type of rhomboid fossa was present in 43 clavicles (26.88%), appearing more frequently in males than in females. In addition, the incidence of the excavated type of rhomboid fossa was greater on the right side than on the left. That type of fossa was also present more frequently on the right side in right-handed specimens and on the left side in left-handed specimens. The high incidence of the excavated type of rhomboid fossa on the dominant hand supports the mechanical theory of fossa formation. Radiologists and physicians should be aware of this fossa, as it may resemble a pathological condition. (Folia Morphol 2009; 68, 3: 163–166)

13

A variant of the double gallbladder. A possible cause of cholelithiasis?

64%

Papaziogas B., Lazaridis C., Paraskevas G., Koutelidakis J., Katsinelos P., Oikonomou B., Chatzimavroudis G., Grigoriou M., Atmatzidis K.

Folia Morphologica

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2005

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tom 64

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nr 3

Congenital duplication of the gallbladder is a rare anatomical malformation, which is usually discovered as an incidental finding during cholecystectomy. We report a case of a double gallbladder in a 45-year-old woman, which was discovered during laparoscopic cholecystectomy for symptomatic cholelithiasis. As it was not possible to identify the anatomical structures safely, the procedure was converted to open cholecystectomy. Inspection of the resected gallbladder showed that it consisted of 2 chambers with separate cystic ducts, which communicated through an ostium. Both chambers contained multiple gallstones. The inadequate drainage of the second chamber could be considered as a predisposing factor for the development of cholelithiasis in this case.

Ograniczanie wyników

A study on the morphology of the popliteus muscle and arcuate popliteal ligament

Anatomic variability in the relation between the retromandibular vein and the facial nerve: a case report, literature review and classification

Co - existence of os acromiale with suprascapular osseous bridge: a case report and review of the literature

High origin of a superficial ulnar artery arising from the axillary artery: anatomy, embryology, clinical significance and a review of the literature

The persistence of the sciatic artery

Abnormal location of the papilla of Vater: a cadaveric study

A rare case of bilateral supernumerary heads of sternocleidomastoid muscle and its clinical impact

Cadaveric-biomechanical study on medial retinaculum: its stabilising role for the patella against lateral dislocation

Morphological study of the calcaneofibular ligament in cadavers

Persistent median artery in the carpal tunnel: anatomy, embryology, clinical significance, and review of the literature

An accessory middle scalene muscle causing thoracic outlet syndrome

Excavated type of rhomboid fossa of the clavicle: a radiological study

A variant of the double gallbladder. A possible cause of cholelithiasis?