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Background: This report aims to supplement the existing knowledge on the inferior oblique muscle. In particular, this study presents detailed anatomical and histological data concerning the muscle's entry point (or entry zone) of the nerve to the inferior oblique muscle. Particular attention was paid to the topographical relationships of the nerve to the inferior oblique muscle (NTIO), including the location of its entry point to the muscle's belly and its anatomical variations. Methods: Sixty orbits from cadaveric hemi-heads fixed in 10% formalin were studied. The course of the NTIO was traced along the lateral border of the inferior rectus muscle as far as its entry point to the inferior oblique muscle. Particular attention was paid to the various ways in which the NTIO's muscular sub-branches penetrated between the fibers of the inferior oblique muscle. Results: Three types of NTIO entries to the inferior oblique muscle's belly were distinguished. In the most common type (48.3%), the nerve entered the muscle's inferior (orbital) surface. In the next most common type (36.7%), terminal muscular sub-branches of the NTIO joined the superior (also referred to as ocular or global) surface of the inferior oblique muscle. In the remaining four cases (15%), the terminal sub-branches of the NTIO were divided into two main groups (superior and inferior) that joined both the superior and inferior surfaces of the muscle. Histological examination confirmed that the distal part of the NTIO shows a characteristic arcuate course (angulation) just before reaching the muscle's belly. The process for splitting and forming separate muscular sub-branches of the NTIO was observed for all the examined histological specimens at the level of the nerve's angulation. Conclusions: The presented findings enhance the understanding of the anatomical variations and precise distribution of motor sub-branches reaching the inferior oblique muscle, which may deepen anatomical knowledge and potentially enhance the management of ocular motor disorders. [ABSTRACT FROM AUTHOR]

The musculocutaneous nerve (C5-C7) is a terminal branch of the lateral cord of the brachial plexus and provides motor innervation to the anterior compartment of arm muscles. Both the musculocutaneous and median nerve may show numerous anatomical variations. Keeping in mind possible aberrations in the course of the upper limb nerves may increase the safety and success rate of surgical procedures. The presented report is a detailed anatomical study of the fusion between the median and musculocutaneous nerve, supplemented by intraneural fascicular dissection. In the presented case, the musculocutaneous nerve was not found in its typical location in the axillary cavity and upper arm during the preliminary assessment. However, a careful intraneural fascicular dissection revealed that musculocutaneous nerve was fused with the median nerve and with its lateral root; Th ose nerves were surrounded by a common epineurium, however they were separable. The muscular branch to the biceps brachii muscle arose from the trunk (fascicular bundle) dissected out from the median nerve and corresponding to the musculocutaneous nerve. Such variation may be of utmost clinical importance, especially during reconstructions of the brachial plexus or its branches. [ABSTRACT FROM AUTHOR]

Renal vessels exhibit a high degree of anatomical variations in terms of their number, level of origin, diameter and topographical relationships. In particular, it applies to the left renal vein which can take retroaortic or even circumaortic placement. Anatomical variations of the left renal vein may be of great clinical significance, particularly in the case of renal transplantation, retroperitoneal surgery as well as vascular or diagnostic procedures. Thus, the aim of this report was to present a complete anatomical description of two cases of the circumaortic left renal vein (CLRV; circumaortic renal collar) co-existing with the presence of various vascular anomalies. In the first case, the circumaortic renal collar was connected via a large anastomosis with the hemiazygos vein and was associated with the presence of the supernumerary left renal artery located below the main left renal artery. In the second case, the circumaortic renal collar was accompanied by the renal artery dividing close to its origin. Moreover, in the latter case, the fusiform aneurysm of the abdominal aorta was observed. In both cases, the CLRV began as a single and short trunk. On its further course, the initial segment of the CLRV was divided into two limbs - anterior (anterior left renal vein) and posterior (posterior left renal vein). Both anterior and posterior limb of the CLRV opened into the inferior vena cava. [ABSTRACT FROM AUTHOR]

Background The posterior petroclinoid dural fold (commonly referred to as a ligament) forms the roof of the trigeminal porus and the roof of the petroclival venous confluence. It lies in close proximity to the oculomotor nerve that crosses it. Due to the low availability of research material, only a few cadaveric studies have been conducted on the microsurgical anatomy of the petroclinoid ligament in cases of its ossification. Thus our report complements earlier studies and provides detailed data on the spatial relationships between the ossified posterior petroclinoid ligament and the trigeminal, oculomotor, and abducens nerves, with special attention to the topographical relationships within the petroclival venous confluence and Dorello's canal. Case Description Bilateral massive ossification of the posterior petroclinoid ligament was observed during the dissection of a 76-year-old female cadaver. The presence of an osseous bridge over the trigeminal notch was also detected on the left side. No narrowing of the space occupied by the petroclival venous confluence was observed. However, the dural sheath of the oculomotor nerve was fixed much more than usual. Conclusions Because the ossification of the posterior petroclinoid ligament may be considered a factor influencing diagnostic and surgical procedures, neurosurgeons and neuroradiologists should be aware of this variation. Ossification of the posterior petroclinoid ligament may also potentially result in greater susceptibility of the oculomotor nerve to injury. [ABSTRACT FROM AUTHOR]

The abducens nerve is characterized by a long intracranial course and complex topographical relationships. Anatomical knowledge may help to understand both the etiology and clinical symptoms of abducens nerve palsy. Typically, the single trunk of the abducens nerve travels on both sides. However, occasionally different variants of unilateral or bilateral duplications of the abducens nerve may be observed. The presented paper is a detailed anatomical description of bilateral duplication of the abducens nerve, with atypical appearance of the nerve in the cavernous sinus and normal distribution within the lateral rectus muscle on both sides of one cadaver. On the right side both trunks of the abducens nerve fused within the subarachnoid space and pierced the dura mater together. On the left side both trunks of the duplicated abducens nerve pierced the dura mater separately, entered the petrous apex separately and fused just below the petrosphenoidal ligament. Within the cavernous sinus the nerve divided once again into two filaments, which reunited into one trunk a er crossing the horizontal segment of the intracavernous part of internal carotid artery. The orbital segments of the abducens nerve showed a typical course on both sides. Duplication of the abducens nerve is anatomical variation which should be taken into account during diagnostic and surgical procedures performed within the petroclival region and cavernous sinus.

Unlabelled: Osteoarthritis of the spine is a major global health problem, it is an epidemic of our times. It affects all parts of the spine, but the hardest to treat is its cervical region. The cervical spine is most mobile, delicate and sensitive to any load. It requires special care in conservative treatment. To date the selection of effective therapeutic approaches has been controversial., Aim: The aim of the study was to assess the progress of rehabilitation in patients with cervical radicular pain syndrome after using two different methods of treatment: HILT and spinal axial traction with the use of Saunders device., Materials and Methods: The randomized study included 150 patients (81 women and 69 men, aged 24-67 years, mean age 45.5) divided into two groups of 75 patients each with characteristic symptoms of radicular pain. The measurement of the range of cervical spine movement of the cervical spine, visual analog scale for pain - VAS and a NDI questionnaire (Neck Disability Index - Polish version) - an indicator of functional disorders - were used to evaluate the effectiveness of the two different therapies., Results: The results obtained by Saunders method remained significantly higher than those obtained when HILT laser therapy was used for most of the examined parameters. A thorough analysis of the results showed greater analgesic efficacy, improved global mobility and reduced functional impairment in patients treated with Saunders method., Conclusions: Both therapeutic methods manifest analgesic effect and a positive impact on the improvement of range of cervical spine movement in patients with radicular pain in this spine region. HILT laser therapy and Saunders traction device reduce neck disability index in the treated patients., (© 2015 MEDPRESS.)

Unlabelled: Spinal radicular syndromes are a serious healthcare issue in the society nowadays. A common form of ailments related to the syndromes is sciatica, manifesting with severe pain radiating along the course of the sciatic nerve or brachialgia manifesting with severe pain perceived from the cervical spine area, through the arm and often along the entire upper limb to the fingers. In many patients the pain limits the ability to perform daily routine at work and at home., Aim: The aim of study was to assess the quality of life in patients with radicular pain and its influence on their ability to function in daily life and at work. The Quality of Life Index was also determined for physical and mental health in the study group., Materials and Methods: The study covered 50 patients, both male and female (25 women with age average 51 and 25 men with age average 54) suffering from medically documented spinal radicular syndromes. The Quality of life SF-36 questionnaire - Short Form Health Survey was used in the study, along with a supplement specifying the study group, with an indication of the pain location and the patients' occupations. Additionally, the Roland-Morris Disability Questionnaire - RM and the Visual Analogue Scale (VAS) were applied. The results were statistically analyzed using descriptive statistics, tests of significance of differences between the two populations, covariance analysis, and correlation meters., Results: In the female patients suffering from spinal radicular syndromes, the pathological process was most commonly located in the cervical spine, while in the male patients - in the lumbar spine. The Quality of Life index, at a statistically significant level (α < 0,05), is higher (hence the quality of life is lower) in females suffering from radicular pain. In the study group, age was a factor strongly correlated with the intensity of pain - the ailment progresses with age. In both groups, exacerbation of the disease process associated with spinal radicular syndromes hindered work performance and daily routines of the patients., Conclusions: Ailments associated with spinal radicular syndromes affect the quality of life of the female patients studied in this research to a greater extent than the male patients, both in terms of mental and physical well-being. The intensity of pain associated with spinal radicular syndromes progresses with age., (© 2015 MEDPRESS.)