نتائج البحث - "Stephen W. Carmichael"

الوصف: Hilton's Law, put forth 150 years ago, is well known and frequently taught in anatomy courses. We critically analyzed the complex description of associated muscular, cutaneous, and articular innervations in order to assess the general applicability of Hilton's Law. We applied rules for interpretation of the Law extrapolated upon but based on Hilton's original writings, and excluded obscure supplementary clauses not considered as part of the Law. We found the Law, as originally written and as we interpreted with some latitude, to be reliable and applicable to all cranial and peripheral nerves. Hilton's Law is a powerful springboard to understand articular anatomy and pathophysiology.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::0d759609d2426b43a905b17ea409993d
https://doi.org/10.1002/ca.22348

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6

The tangled web of Langer's lines

المؤلفون: Stephen W. Carmichael

المصدر: Clinical Anatomy. 27:162-168

مصطلحات موضوعية: Surgical results, medicine.medical_specialty, Histology, integumentary system, business.industry, Langer's lines, General Medicine, Surgery, Plastic surgery, Tension lines, Aesthetics, Medicine, Anatomy, business

الوصف: Langer's lines are often considered to be guides for elective surgical incisions. Interestingly, Karl Langer was not the first to describe the property of skin that leads to the lines he depicted, nor are these lines in common use today. Rather, it is common that relaxed skin tension lines provide a guide for cosmetically pleasing surgical results. Nevertheless, Langer did conduct extensive studies on human skin that remain as a scholarly body of work.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::1b840774b38c75d9b8218a9f5fac6787
https://doi.org/10.1002/ca.22278

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7

Cross-over: A generalizable phenomenon necessary for secondary intraneural ganglion cyst formation

المؤلفون: Stephen W. Carmichael, Kimberly K. Amrami, Huan Wang, Michel Kliot, Robert J. Spinner

المصدر: Clinical Anatomy. 21:111-118

الوصف: The appearances of intraneural ganglion cysts are being elucidated. We previously introduced the cross-over phenomenon to explain how a fibular (peroneal) or tibial intraneural ganglion cyst arising from the superior tibiofibular joint could give rise to multiple cysts: cyst fluid ascending up the primarily affected nerve could reach the level of the sciatic nerve, fill its common epineurial sheath and spread circumferentially (cross over), at which time pressure fluxes could result in further ascent up the sciatic or descent down the same parent nerve or the opposite, previously unaffected fibular or tibial nerves. In this study, we hypothesized that cross-over could occur in other nerves, potentially leading to the formation of more than one intraneural ganglion cyst in such situations. We analyzed the literature and identified a single case that we could review where proximal extension of an intraneural ganglion cyst involving a nerve at a different site could theoretically undergo cross-over in another major nerve large enough for available magnetic resonance images to resolve this finding. A case of a suprascapular intraneural ganglion cyst previously reported by our group that arose from the glenohumeral joint and extended to the neck was reanalyzed for the presence or absence of cross-over. An injection of dye into the outer epineurium of the suprascapular nerve in a fresh cadaveric specimen was performed to test for cross-over experimentally. Retrospective review of this case of suprascapular intraneural ganglion cyst demonstrated evidence to support previously unrecognized cross-over at the level of the upper trunk, with predominant ascent up the C5 and the C6 nerve roots and subtle descent down the anterior and posterior divisions of the upper trunk as well as the proximal portion of the suprascapular nerve. This appearance gave rise to multiple interconnected intraneural ganglion cysts arising from a single distant connection to the glenohumeral joint. The injection study also demonstrated the cross-over phenomenon and produced a similar pattern as the cyst dissection. This article illustrates that cross-over can occur in another nerve (apart from the prototype fibular nerve). Furthermore, understanding the more complex anatomic nature of the upper trunk cross-over model provides insight into important mechanistic information regarding the bidirectional propagation patterns and formation of primary and secondary intraneural ganglion cysts not afforded by the previously described sciatic nerve cross-over model.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b7c8c47d2053192110df01081d079d9d
https://doi.org/10.1002/ca.20590

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8

Peroneal and tibial intraneural ganglia: correlation between intraepineurial compartments observed on magnetic resonance images and the potential importance of these compartments

المؤلفون: Stephen W. Carmichael, Kimberly K. Amrami, Diana Angius, Huan Wang, Robert J. Spinner

المصدر: Neurosurgical Focus. 22:1-10

مصطلحات موضوعية: Pathology, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Radiography, Superior tibiofibular joint, Magnetic resonance imaging, General Medicine, Anatomy, Knee region, Ganglion, medicine.anatomical_structure, Epineurium, medicine, Surgery, Neurology (clinical), Sciatic nerve, business, Tibial nerve

الوصف: Object Previously the authors demonstrated that peroneal and tibial intraneural ganglia arising from the superior tibiofibular joint may occasionally extend proximally within the epineurium to reach the sciatic nerve. The dynamic nature of these cysts, dependent on intraarticular pressures, may give rise to differing clinical and imaging presentations that have remained unexplained until now. To identify the pathogenesis of these unusual cysts and to correlate their atypical magnetic resonance (MR) imaging appearance, the authors retrospectively reviewed their own experience as well as the published literature on these types of intraneural ganglia. Methods A careful review of MR images obtained in 22 patients with intraneural ganglia located about the knee region (18 peroneal and four tibial intraneural ganglia) allowed the authors to substantiate three different patterns: outer (epifascicular) epineurial (20 cases); inner (interfascicular) epineurial (one case); and combined outer and inner epineurial (one case). In these cases serial MR images allowed the investigators to track the movement of the cyst within the same layer of the epineurium. All lesions had connections to the superior tibiofibular joint. Nine patients were identified as having lesions with sciatic nerve extension. Seven patients harboring an outer epineurial cyst (six in whom the cyst involved the peroneal nerve and one in whom it involved the tibial nerve) had signs of sciatic nerve cross-over, with the cyst seen in the sciatic nerve and/or other terminal branches. In only two of these cases had the cyst previously been recognized to have sciatic nerve involvement. In contrast, in one case an inner epineurial cyst involving the tibial nerve ascended within the tibial division of the sciatic nerve and did not cross over. A single patient had a combination of both outer and inner epineurial cysts; these were easily distinguished by their distinctive imaging patterns. Conclusions This anatomical compartmentalization of intraneural cysts can be used to explain varied clinical and imaging patterns of cleavage planes for cyst formation and propagation. Compartmentalization elucidates the mechanism for cases of outer epineurial cysts in which there are primary ascent, sciatic cross-over, and descent of the lesion down terminal branches; correlates these cysts' atypical MR imaging features; and contrasts a different pattern of inner epineurial cysts in which ascent and descent occur without cross-over. The authors present data demonstrating that the dynamic phases of these intraneural ganglia frequently involve the sciatic nerve. Their imaging features are subtle and serve to explain the underrecognition and underreporting of the longitudinal extension of these cysts. Importantly, cysts extending to the sciatic nerve are still derived from the superior tibiofibular joint. Combined with the authors' previous experimental data, the current observations help the reader understand intraneural ganglia with a different, deeper degree of anatomical detail.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::9db771a1c2140a27f08260bc315f5080
https://doi.org/10.3171/foc.2007.22.6.18

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Anatomic compartments of the foot: A 3-Tesla magnetic resonance imaging study

المؤلفون: Norman S. Turner, J. Michael Alcorn, Stephen W. Carmichael, David W. Stanley, John S. Reach, Joel P. Felmlee, Kimberly K. Amrami

المصدر: Clinical Anatomy. 20:201-208

مصطلحات موضوعية: Male, 3 Tesla Magnetic Resonance Imaging, Histology, medicine.diagnostic_test, Foot, business.industry, Interossei, Magnetic resonance imaging, General Medicine, Anatomy, Compartment Syndromes, Magnetic Resonance Imaging, medicine.anatomical_structure, Healthy volunteers, medicine, Humans, Female, Ankle, business, Foot (unit)

الوصف: There is neither consensus on the number nor agreement on the location of the anatomic compartments of the foot. This project utilized high-resolution magnetic resonance imaging (MRI) to identify foot compartments. The purpose of this study was to devise a new system using 3-Tesla (3T) MRI that assessed the number and location of these compartments. Six feet from healthy volunteers were imaged. From these, 10 compartments were described: (1) medial, (2) calcaneal, (3) lateral, (4) central superficial, (5) central deep (adductor), (6–9) interossei, and (10) skin. The 3T MRI and foot/ankle coil allowed us to assess the number and location of foot compartments. Clin. Anat. 20:201–208, 2007. © 2006 Wiley-Liss, Inc.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::228903ee9f6257905319fc4ee3053411
https://doi.org/10.1002/ca.20381

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10

Case Reports: Transsciatic Foramen Pedicle VRAM Coverage of Gluteal Defects

المؤلفون: Nho V. Tran, Franklin H. Sim, David G. Lewallen, Stephen W Carmichael

المصدر: Clinical Orthopaedics and Related Research. 452:270-273

مصطلحات موضوعية: medicine.medical_specialty, business.industry, General Medicine, Thigh, musculoskeletal system, Surgery, body regions, medicine.anatomical_structure, Muscle dysfunction, Orthopedic surgery, medicine, Foramen, Orthopedics and Sports Medicine, Gluteus maximus muscle, Surgical Flaps, Gluteal muscles, business, Rectus abdominis muscle

الوصف: Tumors of the gluteal region are rare. Defects from resection often can be closed primarily. Some patients require local flaps such as a gluteus maximus V-Y advancement flap. Such flaps typically result in some muscle dysfunction. In addition, the use of local irradiated tissue may lead to wound complications and prolonged hospitalization. Avoiding local radiated tissue, such as the gluteal muscles, can be beneficial. We report our experience using a novel route by passage through the transsciatic foramen to transpose a pedicle vertical rectus abdominis myocutaneous flap. This regional option avoids gluteal muscle dysfunction and potential wound complication from irradiated tissue.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::8331ca5d3169f985ebaa185a4b32d441
https://doi.org/10.1097/01.blo.0000229303.59771.6d

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