Anatomia, Volume 1, Issue 1 (September 2022) – 11 articles

Background: The reliability of a recent review of meningiomas in the archeologic record was difficult to assess, given the inverted sex ratio of the report and other contents apparently at variance with anatomical/medical findings in scientifically identified cases. It therefore seemed appropriate to reexamine the nature of meningiomas and derive improve criteria for their recognition in the archeologic record and distinguish them from hemangiomas and bone marrow hyperplasia (recognized in the form of porotic hyperostosis). Methods: Medically documented cases of meningiomas were examined to establish a macroscopic standard distinguishing them. Alleged cases in the archeologic record were examined for conformity with those criteria. Results: An en face pattern of uniform mesh with contained whorls appears pathognomonic for meningiomas. This contrasts with the non-uniform marrow expansion displacement of trabeculae in porotic hyperostosis and non-uniform vascular displacement of trabeculae in hemangiomas. Reassessment of past attributions revealed few cases of meningiomas that could be confidently diagnosed. Those identified have sex ratios parsimonious with medical literature reports. Conclusions: Criteria suggested for identifying meningiomas permit distinguishing from hemangiomas, bone marrow hyperplasia (porotic hyperostosis) and from the macroscopically observable surface spicules characteristic of osteosarcomas. Examination for fulfillment of criteria for meningiomas and hemangiomas seems to provide a picture (including sex ratios) mirroring that of the clinical literature, concluding that Cook and Danforth’s disparate ratios were related to less fastidious case selection. Additionally, confidence in recognizing porotic hyperostosis may be compromised because of apparent similar macroscopic alterations to those seen with hemangiomas. Full article

(1) Background: The anatomical variations of neurovascular canals that are encountered in oral surgery are often overlooked by anatomy textbooks or provided with insufficient information. The aim of this study is to analyze the most common variations, describing their morphology, prevalence and clinical implications. (2) Methods: A review of published literature from the 20th century onwards was performed using the PubMed electronic database as well as anatomical textbooks. The variations being investigated were: retromolar canal (RMC) and foramen (RMF), accessory mental foramen (AMF), midline (MLF) and lateral (MLF) lingual foramina and canalis sinuosus (CS). (3) Results: Anatomical variants of neurovascular canals and foramina have a significant incidence and important clinical implications in the most common oral surgery procedures such as third molar extraction, bone harvesting and implantology. (4) Conclusions: Knowledge of these variables is highly important both for students to have a more accurate anatomical awareness and for professional surgeons to be able to provide better diagnoses and prevent complications during oral surgery techniques. Full article

The objective was to implement a “Breakout” activity using an online platform (Genially^®) similar to those carried out in person to increase interactivity, motivation, and teamwork. The activity was proposed during the 2021–2022 academic year in the Human Anatomy II (Splanchnology) course taken in the second semester of the Bachelor’s Degree in Medicine (University of Zaragoza, Zaragoza, Spain) and was carried out with the participation of 89 students enrolled in the course. The evaluation of the experience by the students was carried out by means of an online questionnaire that comprised four questions (based on the Likert scale) and by the teaching staff through a coordination meeting. In total, 86% of the students agreed regarding the positive effect of these kinds of activities on interactivity and motivation, with 65% agreeing on the usefulness of these tools. Around 70% agree that this activity helped them to integrate course content and to enhance teamwork. Full article

(1) Background: The nasopalatine canal (NPC), or the incisive canal (IC) of maxilla, unites the anterior nasal floor with the anterior palatine region. Different morphological variables of the NPC were investigated, indicating it is either anatomically variable or constant. It was therefore decided to perform an additional study of the NPC. (2) Methods: A retrospective cone beam computed tomography (CBCT) study was performed on 89 patient files: 38 males and 51 females. The study documented the presence or absence of a well-defined NPC, the number of openings, and the anatomic variables of the canal (number, course, and secondary canaliculi). (3) Results: the NPC/IC in the coronal plane was classified into five types: (I) NPC present with two superior, nasopalatine foramina (NPFs) (66.29%); (II) NPC absent with two NPFs (2.25%); (III) NPC present and single NPF (17.98%); (IV) NPC present with three NPFs (3.37%); (V) both absent NPC and NPF (10.11%). (4) Conclusions: The anatomical possibilities of the NPC are numerous and diverse; they include the absence of the canal. Therefore, a standardized description of this canal could not be assumed and a radiological assessment is recommended before surgical treatment in the premaxilla area. Full article

The musculocutaneous nerve (MCN) is the terminal branch of the lateral cord of the brachial plexus, and emerges at the inferior border of pectoralis minor muscle. The nerve can interact with the median nerve (MN), adhering to the nerve and sharing fibers with it. During anatomical dissection of twelve cadavers, we have detected a rare variation of the anastomosis between MCN and MN. The knowledge of this anatomical variation could be of great relevance during surgical and clinical practices. Full article

In the alpaca brainstem, the distribution of the cholinergic system by the immunohistochemical detection of the enzyme choline acetyltransferase (ChAT) has been described, and its relationship with the distribution of somatostatin-28(1-12) is analyzed by double-immunostaining techniques. Overlapping distribution patterns for both substances were observed in many brainstem regions, suggesting that interactions between them may occur in the reticular formation, nucleus ambiguus or laterodorsal tegmental nucleus. Colocalization of the two substances in the same cell bodies was only observed in restricted areas, such as the nucleus of the solitary tract, reticular formation and nucleus ambiguus. In addition, in several regions, an apparent high innervation of the peptidergic fibers on cholinergic neurons has been observed. The results suggest that chemospecific interactions could be crucial for the control of specific cardiorespiratory and/or digestive functions in alpacas. These interactions may represent brain-adaptive mechanisms to particular environments and have a potential therapeutic use in respiratory disorders. Full article

The degree of hippocampal dentation, a morphologic feature of the inferior surface of the human hippocampus, has been positively associated with episodic memory performance in healthy adults. This study examined hippocampal dentation in healthy children and adolescents. The Cincinnati MR Imaging of NeuroDevelopment (C-MIND) dataset was used to examine the relationship between age and hippocampal dentation in 90 healthy children, age < 1 to 18 years old, using T1-weighted MPRAGE scans. Hippocampal dentation was assessed by counting the number of dentes for the left and right hippocampi. Participants had slightly more left than right hippocampal dentes, on average. Dentation did not differ significantly between males and females. Correlational analyses revealed that the numbers of left, right, and total dentes were positively associated with age in this sample. Interestingly, these data highlight the wide variability of dentation in older age groups. While younger children tended to have absent or few dentes, a range of dentation was present in older children and adolescents (ranging from absent to numerous, bilaterally). This is consistent with previous research in a healthy adult cohort, where a range of dentation was also observed. This study is the first to examine hippocampal dentation in children. Full article

Although the presence of an arrector pili smooth muscle is documented in many monkey species, its regional peculiarities are hitherto not well documented. We aimed to study this aspect in the face of rhesus monkeys with different areas of hair coat. Eight different regions of six monkeys (male and female) were studied using light microscopy and immunohistochemistry (antibody against smooth muscle alpha actin). We identified two regions (lips and eyelids) with vellus hairs that did not show an arrector pili muscle. In the eyelids, the hairs are rather small and short; in the lips, the vellus hairs were surrounded by striated muscle fibers from the orbicularis oris muscle. In all other regions (frontal region, forehead, cheek, chin), the vellus hairs contained an arrector pili muscle with comparable morphology. Only in the chin region, where additional striated muscles from the face muscles were present, the arrector pili muscles were thinner. All vibrissae showed a close relation to striated muscle fiber bundles of the facial muscles. They never developed smooth muscle bundles assigned as arrector pili equivalent. Full article

The aim was to prospectively evaluate the diagnostic and prognostic value of different quantitative analysis methods assessing adrenal gland parameters on contrast-enhanced CT scans in patients with septic conditions. Seventy–six patients (49 men, 27 women) received CT scans for focus search. Adrenal glands were analyzed by means of three different methods: subjective region of interest (ROI) measurement, organ segmentation and histogram analysis using semi-automated software. Univariate analyses with multiple testing thresholds and receiver operating characteristic curves were performed. Clinical endpoints were 8-days, 28-days and 6-months mortality. Forty-four CT scans were analyzed (ground truth: patients with no sepsis: n = 6; patients with sepsis: n = 15; patients in septic shock: n = 21). Left adrenal gland (LAG) values were analyzed and compared, as data variation was lower than in the right adrenal glands. In patients with septic conditions, the combination of high LAG and Inferior Vena Cava (IVC) density values was highly specific for septic shock with all three methods. Only segmentation values were significantly different between the sepsis and septic shock groups after confounder correction (p = 0.048). Total adrenal gland volume was 20% higher in the septic shock patients while a relatively small LAG volume within the septic shock subgroup was associated with higher mortality at day 8 (AUC = 0.8; p = 0.006) and at 6 months (AUC = 0.7; p = 0.035). However, time-consuming density analysis methods assessing adrenal glands do not provide additional diagnostic value in patients with septic conditions. The combination of high LAG and IVC attenuation values seems to be highly specific for septic shock, regardless of the analysis type. Adrenal gland volume reveals short- and long-term prognostic capacity. Full article

Development of effective in vitro human lip models, specific to the vermilion epithelium, has not progressed as much as that of skin and oral mucosa/gingiva models in vitro. Our histologic examination demonstrated that a Japanese macaque (male, 7 years and 9 months old) had vermilion in the lip distinct from adjacent skin and oral mucosa, resembling histological characteristics of the human lip. Therefore, in this study, we examined the gene expression profile of the three distinct epithelia (skin/vermilion/oral mucosa) within the lip of a Japanese macaque to explore a single potential marker of human vermilion epithelium. Six pairwise comparisons in the skin/vermilion/oral mucosa epithelium in vitro and in vivo revealed 69 differentially up-regulated genes in vermilion epithelium in vivo, in which a few unique genes were highly expressed when compared with both skin and oral mucosa epithelium in vivo using clustering analysis. However, we could not detect a single marker specific to vermilion epithelium supported by the gene expression profile of a Japanese macaque. Instead, the pair of keratin 10 and small proline-rich protein 3 resulted in a potential marker of vermilion epithelium in the human lip (female, 53-year-old) via a double-immunostaining technique. Nonetheless, our result may provide further clues leading to other potential markers of the vermilion epithelium. Full article