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Related Concept Videos

Anatomical Positions01:11

Anatomical Positions

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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
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Anatomical Terminology01:20

Anatomical Terminology

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Knowledge of anatomy is essential to understand human biology and medicine. Anatomists and health care professionals use standard terminology to describe the human body with more precision and no ambiguity. Anatomical terms have mostly Greek and Latin-derived roots. Because these languages are rarely used in conversation, the meaning of words remains the same. Each term is made up of a root in between the prefixes and suffixes. The root of a term often refers to an organ, tissue, or condition,...
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Anatomical Movements00:51

Anatomical Movements

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Anatomical movements refer to the various actions or motions that can be performed by the body's joints and muscles. These movements are described using specific terms to provide a standardized way of discussing and understanding the range of motion at different joints.
Here are some common anatomical movements:
Flexion and extension motions are in the sagittal (anterior–posterior) plane of motion. These movements take place at the shoulder, hip, elbow, knee, wrist,...
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Cerebrum: Anatomical Overview II01:11

Cerebrum: Anatomical Overview II

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Each cerebral hemisphere can be divided into three main regions. The outermost region, the cerebral cortex, is a thin layer (2 to 4 millimeters thick) made up of gray matter, consisting of neuron cell bodies, dendrites, glial cells, and blood vessels. The middle region, or white matter, is primarily composed of myelinated nerve fibers organized into three types of large tracts: association fibers, commissures, and projection fibers. Association fibers connect different areas within the same...
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Diencephalon: Anatomical Regions01:30

Diencephalon: Anatomical Regions

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The diencephalon, etymologically translated as 'through brain,' plays an integral role as the conduit between the cerebrum and the vast extent of the nervous system. However, the olfactory system is an exception, as it interfaces directly with the cerebrum. The diencephalon, deeply ensconced beneath the cerebrum, primarily consists of three paired structures — the thalamus, hypothalamus, and epithelamus. It also includes accessory structures such as the subthalamus, which houses the...
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Cerebellum: Anatomical Regions01:17

Cerebellum: Anatomical Regions

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The cerebellum, also known as the "little brain," is located in the posterior cranial fossa, inferior to the tentorium cerebelli and dorsal to the brainstem. It plays a significant role in motor control, coordination, and proprioception.
Cerebellar Structure
Externally, the cerebellum features a highly convoluted surface with numerous folia (narrow ridges) separated by shallow sulci (grooves). The cerebellum is divided into two hemispheres by a thin median structure known as the vermis. The...
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Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
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Pterional, Pretemporal, and Orbitozygomatic Approaches: Anatomic and Comparative Study.

Saul Almeida da Silva1, Vitor Nagai Yamaki1, Davi Jorge Fontoura Solla1

  • 1Division of Neurological Surgery, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

World Neurosurgery
|September 30, 2018
PubMed
Summary

The orbitozygomatic (OZ) approach provides significantly wider surgical exposure compared to pterional (PT) and pretemporal (PreT) craniotomies. This enhanced exposure, particularly for the basilar artery, offers greater surgical freedom in complex neurosurgical cases.

Keywords:
OrbitozygomaticPretemporalPterionalSurgical technique

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Area of Science:

  • Neurosurgery
  • Surgical Anatomy
  • Cranial Approaches

Background:

  • Pterional craniotomy (PT) and its variants are standard neurosurgical procedures.
  • Precise indications for PT, pretemporal (PreT), and orbitozygomatic (OZ) approaches require further quantitative evaluation.
  • Understanding the precise exposure characteristics of different cranial approaches is crucial for surgical planning.

Purpose of the Study:

  • To quantitatively compare the pterional (PT), pretemporal (PreT), and orbitozygomatic (OZ) surgical approaches.
  • To measure the area, linear, and angular exposures of intracranial vascular structures for each approach.
  • To determine the surgical advantages of each approach based on objective measurements.

Main Methods:

  • Eight adult cadavers underwent sequential PT, PreT, and OZ dissections.
  • Quantitative measurements of working area, angular exposure of vascular structures, and linear exposure of the basilar artery were performed.
  • Statistical analysis was conducted to compare the measurements between the approaches.

Main Results:

  • The orbitozygomatic (OZ) approach yielded a significantly larger working area (1301.3 ± 215.9 mm²) compared to PT and PreT.
  • Extension from PT to PreT and OZ increased the linear exposure of the basilar artery.
  • OZ and PreT approaches provided significantly wider angles of attack to key intracranial vessels, including the middle cerebral artery bifurcation and basilar artery tip.

Conclusions:

  • The orbitozygomatic (OZ) approach offers superior surgical exposure area and linear access to the basilar artery compared to PT and PreT.
  • Removal of the orbital rim and zygomatic arch in the OZ approach enhances angular exposure and surgical freedom.
  • Individualized selection of surgical approach based on patient anatomy and surgeon experience is essential.