The present study proposes a simple and reproducible method to classify the morphology of the suprascapular notch (SSN), on the basis of specific geometrical parameters that clearly distinguish one type from another. Four hundred twenty-three dried scapulas from the Department of Anatomy in the University of Cologne, Germany, were examined. Five types of SSN were observed: type I, without a discrete notch, 35 (8.3%); type II, a notch that was longest in its transverse diameter, 177 (41.85%); type III, a notch that was longest in its vertical diameter, 177 (41.85%); type IV, a bony foramen, 31 (7.3%); type V, a notch and a bony foramen, 3 (0.7%). For the vertical diameter, we took the maximal diameter of the notch perpendicular to the imaginary line that joins the two superior corners of the notch. For the transverse diameter, we took the diameter perpendicular to the midpoint of the vertical diameter. This classification based on the vertical and the transverse diameters of the SSN suggested a clear distinction of the notch types. This simple classification included all the anatomical variations of the SSN. Using this method, the clinician will be able to define easily and quickly the notch type on a plain radiograph, and perhaps be able to correlate suprascapular nerve entrapment with a specific type of SSN.

Context: Piriform muscle syndrome can be caused by abnormal passage of the sciatic nerve or one of its parts through the belly of the piriform muscle. Objective: To analyze the anatomical and measurement relationships between the piriform muscle and the sciatic nerve in order to contribute towards better anatomoclinical understanding of the gluteal region. Method: Twenty adult cadavers of both sexes were used. The sciatic nerve and piriform muscle were dissected, measured and photodocumented. Results: The sciatic nerve was seen to be a single trunk passing through the lower margin of the piriform muscle in 85% of the 40 gluteal regions, and 15% showed bilateral variation characterized by the passage of the common fibular nerve through the piriform muscle. The data obtained did not show any statistically significant differences.

Aim of the present study was to determine the impact of the COVID-19 outbreak on anatomy teaching to medical and dental students comparing the traditional anatomy teaching with three remote teaching modalities. A cross-sectional study was conducted among undergraduate medical and dental students of the Aristotle University of Thessaloniki. Four hundred and twenty students who attended anatomy classes during COVID-19 outbreak in Greece, were asked to fill in a questionnaire of 22 questions evaluating the formats of the different courses provided. Each student was asked to complete the questionnaire anonymously via the Google Forms ® platform. A total of 200 students participated. During the lockdown, 59.5% of students attended all online anatomy lectures compared to 44.5% in the pre-pandemic year. Overall, the higher percentage of 73.5% was satisfied with the traditional anatomy teaching, instead of 56% which were satisfied with the effectiveness of online anatomy lectures. Asking whether any remote educational method can partially or completely replace the traditional anatomy teaching, the majority of students replied "no" for all the three remote modalities. The traditional anatomy teaching remains the most preferred and effective teaching modality. The students ranked online anatomy lectures and pre-recorded anatomy lectures in second place in terms of effectiveness and preference. The development of remote learning methods has increased students' active participation in anatomy lessons, but significantly negatively affected the students' performance at exams. Remote learning cannot replace the traditional anatomy teaching method, but online lectures could be incorporated into anatomy curricula as an additional tool.

Several congenital anomalies regarding the right (RVA) and left (LVA) vertebral artery have been described. The current paper aims to perform a systematic literature review of the variable vertebral artery (VA) origin from the aortic arch (AOA) and its branches. The incidence of these variants and the ensuing AOA branching pattern are highlighted. Atypical origin cases were found more commonly unilaterally, while LVA presented the majority of the aberrancies. The LVA emersion from the AOA (3.6%) and the RVA from the right common carotid artery (RCCA) (0.14%) were the commonest origin variations. Aberrant RVA origin as last branch of the AOA is very rare. Eighteen cases (0.12%) with an aberrant right subclavian artery (ARSCA) were found. Among them, the RVA originated from the RCCA and right subclavian artery in 94.4 and 5.6%, respectively. Sporadic cases had an AOA origin bilaterally; RVA and LVA had a double origin in 0.027 and 0.11%, respectively. A dual origin was detected in 0.0069%, bilaterally. The atypical VA origin may coexist with: (i) an ARSCA, (ii) a common origin of brachiocephalic artery and left common carotid artery (the misnomer bovine arch) and (iii) a bicarotid trunk. The aberrant VA origin favors hemodynamic alterations, predisposing to cerebrovascular disorders and intracranial aneurysm formation. Detailed information of VA variants is crucial for both endovascular interventionists and diagnostic radiologists involved in the treatment of patients with cerebrovascular disease. Such information may prove useful to minimize the risk of VA injury in several procedures.

Purpose The present study aimed at summarizing and presenting the anomalous muscles that a surgeon might encounter during axillary lymphadenectomy (AL). Methods For this purpose, both the anatomical and surgical literature was reviewed and an anatomical study on 107 cadavers was carried out. Furthermore, based on the anatomical features of the anomalous muscles that came up during our study and taking into consideration the landmarks of the AL, we further analyzed the complications that may arise from each of these muscles, along with their preoperative and intraoperative recognition and management. Results The literature review revealed that there are three supernumerary muscles that may affect the AL, namely the Langer's axillary arch, the pectoralis quartus and the chondroepitrochlearis muscles, as well as the aplasia of the lower part of the pectoralis major muscle. Eight out of the 107 (7.48%) cadavers that we dissected had such an abnormal muscle in the axilla. Specifically, the axillary arch was found unilaterally in five cadavers (4.67%) and the pectoralis quartus muscle was present unilaterally in three cadavers (2.8%). One cadaver had both an axillary arch and a pectoralis quartus muscle in the right side. The abdominal and almost the whole sternocostal portion of the pectoralis major as well the pectoralis minor muscle were absent in one cadaver (0.93%). The chondroepitrochlearis muscle was not found in any of the cadavers that we dissected. Conclusions The present study offers the necessary preoperative knowledge for recognizing these muscles during AL, avoiding thus the complications that may arise from them.