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The sartorius muscle belongs to the anterior compartment of the thigh. Morphological variations of this muscle are very rare, few cases being described in the literature. An 88-year-old female cadaver was dissected routinely for research and teaching purposes. However, an interesting variation was found during anatomical dissection. The proximal part of the sartorius muscle had the normal course, but the distal part bifurcated into two muscle bellies. The additional head passed mediallyto the standard head; thereafter, there was a muscular connection between them. This connection then passed into the tendinous distal attachment. It created a pes anserinus superficialis, which was located superficially to the distal attachments of the semitendinosus and gracilis muscles. This superficial layer was very wide and attached to the medial part of the tibial tuberosity and to the crural fascia. Importantly, two cutaneous branches of the saphenous nerve passed between the two heads. The two heads were innervated by separate muscular branches of the femoral nerve. Such morphological variability could be clinically important.

BACKGROUND: The aim of the study is to create several classifications of the piriformis muscle (PM): proximal and distal attachments, potential fusions, and the relationship with the sciatic nerve. It is the first comprehensive anatomicalexamination of this subject. MATERIAL AND METHODS: One hundred and twenty-four lower limbs from 62 cadavers, fixed in 10% formalin, were examined. RESULTS: The piriformis muscle was present in 120 limbs (96.8% of cases). Four types of proximal attachment were described (I–IV). The most common type was Type I, in which the proximal attachment was at the anterior surface of thesacrum, between S2 and S4 (52 lower limbs; 43.3%). The rarest type was Type IV, in which the proximal attachment was at the gluteal surface of the ilium near the margin of the greater sciatic notch and from the gluteus medius (12 cases; 10%). Three types of distal attachment were distinguished. The most common was Type 1, a single tendon. This type comprised 2 subtypes: A and B (105 lower limbs; 87.5%). The other 2 types accounted for 12.5% of the total. Fusions were noted between the piriformis muscle and adjacent muscles in 31.7% of cases.Four patterns were observed in which the sciatic nerve ran against the piriformis muscle. The most common variation in the relationship was the common fibular nerve exiting superior to the piriformis muscle and the tibial nerve passing inferior to it (10 cases; 8.3%). CONCLUSIONS: The piriformis muscle is highly morphologically variable in both its proximal and distal attachments and its relationship with the sciatic nerve. There are 4 types of proximal attachment and 3 types of distal attachment. The piriformis muscle shows numerous fusions with its adjacent muscles: gluteus medius or minimus or superior gemellus. A new (fourth) type of relationship was demonstrated between the piriformis muscle and sciatic nerve. The piriformis muscle was absent in 4 cases.

The diagnostic process that allows pronator syndrome to be differentiated reliably from carpal tunnel syndrome remains a challenge for clinicians, as evidenced by the most common cause of pronator syndrome misdiagnosis: carpal tunnel syndrome. Pronator syndrome can be caused by compression of the median nerve as it passes through the anatomical structures of the forearm, while carpal tunnel syndrome refers to one particular topographic area within which compression occurs, the carpal tunnel. The present narrative review is a complex clinical comparison of the two syndromes with their anatomical backgrounds involving topographical relationships, morphology, clinical picture, differential diagnosis, and therapeutic options. It discusses the most frequently used diagnostic techniques and their correct interpretations. Its main goal is to provide an up-to-date picture of the current understanding of the disease processes and their etiologies, to establish an appropriate diagnosis, and introduce relevant treatment benefiting the patient.

PurposeThe aim of the present case is to describe an interesting variation of the additional head of the rectus femoris.MethodsA male body donor, 81 years old at death, was subjected to routine anatomical dissection for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland.ResultsWe have found an example of an accessory head of the quadriceps femoris, a double-headed rectus femoris in which the proximal attachment is connected to the rectus femoris muscle originating from the anterior inferior iliac spine. The muscle belly of this additional structure is separate but fused distally with the vastus lateralis muscle. It then passes into the patellar ligament inserted into the tibial tuberosity.ConclusionsKnowledge of the possible occurrence of an additional head is nevertheless important for clinicians, especially for orthopedists performing reconstructive surgeries. It could also be significant for physiotherapists arranging rehabilitation plans after such surgeries because it could potentially help to achieve faster recovery.

Thoracic outlet syndrome is a group of disorders that affect the upper extremity and neck, resulting in compression of the neurovascular bundle that exits the thoracic outlet. Depending on the type of compressed structure, the arterial, venous, and neurogenic forms of TOS are distinguished. In some populations, e.g., in certain groups of athletes, some sources report incidence rates as high as about 80 cases per 1000 people, while in the general population, it is equal to 2–4 per 1000. Although the pathogenesis of this condition appears relatively simple, there are a very large number of overlapping risk factors that drive such a high incidence in certain risk groups. Undoubtedly, a thorough knowledge of them and their etiology is essential to estimate the risk of TOS or make a quick and accurate diagnosis.

The ability to navigate the complex and often deceptive branching patterns of the internal iliac artery can be decisive in planning and performing surgeries within the lesser pelvis. The following case report presents a peculiar quadruple division of the internal iliac artery, accompanied by a venous anastomotic structure. Apart from the posterior and anterior trunks, the superior vesicle and iliolumbar arteries arose independently from the internal iliac artery. The division was surrounded by a venous oval, compressing certain branches and potentially complicating surgical access. Due to the uncommon course of the internal iliac artery and the presence of the anastomosis, a possible nerve root compression has been identified. Both clinical significance and classification method of the case are discussed. Knowledge of this anatomical variation is valuable for both diagnosis and surgery, especially within the specialties of urology, gynaecology and general surgery.

Nowadays universities face ever-increasing demands on quality of education, which is crucial from perspective of future graduates. In face of the need of constant quality improvements of medical curricula, it is important to seek strategies for their efficient management. The general trend is to develop electronic support tools to streamline the curricular design, analysis and harmonization.Based on the requirements we have identified by the needs analysis among curriculum designers, teachers and managers at five universities involved in the Building Curriculum Infrastructure in Medical Education (BCIME) project, and evidence published in literature on curriculum development, we have developed methodological guidelines on curriculum innovations and a software-based tools that help manage, map and analyse curricula in the medical and healthcare study fields.In this paper, we share our experiences with building and implementation of EDUportfolio, an online platform developed within our consortium and intended to facilitate harmonisation and optimisation of medical outcome-based curricula. Its functionalities and outputs were verified by pilot mapping of Anatomy curricula as taught at partner universities in five European countries.The visualisation and the analysis of described curriculum data using natural language processing techniques revealed both the hidden relations between curriculum building blocks and a set of overlaps and gaps in curricula. In addition, we demonstrate both the usability of the platform in the context of the involved academic environments and the capability to map and compare curricula across different institutions and different countries.

Curriculum mapping is the process of designing a multidimensional model of an educational programme for a complete, more transparent and better-integrated learning experience. Many universities worldwide are building or expanding their technical infrastructure to manage their curricula. Our aim was to deliver a synopsis of current practices and describe the focus of research interest in implementing curriculum mapping tools for medical education. As part of the Building Curriculum Infrastructure in Medical Education (BCIME) project, we conducted a state-of-the-art narrative review of the literature. A systematised search of the PubMed/MEDLINE database for the years 2013–2019 resulted in 352 abstracts, from which 23 full-text papers were included in the final review. From these, we extracted guidance on 12 key characteristics of curriculum mapping tools. The collected experiences formed four thematic categories: visualisations, text descriptions and analysis, the outcome-based approach and adaptability in curriculum mapping. As result of the review, we summarised topics regarding ways of: implementating new competency-based catalogues (like NKLM) in curriculum mapping software (e. g., using dynamic checklists), methods of streamlining the authoring process (e. g., by automatic detection and alignment of action verbs in learning objectives descriptions) and graphical forms of presenting curriculum data (e. g., network visualisations using automatic clustering of related parts of a curriculum based on similarities between textual descriptions). We expect further developments in text-mining methods and visual/learning analytics in curriculum mapping. The collected data informed the design of a new curriculum management system called EduPortfolio, which is currently being implemented by the BCIME project.