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Advances in Anatomy 2.0

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (15 September 2023) | Viewed by 24182

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Dr. Aristeidis H. Zibis

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Department of Anatomy, Faculty of Medicine, University of Thessalia, University Hospital of Larissa, Larissa, Greece
Interests: musculoskeletal anatomy; knee anatomy and biomechanics; spine anatomy and radiological anatomy; modern teaching of anatomy; shoulder applied anatomy
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Dear Colleagues,

Diagnostics publishes high-quality articles in all areas of medical sciences and related disciplines after peer review and acceptance, with a fast process. Diagnostics is an open access journal with an impact factor of 3.992. It is indexed in SCIE, PubMed, and Scopus. Diagnostics is going to open a Special Issue entitled “Advances in Anatomy 2.0”. This Special Issue is going to publish original research articles focusing on research on anatomy written by anatomists for clinicians with a special interest in anatomy. We are interested in anatomical research on clinical–surgical anatomy or anatomical variations in and special anatomical characteristics of clinical considerations. Particular attention is going to be given to high-quality illustrations, which are very important for understanding anatomical problems. We are looking for relevant manuscripts concerning the application of anatomical research to clinical problems.

Dr. Aristeidis H. Zibis
Guest Editor

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Keywords

clinical anatomy
surgical anatomy
radiological anatomy
effectiveness in teaching anatomy
surgical anatomical variations
advanced dissection techniques
anatomical implications of clinical problems

Published Papers (12 papers)

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Research

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11 pages, 2397 KiB

Open AccessArticle

Double Transverse Foramina—An Anatomical Basis for Possible Vertebrobasilar Insufficiency Risk and Vertebral Artery Injury

by Nilgün Tuncel Çini, Shahed Nalla, Federico Mata-Escolano, Esther Blanco-Perez, Juan José Valenzuela-Fuenzalida, Mathias Orellana-Donoso and Juan A. Sanchis-Gimeno

Diagnostics 2023, 13(19), 3029; https://doi.org/10.3390/diagnostics13193029 - 23 Sep 2023

Viewed by 1947

Abstract

Cervical vertebrae may exhibit the anomalous presence of a double transverse foramen (DTF) that may impact the anatomy of related structures that traverse the cervical region, such as the vertebral artery (VA). This retrospective anatomical study utilized CT angiography cervical scans to examine the prevalence of DTF, VA, and TF areas. The subjects were separated into two groups: normal TF (NTF group; 26 males and 21 females) and double TF (DTF group; 21 males and 24 females). The males presented significantly higher TF area values (30.31 ± 4.52 mm²) than the females (27.48 ± 1.69 mm²) in the NTF group (p = 0.006). The sex differences disappeared when a DTF was present (p = 0.662). There were no differences in the VA area values between the sexes in both the NTF and DTF groups (p = 0.184). No significant differences in the VA area values between males of the NTF and DTF groups (p = 0.485) were noted. The DTF subjects presented an increased VA/TF area ratio than the NTF subjects (p < 0.001). This study showed that DTF presence reduced the TF area. In contrast, the VA area did not change despite the decreasing TF area. This might be an anatomical risk for transient vertebrobasilar insufficiency in subjects with DTF, especially in females, because VA space in the TF is less in DTF subjects than in NTF subjects. This may lead to easy VA compression in DTF subjects following neck trauma. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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10 pages, 4727 KiB

Open AccessArticle

MRI-Based Evaluation of the Flexor Digitorum Superficialis Anatomy: Investigating the Prevalence and Morphometry of the “Chiasma Antebrachii”

by Clara Elsner, Andreas Steven Kunz, Nicole Wagner, Henner Huflage, Stefan Hübner, Karsten Sebastian Luetkens, Thorsten Alexander Bley, Rainer Schmitt, Süleyman Ergün and Jan-Peter Grunz

Diagnostics 2023, 13(14), 2406; https://doi.org/10.3390/diagnostics13142406 - 19 Jul 2023

Viewed by 1068

Abstract

Recent dissection studies resulted in the introduction of the term “chiasma antebrachii”, which represents an intersection of the flexor digitorum superficialis (FDS) tendons for digits 2 and 3 in the distal third of the forearm. This retrospective investigation aimed to provide an MRI-based morphologic analysis of the chiasma antebrachii. In 89 patients (41 women, 39.3 ± 21.3 years), MRI examinations of the forearm (2010–2021) were reviewed by two radiologists, who evaluated all studies for the presence and length of the chiasma as well as its distance from the distal radioulnar and elbow joint. The chiasma antebrachii was identified in the distal third of the forearm in 88 patients (98.9%), while one intersection was located more proximally in the middle part. The chiasma had a median length of 28 mm (interquartile range: 24–35 mm). Its distances to the distal radioulnar and elbow joint were 16 mm (8–25 mm) and 215 mm (187–227 mm), respectively. T1-weighted post-contrast sequences were found to be superior to T2- or proton-density-weighted sequences in 71 cases (79.8%). To conclude, the chiasma antebrachii is part of the standard FDS anatomy. Knowledge of its morphology is important, e.g., in targeted injections of therapeutics or reconstructive surgery. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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13 pages, 1874 KiB

Open AccessArticle

Superior Gluteal Nerve Anatomy and Its Injuries: Aiming for a More Secure Surgical Approach of the Pelvic Region

by André R. Pinho, Maria J. Leite, João Lixa, Miguel R. Silva, Paula Vieira, João Nery-Monterroso, Mariana C. Bezerra, Hélio Alves, Maria Dulce Madeira and Pedro A. Pereira

Diagnostics 2023, 13(14), 2314; https://doi.org/10.3390/diagnostics13142314 - 8 Jul 2023

Cited by 2 | Viewed by 2089

Abstract

Because most of the recognized causes of superior gluteal nerve (SGN) injury are iatrogenic, detailed knowledge of the anatomy of the SGN is crucial to prevent its injury associated with surgical procedures. This study aims to describe the precise location of SGN or its branches at the greater sciatic foramen, measure the distances of these neural structures to palpable bony landmarks, and evaluate the possible correlation between these parameters and pelvis size. Twenty human cadaveric hemipelvises were studied. After dissection to expose the SGN or its branches at the greater sciatic foramen, the distances from these neural structures to the greater trochanter (GT), to the anterior superior iliac spine (ASIS), to the posterior superior iliac spine (PSIS), to the ischial tuberosity (IT), and to the greater sciatic notch apex were measured. We found that at the greater sciatic foramen, the SGN emerges as a common trunk in 75% of hemipelvises, and already divided in its superior and inferior branches in 25% of hemipelvises. When the SGN exits the pelvis as a common trunk, it does so, in most cases, in contact with the bone at the apex of the greater sciatic notch or superior to the level of the apex. The median distance from the SGN at the greater sciatic notch to the PSIS, ASIS, GT and IT is 7.6 cm, 10.9 cm, 7.5 cm and 10.8 cm, respectively. We found a positive correlation between some of the analyzed parameters and the size of the pelvis. The anatomical data of this study may serve as pivotal guides during orthopedic pelvic surgery, contributing to minimize SNG iatrogenic lesions with significant implications in the patient’s quality of life. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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11 pages, 1017 KiB

Open AccessArticle

Clinical Consideration of Anatomical Variations in the Common Hepatic Arteries: An Analysis Using MDCT Angiography

by Laura Andreea Bolintineanu (Ghenciu), Sorin Lucian Bolintineanu, Nicoleta Iacob and Delia-Elena Zăhoi

Diagnostics 2023, 13(9), 1636; https://doi.org/10.3390/diagnostics13091636 - 5 May 2023

Cited by 2 | Viewed by 1444

Abstract

Purpose: The purpose of this study was to determine the prevalence of normal hepatic vascularization and variations in the common hepatic arteries using multidetector computer tomography angiography. These variants should be acknowledged before any surgery of the upper abdomen. The aim of our work was to analyze the variations in the hepatic arteries and their possible clinical and surgical implications. Materials and methods: This study was carried out on 4192 patients who underwent 64-slice MDCT angiography, from August 2015 to December 2021. We used surface and volume-rendering techniques in order to post-process images of the vascular components in the desired area. Results: We highlighted 76 cases with replaced common hepatic arteries, which are characterized by the origin of the common hepatic artery trunk located outside the classical composition of the celiac trunk. We identified three levels of origin: the abdominal aorta, the superior mesenteric artery and the left gastric artery. We observed six different aspects of the morphological variability of the celiac trunk and the superior mesenteric artery. The trajectory of the artery trunk, between the aortic origin and the hepatic pedicle portion of the hepatic portal vein, is variable and we analyzed the pancreatic trajectory accordingly. Conclusions: The prevalence of hepatic arterial variants found during this study was similar to that in other specialized studies. We came across variants that have not been described in the well-known classification of Michels and even described extremely rare variations. The study of abnormal hepatic vascularization plays an important role in the surgical planning of hepatic transplantation, liver and pancreatic resection and extrahepatic upper abdominal surgeries. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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15 pages, 5806 KiB

Open AccessArticle

Clinically Relevant Anatomical Variations in the Brachial Plexus

by Niki T. Patel and Heather F. Smith

Diagnostics 2023, 13(5), 830; https://doi.org/10.3390/diagnostics13050830 - 22 Feb 2023

Viewed by 4828

Abstract

Anatomical variation in the brachial plexus may result in a variety of clinically relevant patterns, including various neuralgias of the upper extremity and differing nerve territories. Some conditions can be debilitating in symptomatic patients, resulting in paresthesia, anesthesia, or weakness of the upper extremity. Others may simply result in cutaneous nerve territories that deviate from a traditional dermatome map. This study evaluated the frequency and anatomical presentations of a large number of clinically relevant brachial plexus nerve variations in a sample of human body donors. We identified a high frequency of various branching variants, of which clinicians, especially surgeons, should be aware. The medial pectoral nerves in 30% of the sample were found to originate from either the lateral cord, or both the medial and lateral cords of the brachial plexus rather than exclusively from the medial cord. The dual cord innervation pattern greatly increases the number of spinal cord levels traditionally believed to innervate the pectoralis minor muscle. The thoracodorsal nerve arose as a branch of the axillary nerve 17% of the time. The musculocutaneous nerve sent branches to the median nerve in 5% of specimens. The medial antebrachial cutaneous nerve shared a common trunk with the medial brachial cutaneous nerve in 5% of individuals and derived from the ulnar nerve in 3% of specimens. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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9 pages, 7657 KiB

Open AccessArticle

Morphological Analysis of the Mandibular Lingula and Its Relation to Antilingula Using Cone-Beam Computed Tomography in the Saudi Population

by Guna Shekhar Madiraju and Rohini Mohan

Diagnostics 2023, 13(3), 419; https://doi.org/10.3390/diagnostics13030419 - 23 Jan 2023

Cited by 1 | Viewed by 1453

Abstract

Adequate knowledge of the anatomy of the medial aspect of the mandibular ramus is essential in order to prevent inferior alveolar nerve anesthetic failure and nerve injuries associated with mandibular ramal surgical procedures. The purpose of this study was to assess the morphology of the lingula and analyze the correlation of presence probability between the lingula and antilingula using cone-beam computed tomography (CBCT). Three-dimensional images reconstructed from mandibular CBCT images of 125 Saudi individuals (250 sides), aged 16–36 years, were retrospectively evaluated for distribution in the shape of the lingulae. Additionally, the presence probability of the lingula and antilingula was assessed with respect to gender and the mandible (unilateral and bilateral), and correlation between the variables was analyzed. A nodular shape of the lingula was most commonly found (37.6%) followed by a triangular shape (30%). No significant differences were observed between the genders with regard to the presence of the lingula (p = 0.108) and antilingula (p = 0.530). Gender was non-significantly correlated with the presence of the lingula and antilingula, whilst the presence of lingula showed a significant but weak correlation with that of the antilingula (r_s = 0.221; p = 0.000). The present study provides information regarding morphological variations of the mandibular lingula in the Saudi population. The presence of the lingula was unassociated with that of the antilingula and hence consideration of the antilingula as the absolute landmark for mandibular ramus surgical procedures seems insufficient. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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14 pages, 5647 KiB

Open AccessArticle

Prevalence and Characteristics of Accessory Mandibular Canals: A Cone-Beam Computed Tomography Study in a European Adult Population

by Giuseppe Varvara, Beatrice Feragalli, Ilser Turkyilmaz, Aurelio D’Alonzo, Fabiola Rinaldi, Serena Bianchi, Maurizio Piattelli, Guido Macchiarelli and Sara Bernardi

Diagnostics 2022, 12(8), 1885; https://doi.org/10.3390/diagnostics12081885 - 4 Aug 2022

Cited by 8 | Viewed by 1946

Abstract

The purpose of this observational study is to evaluate the prevalence and main characteristics of bifid canals within a European adult population, analyzing cone-beam-computed tomography (CBCT). The population study examined 300 subjects. The CBCTs were performed between 2012 and 2019, using PaX-Zenith3D with a standard protocol of acquisition. The parameters analyzed were the presence and lengths of the bifid mandibular canals. The sample included 49% male and 51% female participants. The mean age of the patients was 47.07 ± 17.7 years. Anatomical variants of the mandibular canal were identified in 28.8% of the sides and 50.3% of the patients. In 7.3% of the subjects, the anatomical variants were present bilaterally. The most frequently encountered bifid canal was Type 3 (40.5%), followed by the Type 1 canal (39.3%), the Type 2 canal (14.5%), and the Type 4 canal (5.9%), 40% on the right side and 60% on the left side. The average length of the bifid canals located on the right side of the mandible was 11.96 ± 5.57 mm, compared to 11.38 ± 4.89 mm for those measured on the left side. The bifid mandibular canal is a common anatomical variation of the mandibular canal. It is fundamental to performing an accurate preoperative evaluation using CBCT analysis to avoid and/or reduce intraoperative and postoperative complications. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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Review

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23 pages, 10705 KiB

Open AccessReview

Petroclival Clinoidal Folds and Arachnoidal Membranes of the Anteromedial Incisural Space: Clinical Anatomy for Neuro Critical Care

by Lorenzo Pescatori, Samanta Taurone, Antonello Ciccarelli, Mauro Palmieri, Alessandra Serraino, Marco Artico, Francesco Fornai, Yaroslava Longhitano, Christian Zanza, Manfredi Tesauro, Gabriele Savioli, Selenia Miglietta and Pasqualino Ciappetta

Diagnostics 2023, 13(20), 3203; https://doi.org/10.3390/diagnostics13203203 - 13 Oct 2023

Viewed by 897

Abstract

A systematic and narrative literature review was performed, focusing attention on the anatomy of the area located at the junction of the sphenoid and the basal portion of the temporal bone (petrous bone, petrous apex, upper petro-clival region) encircled by the free edge of the tentorium, the insertion of the tentorium itself to the petrous apex and the anterior and posterior clinoid processes that give rise to three distinct dural folds or ligaments: the anterior petroclinoid ligament, the posterior petroclinoid ligament and the interclinoid ligament. These dural folds constitute the posterior portion of the roof of the cavernous sinus denominated “the oculomotor triangle”. The main purpose of this review study was to describe this anatomical region, particularly in the light of the relationships between the anterior margin of the free edge of the tentorium and the above-mentioned components of the sphenoid and petrous bone. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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18 pages, 1159 KiB

Open AccessReview

New Challenges for Anatomists in the Era of Omics

by Anna Maria Stabile, Alessandra Pistilli, Ruggirello Mariangela, Mario Rende, Desirée Bartolini and Gabriele Di Sante

Diagnostics 2023, 13(18), 2963; https://doi.org/10.3390/diagnostics13182963 - 15 Sep 2023

Viewed by 1360

Abstract

Anatomic studies have traditionally relied on macroscopic, microscopic, and histological techniques to investigate the structure of tissues and organs. Anatomic studies are essential in many fields, including medicine, biology, and veterinary science. Advances in technology, such as imaging techniques and molecular biology, continue to provide new insights into the anatomy of living organisms. Therefore, anatomy remains an active and important area in the scientific field. The consolidation in recent years of some omics technologies such as genomics, transcriptomics, proteomics, and metabolomics allows for a more complete and detailed understanding of the structure and function of cells, tissues, and organs. These have been joined more recently by “omics” such as radiomics, pathomics, and connectomics, supported by computer-assisted technologies such as neural networks, 3D bioprinting, and artificial intelligence. All these new tools, although some are still in the early stages of development, have the potential to strongly contribute to the macroscopic and microscopic characterization in medicine. For anatomists, it is time to hitch a ride and get on board omics technologies to sail to new frontiers and to explore novel scenarios in anatomy. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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31 pages, 19941 KiB

Open AccessReview

Surgical Anatomy of the Liver—Significance in Ovarian Cancer Surgery

by Stoyan Kostov, Ilker Selçuk, Rafał Watrowski, Svetla Dineva, Yavor Kornovski, Stanislav Slavchev, Yonka Ivanova, Deyan Dzhenkov and Angel Yordanov

Diagnostics 2023, 13(14), 2371; https://doi.org/10.3390/diagnostics13142371 - 14 Jul 2023

Viewed by 3302

Abstract

Introduction: Ovarian cancer is the leading cause of death among all gynecological malignancies. Most patients present with an advanced stage of the disease. The routes of spread in ovarian cancer include peritoneal dissemination, direct invasion, and lymphatic or hematogenous spread, with peritoneal and lymphatic spread being the most common among them. The flow direction of the peritoneal fluid makes the right subphrenic space a target site for peritoneal metastases, and the most frequently affected anatomical area in advanced cases is the right upper quadrant. Complete cytoreduction with no macroscopically visible disease is the most important prognostic factor. Methods: We reviewed published clinical anatomy reports associated with surgery of the liver in cases of advanced ovarian cancer. Results: The disease could disseminate anatomical areas, where complex surgery is required—Morrison’s pouch, the liver surface, or porta hepatis. The aim of the present article is to emphasize and delineate the gross anatomy of the liver and its surgical application for oncogynecologists. Moreover, the association between the gross and microscopic anatomy of the liver is discussed. Additionally, the vascular supply and variations of the liver are clearly described. Conclusions: Oncogynecologists performing liver mobilization, diaphragmatic stripping, and porta hepatis dissection must have a thorough knowledge of liver anatomy, including morphology, variations, functional status, potential diagnostic imaging mistakes, and anatomical limits of dissection. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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Other

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8 pages, 972 KiB

Open AccessBrief Report

Observation of Anatomical Structures in the Human Larynx Using Micro-Computed Tomography with Lugol’s Solution Enhancement

by Kyu-Ho Yi, Siyun Lee, Ji-Hyun Lee and Hyung-Jin Lee

Diagnostics 2023, 13(18), 3005; https://doi.org/10.3390/diagnostics13183005 - 20 Sep 2023

Viewed by 804

Abstract

Histological and naked-eye dissections are frequently used to investigate human anatomy. However, limitations of conventional methods include tissue damage and difficulty in observing structures, rendering findings limited. Micro-computed tomography (micro-CT) allows for a three-dimensional observation with whole-mount staining for contrast enhancement. A precise anatomical understanding of the larynx is essential for both the medical and surgical fields; however, the larynx is difficult to dissect because of its minuscule and complex structures. Therefore, we aimed to clarify the detailed anatomy of the larynx using micro-CT. The study was conducted on twelve specimens of cadavers using Lugol-based-contrast micro-CT. Using Lugol-micro-CT, relevant information on human structures was obtained. Consequently, we successfully employed the Lugol-micro-CT technique in the analysis of specific human soft tissue structures that are challenging to analyze using conventional methods. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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9 pages, 2737 KiB

Open AccessCase Report

Chronic Atherothrombosis in a Sub-Massive Infrarenal Abdominal Aortic Aneurysm in a 91-Year-Old White Male Donor

by Andrea Sparks, Scott Oplinger, Elizabeth Maynes, Keiko Meshida, Maria Ximena Leighton, Gary Wind and Guinevere Granite

Diagnostics 2022, 12(10), 2270; https://doi.org/10.3390/diagnostics12102270 - 20 Sep 2022

Viewed by 1346

Abstract

Screening for abdominal aortic aneurysms became the standard of care in 2005, yet screening procedures continue to be underutilized. While improvements in mortality rates have been noted over the past 15 years, continued patient mortality from ruptured abdominal aortic aneurysms suggests a need for further research, regarding the effectiveness of the current screening process. Abdominal aortic aneurysms can progress silently, and the risk of rupture increases significantly with increase in diameter. We report a large, untreated infrarenal abdominal aortic aneurysm of 17 cm in length and 8 cm in diameter, showing the chronic atherothrombosis discovered in a 91 year-old white male cadaveric donor. A literature review was conducted to elucidate current understanding of the pathology, risk factors, screening recommendations, and treatment options available for abdominal aortic aneurysms. Full article

(This article belongs to the Special Issue Advances in Anatomy 2.0)

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