Anatomical variations include the absence of a muscle or tendon or its presence as an accessory muscle or tendon. Clinically, anatomic variations play an important role in diagnosis and theraphy. In anatomy dissection laboratory, during routine dissection for educational purposes, a 83 -year- old male cadaver was dissected and a two-headed accessory muscle was observed on the plantar surface of the left foot. The medial and lateral heads of the muscle were observed close to the medial and lateral plantar neurovascular bundles. The accessory muscle was pierced by the tendon of the flexor digitorum longus muscle and both muscles were inserted to the distal phalanx of the fifth toe. The variations of the accessory muscles should be taken into consideration in surgical interventions, since, they may change the course of the intervention or as in the case of abductor hallucis muscle, they may be used in reconstructive procedures as grafts. Therefore, it is crucial for surgeons, orthopedic physicians, and anatomists to have a detailed knowledge of the intrinsic muscles of the foot.

Forty-five mandibles (90 cases) used in education at the Anatomy Departments of Bezmialem Vakif University, Hitit University and Marmara University Faculty of Medicine were examined macroscopically and the incidence of mylohyoid bridge was investigated. In some cases, the proximal part of the mylohyoid groove (sulcus mylohyoideus) may appear as a canal through a bony bridge (mylohyoid arc = mylohyoid bridge). Knowledge the frequency of mylohyoid bridge variations will contribute to the literature studies on this subject and will guide the practice of oral surgery and dentistry. Investigating anatomical variations, as well as collecting anthropometric data, is important to draw attention to clinical practices and guide clinicians.

ABS TRACT Objective: To investigate the impact of morphometric characteristics of neural foramen (NF) and intervertebral disc (ID) on magnetic resonance imaging (MRI) to the treatment outcomes after transforaminal epidural steroid injection (TFESI).Few clinical and radiological features are suggested predicting treatment success after epidural steroid injection.However, the impact of morphometric characteristics of the relevant NF to the response to TFESI is unknown.Material and Methods: This study was carried out prospectively with the participation of 45 patients who were treated with single level TFESI to L5 nerve root.Pain intensity, disability, and depression levels were assessed at baseline, 3rd week and 3rd month.The morphometrics of the relevant NF and ID were evaluated on sagittal MRI scans and compared between patients who responded and did not respond to the treatment.Results: The interrater reliability of all morphometric measurements of NF and ID performed by 2 physicians were high or excellent.Pain, depression, and disability scores were improved significantly at 3rd month compared to baseline.No statistically significant difference was found between responders and non-responders regarding morphometric evaluation (p>0.05).Conclusion: The results of the present study indicate that MRI based morphometric parameters like disc height, pedicle length, minimum and maximum foraminal width, foraminal crosssectional area (CSA), and nerve root CSA have no effect on the efficacy of TFESI.

Objective: Hypermobility is the excessive range of motion of joints, and related to various musculoskeletal and extra-articular problems that may significantly impair quality of life (QoL) by causing pain. The aim of the study is to examine the prevalence of hypermobility in young adults, and its relationship with pain in various regions of body and QoL. Methods: Two hundred and twenty five volunteers, aged between 17 and 23, were classified as subjects-with-hypermobility or subjects-without-hypermobility according to the Beighton Criteria. Chronic pain was identified by using Nordic Pain Questionnaire, QoL was identified by Short Form-36 (SF-36) Questionnaire. Pain presence in 9 body regions and SF-36 scores were compared between groups using chi-square test and Independent Samples T-test, respectively. Results: Of the participants, 164 (64%) were female, 91 (36%) were male, 119 (46.7%) had hypermobility. Upper back was the body region with the highest pain prevalence where 79% of hypermobile and 74% of non-hypermobile subjects reported pain at least once in past 12 months. Pain prevalence in body regions did not differ between groups (p>0.05). In terms of QoL, physical and mental component scores of SF-36, as well as all subgroup scores except social function were significantly lower in hypermobile subjects (p<0.05). Conclusion: Pain prevalence in different body regions did not differ between subjects with and without hypermobility whereas the QoL was significantly impaired in hypermobile subjects. Hypermobility is a substantial anatomical finding in young adults that should not be disregarded. Education, emotional support and encouraging about strengthening and proprioception exercises may contribute to their quality of life.

Objective:Hypermobility is the excessive range of motion of joints, and related to various musculoskeletal and extra-articular problems that may significantly impair quality of life (QoL) by causing pain. The aim of the study is to examine the prevalence of hypermobility in young adults, and its relationship with pain in various regions of body and QoL.Methods:Two hundred and twenty five volunteers, aged between 17 and 23, were classified as subjects-with-hypermobility or subjects-without-hypermobility according to the Beighton Criteria. Chronic pain was identified by using Nordic Pain Questionnaire, QoL was identified by Short Form-36 (SF-36) Questionnaire. Pain presence in 9 body regions and SF-36 scores were compared between groups using chi-square test and Independent Samples T-test, respectively.Results:Of the participants, 164 (64%) were female, 91 (36%) were male, 119 (46.7%) had hypermobility. Upper back was the body region with the highest pain prevalence where 79% of hypermobile and 74% of non-hypermobile subjects reported pain at least once in past 12 months. Pain prevalence in body regions did not differ between groups (p>0.05). In terms of QoL, physical and mental component scores of SF-36, as well as all subgroup scores except social function were significantly lower in hypermobile subjects (p<0.05).Conclusion:Pain prevalence in different body regions did not differ between subjects with and without hypermobility whereas the QoL was significantly impaired in hypermobile subjects. Hypermobility is a substantial anatomical finding in young adults that should not be disregarded. Education, emotional support and encouraging about strengthening and proprioception exercises may contribute to their quality of life.

BackgroundThe aim of this study is to determine the sex of the first cervical vertebra, which is one of the best known bones in the columna vertebralis.Materials and methodsA total of 284 cases were examined in this study in which cases were 200 neck computed tomography (CT) examinations (100 female and 100 male) and 84 cases were dry atlas bones. First of all, six parameters were used while measuring the distance between both medial and lateral edge of the transverse foramen which belongs to adult male's and female's CT images. Then by taking the averages of them and two more other parameters (FTMAVG-FTLAVG) were obtained.ResultsIn our radio-anatomic study, by examining parameters of the for using ROC analysis, it was found that, the cut-off value of FTMAVG was 4.64 cm and the cut-off value of FTLAVG was 5.92 cm. Then these data were applied to 84 dry atlas bones whose sex were unknown.ConclusionsIn conclusion, it was assessed that, with the cut-off values found by measuring the distance between both medial and lateral edge of the transverse foramen. The accuracy of sex estimation in CT images by FTMAVG cut-off was 76% while it was 80% for FTLAVG. As a result of this study sex estimation can be made in atlas bones with a 78.8% accuracy in the unknown sexs.

The axillary artery is the main artery supplying the shoulder region and is clinically important. In the present case we report an arterial variation of the left upper extremity of a 65 year-old female cadaver. The radial artery arose from the axillary artery 2.5 cm below the anterior humeral circumflex artery and above the teres major muscle. It first coursed along the medial aspect of the arm, then it passed laterally between the biceps brachii and the brachialis muscle. Reaching the upper part of the elbow, it coursed medial to the brachioradialis muscle. It did not give off any branches in either the arm or in the forearm regions. It contributed to the formation of the superficial palmar arch in the palm of the hand. Further, the brachial artery entered the cubital fossa and divided into ulnar and common interosseous arteries. The right upper extremity had a normal arterial branching pattern. Being aware of the variations of the axillary artery may help to prevent diagnostic errors and avoid complications during the surgery of the region.

Morphometric measurements of cranial nerves in posterior cranial fossa of fetus cadavers were carried out in an attempt to identify any asymmetry in their openings into the cranium. Twenty-two fetus cadavers (8 females, 14 males) with gestational age ranging between 22 and 38 weeks (mean 30 weeks) were included in this study. The calvaria were removed, the brains were lifted, and the cranial nerves were identified. The distance of each cranial nerve opening to midline and the distances between different cranial nerve openings were measured on the left and right side and compared. The mean clivus length and width were 21.2 ± 4.4 and 13.2 ± 1.5 mm, respectively. The distance of the twelfth cranial nerve opening from midline was shorter on the right side when compared with the left side (6.6 ± 1.1 versus 7.1 ± 0.8 mm, p = 0.038). Openings of other cranial nerves did not show such asymmetry with regard to their distance from midline, and the distances between different cranial nerves were similar on the left and right side. Cranial nerves at petroclival region seem to show minimal asymmetry in fetuses.

We investigated the effects of Nigella sativa on apoptosis and gamma-aminobutyric acid (GABA(A)) receptor density in cerebral cortical and hippocampal neurons in a pentylenetetrazol (PTZ)-induced kindling model in rats. The PTZ kindling model was produced by injecting PTZ in subconvulsive doses to rats on days 1, 3, 5, 8, 10, 12, 15, 17, 19, 22 and 24 of the study into animals of PTZ treated (PTZ) and PTZ + N. sativa treated (PTZ + NS) groups. Clonic and tonic seizures were induced by injecting a convulsive dose of PTZ on day 26 of the study. Rats in the PTZ + NS group were treated also with a 10 mg/kg methanolic extract of N. sativa 2 h before each PTZ injection. Rats in the control group were treated with 4 ml/kg saline. The number of neurons that expressed GABA(A) receptors in the hippocampus and cerebral cortex of rats in the PTZ and PTZ + NS groups increased significantly. There was no significant difference in the number of GABA(A) receptors between the PTZ and PTZ + NS groups. GABA(A) receptor density of the neurons in the cerebral cortex, but not hippocampus, was increased in PTZ group compared to controls. We observed a significant increase in the number of apoptotic neurons in the cerebral cortex of rats of both the PTZ and PTZ + NS groups compared to controls. We observed a significant decrease in the number of the apoptotic neurons in the cerebral cortex of rats in the PTZ + NS group compared to the PTZ group. N. sativa treatment ameliorated the PTZ induced neurodegeneration in the cerebral cortex as reflected by neuronal apoptosis and neuronal GABA(A) receptor frequency.

The inferior phrenica artery (IPA), which arises from the abdominal aorta just distal to the aortic hiatus, may arise from different sites. Although comprehensive analyses of the IPA are described in other populations, the rates of the variations of the origins are not well elucidated in Turkish people. In this study, we report IPA arising as a common trunk from the abdominal aorta. This finding in a 52 year old male cadaver was noticed during a routine dissection for students in the 2010-2011 academic year. We believe this report is a valuable contribution to the literature on variation of the phrenic arteries and is of interest to clinicans in the surgical and interventional radiological procedures of the adrenal glands, spleen, liver and stomach as well as to the educators of anatomy.

During routine cadaver dissection two different sural nerve formations were observed in the 64-year-old male cadaver. Clinically, sural nerve is largely used in biopsy and as a graft in nerve transplantations. Therefore, knowing about the course, formation pattern and variations of sural nerve are important for the abovementioned procedures, as well as explaining the different clinical findings.

A persistent median artery may supply the hand in radial or ulnar artery injuries, or it may be used as a graft artery elsewhere in the body. It may compress the median nerve and cause symptoms of carpal tunnel syndrome as well. We encountered a persistent median artery in the right upper extremity of a 55-year-old male cadaver during routine dissection. The enlarged persistent median artery ran distally and passed under flexor retinaculum, gave branches to metacarpal bones along with the branches of the median nerve. It showed no anastomosis with the superficial palmar arch. Although it is a common variation, it should be taken into account as it may cause carpal tunnel syndrome and it may be a useful route of blood supply to the hand in radial or ulnar artery injuries.

Ozet Amac: Bu cal›flmada her iki cinsiyette alt servikal bolgede vertebra ve disklerde yafl ile iliflkili de¤ifliklikler incelendi. Yontem: Yafllar› 16-87 aras›nda de¤iflen 200 kiflinin (74 erkek, 126 kad›n) direkt lateral boyun radyografileri retrospektif olarak de¤erlendiril- di. C3’den itibaren her bir servikal vertebra korpusunun on (Ha) ve arka (Hp) yukseklikleri, C3-T1 aras›ndaki intervertebral disklerin on (Da) ve arka (Dp) yukseklikleri 0.01 mm hassasiyeti olan dijital bir kompas ile olculdu. Bu olcumler kullan›larak de¤erlendirilmeye al›nan her bir servikal segmente ait Ha/Hp ve Da/Dp oran› hesapland›. Bulgular: Her bir servikal segmentte Ha/Hp ve Da/Dp oranlar› cinsiyete gore karfl›laflt›r›ld›¤›nda anlaml› farkl›l›k saptanmad› (p>0.05). Ha/Hp oran› ile yafl aras›nda her iki cinsiyette de anlaml› de¤ifliklikler gozlenmedi (p>0.05). Erkeklerde Da/Dp oranlar›n›n hic birisinde yaflla anlaml› de¤ifliklik gozlenmedi (p>0.05). Kad›nlarda C3-4, C4-5, C5-6, C6-7, C7-T1 Da/Dp oranlar› ile yafl aras›nda pozitif, zay›f ve anlaml› korelasyon saptand› (p 0.05). No significant changes were observed in the value of Ha/Hp ratio with the advance of age in either sex (p>0.05). There were no significant correlations between age and Da/Dp ratios in males (p>0.05). There was weak, positive and significant correlation between age and C3-4, C4-5, C5-6, C6-7, C7-T1 Da/Dp ratio in females (p<0.05). Conclusion: It could be suggested that cervical lordosis increases with the advance of age in females. These results may be useful for eval- uating age-related morphological changes that occur in the cervical vertebrae. Key words: Cervical vertebra, intervertebral disc, morphometry, plain radiograph, gender Cerrahpasa J Med 2008; 39: 111-116

The level of the conus medullaris (CM) in adults has been described in many studies with cadavers and living people. T1-weighted sagittal spin-echo MR images of the lumbar spine were reviewed in 364 consecutive patients (207 women, 157 men) with a mean age of 45 years (range 18-80). The most common level of CM was the L1-L2 intervertebral disc level in females and the T12-L1 intervertebral disc level in males. The distribution of CM location in a large adult population was shown to range from the T11-T12 intervertebral disc level to L2-L3 intervertebral disc level.

We report a case with double superior gemellus and double piriformis mm. associated with the sciatic n. dividing high and passing between the two piriformis mm. in the same lower extremity. This abnormality has not previously been described in the literature. As many musculoskeletal structures may be involved in sciatica, the supernumerary superior gemelli and piriformis mm. may exert pressure on the sciatic n. and this should be taken into account by clinicians.

An accessory muscle and a muscular bundle were found and prepared in both forearms of a 55-year-old male cadaver. On the left side, the accessory muscle-originated from the medial aspect of the extensor carpi radialis brevis (ECRB) muscle, coursed downwards, crossed posterior to the tendon of ECRB, passed through the second chamber of the extensor retinaculum and inserted into the base of second metacarpal bone. Additionally, a muscular bundle was observed between the extensor carpi radialis longus (ECRL) and ECRB muscles. On the right side, both ECRL and ECRB had bifid tendons. The long and thin additional tendon of ECRL coursed downwards and joined the accessory tendon of the ECRB before entering the second chamber of the extensor retinaculum and the common tendon inserted into the base of the second metacarpal bone.