Medicine and Health Sciences Commons^™

Bilateral Sternocleidomastoid Variant With Six Distinct Insertions Along The Superior Nuchal Line., Graham Dupont, Joe Iwanaga, Juan J Altafulla, Stefan Lachkar, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Anatomical variations of the sternocleidomastoid muscle (SCM) have been observed to occupy multiple origins and insertion points and have supernumerary heads, sometimes varying in thickness. During routine dissection, a SCM was observed to have six distinct insertions that interface with the course of the superior nuchal line, ending at the midline, bilaterally. This variation was also seen to receive innervation from the accessory nerve as well as the great auricular nerve. To our knowledge, this variant of supernumerary insertions and nerve innervations has not yet been reported. These variants may pose as problematic during surgical approaches to the upper neck …

Henle's Ligament: A Comprehensive Review Of Its Anatomy And Terminology Over Almost One And A Half Centuries., Raja Gnanadev, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

Henle's ligament was first described by German physician and anatomist, Friedrich Henle, in 1871. This review article will cover Henle's original description of the ligament, historical changes in terminology, embryological studies of the ligament, and the clinical significance of Henle's ligament. This article has a particular focus on the variation in the terminology of this structure and the implications of this.

Bilateral Displacement Of The Common Carotid Arteries By A Large Goiter., Lexian J Mcbain, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

Large goiters are less common in the developing world due to the use of iodized salt. However, these are seen occasionally. Herein, we report a case of very large goiter identified in a cadaver. This case is also of interest due to the significant lateral displacement of the common carotid arteries (CCA) and the midline shift of the trachea. This case and the salient literature addressing this topic have been discussed.

Variations Of The Transverse Sinus: Review With An Unusual Case Report., Chrissie Massrey, Juan J Altafulla, Joe Iwanaga, Zachary Litvack, Basem Ishak, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The dural venous sinuses are venous channels in the cranium that drain blood and cerebrospinal fluid circulating from the brain into the vascular system via the internal jugular veins. The transverse sinus is a dural venous sinus present in the posterior aspect of the cranium. We report an unusual variant of this sinus with the presence of a fenestration at its proximal segment. We will review and discuss the background and the potential clinical relevance of this anatomical variation.

Bifid Xiphoid Process: Case Report And Review., Seif Eid, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The xiphoid process is a bony process that comprises part of the sternum. This anatomical structure exhibits several morphological variations, which may complicate diagnostic examinations and invasive thoracic procedures. Variations include bifurcated or trifurcated, deflected, and curved processes. This report discusses a case of a bifid xiphoid process during cadaveric dissection and compares similar findings in the literature. The aim is to improve our knowledge of anatomical variations in an effort to reduce complications and improve patient care.

Anatomical Study Of The Lingual Nerve And Inferior Alveolar Nerve In The Pterygomandibular Space: Complications Of The Inferior Alveolar Nerve Block., Joe Iwanaga, Paul J Choi, Marc Vetter, Mayank Patel, Shogo Kikuta, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The inferior alveolar nerve block (IANB) procedure delivers anesthetics to the pterygomandibular space through which the lingual nerve (LN) and inferior alveolar nerve (IAN) travel. Injury to the LN has been reported more often than injury to the IAN. However, the number of anatomical studies of LN injury is limited. We aimed to establish evidence by investigating LN and IAN anatomy at the level of the mandibular foramen (MF). Forty-four sides from 22 Caucasian cadaveric heads (16 fresh-frozen and six formalin-fixed cadavers) were used in this study. The LN and IAN were laterally dissected, and the diameter and the distance …

Tendinous Inscriptions Of The Rectus Abdominis: A Comprehensive Review., Rabjot Rai, Lilian C Azih, Joe Iwanaga, Marios Loukas, Martin Mortazavi, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The rectus abdominis muscles are interrupted by tendinous inscriptions, which typically appear as fibrous bands crossing the muscle. The current literature on tendinous inscriptions is scarce; hence, this review will provide a detailed overview of their anatomical description, including their variation, embryology, comparative anatomy, and clinical application. Understanding the anatomy and function of the tendinous inscription assists in providing clinical relevance and in guiding reconstructive surgeons in their surgical planning and design.

Radial Artery Injury With Attempted Intravenous Catheterization On The Dorsal Hand: A Case Report., Yusuf Alimi, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

Intravenous (IV) access on the dorsum of the hand is of high clinical significance. As it is possible for an arterial injury during IV access on the dorsum of the hand to occur, clinicians and healthcare providers should be cognizant of regional anatomy and anatomical variations during IV placement so as to prevent injuries to the radial artery. We report a case of an injury to the radial artery with an attempted hand IV placement in a cadaver and suggest possible ways to prevent this complication.

Superior Cerebellar Arteries Originating From The Posterior Cerebral Arteries But Normal Course Of The Oculomotor Nerves., Dominic Dalip, Joe Iwanaga, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The posterior cerebral artery (PCA) is a branch of the terminal part of the basilar artery and perfuses the temporal lobes, midbrain, thalamus, and the posterior inferior portion of the parietal lobes. It is divided into P1-P4 segments. Variations in the P1 segment of the PCA are important to neurosurgeons when performing surgery, for example, on basilar tip aneurysms. We report bilateral superior cerebellar artery (SCA) arising from the P1 segment of the PCA. Such a configuration appears to be uncommon but should be kept in mind by neurosurgeons, neurointerventionalists, and neuroradiologists.

Anatomy And Physiology I & Ii (Ghc), Carol Hoban, Merry Clark, Kimberly Subacz, Sharryse Henderson, Karin Bennedsen

Biological Sciences Grants Collections

This Grants Collection for Anatomy and Physiology I & II was created under a Round Nine ALG Textbook Transformation Grant.

Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process.

Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials:

• Linked Syllabus
• Initial Proposal
• Final Report

Duplication Of The Alar Ligaments: A Case Report., Asad Rizvi, Joe Iwanaga, Rod J Oskouian, Marios Loukas, R Shane Tubbs

Articles, Abstracts, and Reports

The alar ligament is one of the two strongest ligaments stabilizing the craniocervical junction. The literature describes many variations of the attachment, insertion, shape, and orientation of the alar ligament and an understanding of these variations is vital as they can lead to altered biomechanics or misinterpretation on imaging. Herein, we report, to our knowledge, the first case of duplication of the alar ligaments and discuss the anatomical variations present in the literature.

Design, Development, Manufacturing And Biomechanical Testing Of Stand-Alone Cage For Posterior Lumbar Interbody Fusion, Fahad Alhelal

Electronic Thesis and Dissertation Repository

Introduction: The most common method of spinal fusion includes pedicle screws instrumentation, either with or without interbody cage fusion. This thesis aimed to develop and test a novel stand-alone intervertebral device that eliminates the need for pedicle screws and rods.

Method: The stand-alone cage was designed in collaboration with spinal surgeons and engineers using computer assisting drawings, and manufactured in titanium by 3D printing. Biomechanical testing comparing the stand-alone cage with standard posterior lumbar interbody fusion (PLIF) in sawbones (n=6) and cadavers (n=8).

Result: Compared to PLIF, the stand-alone cage demonstrated no significant difference in range of flexion, lateral bend …

A Variant Of The Sciatic Nerve And Its Clinical Implications., Graham Dupont, Florence Unno, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Variants of gluteal neural anatomy are important to consider, especially during surgical approaches to the hip. During the routine dissection of the gluteal region, a variant of the sciatic nerve was found where the nerve left the pelvis fully split into its tibial and common fibular components. Intrapelvically and extrapelvically, there was no splitting of the two components by the piriformis muscle. Distally, the two parts of the nerve were draped over the medial and lateral edges of the ischial tuberosity. To avoid iatrogenic injury to the sciatic nerve during invasive or surgical approaches to this region, all possible anatomical …

Pelvic Kidney: A Review Of The Literature., Seif Eid, Joe Iwanaga, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Kidney development is a complex process that begins during the sixth to eighth weeks of life. Failure of ascent of the kidney will cause the kidney to remain in the pelvis i.e., pelvic kidney. Here, we review this entity in detail and illustrate such embryological derailment. In most cases, a pelvic kidney is an incidental finding and is usually asymptomatic. Anatomic variations of the renal vasculature have been reported in cases of pelvic kidneys and these are highlighted in this review. Clinicians who treat patients for renal or pelvic disease or interpret images of the pelvis should be well informed …

A Comprehensive Review Of The Fabella Bone., Dominic Dalip, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

The fabella is a sesamoid bone that is embedded in the lateral head of the gastrocnemius muscle and often articulates directly with the lateral femoral condyle. It is present in 10-30% of the general population with a higher incidence in Asians. The fabella can lead to various pathologies such as fabella pain syndrome and common fibular nerve palsy. Conservative treatment involves physical therapy or injecting local anesthetics or steroids around this bone. However, if symptoms persist, then a fabellectomy can be performed. Physicians should be aware of the fabella bone and the multiple pathologies associated with it in order to …

Variant Distal Ulnar Nerve Loop: A Previously Undescribed Anatomical Finding., Mayank Patel, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

A previously undescribed variant ulnar nerve loop was discovered during the routine anatomic forearm and hand dissection of an adult female. The major finding was that of a large loop traveling around the distal tendon of the flexor carpi ulnaris. The variation presented here appears to be unique. The exact function of such derailed anatomy is not clear but, if found during surgery, might confound normal dissection methods or, when present, could result in varied clinical presentations regarding the sensory or motor examination of the hand.

Plastination Procedure @ Pcom: Current Practice And Future Uses, Derek D. Jolley, Vishwant R. Tatagari, Kerin M. Claeson

Research Day

Introduction: Since its invention by German anatomist Gunther von Hagens, the process of forced-impregnation plastination of organic specimens has become the standard for the preservation of biological tissue specimens. This practice serves as the most practical method to preserve these specimens for study and is utilized at PCOM regularly for this purpose. During the steps of plastination, aqueous and lipid tissues are replaced by a curable polymer to produce plastinates that do not decompose, can be handled without gloves, and retain most characteristics of the original specimens. For decades, PCOM used this method to prepare a permanent teaching collection …

Anatomy And Physiology I & Ii (Ung), Larry Gibson, Valerie Fambrough

Biological Sciences Grants Collections

This Grants Collection for Anatomy and Physiology I & II was created under a Round Eight ALG Textbook Transformation Grant.

Affordable Learning Georgia Grants Collections are intended to provide faculty with the frameworks to quickly implement or revise the same materials as a Textbook Transformation Grants team, along with the aims and lessons learned from project teams during the implementation process.

Documents are in .pdf format, with a separate .docx (Word) version available for download. Each collection contains the following materials:

• Linked Syllabus
• Initial Proposal
• Final Report

Fenestration Of The Proximal Left Ovarian Vein., Mayank Patel, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

A fenestration in the left ovarian vein was found in a fresh-frozen female cadaver. The opening did not have any vessels or additional anatomical structures passing through it. The ovarian vein is also referred to as the female gonadal vein. This type of anatomical variation is clinically relevant in procedures that deal with the manipulation of the gonadal veins, specifically conditions such as ovarian vein thrombosis, ovarian vein stenosis, and pelvic congestion syndrome.

Injury Of The Radial Nerve In The Arm: A Review., Taroob J Latef, Muhammad Bilal, Marc Vetter, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Compression of the radial nerve is most commonly described at the supinator muscle (i.e., arcade of Frohse). However, radial nerve compression can occur in the arm. Therefore, the purpose of this article is to review both etiologies of radial nerve entrapment and the sites at which this can occur in the arm. The clinical presentation of radial nerve entrapment in the arm and how it differs from that of entrapment at other sites is reviewed and the conditions potentially predisposing to nerve entrapment are described. Particular attention is paid to the nerve's course and potential variants of the anatomical structures …

Anatomical Study Of The Extreme Lateral Transpsoas Lumbar Interbody Fusion With Application To Minimizing Injury To The Kidney., Joe Iwanaga, Emre Yilmaz, Tamir Tawfik, Amir Abdul-Jabbar, Marc Vetter, Marc Moisi, Koichi Watanabe, Koh-Ichi Yamaki, R Shane Tubbs, Rod J Oskouian

Articles, Abstracts, and Reports

Objective Since the extreme lateral lumbar interbody fusion procedure was first reported by Ozgur in 2006, a large number of clinical studies have been published. Anatomical studies which explore methods to avoid visceral structures, such as the kidney, with this approach have not been examined in detail. We dissected the retroperitoneal space to analyze how the extreme lateral transpsoas approach to the lumbar spine could damage the kidney and related structures. Methods Eight sides from four fresh Caucasian cadavers were used for this study. The latissimus dorsi muscle and the thoracolumbar fascia were dissected to open the retroperitoneum. The fat …

A Comprehensive Review Of Medical Imaging Equipment Used In Cadaveric Studies., Emily Simonds, Charlotte Wilson, Joe Iwanaga, Tyler Laws, Gary Holley, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Medical imaging techniques have led to great advances in clinical anatomy and forensic pathology. New and emerging technologies allow healthcare professionals to view and understand the human body from different perspectives. This gives way to new and improved interventions, treatment plans, and an overall understanding of the human body. Herein, we present a comprehensive review of the various medical imaging equipment used in cadaveric studies along with their individual strengths and limitations.

Developing Graphic Libraries To Accompany The Craniofacial Human Ontology, Melissa D. Clarkson

Institute for Biomedical Informatics Faculty Publications

I describe the development of two graphic libraries to accompany parts of the Craniofacial Human Ontology. One library depicts phenotypes of cleft lip. The other represents development of the human head between 4 and 8 weeks of gestation.

The Effectiveness Of Anatomy Laboratory Videos On Osteopathic Medical Students’ Performance, Sumathilatha Sakthi Velavan, Bedia Castellanos

Touro College of Osteopathic Medicine (New York) Publications and Research

Introduction: The usage of audio-visual aids in medical education has always been rewarding. This study aimed at evaluating the efficacy of supplementing traditional dissection based laboratories with the video demonstration of specimens.

Methods: The study was conducted among first-year osteopathic medical students of two consecutive years. The laboratory demonstration videos were recorded and provided to the experimental group and the previous class served as the historical controls. Two Likert scale based questionnaires were completed by the experimental group before and after their final examination. The students' performance in the Anatomy practical examinations were compared between the two groups. …

Does The Foundational Model Of Anatomy Ontology Provide A Knowledge Base For Learning And Assessment In Anatomy Education?, Melissa D. Clarkson, Mark E. Whipple

Institute for Biomedical Informatics Faculty Publications

Throughout the development of the Foundational Model of Anatomy (FMA) ontology, one of the use cases put forth has been anatomy education. In this work, we examine which types of knowledge taught to anatomy students can be supported by the FMA knowledge base. We first categorize types of anatomical knowledge, then express these patterns in the form “Given ____, state ____”. Each of the 33 patterns was evaluated for whether this type of knowledge is compatible with the modeling and scope of the FMA.

Teaching Cross-Sectional Anatomy In Parallel With Gross Anatomy Through A Curriculum Incorporating Ct Scanning Of Cadavers, Peter Haar

Health Sciences Education Symposium

Navigating and interpreting cross-sectional medical image sets are important skills used by most physicians to apply anatomical knowledge to patient care. However, few medical schools provide formal instruction in understanding cross-sectional anatomy. For these reasons, a curriculum was developed in which the medical school gross anatomy cadavers were CT scanned prior to dissection, and CT images of specific cadavers were correlated both to labelled atlas images and to direct structural observations of those same cadavers during dissection. The students were taught to navigate CT data sets in axial, coronal, and sagittal planes, to mentally synthesize three-dimensional understandings of individual cadaveric …

The Use Of Interactive Holographic Technology To Teach Surgical Anatomy And Improve Self-Perceived Preparedness For Surgery In Urogynecology, Lauren Siff

Health Sciences Education Symposium

Abstract Purpose: One of the biggest challenges teaching urogynecologic surgery is developing a spatial understanding of the 3-Dimensional relationships of musculature, ligamentous supports and neurovasculature of the pelvic floor. Therefore, we created an innovative curriculum to improve trainee-preparedness for complex vaginal surgery. The aim of the study is to determine if an interactive holographic curriculum will improve self-perceived preparedness, surgical knowledge and learner-satisfaction compared to usual self-study. Methods: This is a prospective study of 18 OB/GYN residents. Participants prepared like they were “scrubbing into a case of uterosacral ligament suspension (USLS) and sacrospinous ligament fixation (SSLF).” They then completed a …

Soft Spot: The Important Zone At The Standard Posterior Portal Of Shoulder Arthroscopy, Burcu Erçakmak, Ceren Günenç Beşer, Mehmet Hakan Özsoy, Mehmet Deni̇z Demi̇ryürek, Alp Bayramoğlu, Kadi̇r Mutlu Hayran

Turkish Journal of Medical Sciences

Background/aim: The localization of the standard posterior portal of shoulder arthroscopy and landmarks mentioned in the literature are unclear. The purpose of this prospective cadaveric study was to determine the localization of the standard posterior portal and its distance to the neural structures. Materials and methods: One fresh frozen and 10 formalin-fixed adult cadaveric shoulders were dissected. In the beach chair position, a 5-mm trocar was placed anteroposteriorly from the superior edge of the subscapularis muscle, superior to the tip of the coracoid process and tangent to the glenoid. The relevant distances of the posterior exit point were measured. Results: …

The Effect Of Soleus Fatigue During Sidestep Cutting Maneuvers: Implications For The Acl, Michael William Ciesa

Browse all Theses and Dissertations

The soleus muscle is a monoarticular plantarflexor composed slow-twitch fatigue-resistant muscle fibers. Through its attachment to the proximal tibia, contraction of the soleus muscle in a closed kinetic chain (when the foot is planted) produces a posterior pulling force on the posterior proximal tibia. The anterior cruciate ligament (ACL) is responsible for preventing anterior displacement of the tibia relative to the femur. Through the production of a posterior pulling force on the tibia, soleus muscle contraction in a closed kinetic chain could help reduce strain on the ACL. Fatigue is a neuromuscular phenomenon that can alter biomechanical strategies during athletics …