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1

Quantitative anatomy of the posterior cricoid region

100%
Tubbs R. S., Wilson T., Salter E. G., Oakes W. J.
Folia Morphologica
|
2005
|
tom 64
|
nr 4
237-239
The anatomy of the posterior cricoid cartilage region was examined to obtain a better quantitative understanding of this region. The mean height and width of the posterior cricoid cartilage in the midline measured 24.5 mm and 25 mm respectively. The mean distance between the fibres for the left and right posterior cricoarytenoid muscles was 5 mm at the midpoint of the posterior cricoid cartilage. The height of these muscles averaged 19 mm for left sides and 20 mm for right sides. The mean distances from the midpoint and superior midline of the posterior cricoid cartilage to the inferior laryngeal nerve were 14 mm and 15 mm respectively for left sides and 17 mm and 18 mm respectively for right sides. It is hoped that these data will be of use to clinicians performing invasive procedures in this area.
2

An unusual muscle of the wrist with potential compression of the ulnar nerve

100%
Hill M. L., Shoja M. M., Salter E. G., Tubbs R. S.
Folia Morphologica
|
2006
|
tom 65
|
nr 2
178-180
During routine cadaveric dissection of the upper extremity an unusual muscle was discovered arising from the tendon of the flexor carpi ulnaris and inserting into the muscle belly of the flexor digiti minimi. The muscle’s course was superficial to the ulnar nerve and artery in Guyon’s canal. We review the literature regarding such muscle variations and discuss the potential for compression of the ulnar nerve by such muscles.
3

Unilateral agenesis of the facial artery with compensation by a giant transverse facial artery

100%
Tubbs R. S., Salter E. G., Oakes W. J.
Folia Morphologica
|
2005
|
tom 64
|
nr 3
During routine dissections carried out in the course of our medical gross anatomy work, an unusual structure was found unilaterally on the left side of an adult male cadaver. Upon investigation, this was determined to be a hugely dilated transverse facial artery. Also noted was the complete absence of the ipsilateral facial artery. To our knowledge, this is the first report of complete agenesis and not simply diminution of the facial artery with compensatory enlargement of the transverse facial artery.
4

Severe bilateral atrophy of the spinati muscles in a cadaver

100%
Tubbs R. S., Salter E. G., Oakes W. J.
Folia Morphologica
|
2005
|
tom 64
|
nr 3
During the routine dissection of a 62-year-old male cadaver, bilateral atrophy of the supra and infraspinatus muscles was observed. The suprascapular nerves, cervical spinal cord and surrounding muscles were found to be normal. We propose that, in the face of normal histology and other normal shoulder girdle muscles and normal nerves, this case represents an instance of Parsonage-Turner syndrome. To our knowledge, this is the first report of bilateral spinati atrophy in a cadaver.
5

Bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior circulation

76%
Daghigi M. H., Tubbs R. S., Shoja M. M., Shakeri A. B., Pourisa M., Salter E. G., Oakes W. J.
Folia Morphologica
|
2006
|
tom 65
|
nr 2
161-163
An accessory middle cerebral artery is one variation of the intracranial vasculature that may be a source of misinterpretation by clinicians dealing with cerebrovascular diseases. We report a case of an elderly female found to have bilateral accessory middle cerebral arteries, who presented with the rupture of an aneurysm of the anterior part of the circle of Willis. Accessory middle cerebral arteries are rare anatomical findings and the bilateral occurrence is exceedingly rare. We believe this to be the first report of bilateral accessory middle cerebral arteries associated with an aneurysm of the anterior cerebral-anterior communicating arteries. The anatomical and clinical relevance of this variation is described.
6

An unusual muscular variation of the infratemporal fossa

76%
Tubbs R. S., Stetler W., Shoja M. M., Loukas M., Salter E. G., Oakes W. J.
Folia Morphologica
|
2007
|
tom 66
|
nr 3
The infratemporal fossa is often the site of pathology or surgical intervention. We describe an unusual muscle found during the routine dissection of the right infratemporal fossa. The literature germane to this variable muscle, best described as a variant of the pterygoideus proprius, is reviewed. The clinician may contemplate the wide array of muscular anomalies within the infratemporal fossa when considering unexplained neurological symptoms attributed to branches of V3 and pursue appropriate diagnostic testing.
7

Does a third head of the rectus femoris muscle exist?

64%
Tubbs R. S., Stetler W. J., Savage A. J., Shoja M. M., Shakeri A. B., Loukas M., Salter E. G., Oakes W. J.
Folia Morphologica
|
2006
|
tom 65
|
nr 4
377-380
Current anatomical texts describe only two tendinous origins of the rectus femoris muscle. The authors identified one older reference in which a third head of the rectus femoris muscle was briefly described. In order to confirm the existence of this head, 48 adult cadavers (96 sides) underwent detailed dissection of the proximal attachments of the rectus femoris muscle. Of these sides 83% were found to harbour a recognised third head of the rectus femoris muscle. This additional head was found to attach deeply to the iliofemoral ligament and superficially with the tendon of the gluteus minimus muscle as it attached into the femur. This tendon attached to the anterior aspect of the greater trochanter in an inferolateral direction compared to the straight head. The mean length and width of the third head was 2 cm and 4 cm, respectively. The mean thickness was found to be 3 mm. Most commonly this third head was bilaterally absent or bilaterally present. However, 4.2% were found only on left sides and 5.2% were found only on right sides. The angle created between the reflected and third heads was approximately 60 degrees. Two sides (both left sides with one female and one male specimen) were found to have third heads that were bilaminar. These bilaminar third heads had a distinct layer attaching to the underlying iliofemoral ligament and a superficial layer blending with the gluteus minimus tendon to insert onto the greater trochanter. Although the function of such an attachment is speculative, the clinician may wish to consider this structure in the interpretation of imaging or in surgical procedures in this region, as in our study it was present on the majority of sides.
8

The results of compression forces applied to the isolated human calvaria

64%
Tubbs R. S., Murphy R. L., Golden J. B., Etheridge B., Wellons J. C., Blount J. P., Salter E. G., Oakes W. J.
Folia Morphologica
|
2005
|
tom 64
|
nr 4
321-325
Data for the force necessary to fracture the isolated calvaria (skull cap) are not available in the extant literature. Twenty dry adult calvaria were tested to failure quasistatically at the vertex using a 15-kN load cell. The forces necessary to fracture or cause diastasis of calvarial sutures were then documented and gross examination of the specimens made. Failure forces had a mean measurement of 2772 N. Initial fractures did not cross suture lines. Prior to complete destruction of the calvaria there were 7 specimens in which all sutures of the calvaria became diastatic, 6 specimens in which the calvaria became diastatic along only the coronal sutures, 2 specimens in which the calvaria became diastatic along only the sagittal suture and 5 specimens in which there were diagonal linear parietal bone fractures. Our hopes are that these data may contribute to the structural design of more safer protective devices for use in our society, assist in predicting injury and aid in the construction of treatment paradigms.
9

The morphology and function of the quadrate ligament

64%
Tubbs R. S., Shoja M. M., Khaki A. A., Lyerly M., Loukas M., O'Neil J. T., Salter E. G., Oakes W. J.
Folia Morphologica
|
2006
|
tom 65
|
nr 3
225-227
There is a paucity of information in the literature regarding the quadrate ligament and the information that does exist is extremely conflicting. We dissected 30 cadavers (60 sides) to determine the morphology and function of this enigmatic ligament. A quadrate ligament (thickening of the elbow joint capsule) was found in all specimens. In all specimens this band was distinct from the circumferential fibres of the annular ligament. The length, width, and thickness of the quadrate ligament were found to be 11 mm, 8 mm, and 1 mm respectively. This ligament not only aided in securing the neck of the radius to the ulna but also resisted excessive supination and, to a lesser degree, pronation of the forearm. Following transection of the quadrate ligament, the head of the radius was secured to the ulna considerably less firmly and supination and pronation increased by 10 to 20 degrees and 5 to 8 degrees respectively. The quadrate ligament contributes to proximal radioulnar stability, limits the “spin” of this joint, and should be considered in manipulation, surgery, or imaging of the proximal forearm.
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