Thirty-seven dissections have shown that the skin of the low back is innervated by the lateral branches of the dorsal rami of T12 and L1 in 22 cases (60%) or T12 L1 and L2, in 10 cases (27%) or T12 L1 and L2 receiving an anastomosis from L3 in 5 cases (13%). The most medial nerve crossed the iliac crest through a rigid osseo-aponeurotic orifice located 7–8 cm from the midline which was seen compressing the nerve in 2 instances. This pattern of distribution may sometimes explain unilateral low back pain.

The lateral cutaneous branches of the dorsal rami of the thoraco-lumbar junction. An anatomical study on 37 dissections.

We present an anatomical study of the palmar cutaneous branch of the median nerve emphasizing its frequency, origin, perforation point at the transverse carpal ligament, point of emergence in the palm, width, length, divisions and innervation territory. For this purpose, fifty cadaver hands were dissected under a stereomicroscope and/or magnifying glass. The origin of the palmar cutaneous branch (PCB) was on the average 4.56 cm proximal to conventionally named “zero point” on the most distal transverse volar wrist crease. Perforation of the aponeurosis occurred on average 0.79 cm from the mentioned point and its emergence in the palm at 0.76 cm. The nerve had an average length of 5.24 cm. PCB's divisions in the palm resulted in a medial branch in 42%, a lateral branch in 92% and an intermediate branch in 100% of the hands studied. In six specimens PCB presented a deep branch which was directed toward the thenar eminence or made communication with the superficial branch of the palmar digital nerve or still penetrated between the first or second metacarpal. In 4% of the cases there was a communicating branch between the superficial branch of the radial nerve and the PCB. These anatomical results should be considered in the evaluation of the best surgical techniques for decompression of the median nerve in the carpal tunnel.

An anatomical study of the palmar cutaneous branch of the median nerve

The controversial arcade of Struthers.

The closing mechanism at the gastroesophageal junction.

The perirectal fasciae and their vascular and neural relationships were studied based on the dissection of 46 fresh cadavers. The rectal fascia is a tubular sleeve, areolar in nature, which houses the superior rectal vessels and lymphatics. The nerves which supply fibres to the pelvic plexus run close to the rectum, contained in the urogenital and presacral fasciae. The rectum is attached to these two fasciae by the rectal stalks, which take a spiral course round the rectum, being posterolateral in the upper rectum, lateral in the mid-rectum and anterolateral in the lower rectum. During rectal resection the pelvic nn. may be preserved if the rectal dissection proceeds close to the rectal fascia. After cutting the rectal insertion of the presacral fascia, the lower rectal stalks (paraproctium) come into direct view and can be divided close to the rectal wall with no risk of damage to the pelvic plexus.

The surgical anatomy of the fasciae and the fascial spaces related to the rectum.

Abrégé d'anatomie

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Abrégé d'anatomie