Muscle injury frequently occurs in the medial head of the gastrocnemius (MG), and stretching is used for treatment. However, there are no studies based on anatomical considerations and biomechanics. This study therefore examined the macroscopic anatomical structure of the triceps surae muscle to design an effective and selective MG stretching method, before quantitatively verifying that method by ultrasonography. The macroscopic anatomy was analyzed in 16 Japanese cadavers (25 legs). Based on the anatomical findings and the arrangement of fascicles in the MG, we concluded that ankle inversion might be advantageous for selective stretching of the tendon fiber bundles into which the MG inserts. We devised a method in which the limb was initially positioned with the knee joint in extension and the ankle joint in plantar flexion. Then, the ankle was dorsiflexed and inverted. The proposed method was compared with standard stretching and verified by ultrasonography in eight healthy adult males. This method effectively and selectively stretched the MG, producing a significantly decreased pennation angle and increased muscle fiber length. This method may be beneficial for preventing future injuries and may enhance the effect of therapy on the MG.
Many authors have studied variation in the maxillary artery but there have been inconsistencies between reported observations. The present research aimed to examine the courses and branching patterns of the trunk and branches of the maxillary artery in a large sample of Japanese adult cadavers. The course of the maxillary artery should be reclassified into seven groups as a clear relationship was found between the origin of the middle meningeal artery and the course of the maxillary artery. This indicates that conventional theory about the formation of the maxillary artery, which was considered to be a direct derivative of the stapedial artery, might be inaccurate. Many variations in the origin of the inferior alveolar artery were found. Notably, the inferior alveolar artery origin from the external carotid artery and a double origin of the inferior alveolar artery was also observed. Thus, the maxillary artery might be derived from a combination of both the external carotid and stapedial arteries.
Coronary arteries are frequently covered by cardiac muscles. This arrangement is termed a myocardial bridge. Previous studies have shown that myocardial bridges can cause myocardial ischemic diseases or cardiac arrhythmia, but the relevant pathogenic mechanisms remain unknown. We examined 60 hearts from Japanese cadavers macroscopically to clarify the spatial relationships among coronary arteries, cardiac veins and autonomic nerves. We found 86 myocardial bridges in 47 hearts from the 60 cadavers examined (78.3%). Next, we dissected out nine hearts with myocardial bridges in detail under the operating microscope. We found no additional branches of coronary arteries on the myocardial bridge surfaces. However, the cardiac veins, which usually accompany the coronary arteries, ran independently on the myocardial bridge surfaces in the same region. Cardiac autonomic nerves comprised two rami: one was associated with the coronary artery under the myocardial bridge and the other ran on the surface of the bridge. Such spatial relationships among the coronary arteries, cardiac veins and cardiac autonomic nerves at the myocardial bridges are quite similar to those in mouse embryo hearts.
An accessory soleus muscle was found in the right leg of a cadaver in the dissecting room. This anomalous muscle was situated medially between the distal part of the tibia and the tendo calcaneus. The muscle arose from the anterior aponeurosis of the soleus muscle and was attached with a separate tendon to the calcaneus anteromedial to the tendo calcaneus. The soleus muscle was supplied by two nerves from the tibial nerve. The ramus posterior entered its posterior surface near the proximal border, and the ramus anterior entered the bipenniform part which was located on the anterior aspect of the soleus. One of branches from the r. anterior descended on the surface of the medial half of the bipenniform part and gave off a few twigs for this muscle part. Finally, its terminal entered the accessory soleus muscle and ramified in this muscle. In a teased preparation of the tibial nerve, both the nerve fibres composing this branch to the anomalous muscle and those constituting the r. anterior proper which supplied the bipenniform part were contained in the same funiculus. This mode of nerve supply to the soleus and the accessory soleus muscle suggested that this anomalous muscle derived from the part of the proper soleus muscle supplied by the r. anterior.
The formation and distribution of the sural nerve are presented on the basis of an investigation of 31 legs of Japanese cadavers using nerve fascicle and fiber analyses. Nerve fibers constituting the medial sural cutaneous nerve were designated as 'T', whereas those constituting the peroneal communicating branch were designated as 'F'. In 74.2% of cases (23/31), the T and F fibers joined each other in the leg, whereas in 9.7% of cases (3/31) they descended separately. In 16.1% of cases (5/31), the sural nerve was formed of only the T fibers. The sural nerve gave off lateral calcaneal branches and medial and lateral branches at the ankle. The lateral calcaneal branches always contained T fibers. The medial branches consisted of only T fibers, whereas most of the lateral branches consisted of only F fibers (71.0%; 22/31). In addition to the T and F fibers, P fibers, which derived from the superficial and deep peroneal nerves, formed the dorsal digital nerves. The P fibers were entirely supplied to the medial four and one-half toes. However, they were gradually replaced by the T and F fibers in the lateral direction. The 10th proper dorsal digital nerve consisted of T fibers only (38.7%; 12/31), of F fibers only (19.4%; 6/31) or of both T and F fibers (38.7%; 12/31). These findings suggest that the T fibers are essential nerve components for the skin and deep structures of the ankle and heel rather than the skin of the lateral side of the fifth toe. The designation of the medial sural cutaneous nerve should be avoided and only the T fibers are appropriate components for naming as the sural nerve.
Two livers with an aberrant course of the left gastric vein were found in 245 Japanese cadavers. The left gastric vein collects branches from the lesser curvature of the stomach, enters the left side of the hepatogastric ligament from the cardiac region and runs towards the left side of hepatic hilus.The vein enters the liver at the left side and joins an intrahepatic branch ramified from the portal vein.
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