RESUMO
PURPOSE: The increase in ankle sprains in children is a reflection of the greater inclusion of this population in sports. This places the calcaneofibular (CFL) and the anterior talofibular (ATFL) ligaments in focus for study. In adults, the presence of arcuate fibers extending between these two ligaments suggests the existence of a new anatomical and functional complex called the lateral fibulotalocalcaneal ligament of the ankle (LFTCL), which can be associated with the persistence of instability of the talocrural joint in ankle sprains. This study aimed to verify the presence of arciform fibers between the CFL and ATFL in human fetuses and to study the topography of the lateral ankle region. METHODS: Forty matched fetal ankles aged between 28 and 38 weeks, fixed in 4% formalin, were macroscopically, chemically and mesoscopically dissected and analyzed in stereoscope. RESULTS: The ATFL was characterized as a capsular ligament consisting of two fascicles (proximal and distal). The CFL was characterized as an extracapsular ligament. The LFTCL complex was verified in all specimens, characterized by the arcuate fibers between the ATFL and the CFL. CONCLUSION: Such results suggest that this functional unit is congenital and that it should be taken into consideration in the treatment of persistent ankle instabilities in the pediatric population.
Assuntos
Traumatismos do Tornozelo , Instabilidade Articular , Ligamentos Laterais do Tornozelo , Criança , Adulto , Humanos , Lactente , Articulação do Tornozelo , Tornozelo , Ligamentos Articulares , CadáverRESUMO
Although arterial variations in the upper limb are usually found during anatomical dissections and clinical practice, multiple arterial variations associated with nervous variations along the limb is rare and clinically relevant. This paper described a combined anatomical variation involving the neurovasculature in the upper limb. A left upper limb dissection of a male cadaver with approximately 50-60 years of age, fixed in 10% formalin, was performed. During the dissection was observed, the brachial artery ending in the middle third of the arm in three branches: a nutritional branch for the biceps brachii muscle, a "lateral brachial artery" and a "medial brachial artery", which became, after unusual paths crossing over the cubital fossa, the ulnar artery and the radial artery, respectively. Radial and ulnar artery demonstrated several unusual anastomotic branches, respectively, and an anastomotic arch around the biceps brachii muscle tendon. Such combined anatomical variation is unique and relevant for clinical and surgical practice.
Assuntos
Artéria Braquial/anatomia & histologia , Artéria Radial/anatomia & histologia , Artéria Ulnar/anatomia & histologia , Extremidade Superior/irrigação sanguínea , Cadáver , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: The uncertainty about the morphological classification of the manubriosternal joint is historical in the field of Anatomy and is still under discussion. This makes it difficult to teach and diagnosing related matters, especially those that require radiological images. In fact, this subject lacks specific data. PURPOSE: This study aims to describe the morphology of the manubriosternal joint and its age-related changes. METHODS: Thirty specimens were divided in three groups: young adults up to 35 years of age, middle-aged adults ranging from 36 to 55, and older adults over 56 years. The subjects were labeled, and blind analysis were performed using the macroscopic and microscopic analysis. RESULTS: The large presence of isolated fibroblasts and chondrocytes and the lower degree of isogenic groups proved that the manubriosternal joint is a symphysis. Its age-related changes involve the reduction of thickness and hydrated characteristics, loss of uniformity and arrangement of the collagen fibers, hyalinization and the presence of focal lesions, that corroborate with the degenerative process. CONCLUSION: The manubriosternal joint is classified as symphysis and the main age-related changes is the relative thickness of the tissue.
Assuntos
Envelhecimento , Manúbrio/anatomia & histologia , Adolescente , Adulto , Idoso , Brasil , Cadáver , Feminino , Humanos , MasculinoRESUMO
Back muscles are commonly described in a topographically-oriented manner without necessarily following morphological criteria. In this manner, non-standard terms may be employed which convey incorrect morphological concepts and demanding more time from both faculty and students to transmit knowledge. We propose a classification system for spinal muscles incorporating morphological concepts with the goal of facilitating knowledge transfer and suggest the term "spinal muscles". Those muscles were systematically divided and classified in seven strata from anterior to posterior: vertebro-appendicular (VA), transversarium (Tr), deep post-transversarium (DPT), middle post-transversarium (MPT), superficial post-transversarium (SPT), deep spino-appendicular (DSA) and superficial spino-appendicular (SSA). Besides topography and function, this system incorporates innervation and embryological origins of each muscle. The extrinsic (VA, DSA, SSA) or intrinsic (Tr, DPT, MPT, SPT) nature of these muscles in relation to the spine and also the topographic relationship to the transverse process is represented in this system. Specific areas of functional, nervous and developmental transition exist on Tr and DPT strata due to being adjacent to extrinsic strata. We believe this system represents a more modern and concise teaching strategy for back muscles which may be employed partially or fully within any program. We envision its full version may be particularly useful in postgraduate medical training for specialties dealing with the spinal column such as neurosurgery, orthopedic surgery and physical medicine and rehabilitation.
Assuntos
Músculos do Dorso/anatomia & histologia , Anatomia/educação , Anatomia Transversal , Músculos do Dorso/embriologia , Vértebras Cervicais/anatomia & histologia , Humanos , Vértebras Lombares/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Projetos Piloto , Coluna Vertebral/anatomia & histologia , Coluna Vertebral/cirurgia , Ensino , Terminologia como Assunto , Vértebras Torácicas/anatomia & histologiaRESUMO
The adductor canal is a conical or pyramid-shaped pathway that contains the femoral vessels, saphenous nerve and a varying amount of fibrous tissue. It is involved in adductor canal syndrome, a claudication syndrome involving young individuals. Our objective was to study modifications induced by aging on the connective tissue and to correlate them to the proposed pathophysiological mechanism. The bilateral adductor canals and femoral vessels of four adult and five fetal specimens were removed en bloc and analyzed. Sections 12 microm thick were obtained and the connective tissue studied with Sirius Red, Verhoeff, Weigert and Azo stains. Scanning electron microscopy (SEM) photomicrographs of the surfaces of each adductor canal were also analyzed. Findings were homogeneous inside each group. The connective tissue of the canal was continuous with the outer layer of the vessels in both groups. The pattern of concentric, thick collagen type I bundles in fetal specimens was replaced by a diffuse network of compact collagen bundles with several transversal fibers and an impressive content of collagen III fibers. Elastic fibers in adults were not concentrated in the thick bundles but dispersed in line with the transversal fiber system. A dynamic compression mechanism with or without an evident constricting fibrous band has been proposed previously for adductor canal syndrome, possibly involving the connective tissue inside the canal. The vessels may not slide freely during movement. These age-related modifications in normal individuals may represent necessary conditions for this syndrome to develop.