The Rectum - Position - Neurovascular Supply - TeachMeAnatomy
The anatomical relationships between the renal venous arrangement and the pelviocaliceal system were studied in 52, 3-dimensional polyester resin corrosion . We investigated the anatomical relationship between the urethra and the surrounding erectile tissue, and reviewed the appropriateness of the. The purpose of this study was to provide a quantitative description of the anatomical relationship between the proximal tibia and posterior neurovascular.
The transforaminal approach is typically used to access intervertebral discs through the foramen without sacrificing the paravertebral muscles and facet joint. This concept is widely accepted for not only PELD but also epidural injection and interbody fusion techniques. At the time of open dissection, there was no ENR injury from the wire insertion. On the other hand, Ozer et al. They observed only They suggested using a partial superior facetectomy to avoid ENR injury [Figure 2].
Partial fecetectomy to widen transforaminal space. An area of partial fecetectomy is colored by blue Arslan et al.
InYeung and Tsou[ 3 ] reported on surgical outcomes and complications. The rate of postoperative dysesthesia POD was 1.
Anatomical relationship between Kambin’s triangle and exiting nerve root
Although they used a contrast material injection technique in the epidural space to determine the ENR anatomy during surgery, it did not prevent nerve irritation.
In their retrospective analysis of patients treated with PELD for lumbar disc herniation, 20 4. They did not describe about the type of anesthesia used during the surgery. They recommended that measuring this distance during preoperative MRI studies may allow surgeons to choose more optimal approaches.
Recently, the diffusion tensor imaging technique has been used for the structural and functional diagnosis of lumbar nerve damage before and after surgery. In their series of patients, none had ENR injury.
The proximal third of the neck was visualized transversely with a 7. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein.
Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed. Seventy-eight patients were included, 44 of whom were men.
The patients' ages ranged from 17 to 90 years median The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age.
Additionally, left-sided localization and male sex further increased the probability of an anterior position. This procedure is used for hemodynamic monitoring, the administration of fluids, the delivery of irritating or hyperosmolar drugs, the supply of parenteral nutrition, and for hemodialysis 1 - 3among other purposes.
Real-time ultrasound imaging has been very useful for locating the vessel to guide the puncture. Although this method of visualization aids in vessel location, the possibility of complications remains 256.
The ultrasonographic study of the relationships between the internal jugular vein and the carotid artery results in variable outcomes.
These outcomes depend partially on the imaging technique employed, the definitions utilized and racial issues that have not yet been clarified 7 - Different researchers have noted than an anterior position of the vein that partially or completely overlies the artery is a risk factor for arterial puncture during venous cannulation 911 It has been suggested that this condition is exacerbated with the rotation of the head, in men, and on the right side and that the condition increases with age 14 - In one-third of cases in our experience, the vein moves medially with the rotation of the head; the vein moves laterally in one-third of cases and does not change in position in the remaining third.
In this study, the association between sex, age and assessed side and the anatomical relationships between the internal jugular vein and the common carotid artery were observed by ultrasound.
These results could be useful in cases of ultrasound-guided insertions as well as in in those guided by anatomical repair.
Materials and Methods A cross-sectional study was conducted to describe the anatomical relationships of the internal jugular vein and the carotid artery in the base of the neck, and the characteristics that predisposed to an anterior position of the vein overlaying the artery were also examined by ultrasound. Seventy eight inpatients from a mixed intensive care unit ICU were included in the study. The patients were hemodynamically stable and attended consecutively.
Patients with any of the following characteristics were excluded: It was estimated that the required sample size was patients. Sample size and statistical analysis were performed using the statistical package Stata r Ultrasound technique and interpretation The examination technique was standardized, and all of the examinations were implemented by some of the researchers, who previously received training and certification for the practice of ultrasound-guided internal vascular access On 20 occasions, the study was interpreted by two independent researchers who were blind to the interpretation of the other examiner.
In each of these studies, both researchers agreed on the interpretation of the anatomical relationships. The ultrasound study was performed with the patient in the supine position.
The head was initially in a neutral position and was then rotated toward the side opposite of the side to be assessed. The reference point of the device was directed to the midline.
The data were digitally saved for later analysis.
Patient positioning for the examination. The head is rotated to the opposite side and the probe is oriented transversely, perpendicular to the axis of the vessels.
Classification of the anatomical relationship between the internal jugular vein and common carotid artery. The relationship between the vessels was described according to the proportion of the artery overlapped by the vein Fig. This method of describing the relationship between vascular structures was chosen instead of those describing the proportion of overlap in degrees 1017 or the magnitude of overlap or separation Examples of different magnitudes of overlap.
The vein covers completely the artery.
The vein is located lateral to the artery. The influence of several variables on the relationship between the vein and the artery was analyzed with data obtained from the studies performed with the head in the rotated position. The relationship was dichotomized as "non-significant overlap" and "significant overlap". The differences depending on the left or right position, age group and gender were analyzed.
The patient's data and relationships in different positions were recorded in a precoded format. Statistical analysis Continuous variables are reported as range, median and interquartile range.Anatomical Planes, Axes & Directions
Discrete variables are reported as quantities and proportions. The proportions were compared using Pearson's Chi-square Chi2 test. A multivariate logistic regression model was constructed to determine the contribution of each variable to the location of the vein in a position of "significant overlap". Ethical considerations This research was considered of minimal risk according to Resolution of the Colombian Ministry of Health Information was collected and stored during the routine patient exam, with the patient's consent, to be used as teaching material.
The demographic data were handled anonymously. No sensitive information was recorded. Results Seventy eight patients, 44 The patient ages ranged from 17 to 90 yrs with a median of 64 yrs and an interquartile range of Age and gender distribution. A total of studies were collected between October and March On eight occasions, only one side was examined due to limitations during rotation or to the presence of a catheter. Two patients were excluded because images were damaged during the storage process.
In the neutral position, the internal jugular vein significantly overlapped the common carotid artery in 23 out of 75 When the head was rotated to the opposite side, significant overlap was observed in 28 out of 75 Anatomical relationship of the common carotid artery and the internal jugular vein, according to the assessed side and the position of the head, rotated or not.
Analysis of factors associated with an overlap of least half of the common carotid artery by the internal jugular vein The proportion of vessels with significant overlap of the artery was This finding was more common on the left side, The proportion of men and women differed according to the age group.
In the group of patients younger than 40 yrs, the men: Significant overlap of the common carotid artery, according to age groups. The results of the multivariate analysis are presented in Table 4.