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The purpose of the study was to explain the architecture of the posterior cruciate ligament because the views on its structure presented in the literature are inconsistent — from those considering it as indivisible to those presenting it as a multifascicular structure. Twenty formalin-fixed ligaments from human knee joints were tested using the preparation technique. All posterior cruciate ligaments clearly divided into the anterolateral bundle and the posteromedial bundle (20/20). In all ligaments, 2 fascicles were identified in the posteromedial bundle (20/20). In most cases, 2 fascicles were also seen in the anterolateral bundle (14/20). Less commonly, it consisted of multiple fascicles (6/20). (Folia Morphol 2009; 68, 1: 8–12)
The aim of study was the examination of the median branches (MB) of the basilar artery (BA). 783 MB were found in 100 human brainstems injected with coloured latex. The attachment of the MB to the quadrants of the BA’s trunk, their structural shape, length of trunks, topographical arrangement (on three vascular levels) and the clinical importance of this vascular pattern was evaluated. The MB arise from Pr and Pl quadrants of the BA’s trunk in 100% cases, represent 37.7% of BA’s branches and are mostly located in the foramen caecum area (56%). The MB confine the BA’s stem mobility on the V CN area and above, because of their shortest trunks especially on these vascular levels. In the examined specimens the MB varied in number from 0 to 22 (mean, 8).
Neuronavigation is a kind of image-guided surgery used during neurosurgical procedures. Based on specific equipment which is compatible with the software calculating and processing the patient’s data; this method allows the determination of the location of anatomical structures and visualisation of surgical instruments in the operative field. Although standard brain dissection is still the best method of neuroanatomical training, some limitations occur. The most important of these is the inability of conversion from three-dimensional (3D) view to flat pictures of the brain structures, as viewed on computed tomography (CT) and magnetic resonance imaging (MRI), being essential in neuroanatomical training nowadays. The aim of the study was the implementation of a neuronavigating system for brain anatomy training purposes. The study was performed on 10 human brain hemispheres, dissected due to classical methods (standard brain anatomical sections, stepwise ventricular system opening and partial dissection of white matter tracts using Klingler’s dissection technique). The material was scanned in a 1.5 T magnetic resonance scanner using a modified neuronavigation protocol. The brains were prepared before dissection as proposed by Klingler. The subsequent steps of the dissection were documented with a digital camera. The progress of the dissection was visualised using the neuronavigation system (Medtronic Stealth Station Treon) with cranial application software. In the course of the study, numerous 3D and 2D images were obtained. The images were related to each other and linked anatomical structures in the specimen with their appearance on CT and MRI scans. The implementation of a neuronavigation system for brain structures dissection facilitates visualization and understanding of their proper location. This new method offers a constant and precise orientation and simplifies understanding of the relation of the 3D view of a specimen to that of the 2D image. (Folia Morphol 2009; 68, 3: 135–139)
Background: The median aperture of Magendie is the largest of three openings of the fourth ventricle and thus it forms the main path for the outflow of the cerebrospinal fluid from the ventricle. The Magendie aperture connects the fourth ventricle with the cisterna magna and makes a natural corridor for neurosurgical approach and inspection of the ventricle and its floor. The purpose of this study was to give a contemporary anatomical view of this structure in the context of historical data. Material and methods: The Magendie foramen was studied in 30 fixed specimens of human brainstems with cerebella. The microdissection technique was used. Measurements were taken with a microscope ocular ruler. Results: The aperture is limited by the following structures: obex and gracile tubercles inferiorly, and tela choroidea with choroid plexus superolaterally. Obex tubercles usually have the form of a piece of neural tissue bridging two halves of the brainstem above the entrance to the central canal. Gracile tubercles together are 8.15 mm wide and the maximal width of the foramen is 6.53 mm. Tela choroidea attaches laterally at both sides to the inferior medullary velum. In most cases the right and left choroid plexus are connected to each other with a triangular membrane of tela choroidea, which protrudes through the median foramen and attaches to the vermis at a highly variable level. Conclusions: We hope that the presented description of anatomical relations around the Magendie aperture, with its new measurements, will be helpful for those operating in the area and will explain some of the inaccuracies found in literature. (Folia Morphol 2011; 70, 2: 84–90)
Background: The distal tendon of the semitendinosus is often used as a graft in orthopedic reconstructive surgery. Knowledge of the exact morphology of this tendon, and also the ability to predict its morphometric data are certainly helpful when planning the procedure of surgery. Comparison of the semitendinosus distal tendon anatomy in adults and foetuses may be scientifically relevant. There are no scientific reports on this tendon anatomy in foetuses. Materials and methods: Seventy semitendinosus muscles from cadavers were obtained using standard dissection techniques (50 muscles were obtained from adults and 20 from foetuses). Moreover, ultrasound examinations of 20 muscles were performed in living individuals. Results: Two main parts of the distal tendon were distinguished — the external part not covered with muscle fibres and the internal part, which is partially or entirely hidden within the muscle belly (venter). The average length of the distal tendon was 32.34 cm, while the average lengths of the external and internal parts were 9.65 cm and 12.59 cm, respectively. The external part was solid and cylindrical. The internal part was flat and rolled like a trough, thus making the tendon a poor transplant material. Similarly, the distal tendon in foetuses consisted of two parts, including the external and internal part. Conclusions: The proportions between the lengths of different muscle parts were very similar in adults and foetuses. (Folia Morphol 2020; 79, 2: 339–349)
The choroid plexus of the fourth ventricle consists of two symmetrical parts located in the roof of the ventricle and protruding through its openings, the foramina of Luschka and Magendie. The arteries supplying the choroid plexus of the fourth ventricle are difficult to approach because of their deep location within the cerebellopontine angles and the cerebellomedullary fissure. They originate from multiple sites on the cerebellar arteries, and pass near the vital structures of the pons and medulla. The increasing use of the operating microscope and endoscopy during operations in the posterior cranial fossa has created a need for better understanding of the microsurgical anatomy of the plexus and its arteries. The arteries of 15 human brain-stems with cerebelli were injected with coloured gelatine and fixed in 10% formaldehyde solution. The specimens were studied under an operating microscope. The choroids plexus on each side of the midline was divided into four segments, the medial and lateral horizontal segments and the rostral and caudal sagittal segments, in order to facilitate the description of their blood supply. The anterior inferior cerebellar artery (AICA), the posterior inferior cerebellar artery (PICA) and the superior cerebellar artery (SCA) were the main supplying vessels. AICA supplied the portion of the plexus in the cerebellopontine angles and the adjacent part of the lateral recess of the fourth ventricle through the foramina of Luschka. PICA supplied most of the choroid plexus in the roof and the median opening of the fourth ventricle.
A sartorius muscle is the longest muscle of the human system. It runs over 2 joints — hip and knee joints. In the study 10 sartorius muscles were examined. They were dissected free of lower human limbs. Dimensions of limbs which these muscles come from and dimensions of the muscles and their component parts were examined. The attention was paid mainly to parts of tendon located inside the muscle belly. The results show that they are either of a comparable length (distal tendon) or several times longer (proximal tendon) than visible parts located outside of the muscle. Moreover, a complex structure of the distal tendon which includes 2 tracts of different places of insertion was stated. Inferior tract inserted in the same place as muscle tendons: semitendinosus and gracilis. The superior tract inserted transversely against the former one. The tendon of the sartorius muscle forms additionally an aponeurosis whose fibres enter into the deep fascia of crus. The muscle belly is characterised with various width on different levels of its length. In half of cases sword-like distal segment of belly is formed. (Folia Morphol 2014; 73, 3: 359–362)
Ambient cistern (AC) is a thin extension of the subarachnoid space surrounding the brainstem at the level of the mesencephalon and pons. Despite various definitions, it constitutes an important landmark in clinical assessment of intracranial volume reserve. Although it is indisputably useful, there exists no defined standard for radiological examination for the dimensions and ranges in specific age groups. This paper aims to describe the ambient cistern anatomically and give the ranges of dimensions for proper radiological interpretation. The study was performed on 160 axial computed tomography (CT) examinations of Polish children of both sexes, aged 1–18 years, admitted to the hospital because of mild brain concussion. Pictures were made using a Siemens 8-row CT scanner, without contrast administration. We estimated distances at the level of the pons and midbrain, based on axial cross-sections, according to standard radiological protocol. The parameters included the width of the AC in its anterior and posterior part, the width of the tentorial notch, and the distance from the pons and sella. All measurements were analyzed statistically with StatSoft Statistica 8.0 software. The average width of the AC differs between age groups. It is greatest at 1–3 years (2.8 ± 0.6 mm) and lowest at 4–10 years (2.4 ± 0.6 mm). AC is more likely to be greater in its anterior part in boys. The distance from the sella to the pons is greatest in 1–3- -year-old girls (6.9 ± 1.3 mm), and the tentorial notch is widest in the 15–18-year-old group (24.6 ± 2.4 mm). Dimensions of the AC correlate with intracranial reserve volume. This is particularly visible in the youngest children. Thin and narrow AC is not always a sign of raised intracranial pressure. It may be specific for the child’s age. (Folia Morphol 2010; 69, 2: 78–83)
Ten human gracilis muscles obtained from adults and ten gracilis muscles collected from human foetuses between the 15th and 21st week of gestation were examined. The results of this preparatory study show that the gracilis muscle in adults is narrow and long — 482 mm on average. The distal tendon of gracilis muscle is long, 294 mm on average. It can be divided into two sections — external part, outside the muscle belly, and internal, intramuscular, part. The latter one is partially covered by muscle fibres and some of it is completely hidden inside the muscle belly, which is on average 76 mm long. Presence of an intramuscular part of the distal tendon was also demonstrated in the foetal material. Moreover, very strong correlations between particular muscle lengths were noted in foetuses. (Folia Morphol 2018; 77, 1: 138–143)
The anterior maxilla wall and alveolar process are covered by the arterial network. Procedures in this region can cause heavy bleeding. Knowledge of the anatomical course of a particular artery is essential for performing surgery in this area. The aim of this study was to search for and then analyse anastomoses between the infraorbital and posterior superior alveolar artery. In the study, 19 maxillas of foetuses were analysed. The arteries were injected with coloured latex. The dissection was carried out using a surgical microscope and microsurgical equipment. The lower eyelid with cheek skin was separated and the facial muscles were cut to expose the maxilla and arteries of the alveolar process. The study revealed that in 10 out of 19 of the specimens there was an arterial connection between the infraorbital and posterior superior alveolar artery. The course of the analysed anastomosis was diverse. In all cases we observed an anterior superior alveolar artery. In all specimens the alveolar process was vascularised by many arteries originating from the analysed anastomosis. The location of the analysed anastomosis can be stated before operation, on the line between the medial eye angle and the sixth tooth of the same side. The anastomosis described in the study means that caudally running arteries are important in choosing incisions in procedures performed at the alveolar process. (Folia Morphol 2009; 68, 2: 65–69)
Background: The aim of the work was to perform a morphometric analysis of the long peroneal muscle (LPM) of the leg and explore the relationship between muscle belly and tendon. Materials and methods: Ten lower limbs (8 right and 2 left) were fixed in formaldehyde and dissected using standard technique. The LPM was exposed from the proximal attachment to the top of a lateral malleolus. Results: The tendon was subsequently freed and various measurements were taken. The tendon of the LPM enters deep into the muscle belly. Muscle fibres surround the tendon and descend as far down as 4 cm above the lateral malleolus. Muscle fibres insert mainly along posterior border of the tendon and on its medial surface, leaving lateral surface only partly covered. Conclusions: The LPM contains a long intramuscular segment of the tendon and area of the musculotendinous junction varies along the LPM. It makes the idea of uniform pennation pattern of the LPM unlikely. (Folia Morphol 2017; 76, 2: 284–288)
The aim of the study was to describe anatomy of the common calcaneal tendon in rat (Rattus norvegicus) and to correlate individual parts of the tendon with the muscles that act with the aid of them. Ten pelvic extremities of adult rats were fixed in 10% of formaldehyde and were dissected layer-by- layer method with microsurgical instruments under the operating microscope (4 and10 fold magnification). The fascicles of the soleus muscle and the lateral head of the gastrocnemius muscle compose the deepest layer of the tendon. The fascicle of the medial head of the gastrocnemius muscle is located more superficially. The strong tendon of the plantaris muscle covers the fascicles listed above. The common calcaneal tendon in rat is composed of twisted fascicles attaching on the tuber calcanei. Fascicles of the following muscles: gastrocnemius and soleus are twisted along the long axis of the common calcaneal tendon, which is additionally strengthened from behind by the plantaris tendon. A detailed knowledge of anatomy of the common calcaneal tendon in rats provides a better understanding of pathology of the tendon. Conclusions are often extrapolated to the human calcaneal tendon.
Destruction of the vascularisation of the olfactory structures during fronto-orbital surgical approaches to the sellar region may result in anosmia as a complication. The goal of this study was to describe the sources of blood supply to the proximal olfactory tract and the macroscopic distribution of these vessels. 20 human brains fixed in formalin with arteries injected with ink-coloured gelatine were studied using a surgical microscope and the micro-dissection technique. The vessels running along the olfactory tract posteriorly and anteriorly on its inferior and superior surface were observed. These arteries and arterioles were most often branches of the constant artery supplying the posterior part of the straight gyrus and orbital gyri (38/40). Similarly, as branches of the medial orbitofrontal artery (7/40), they were found on the superior aspect of the tract. Branches of the distal medial striate artery directed to the olfactory structures were observed on the basal surface of the tract (20/40).
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