Structural Anatomy
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/29943
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Item A Case of An Accessory Levator Scapulae Muscle(2020) Mong, Joy; Fisher, Cara; Wagner, LianneIntroduction: The levator scapulae is a posterior axioappendicular muscle that attaches the upper limb to the vertebral column. It originates from C1-C4 transverse processes and inserts on the margin of the superomedial angle of the scapula. This case report documents a variation of the musculature in the levator scapulae with a unilateral accessory muscle inserting into the trapezius instead of the scapula. Background: There have been some documented cases of anatomical variations of levator scapulae, however these variations were usually found to be of atypical origin or insertion. There have not been any documented cases of an accessory levator scapulae muscle belly matching the morphology noted here. The clinical implications of anatomical variants such as this one must be considered. Case Findings: During a detailed cadaver dissection of a 92 year-old female, a left unilateral accessory muscle of the levator scapulae was discovered. It originated just anterior to the bulk of the levator scapulae at the C2 level and inserted into the superior descending trapezius. This accessory levator scapulae measured 6.5 cm long and 0.5 cm wide. Conclusion: Knowledge of anatomical variants of levator scapulae is relevant to clinicians working in the fields of surgery, neurology, radiology and musculoskeletal medicine. This muscle is frequently implicated in the etiopathology of neck and shoulder pain and increased tension in levator scapulae has also been linked to increased cervicogenic headaches. Structural variations, such as this, may be a contributing factor to postural abnormalities leading to chronic myofascial pain and headaches.Item A DILATED, TORTUOUS UTERINE ARTERY: GROSS ANATOMICAL VARIANT AND CLINICAL SIGNIFICANCE(2020) Fisher, Cara; Clark, ChelseaPurpose: Dilated tortuous uterine arteries are associated with multipara, and the resultant decreased blood flow can lead to a multitude of pre- and post-partum complications. We report an anatomical variant, provide retrospective discussion on previous research, and advocate future efforts in identification specifically to aid in preeclampsia screening and prevention. Methods: A left hemisected pelvis of a 43-year-old embalmed female cadaver was dissected. It revealed a dilated tortuous ascending branch of the uterine artery. We used digital imaging measurement software (ImageJ NIH, Bethesda MD) to measure the artery. Results: The dilated tortuous segment contained a total of eighteen direction changes in a ~2cm span. Conclusions: This variant illustrates the substantial compression of uterine artery vasculature in the body to less than 1/3 of its true length, a common finding in multiparous women experiencing preeclampsia. We suggest research focusing on developing a reproducible, credible identification method for uterine artery variants in women presenting with associated symptoms in order to prevent dangerous clinical manifestations.Item A Literature Review of Velopharyngeal Insufficiency and Stress Velopharyngeal Insufficiency in Wind Players(2020) Behel, KensleyA literature review was conducted to evaluate diagnostic tools, as well as surgical and non-surgical reparative options used to diagnose and rehabilitate musicians suffering from velopharyngeal insufficiency (VPI) in musicians. Purpose: The purpose of this paper is to inform music educators and physicians of the prevalence, underlying causes, and possible manifestation of VPI in their students. Methods: Databases (PubMed and Web of Science), a scholarly search engine (Google Scholar), and journal archives (Medical Problems of Performing Artists) were searched yielding a total of 395 possible studies. After the exclusion criteria were applied (must include a minimum of one wind instrumentalist), 32 studies were selected for analysis. Results: As a result, 23 case studies from 1970 and 2018 were found to include relevant information about symptoms, diagnostic tools, and treatment options pertaining to VPI and SVPI in musicians. Conclusions: Nasal grunting, hypernasality, facial grimacing, decreased vocal intensity, fatigue, and maladaptive articulation were some of the side-effects of VPI in musicians. VPI under stress, known as SVPI, has been characterized as a potentially career-preventing or career-ending phenomenon. Medical intervention is often recommended to diagnose and treat VPI in musicians. To improve the quality of medical care for these musicians, more instrument-specific research is needed in this area.Item Aberrant Extensor Digitorum Tendon Lies Superficial to Extensor Retinaculum(2020) Son, Benjamin; Paez-Espinoza, Monserrat; Brevell, Bailey; Fisher, Cara; Evans, ZacharyBACKGROUND: The extensor digitorum muscle (EDM) is located on the posterior aspect of the forearm. The tendons of this muscle typically run deep to the extensor retinaculum (ER) and a fibrous sheath that, not only stabilizes and aligns the extensor tendons but prevents them from bowstringing with extension of the wrist. The ER has been used in the past as a graft source to treat Boxer's knuckle, an injury of the metacarpophalangeal (MP) joint capsule. This indicates the minor role the ER plays in physiologic function. EDM is innervated by the posterior interosseous nerve, a branch of the radial nerve, and is used in extending digits 2 through 5. CASE INFORMATION: This case report documents an anatomical variant that was found during routine dissection of a 66-year-old male cadaver's EDM. The most medial tendon of the EDM, attached distally to digit 5, was discovered to be passing superficial to the ER. CONCLUSION: To our knowledge, this anatomic variation has yet to be documented. The donor's medical history reports no motor dysfunction to the phalanges; thus it is suspected that this variation likely resulted in little to no complications for the donor. The lack of previous documentation on this variant, both in scientific literature and the donor's personal medical history, leads us to suspect that the variant is either uncommon or not of mechanical significance. We have theorized that this anatomical variance would present itself in a similar manner as the palmaris longus tendon.Item Anatomical Mapping of The Posterior Interosseous Nerve and Artery(2020) Liu, Howe; Salem, Yasser; Bell, Richard; Penfield, MonicaPurpose: To determine variation of where the posterior interosseous artery (PIA) and nerve (PIN) converge in the distal, posterior aspect of the forearm. Methods: At the UNTHSC anatomy lab, 10 cadavers (five men and five women) were selected and dissected. The merging of the PIN and PIA was revealed in the left and right forearms for each cadaver. A digital caliper was used to measure from the middle point between the olecranon process and lateral epicondyle to the location of where the structures meet in the forearm. These measurements were then converted to average thumb interphalangeal joint (IPJ) widths (based on previous research). Results: The data collected from the ten cadavers indicate that the PIN and PIA converge, on average, 91.492 mm (9.1492 cm, about 4.5 thumb IPJ widths) down the length of the forearm. The variation between the left and right upper extremities within each cadaver ranged from 0 mm to 8.667 mm. Conclusion: The results provide a valuable clinic resource for medical professionals attempting to provide effective manual intervention or modalities to relieve the symptoms of PIA or PIN entrapment within the posterior forearm. The clinician can use an average of 4.5 thumb IPJ widths to measure distally down the forearm to identify the approximate convergence location of the PIA and PIN structures. Keywords: surface projection, cadaver, posterior interosseous nerve, posterior interosseous artery.Item Anatomical Variation in a Deep Back Muscle and Possible Implications(2020) Meehan, Grace; Park, Clair; Riggs, Alison; Hayes, Olivia; Fisher, Cara; Floyd, JillianBackground: The longissimus thoracis muscle is a part of the erector spinae muscle group, originating from the thoracolumbar fascia, and inserting onto the transverse processes of the first through twelfth thoracic vertebrae. The multifidus muscle originates from the posterior superior iliac spine (PSIS) and inserts on the spinous processes; it is involved in extension and stabilization of the vertebrae in localized movements. Dysfunctions of these muscles are often associated with low back pain, a common complaint among U.S. patients. Case Presentation: This case study describes a novel anatomical variation in the musculature of the deep back discovered during a routine dissection of a 72-year-old female cadaver. The variation identified in this subject is located unilaterally on the right side, from the PSIS, and ends at the transverse process of the third lumbar vertebrae. Conclusions: Based on our literature review, we have concluded that the variation is an atypical deep back muscle. Future studies could examine the effects of these variants, and their implication, in somatic and physiological dysfunctions, such as scoliosis.Item Anatomical Variation of the Splenius Capitis Muscle(2020) Fisher, Cara; Wright, Tommy; Reeves, KirkBackground: This study involves the post-mortem dissection of a unique orientation of muscle fibers branching from the splenius capitis. The splenius capitis muscle is part of the superficial back, which functions bilaterally to extend the head and unilaterally to flex and rotate to the ipsilateral side. The splenius capitis originates on the spinous processes in the cervical region and inserts into the mastoid process of the temporal bone and lateral one-third of the superior nuchal line of the occiput. Case Information: The muscle variant arose from the medial border of the along the superior nuchal line, traveled lateral to the primary muscle body for 6.1 cm, and inserted into the fascial layer below the mastoid process. Careful attention was paid to accompanying variations in neurovasculature and musculoskeletal function during the dissection. However, no additional structures were found to be travelling along the novel fibers. Due to the small size of the fiber and the insertion into the superficial fascia, no change in function was proposed to be caused by the variant. Conclusions: Due to the variability in musculoskeletal formation in the muscles of the back, care must be taken during surgical procedures in which anatomical variants could alter or impede surgical technique. In addition, variations in musculature of the back must be considered in patients undergoing long-term tension headaches. Careful dissections should be performed in the future to identify anatomical variations.Item Bilateral Enlarged Testes: A Case Report(2020) Ly, Connie; Matthews, Joel; West, Lauren; Fisher, Cara; Spore, PaulDuring a routine cadaver dissection, a 76-year old male presented with bilateral enlarged testes. The right testis in this case report was measured at 10 cm and the left testis was measured at 11 cm, both nearly five times the size of an average male testis. Removal of the outer layers of the scrotum revealed solidified green, yellow, and grayish purulent exudate surrounding both testes between the layers of the parietal and visceral tunica vaginalis. While the testes showed some similarities, the presentation of both testis also differed greatly. The left testis was easily compressible and had a large varicocele, while the right testis was turgid and, when dissected, contained a large hematoma. Furthermore, the inferior pole of the left testis had extensive fibrous scarring and epididymal-testis junction and the anterior surface of left testis had two small nodules protruding from the tunica albuginea. In addition to the findings within the reproductive system, an indirect inguinal hernia was identified within the right spermatic cord. The cadaver did not have any documented history of sexually transmitted infection or testicular torsion. He did, however, have a history of benign prostatic hyperplasia without lower urinary tract symptoms. We believe the cause of the bilateral enlarged testes were from two different sources rather than a single disease or incident, due to the stark differences between the two. This case report attempts to further the understanding of the causes of enlarged testes and the relationship between gastrointestinal and reproductive disorders.Item Bilateral Omohyoid Variant(2020) Reeves, Kirk; Fisher, Cara; Robert Wright, TommyBackground: This case report describes and documents a bilateral anatomical omohyoid variant that was discovered during a routine cadaveric dissection. The omohyoid is one of the infrahyoid muscles consisting of a superior and inferior muscle belly, with an intermediate tendon connecting the two at an angle. While the omohyoid muscles play an important role in depressing the hyoid bone during phonation and swallowing, they also serve as an important surgical landmark for level III and IV lymph node metastasis. Therefore, it is important for clinicians to be aware of the variations that could occur with the omohyoid muscles and their subsequent potential side effects. Case Information: Careful dissection of the omohyoid muscles of a 92-year-old female cadaver revealed alterations from the normal anatomy. The left omohyoid muscle exhibited two inferior muscle bellies, with one having a midclavicular attachment and the other attaching to the superior border of the scapula. The right omohyoid displayed three different inferior muscle bellies, with one attaching to the midshaft of the clavicle, another attaching to the lateral aspect of the clavicle, and the last attaching to the superior border of the scapula. Conclusions: Aberrant omohyoid musculature has been described on numerous occasions and warrants significant consideration during a variety of procedures. Variations of the omohyoid muscle can have a range of clinical manifestations including torticollis, dysphagia, dyspnea, and they also serve as important surgical landmarks. Therefore, knowledge of omohyoid variants could lead to better management of patients with omohyoid disorders.Item Biosafety measures to address challenges in expanding an anatomical laboratory(2020) Nair, Maya; Reeves, Rustin; Yellott, Claudia; Tolulope Orimoloye, HelenIntroduction Laboratory work requires the use of potentially hazardous materials, sophisticated equipment, technical operations, and procedures to enhance discoveries. Health and biosafety considerations are made when designing laboratories, or when labs are renovated to accommodate more storage or research. The question then arises for the need of further biosafety requirements for a lab expansion. The anatomy laboratory at UNTHSC recently expanded their storage facilities to accommodate more donors to the Willed Body Program. Biosafety practices are crucial to prevent exposures to chemical and biological agents. There is a gap in knowledge about the biosafety challenges involved with the expansion of an anatomy lab. The purpose of this article is to evaluate the biosafety requirements and challenges for anatomical lab expansion. Methods Current regulations and recommendations for biosafety practices in anatomical laboratories from the State Anatomical Board of Texas will be reviewed to ensure compliance. A risk assessment of the laboratory will be performed to determine the potential hazards and the engineering requirements of safety protocols that will be needed during expansion. Materials and waste management, as well as air handling procedures will be reviewed, as well as the training procedures and Standard Operating Procedures (SOPs). The biosafety officer will ensure that the SOPs must cover hazard communication, accident and incident reporting system, personal protective equipment use, post-exposure and prophylaxis plan, transfer of equipment, and entry and exit procedures. Conclusion Our goal is to ensure the biosafety measures will help reduce the challenges in expanding the anatomical laboratory at UNTHSC.Item Circumaortic Left Renal Vein(2020) Craig, Matthew; Walter, Kathryn; Fisher, Cara; Ditter, HannahThis case report documents a circumaortic left renal vein (CLRV) observed during a routine dissection of a 65-year-old male cadaver. Two distinct renal veins were observed arising separately from the hilum of the left kidney. The first left renal vein runs transversely to the inferior vena cava (IVC), passing anterior to the aorta. This preaortic renal vein follows the path of a typical left renal vein and drains both the left testicular and suprarenal veins. The second left renal vein runs inferiorly to the IVC within the coronal plane, passing the aorta posteriorly. An in-depth literature review revealed that various anatomical anomalies of the left renal vasculature have also been observed in addition to CLRV, such as multiple renal veins (MRV) and retroaortic left renal vein (RLRV). In the case of RLRV, the left renal vein passes posterior to the aorta. In the case of CLRV, a supranumerary retroaortic left renal vein exists in addition to a typical preaortic left renal vein. While these anatomical abnormalities may go undiagnosed in healthy individuals, they do have clinical implications such as correlation with nutcracker syndrome, which can lead to hematuria. Surgical implications of CLRV also include increased risk of hemorrhage during laparoscopic nephrectomies. Awareness of anatomical variations, such as the CLRV discovered in this cadaver, hold significant clinical implications and should be considered in pre-surgical work-up for various retroperitoneal surgeries.Item Craniofacial Morphology of Juvenile Mice with Osteogenesis Imperfecta(2020) Menegaz, Rachel A.; Organ, Jason; Steele, Ashley T.Osteogenesis imperfecta (OI) type III is a severe genetic disorder of type I collagen (Col1) which results in bone fragility, reduced stature, and impaired craniofacial growth. To investigate the mechanisms by which Col1 mutations alter craniofacial growth, we used the homozygous recessive OI murine (OIM) mouse model, which is known to exhibit human-like adult phenotypes but for which the juvenile phenotype is unknown. Weaning OIM and wild type (WT) littermates were µCT scanned at 21 days. Craniofacial landmarks were collected using 3D Slicer software. Interlandmark distances (ILDs) and centroid sizes were calculated using Past 2.17 software. ILDs were scaled against skull/mandible centroid size to remove the effect of overall body size for shape analyses. Mann-Whitney U-tests were used to compare absolute and relative (scaled) ILDs between genotypes. Craniomandibular centroid sizes and absolute linear distances (skull, rostrum, palate, and mandible lengths) demonstrate that OIM mice are smaller overall compared to WT littermates. When scaled to centroid size, juvenile OIM mice have a decrease in midface height, nasal and mandibular diastema length but increased hemimandible length compared to WT mice. For a given skull length, OIM mice have shorter faces in both the anteroposterior and dorsoventral dimensions. The morphometric changes seen in juvenile OIM mice replicate the midfacial hypoplasia seen in human children with OI. This mouse model can be used to investigate the structural changes underlying the human OI phenotype and potential therapeutic interventions. These results can be used to inform future investigations of Col1 in craniofacial development.Item Development of Craniofacial Biomineralization in Mice with Osteogenesis Imperfecta (OI)(2020) Menegaz, Rachel A.; Robert Wright, TommyOsteogenesis Imperfecta (OI) is a rare autosomal dominant disorder characterized by genetic mutations that affect type I collagen (Col1) synthesis. The severe OI type III phenotype generally includes a short stature, low bone mineral density (BMD), dental problems, hearing loss, and blue sclerae. In this study, we use a mouse model of OI type III to examine how mutations in type I collagen synthesis impact craniofacial biomineralization during postnatal growth. The homozygous recessive osteogenesis imperfecta murine (OIM) is characterized by increased skeletal fractures, low postcranial BMD, progressive skeletal deformities, and small body size. Wild type mice (WT) and OIM littermates (n>3/genotype) were micro-CT scanned at weaning (4 weeks) and adulthood (16 weeks). BMD at three regions of interest (ROI) within the mouse skull was measured using Bruker CTAnalyzer software: (1) the temporomandibular joint (TMJ), (2) the parietal bone (1mm from the sagittal suture), and (3) the anterior maxilla at the incisal alveolus. Mann-Whitney U-tests (?=0.05) were used to compare BMD values between the genotypes for each ROI. At weaning, OIM mice had significantly lower BMD values (g.cm-3 CaHA) than their wild type littermates at all three ROIs, and these differences persist into adulthood. This decrease in BMD reflects decreased deposition of CaHA due to an abnormal collagen framework in the craniofacial skeleton of OIM mice. Ongoing efforts will expand this analysis to quantify the development of BMD at additional regions within the craniofacial skeleton.Item Intermuscular Lipoma: A Case Report(2020) Fisher, Cara; Bilbao, JorgeABSTRACT: Background: Lipomas are the most common type of soft-tissue tumors. Superficial lipomas account for about 50% of all soft-tissue tumors and are usually found in the upper back, neck, proximal extremities, and abdomen. Deep-seated lipomas are far less common and usually found in the lower extremity, trunk, shoulder, and upper extremity. Case Presentation: In our study we report a case of a deep-seated, intermuscular lipoma with a rare location in the erector spinae musculature of the lower back. This mass was found during a routine dissection of a 68-year-old male cadaver and it serves to expand knowledge on the anatomical aspects of rare intermuscular lipoma locations. On gross examination, the lipomatous mass was seemingly circumscribed with a uniform, yellowish adipose color, lobulated surface, and soft consistency. Histological examination exhibited a discrete mass of uniform, mature adipocytes, which are clearly delineated from the surrounding musculature. Conclusions: These findings are diagnostic of a well-circumscribed intermuscular lipoma. It is important to note that these lesions are benign and have no metastatic potential. Knowledge of rare intermuscular lipoma locations is necessary for clinicians and surgeons during diagnostic and therapeutic procedures. It is necessary that current clinical guidelines take rare variants into consideration.Item Levator Glandulae Thyroideae(2020) Fisher, Cara; Laborde, Alfred; Blackwood, TaylorBackground: Levator Glandulae Thyroideae (LGT) is an accessory fibromuscular band that originates from the hyoid bone and inserts on the thyroid gland. It is an embryological remnant of contested origin and functions in elevation of the thyroid gland. The incidence of LGT is suggested to be approximately 1 in 6. Case Information: During routine dissection of a 70-year-old African American male cadaver a midline Levator Glandulae Thyroideae muscle was discovered which contained glandular tissue of the pyramidal lobe of the thyroid. The muscle fibers originated from the left side of the hyoid bone and passed superficially over the thyroid cartilage with insertion into the right side of the thyroid gland. Upon deeper dissection, it was noted that the LGT created a permanent indentation within the left aspect of the thyroid cartilage notch. This cadaver was noted to also have an anatomical variation in his neck region with his left external jugular vein coursing superficially to the clavicle. The cause of death is suspected to be unrelated and was noted to be metastatic esophageal carcinoma. Conclusions: Variations in cervical anatomy are common and knowledge of these variants is critical for surgeons to achieve quality patient outcomes. Clinicians using ultrasonography and CT imaging should be aware of the LGT to prevent a misdiagnosis of tumor or thyroglossal duct infection. While further study is needed to determine the embryological origin of the LGT, we postulate that the impression in the thyroid cartilage will help anatomists discover those details.Item Modern Day Osteometrics: Testing the Concordance of Postcranial Measurements Collected Manually vs. Digital Methods(2020) Maddux, Scott D.; Kelly, Alexa; Tadlock, JohnathanThe use of medical imaging (CT/MRI) modalities for the collection of osteometric data has become increasingly common in anatomical research. However, the relative accuracy of skeletal measurements collected using these modalities is poorly established. Thus, the purpose of this study was to test the hypothesis that osteometric data collected manually and digitally are reliably comparable. The software program 3D Slicer was chosen for collection of digital measurements because of its widespread usage in modern morphometric research. Maximum femoral length, maximum humeral length, humeral epicondylar breadth, and anteroposterior femoral head diameter (FHD) were collected on 36 humeri and 23 femora. Each of these measurements was taken three times using different methods: (1) physical anthropometry, (2) digitally directly from raw Computed Tomography (CT) scans, and (3) digitally from full-bone 3D models generated from CT scans. Maximum length and epicondylar breadth measurements were all found to be highly comparable between all three measurement methods (Lin's Concordance coefficients 0.96-0.99). Conversely, FHD measurements collected via the two digital methods were found to be poorly comparable to manual measurements (Lin's CC: 0.0832-0.160) with average differences of approximately 7.0 mm (16%). These results suggest that measurements collected digitally are generally comparable to those collected manually using traditional osteometric tools. Methodological discrepancies in measuring FHD may relate to the difficulty of reliably orienting the proximal femur in 3D digital space. Future research into these discrepancies is necessary as FHD is frequently used in regression formulae for estimating stature, body mass, and metabolic requirements.Item Multiple Anatomical Variations in a Pair of Cadaveric Feet(2020) Aten, Kristopher; Fisher, Cara; Daniel, CatherineBackground: The intrinsic muscles of the foot consist of all muscles that originate and attach to the foot itself (as opposed to those that originate in the leg and insert onto the foot). These muscles include the lumbricals, extensor digitorum brevis, and flexor digitorum brevis, among others, which primarily assist with movement of the toes and in stabilizing the arches of the feet. Case report: During a routine dissection of a pair of cadaveric feet and legs, several variants in the intrinsic musculature of the foot were noted. Bilaterally, there was an absence of the 4th lumbrical and the 4th muscle belly of the flexor digitorum brevis. Also found, were bilateral accessory tendons of the extensor digitorum brevis. While variations of all of these muscles are reported in the literature, there are few descriptions describing bilaterality of the variants described in this specimen. For example, multiple publications describe the absence of at least one lumbrical of the foot in 1-9% of specimens, but only three descriptions of bilateral absence were found on literature review. Discussion: The intrinsic muscles of the foot play an important role in the biomechanics of gait. In addition, the extensor digitorum brevis muscles are frequently used as flaps to repair defects of the foot and ankle. Knowledge regarding the type and incidence of variations in the anatomy of these muscles, therefore, caries true clinical significance and would likely benefit from further research in both cadaveric specimens and living human subjects.Item Multiple Lateral Cervical Musculature Variation: A Case Report(2020) Mong, Joy; Fisher, Cara; Wagner, LianneIntroduction: The paired anterior, middle, and posterior scalene muscles are found in the lateral neck. The anterior scalene originates from the transverse processes (TPs) of C3-C6 and inserts on the first rib. The middle scalene originates from the TPs of C2-C7 and also inserts on the first rib. The posterior scalene originates from the TPs of C5-C7 and inserts on the second rib. The levator scapulae originates from C1-C4 and inserts on the angle of the scapula. This case report documents multiple anatomical variations of the scalenes and levator scapulae in the lateral neck. Background: While there have been case studies on other scalene variations, including the scalenus minimus, there are no documented cases matching the morphologies noted here. Case Findings: Detailed dissection revealed multiple muscle variations. The first, an accessory middle scalene muscle with two bellies. The superior belly originates at C1-C5 TPs, running in an inferomedial fashion, anterior to the middle scalene. The inferior belly runs in an inferior fashion, anterior to the middle scalene, with some fibers inserting on the middle scalene and the remainder merging with the first intercostal fibers. The second, an accessory levator scapulae muscle, with two bellies coming off the 3rd belly of levator scapulae and attaching to C5. The final variation, the posterior scalene muscle attaching to the first rib instead of the second. Conclusion: Some possible clinical implications of this variant include cervicogenic headaches, thoracic outlet syndrome, and compression of the brachial plexus.Item Musculoskeletal Asymmetry in Individuals with Lower Limb Amputation(2020) Moudy, Sarah; Menegaz, Rachel A.; Finco, MalakaPurpose: Individuals with lower limb amputation experience differences in musculoskeletal loading that can lead to gait asymmetries, increased fall risk, and overuse injuries. This study investigates how lower limb amputation affects musculoskeletal properties. Cadaver assessment provides the ability to examine long-term asymmetrical loading that can be difficult to examine in living individuals. Methods: Five male unembalmed donors (61-81 years of age) with various levels of lower limb amputation were obtained through the UNTHSC Willed Body Program. Dual-energy x-ray absorptiometry, x-ray, and gross dissection were performed to collect musculoskeletal properties related to biomechanical loading during locomotion. Percent differences between limbs were calculated to assess the degree of asymmetry. Results: Each subject's most compromised side showed lower bone mineral density (19.3-36.6%) and bone mineral content (11.5-64.5%), higher tissue fat (38.8-51.8%), and wider knee joint space (9.1-53.3%), which is consistent with previous research, and a larger biceps femoris long head physiological cross-sectional area (PCSA) (18.1-68.6%). PCSA differences were inconsistent in the gluteus maximus (37.1-60.4%), rectus femoris (22.5-66.1%), and sartorius (1.4-33.9%). Differences less than 10% were found in acetabular joint space and femoral midshaft width. Conclusions: Able-bodied asymmetry is a limb difference greater than 10%. Larger musculoskeletal asymmetries of up to 68% were observed in individuals with amputation, denoting asymmetrical biomechanical loading and possibly compensations related to prosthesis use. Observed consistencies in asymmetry can be used in rehabilitation techniques to reduce the risk of falling and developing overuse injuries.Item Nasal morphology and health disparities in asthma: A study assessing semi-automated tools for processing computed tomography scans in 3D morphometric research(2020) Maddux, Scott D.; Kim, Suhhyun; Das, SiddharthPurpose: As the nasal complex is predominantly responsible for respiratory heat and moisture exchange, it has been suggested that abnormal nasal anatomy may increase asthmatic symptoms. Recent research has increasingly turned to medical imaging modalities, requiring processing of large samples (n>10,000). The lack of automated procedures for scan processing has represented a significant obstacle for such studies. Accordingly, the purpose of this project was to evaluate the applicability of a newly developed subroutine for the NIH-funded 3D Slicer program to semi-automate the alignment of cranial CT-scans into the Frankfort Horizontal plane for subsequent morphometric assessment as a part of a larger asthma-related study. Methods: Selected CT scans were drawn from 5,221 asthma and control cohorts from JPS hospital in Fort Worth, TX. Each scan was first processed using traditional methods for aligning the cranium into the Frankfort Horizontal plane, followed by a trial employing a new python-based alignment subroutine for "SlicerMorph" extension on 3D Slicer for comparison. Results: Overall, the subroutine showed a significant improvement in image processing times, reducing alignment time for a single scan by approximately 60%. The accuracy of alignment was found to be substantially improved due to the relative ease of locating three fiducial landmarks (left orbitale, left porion, right porion) for alignment compared to the traditional method. Conclusion: This novel subroutine allows for efficient processing of CT scans. Furthermore, we expect use of this subroutine will significantly decrease intra- and inter-observer error, increasing the accuracy of obtained morphometric data.