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Concept: Anatomical terms of location

177

The lambeosaurine Tsintaosaurus spinorhinus has traditionally been reconstructed with an elevated, hollow, spike-like crest composed entirely of the nasal bones, although this has been disputed. Here, we provide a new reconstruction of the skull of this species based on reexamination and reinterpretation of the morphology and articular relationships of the type and Paratype skulls and a fragmentary crest. We confirm the presence of a supracranial crest composed of the elevated nasal bones, but also including the premaxillae. We hypothesize that the crest is a tall, lobate, hollow structure that projects dorsally and slightly caudally a distance greater than the height of the skull along the quadrate. In our reconstruction, the nasal passage passes through the crest, but enters the skull rostral to the tubular process of the nasals, not through it. Tsintaosaurus spinorhinus is rediagnosed on the basis of a suite of cranial autapomorphies including a circumnarial fossa subdivided into three accessory fossae, prefrontal with ascending rostral process and lateral flange, nasals fused sagittally to form elongate tubular process that rises dorsally from skull roof, each nasal being expanded rostrocaudally into a rhomboid distal process, and medial processes of premaxillae at the summit of the cranial crest inserted between rhomboid processes of nasals. Tsintaosaurus spinorhinus lacks characters that are present in more derived lambeosaurines (parasaurolophins and lambeosaurins), such as rotation of the caudal margin of the crest to an acute angle with the skull roof, lateral processes of the nasals that enclose part of the intracranial cavity and participate in the formation of the walls of the common median chamber, and a smooth narial fossa lacking ridges and accessory fossae. We hypothesize that ancestrally the rostrum of lambeosaurines may have been more similar to that in Saurolophinae, and became subsequently reduced in complexity during evolution of the group.

Concepts: Snake scales, Skull, Anatomy, Anatomical terms of location, Occipital bone, Animal anatomy, Skull and Bones, Vomer

168

This paper emphasizes the anatomical substrate of several foot conditions that are seldom discussed in this context. These include the insertional and non-insertional Achilles tendinopathies, plantar fasciopathy, inferior and posterior heel spurs, foot compartment syndromes, intermetatarsal bursitis and Morton’s neuroma. It is a rather superficial anatomical review of an organ that remains largely neglected by rheumatologists. It is our hope that the cases discussed and the cross examination by instructors and participants will stimulate study of the foot and the attention it deserves.

Concepts: Medicine, Biology, Foot, Anatomy, Human anatomy, Anatomical terms of location, Morton's neuroma, Neuroma

93

Shoulder pathologies of the rotator cuff of the shoulder are common in clinical practice. The focus of this pictorial essay is to discuss the anatomical details of the rotator interval of the shoulder, correlate the anatomy with normal ultrasound images and present selected pathologies. We focus on the imaging of the rotator interval that is actually the anterosuperior aspect of the glenohumeral joint capsule that is reinforced externally by the coracohumeral ligament, internally by the superior glenohumeral ligament and capsular fibers which blend together and insert medially and laterally to the bicipital groove. In this article we demonstrate the capability of high-resolution musculoskeletal ultrasound to visualize the detailed anatomy of the rotator interval. MSUS has a higher spatial resolution than other imaging techniques and the ability to examine these structures dynamically and to utilize the probe for precise anatomic localization of the patient’s pain by sono-palpation.

Concepts: Biology, Anatomy, Medical school, Human anatomy, Anatomical terms of location, Shoulder, Rotator cuff, Glenohumeral joint

53

The head and anterior trunk region of most actinopterygian fishes is stiffened as, uniquely within vertebrates, the pectoral girdles have a direct and often strong connection through the posttemporal to the posterior region of the skull. Members of the mesopelagic fish family Stomiidae have their pectoral girdle separated from the skull. This connection is lost in several teleost groups, but the stomiids have an additional evolutionary novelty-a flexible connection between the occiput and the first vertebra, where only the notochord persists. Several studies suggested that stomiids engulf significantly large prey items and conjectured about the functional role of the anterior part of the vertebral column; however, there has been no precise anatomical description of this complex. Here we describe a unique configuration comprising the occiput and the notochordal sheath in Aristostomias, Eustomias, Malacosteus, Pachystomias, and Photostomias that represents a true functional head joint in teleosts and discuss its potential phylogenetic implications. In these genera, the chordal sheath is folded inward ventrally beneath its connection to the basioccipital and embraces the occipital condyle when in a resting position. In the resting position (wherein the head is not manipulatively elevated), this condyle is completely embraced by the ventral fold of the notochord. A manual manipulative elevation of the head in cleared and stained specimens unfolds the ventral sheath of the notochord. As a consequence, the cranium can be pulled up and back significantly farther than in all other teleost taxa that lack such a functional head joint and thereby can reach mouth gapes up to 120°.

Concepts: Vertebral column, Skull, Vertebra, Vertebrate, Anatomical terms of location, Chordate, Actinopterygii, Tetrapod

28

In 1879, the French surgeon Segond described the existence of a ‘pearly, resistant, fibrous band’ at the anterolateral aspect of the human knee, attached to the eponymous Segond fracture. To date, the enigma surrounding this anatomical structure is reflected in confusing names such as ‘(mid-third) lateral capsular ligament’, ‘capsulo-osseous layer of the iliotibial band’ or ‘anterolateral ligament’, and no clear anatomical description has yet been provided. In this study, the presence and characteristics of Segond’s ‘pearly band’, hereafter termed anterolateral ligament (ALL), was investigated in 41 unpaired, human cadaveric knees. The femoral and tibial attachment of the ALL, its course and its relationship with nearby anatomical structures were studied both qualitatively and quantitatively. In all but one of 41 cadaveric knees (97%), the ALL was found as a well-defined ligamentous structure, clearly distinguishable from the anterolateral joint capsule. The origin of the ALL was situated at the prominence of the lateral femoral epicondyle, slightly anterior to the origin of the lateral collateral ligament, although connecting fibers between the two structures were observed. The ALL showed an oblique course to the anterolateral aspect of the proximal tibia, with firm attachments to the lateral meniscus, thus enveloping the inferior lateral geniculate artery and vein. Its insertion on the anterolateral tibia was grossly located midway between Gerdy’s tubercle and the tip of the fibular head, definitely separate from the iliotibial band (ITB). The ALL was found to be a distinct ligamentous structure at the anterolateral aspect of the human knee with consistent origin and insertion site features. By providing a detailed anatomical characterization of the ALL, this study clarifies the long-standing enigma surrounding the existence of a ligamentous structure connecting the femur with the anterolateral tibia. Given its structure and anatomic location, the ALL is hypothesized to control internal tibial rotation and thus to affect the pivot shift phenomenon, although further studies are needed to investigate its biomechanical function.

Concepts: Knee, Anterior cruciate ligament, Joint, Anatomy, Human anatomy, Anatomical terms of location, Tibia, Lateral meniscus

28

: The anatomy of the facial nerve and its branches has been well documented. The course of the extratemporal facial nerve, its anatomical planes, and the surface landmarks of the temporal division and marginal mandibular division are well known. However, the surface landmark of the middle division of the facial nerve has not been studied to date.

Concepts: Cranial nerves, Anatomy, Anatomical terms of location, Superficial anatomy

28

Many neurons in the central auditory pathway, from the inferior colliculus (IC) to the auditory cortex (AC), respond less strongly to a commonly occurring stimulus than one that rarely occurs. The origin of this phenomenon, called stimulus-specific adaptation (SSA), remains uncertain. The AC sends descending projections to the IC that terminate most densely upon the dorsal, lateral and rostral IC cortices - areas where strong SSA has been reported. To investigate whether SSA in the IC is dependent upon the AC for its generation, we recorded the response from single IC neurons to stimuli presented in an oddball paradigm before, during and after reversibly deactivating the ipsilateral AC with a cryoloop. While changes in the basic response properties of the IC neurons were widespread (89%), changes in SSA sensitivity were less common; approximately half of the neurons recorded showed a significant change in SSA, while the other half remained unchanged. Changes in SSA could be in either direction: 18% enhanced their SSA sensitivity, while 34% showed reduced SSA sensitivity. For the majority of this latter group, cortical deactivation reduced, but did not eliminate, significant SSA levels. Only eight neurons seemed to inherit SSA from the AC, as their pre-existing significant level of SSA became non-significant during cortical deactivation. Thus, the presence of SSA in the IC is generally not dependent upon the corticocollicular projection, suggesting the AC is not essential for the generation of subcortical SSA; however, the AC may play a role in the modulation of subcortical SSA.

Concepts: Brain, Cerebral cortex, Auditory system, Anatomical terms of location, Thalamus, Superior colliculus, Projection, Inferior colliculus

28

PURPOSE: Ideally, a classification should have some prognostic value, and should therefore include precise information upon extent and location of the Achilles tendon disorders. We propose a new imaging and anatomical system to classify Achilles tendon disorders at imaging using US and MRI. APPROACH: We consider the non-insertional region as the tendon mid-portion, and distinguish the insertional component into a pre-insertion site, located about two centimetres above the calcaneum, and a calcaneal insertion, where the tendon is attached to the bone. On sagittal scans, we introduced a new classification which considers two main portions: “musculotendinous” and “insertional”. In the context of the muscolotendinous portion, it is possible to find muscle fibres proximally, and the free tendon distally. This latter is made up of proximal, middle and distal portions. We also propose a 5 grade Doppler classification system to quantify blood flow, in which Grades I and II are respectively characterised by the presence of one and two vessels within the tendon; in Grades III, IV and V, the neovascularisation respectively involves less than 50 %, from 50 to 90 %, and more than 90 % of the tendon tissue. These proposed systems will require validation and possible modification to be applied to different tendons.

Concepts: Muscle, Anatomy, Anatomical terms of location, Tendon, Achilles tendon, Calcaneus

27

We describe a new computer reconstruction to obtain complete anatomical information of the ecto- and endocranium from the imperfectly preserved skull of the Neanderthal Amud 1.

Concepts: Skull, Anatomical terms of location, Occipital bone, Skull roof, Animal anatomy, Craniometry

27

Adolescent idiopathic scoliosis (AIS) affects up to 3% of the population. It can be stratified by curve type according to the Lenke classification. This classification system incorporates curve magnitude, flexibility, the lumbar modifier, and the sagittal plane. The Lenke classification serves as a guide for selection of levels for surgical treatment of AIS. Surgical treatment of AIS includes anterior and posterior approaches; most AIS is treated through a posterior approach. Surgical goals include maximizing correction in the coronal, sagittal, and axial planes.

Concepts: Scoliosis, Anatomy, Anatomical terms of location, Coronal plane, Sagittal plane