The temporoparietal, parieto-occipital flaps or the forehead flaps that are used in reconstructive surgery are prepared on the superficial temporal artery (STA) and its branches. For a successful surgery and a suitable flap design, adequate anatomical knowledge is needed. In our study, the red colored latex solution was injected into the external carotid artery; the STA and its branches were dissected in 27 specimens. The mean diameter of the STA at the zygomatic arch was determined as 2.73+/-0.51 mm. The diameters of the frontal branch were bigger than those of the parietal branch in 15 samples out of 27. The diameters of both the frontal and parietal branches were equal in four samples. The diameter of the parietal branch was bigger than that of the frontal branch in eight samples. In 20 samples out of 27 (74.07%), the bifurcation point of the STA was above the arch. In six samples (22.22%), the STA bifurcated directly over the arch. In only one sample (3.70%), bifurcation was not observed and the STA continued only as a frontal branch (absence of the parietal branch). The absence of the frontal branch was not encountered. In one sample (3.70%), double parietal branches were observed. In six samples out of 27 (22.22%), zygomatico-orbital artery was not encountered. In 21 samples (77.77%), zygomatico-orbital arteries ran towards the face, parallel to zygomatic arch and distributed in the orbicularis oculi muscle. The transverse facial artery existed in all samples. The auricular branches running to the helix and tragus were observed in all samples. The STA was 16.68+/-0.35 mm at the front of the tragus. Some landmarks were chosen on the head and then the STA was observed where it crossed all of these landmarks. This paper confirms the well-known variability of the superficial temporal arterial branches and their relation to the pericranial region. Knowledge concerning the arterial features of the lateral forehead region is important for the aesthetic surgeon. STA and its branches have been found to be suitable for use in microvascular anastomoses. A better understanding of the midline forehead vascularity should allow modification of reconstructive techniques and reduce postoperative complications.

The use of flaps to reconstruct lip defects requires detailed knowledge of the local vasculature. New flaps for surgery around the mouth can be devised if the surgeon knows the distribution of the perioral arterial branches. Examination of the anatomy of perioral branches of the facial artery (FA) confirmed the consistent presence of septal and alar branches in the upper lip and a labiomental branch in the lower lip. Mucosal flaps from the upper lip based on the deep septal branch or the alar branch of the FA can be used to restore lower lip defects. A composite flap from the lower lip supplied by the labiomental branch of the FA can be used to restore combined defects of the upper lip and nose or partial defects of the lower lip. We studied the vascular anatomy of the perioral region in 25 cadaver dissections. Fixation was by 10% formaldehyde solution. Red latex was injected into the common carotid arteries before dissection. In the 50 specimens, the primary supplying vessels were identified and the size and distribution of the vessels were investigated. The FA was symmetrical in 17 (68%) of 25 heads. It terminated as an angular facial vessel in 11 (22%), as a nasal facial vessel in 30 (60%), as an alar vessel in six (12%), and as a superior labial vessel in two (4%) facial halves. It terminated as a hypoplastic type of FA in one (2%) facial half. The average external diameter of the superior labial artery (SLA) was 1.6 mm (min-max: 0.6-2.8 mm) at its origin. The origin of the SLA was superior to the angle of the mouth in 34 of 47 specimens (72.3%), and at the angle of the mouth in 13 of 47 specimens (27.7%). In two of the remaining three specimens, the SLA was the continuation of the FA and the other was of the hypoplastic type. The SLA supplied the columellar branches in all specimens except for the hypoplastic type (49 specimens). Columellar branches were classified according to their number and their type. In five specimens (10%) the inferior labial artery (ILA) was not found. In the other specimens, the site of origin of the ILA varied between the lower margin of the mandible and the corner of the mouth. Its external diameter measured min-max: 0.5-1.5 mm. The ILA arose from the FA above the angle of mouth in 4 specimens (8%), inferior to the angle of mouth in 11 specimens (22%), and at angle of mouth in 30 specimens (60%). We observed that the labiomental arteries, which formed anastomoses between the FA, ILA, and submental artery, showed variations in their course in the labiomental region. We suggest that knowledge of the location of arteries with respect to easily identifiable landmarks will help to avoid complications at surgery.

Anatomy is the fundamental of medical and health professional education. Anatomic dissection enables the examination of the organs in the human cadavers systematically and topographically. The aim of this study was to determine the effect of the first cadaver demonstration and the anxiety of medical, dental and pharmacy students. A questionnaire was distributed to 486 students in the same academic year (2009-2010) at Ege University. The review of anxiety reveals the circumstances such as exhaustion, stress, depression, anxiety, destructive life, deterioration of mental or physical quality or asthenia (over-fatigue), professionally having a serious effect on the students. 486 (85.3 %) students in total participated in this research carried out as based on voluntariness as 338 (93.9 %) students from the medical faculty, 78 (70.9 %) students from the faculty of dentistry and 70 (70 %) students from the faculty of pharmacy.A medium level of anxiety was detected in the students in their first encounter with the cadaver. The state anxiety score (SAS) average taken by all the students who took part in the research is 42.6 ± 5.60 and trait anxiety score average is 46.6 ± 5.0. No discrepancy was detected among the faculties with respect to anxiety score. While the SASs of the male students were higher than the girls, the trait anxiety scores of the girl students were detected to be higher than male students. While the characteristics and the cultural life of our society force the male students into stronger behavioral patterns, they may actually increase their anxiety level in distressed conditions. The fact that trait anxiety is high in both sexes, particularly in female students can be explained by the patient responsibility and the work load undertaken in the professions in the medical field as early as the period of education.Before the students' applied lessons with the cadavers start, a preparatory session must be planned for this education to decrease the anxiety level by sharing their sensations, feelings and perceptions related to the demonstration.

The vascular anatomy of the hand is a complex and challenging area and has been the subject of many studies. Knowledge of the vascular patterns and diameters of the hand gained more importance with improvements in microsurgical techniques in reconstructive hand surgery. We evaluated 50 hands (26 left, 24 right) of 26 formalin preserved cadavers to determine the superficial palmar arch, its branches and contributing vessels with special attention to the diameters. The symmetry of the types was also evaluated in detail for the first time in the literature. Measurements were made with the help of a digital caliper. The diameters of the ulnar, radial and median arteries were taken at the level of the wrist while the common palmar digital arteries, hypothenar branches and the superficial palmar branch of the radial artery were measured at their origin. Two types of superficial palmar arch were found and defined as complete (43/50 hands) and incomplete arches (7/50 hands). The complete arches were divided into four subgroups and incomplete arches into three subgroups. Most cases were found at the complete AI group (17 hands). Comparison of the arterial diameters showed the ulnar artery was the dominant vessel of the palm. The diameters of the common palmar digital arteries were not different with regard to complete or incomplete arches and between both sides. It looks safe to sacrifice one of the radial or ulnar arteries in some arterial interventions including radial artery cannulation, radial forearm flap and radial or ulnar artery harvesting for bypass grafting if the arch is complete. But we still recommend the noninvasive tests like modified Allen test or Doppler ultrasonography, before performing an invasive arterial intervention. We propose the radiologists to incorporate the median artery into the Doppler dynamic test in particular the existence or the absence of anastomoses between radial and ulnar arteries.

To lead a quality life, tendon repair must be performed in a trauma causing damage to the extensor tendon of the hand. The aim of this study is to study the structures that can be used as donor tendons. Fifty-four dissected adult hands were examined to study the pattern of the extensor tendons on the dorsum of the hand. The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius (EIP) tendon which inserted ulnar to the extensor digitorum (ED)-index; a single ED-index; a single ED-middle; a single ED-ring; an absent ED-little; a double extensor digiti minimi (EDM), and a single ED-ring to the little finger. The frequency of the number of tendons is as follows: a single (87.03%) EIP, a single ED-index (100%), a single (92.6%) ED-middle, a single (75.9%) ED-ring, and an absent (68.5%) or a single (24.1%) ED-little. A double (88.9%) EDM tendons were seen. The thickest type of juncturae tendinum (JT) is found primarily between the ring and little fingers (90%). Suitable excessive tendon and the thickest JT as donor tendon were found in the fourth intermetacarpal space. The present findings, especially the fourth intermetacarpal space, may explain why incisions on the dorsum of the hand should be large and performed with particular care. It is necessary to have a thorough understanding of the arrangements of the multiple extensor muscles and their junctural connections of the hand when tenoplasty or tendon transfer is required.

In many diseases of foot, such as the talocalcaneal artritis and coalition, intraarticular fractures and congenital dysmorphology, flatfood, valgus deformities, the size and shape of the bones, the relationships of the talus and calcaneus with each other and other bones of the foot must be considered for the internal and external fixation and surgical procedures. Type B calcaneus was defined as the most comman type in Turkish race and these results correlate with the ones which were performed on bones of American, Indian and African people, and it was uncorrelated with the results of the researches performed in Europe.

Ideal reconstruction of scalp defects relies on a comprehensive understanding of scalp anatomy and detailed information of patient factors. The classification of the hairline and measured forehead reference lengths will be beneficial in the correction of wide foreheads. There were significant gender differences in the esthetic rankings of the hairline contour. Compared to women, both of the measured average forehead reference lengths displayed a significantly greater value in men. Our results clearly showed that sex difference affected the predominance of the contour type. The M shape was the most common, and the triangular type was poorly classified in men, whereas the rectangular hairline was the most common type among women.

Background Lip augmentation and changing contour lines have become more popular ways of improving the appearance. However, validated measures of lip fullness for quantification of outcomes are needed; ethnic background and personal goals can optimise outcomes while tailoring lip enhancement treatment to each individual's anatomy. The aim of this study is to analyse the morphological features of the lip in detail and to clarify the objective parameters in related with the subjective ones regarding the lip augmentation and lip reconstruction. Methods Standard photographs of the lips of 200 young Anatolian adults were calculated with linear and angular components. The features of the lower third of the face were analysed with the software program. Linear analyses (heights of the upper lip, the upper vermilion, the lower lip height, the lower vermillion and the chin height) and angular analyses (the upper lip, the lower lip, the apex and Cupid's bow angles) were measured as reference points. The lip shape was classified into five groups: thin, very thin, medium, full and very full. Results The lower third of the face was divided into three segments (Sn-Sto, Sm-Me and Sto-Sm), and the largest portion of the lower face was occupied by the chin and the smallest by the lower lip height in both genders. The upper vermilion height was 8.07 ± 1.8 mm in males and 7.08 ± 1.5 mm in females. The lower vermilion height was 10.1 ± 2.4 mm in males and 9.7 ± 1.9 mm in females. The upper lip angle was calculated as 30.3 ± 9.6°in males and 24.2 ± 6.2°mm in females. The lower lip angle was calculated as 38.3 ± 9.7°in males and 36.5 ± 6.4°in females. Meanwhile, the angular measurements of Cupid's bow (i.e., the apex and the central angle of Cupid's bow) were smaller in men than in women. When the lip was analyzed, the medium and full types in upper and lower lips accounted for substantial fractions in men, whereas medium and thin types were predominant also in women. Conclusions With the help of certain software, this research has made possible to define the best cosmetical redesign solution of lip construction and augmentation with a natural appearance for the patient. Level of Evidence: Level III, diagnostic study.