Structural Anatomy
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30455
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Browsing Structural Anatomy by Author "Barnes, Kalan"
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Item Accessory Iliacus Muscle with Split Femoral Nerve: A Case Report(2021) Barnes, Kalan; Kluber, Kristen; Lee, Yein; Fisher, CaraBackground: The femoral nerve originates from the anterior rami of nerve roots L2, L3, and L4 of the lumbar plexus. In its usual course, the femoral nerve descends down between the psoas major and iliacus muscles of the posterior abdominal wall where it supplies branches to the iliacus and pectineus muscles prior to entering the thigh through the femoral triangle. Subsequently, it splits into multiple branches to supply the muscles and skin of the anterior thigh. Case Information: Herein, we report a variant of this course where during routine dissection of the posterior abdominal wall, an accessory iliacus muscle and split femoral nerve was observed on the right side of a 75-year-old female cadaver. The femoral nerve had divided into two branches that passed anterior and posterior to the accessory iliacus muscle prior to leaving the pelvis. After the two branches descended below the inguinal canal, the posterior branch split again into medial and lateral branches. The original anterior branch combined with the medial branch before splitting again. In addition, the accessory iliacus muscle had its own tendon that inserted a few millimeters below the lesser trochanter of the femur. Conclusions: Knowledge of the existence of muscle and nerve variants is useful in determining the pathology and proper treatment for tendinopathies, compressive neuropathies, and other pathological states. In this study, a rare nerve variant and accessory muscle has been described along with potential clinical implications.Item Localizing the Course of the Radial Nerve Based on Anatomical Landmarks: A Cadaveric Study(2021) Barnes, Kalan; Powell, Jake; Beck, Cameron; Skinner, Matthew; Pientka II, William; Fisher, CaraPurpose: Iatrogenic radial nerve injury during the posterior approach to the humerus is a well-documented complication. The aim of this study is to define the course and variability of the radial nerve along the posterior humerus in relationship to the medial and lateral epicondyles. Methods: With the cadaver in a lateral position, the shoulder and elbow were flexed to 90 degrees and supported as done intraoperatively. The epicondyles of the humerus were aligned and tensioned to be held parallel to the operating table. The forearm was clamped in neutral to the supporting pipe. A posterior incision was made over the humerus to expose the triceps muscle. Dissection was continued to the bone and exposure of the radial nerve was completed with care. The location where the radial nerve intersected the medial and lateral edges of the humerus was marked. Images, with a ruler placed on the humerus, were taken of the posterior arm from a standard camera setup. ImageJ was utilized to measure the distance from the epicondyles to where the radial nerve crossed the humerus. Results: Measurements are currently being performed and analyzed in arms of 25 cadavers. Conclusion: Identification of the radial nerve allows for protection of the nerve during a posterior surgical approach to the humerus. This study allows for simple guidelines for orthopedic surgeons to identify the radial nerve and limit iatrogenic injury.