Person:
Aragonés Maza, Paloma

First Name

Paloma

Last Name

Aragonés Maza

URI

https://hdl.handle.net/20.500.14352/79263

Affiliation

Universidad Complutense de Madrid

Faculty / Institute

Medicina

Department

Anatomía y Embriología

Area

Anatomía y Embriología Humana

Identifiers

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Now showing 1 - 10 of 25

Curso básico teórico-práctico de cirugía del antepié
(2023) Aragonés Maza, Paloma; Valverde Villar, Ana María; Espina Flores, Irene; Cuadrado Rubio, Luis
El pie es el eslabón más distal de la extremidad inferior, nos sirve para conectar el organismo con el medio que lo rodea y para sustentar al resto del aparato locomotor en la posición bípeda. Tiene la capacidad, gracias a su peculiar biomecánica, de convertirse en una estructura rígida o flexible en función de las necesidades para las que es requerido y las características del terreno en que se mueve. En este texto se exponen por capítulos, tanto la anatomía y biomecánica del antepié, así como las principales patologías que puede presentar y las técnicas conservadoras y quirúrgicas para su tratamiento, con bibliografía actualizada. Se trata de un manual de divulgación para uso entre médicos residentes en cirugía ortopédica y traumatología, podólogos, fisioterapeutas y otros profesionales sanitarios interesados en la patología de esta localización
Popliteal artery: Anatomical study and review of the literature
(Annals of Anatomy, 2020) Aragonés Maza, Paloma; Rodríguez-Niedenführ, Marc; Quinones, Sara; Simón de Blas, Clara; Konschake, Marko; Sañudo Tejero, José Ramón; Vázquez, María Teresa
Background The frequency of appearance of anatomical variability in the terminal division of the popliteal artery (PA) is different according to the type of sample used, and ranges from 2% to 21%. The PA locates 1,01 cm behind to the lateral meniscus, which makes it vulnerable during surgical procedures. Iatrogenic injury of the PA or its terminal branches increases if anatomical variables are present. Our aim was to describe and review the branching pattern of the PA in a body-donors to science sample to determine the influence of the sample used (body-donors vs imaging test). Methods A sample consisting of 260 popliteal regions, corresponding to 130 corpses (66 women, 64 men), have been dissected. Multivariate analysis was carried out. Results The terminal division of the PA was classified as follows: Pattern 1: the PA divided into the anterior tibial (ATA) and the posterior tibial arteries (PTA) at the level or distal to the lower border of the popliteal muscle (PM) (94.7%). Pattern 2: the PA bifurcated into the ATA and PTA, proximal to the lower border of the PM (3.3%). Pattern 3: the PA divided at the same level into the ATA, PTA and PEA. (2%). No significant differences between gender and side of the limb could be find. Conclusions We propose a classification that encloses three identifiable groups only. This will allow clinicians to bear in mind these variables easily, at the same time avoiding injuries during surgical procedures such as lateral meniscus repair.
Quadriceps or multiceps femoris?—Cadaveric study
(Clinical Anatomy, 2020) Olewnik, Lukasz; Tubbs, Richard Shane; Ruzik, Kacper; Aragonés Maza, Paloma; Wasniewska, Anna; Karauda, Piotr; Szewczyk, Bartłomiej; Sañudo Tejero, José Ramón; Polguj, Michal
Purpose The quadriceps femoris (QF) consists of four muscles: the rectus femoris; vastus medialis; vastus lateralis, and vastus intermediate. The tendons of all of these parts join together into a single tendon that attaches to the patella. The QF is a powerful extensor of the knee joint that is needed for walking. A growing number of publications have examined the fifth head of the QF muscle. There is no information about the possibility of other heads, and there is no correct classification of their proximal attachments. Further, the frequency of occurrence of additional heads/components of the QF remains unclear. Methods One hundred and six lower limbs (34 male and 18 female) fixed in 10% formalin solution were examined. Results Additional heads of the QF were present in 64.1% of the limbs. Three main types were identified and included subtypes. The most common was Type I (44.1%), which had an independent fifth head. This type was divided into two subtypes (A-B) depending on its location relative to the vastus intermediate. The second most common type was Type II (30.8%), which originated from other muscles: IIA from the vastus lateralis; IIB from the vastus intermediate, and IIC from the gluteus minimus. In addition, Type III (25%) was characterized by multiple heads: IIIA—two heads with a single common tendon; IIIB—two heads with two separate tendons; IIIC—three heads (lateral, intermediate, medial), and IIID—four heads (bifurcated lateral and bifurcated medial). Conclusion The introduction of a new classification based on a proximal attachment is necessary. The presence of the fifth, sixth, seventh, or eighth head varies.
Estudio de la variabilidad anatómica en la división terminal de la arteria poplítea
(2020) Aragonés Maza, Paloma; Vázquez Osorio, María Teresa
La arteria poplítea es la continuación de la arteria femoral. Comienza a nivel del hiato de Hunter y finaliza a nivel del borde inferior del músculo poplíteo, bifurcándose en sus dos ramas terminales; las arterias tibial anterior y posterior. La arteria peronea nace a partir de la arteria tibial posterior, distal a la bifurcación poplítea.La arteria poplítea en su división terminal presenta gran variabilidad anatómica; entre el 2% y el 21% según las fuentes. Las variables anatómicas a este nivel han sido clasificadas en múltiples ocasiones, siendo actualmente empleada la clasificación descrita por Kim.3. OBJETIVOS 1. Describir, mediante un estudio en cadáver, los patrones de bifurcación de la arteria poplítea. Encontrar si existe o no influencia del género y lado.2. Describir los diámetros de las arterias poplítea y sus ramas terminales, así como la longitud de la arteria tibial posterior proximal. Analizar si existen diferencias por género y lado.3. Estudiar la posible asociación entre la aparición de determinadas variables anatómicas y lesiones iatrogénicas vasculares durante procedimientos quirúrgicos...
The accessory heads of the quadriceps femoris muscle may affect the layering of the quadriceps tendon and potential graft harvest length
(Knee Surgery, Sports Traumatology, Arthroscopy, 2023) Olewnik, Lukasz; Zielinska, Nicole; Aragonés Maza, Paloma; Ruzik, Kacper; Paulsen, Friedrich; Borowski, Andrzej; La Prade, Robert F.
Purpose The aim of the study was to assess the quadriceps femoris system for the presence of additional layers. Methods One hundred and twenty-eight lower limbs fixed in 10% formalin were examined. Results Five types of quadriceps tendon layering were found based on the accessory heads of the quadriceps muscle. Type I (55%)—represented by four heads and four layers, and it was something new because standard orthopaedic textbooks described quadriceps tendon as a structure composed of only three layers. Type II (27.4%)—the first four layers were the same as in Type 1, but the accessory tendon of the fifth head of the quadriceps femoris muscle had the deepest attachments. Type III (10.9%)—this type included 6 heads of quadriceps femoris. It consisted of five layers. Type IV (3.1%)—this type included 7 quadriceps femoris heads. This type consisted of only four layers. Type V (3.1%)—this type included 8 heads of the quadriceps femoris heads. This type consist of 5 layers. Conclusion The findings of this study provide a detailed anatomy of the quadriceps tendon including the accessory tendons of the accessory heads of the quadriceps tendon. The accessory heads of the quadriceps femoris muscle contribute to the layering of the quadriceps tendon. The second conclusion of this study is the development of safe distances depending on the types. Not all types are perfect for harvesting—Type IV seems to be the safest type, in turn Type V the most dangerous.
A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance
(Scientific Reports, 2021) Olewnik, Lukasz; La Prade, Robert F.; Paulsen, Friedrich; Gonera, Bartosz; Kurtys, Konrad; Podgórski, Michał; Aragonés Maza, Paloma; Sañudo Tejero, José Ramón; Polguj, Michał
The purpose of this study was to characterize the morphological variations in the proximal attachments and create an accurate classification of the PPM for use in planning surgical procedures in this area, for evaluating radiological imaging and rehabilitation. One hundred and thirty-four lower limbs of body donors (52 woman and 82 man) fixed in 10% formalin solution were examined. The popliteus muscle was present in all 134 limbs. Four main types were identified with subtypes. The most common type was Type I (34.3%), characterized by a single tendon in the popliteus sulcus. Type II (30.6%) characterized by a main tendon in the popliteus sulcus and accessory bands. This type was divided into five subtypes (A–E) based on presence of specific accessory bands. Type III (15.3%) was characterized by two tendons in the popliteal sulcus. Type IV (19.4%) was characterized by two tendons in the popliteus sulcus and additional bands. This type was also divided into five subtypes (A–E) based on presence of specific accessory bands. The popliteofibular ligament was present in 90.3% of cases. A new classification based on a proximal attachment is proposed. The popliteus tendon is characterized by a very high morphological variability, which can affect posterolateral knee stability and the natural rotation of the tibia. Such a classification system may be useful for clinicians performing medical procedures within the knee joint, including orthopedic surgeons.
Clinical anatomy of the lumbar sinuvertebral nerve with regard to discogenic low back pain and review of literature
(European Spine Journal, 2021) Quinones, Sara; Aragonés Maza, Paloma; Bouzada, J.; Valderrama Canales, Francisco José; Vázquez Osorio, María Teresa; Sañudo Tejero, José Ramón
Purpose: Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods: Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results: 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43, 72.1%), common branch diverging into two branches (10/43, 23.3%), double ascending branch (1/43, 2.3%) finalizing two levels above and a descending branch (1/43, 2.3%). In 12/43 cases (27.9%) the SVN had ipsilateral connections with another SVN. The distribution ended in the middle of the vertebral body supplying adjacent structures. Conclusion: A thorough understanding of the anatomy of the SVN might lead to significant benefits in therapy of discogenic low back pain. We suggest blocking the SVN at the level of the inferior vertebral notch of two adjacent segments. Level of evidence I: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding
Variant plantaris muscle with degenerated accessory head: Gross and histological analysis
(Anatomia Histologia Embryologia, 2023) Futa, Brianne A.; Olewnik, Lukasz; Konschake, Marko; Cardona, Juan J.; Iwanaga, Joe; Aragonés Maza, Paloma; Sañudo Tejero, José Ramón; Tubbs, R. Shane
The variant plantaris muscle has itself been reported to have variable presentations. Here, we report an unusual finding of the plantaris muscle and report its gross and histological findings. A duplicated head of the plantaris muscle was identified in the right leg of an adult cadaver age and sex. The more anterior head of the muscle was in the typical location and originated from the superolateral condyle of the femur. However, the more posteriorly located head arose from the iliotibial band at the level of the distal thigh. The two heads united and continued as the typical distal tendon of the plantaris muscle to insert into the calcaneus tendon (Achilles). The normally positioned head of the plantaris muscle was found to be composed of typical skeletal muscle fibres. However, the accessory head of the plantaris muscle was found to be severely degenerated and infiltrated with adipose tissue. We report a duplicated head of the plantaris muscle. Histologically, the accessory head was degenerated and infiltrated with adipose tissue. To our knowledge, this is the first report of such a case. Further cases are now necessary to further elucidate this finding.
Project number: 132
Elaboración de un manual de casos clínicos de anatomía radiológica aplicada de la extremidad inferior
(2023) Aragonés Maza, Paloma; Maranillo Alcaide, Eva; Quiñones Garrido, Sara; Rodríguez Vázquez, José Francisco; Sañudo Tejero, José Ramón; Valderrama Canales, Francisco José; Vázquez Osorio, María Teresa; Viejo Tirado, Fermín
Is it the coracobrachialis superior muscle, or is it an unidentified rare variant of coracobrachialis muscle?
(Surgical and Radiologic Anatomy, 2021) Olewnik, Lukasz; Zielinska, Nicol; Golek, Lukasz; Aragonés Maza, Paloma; Sañudo Tejero, José Ramón
The coracobrachialis muscle (CBM) originates from the apex of the coracoid process, in common with the short head of the biceps brachii muscle, and from the intermuscular septum. The CBM demonstrates variability in both the proximal and distal attachment, with some extremely rare varieties, such as the coracobrachialis superior, coracobrachialis longus and coracocapsularis muscle. This case report describes an extremely rare variant of the coracobrachialis superior muscle, or a very rare variant of the CBM. Our findings highlight the importance of muscle variants in the shoulder region, especially the coracoid region, and are significant for radiologists, anatomists, physiotherapists and surgeons specializing in the shoulder joint.