Person: Sañudo Tejero, José Ramón
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First Name
José Ramón
Last Name
Sañudo Tejero
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Anatomía y Embriología
Area
Anatomía y Embriología Humana
Identifiers
10 results
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Item What is new in flexor tendon pulleys and the gaps between them in triphalangeal fingers of the hand?(Journal of Anatomy, 2024) De las Heras, Julio; Simón de Blas, Clara; Salaberri, Guillermo José; Krompas, Ioannis; Olewnik, Lukasz; Quinones, Sara; García Elías, Marc; Sañudo Tejero, José Ramón; Aragonés Maza, PalomaThe flexor tendon pulleys in the fingers of the hand are fibrous structures of variable size, shape, and thickness that cover the synovial sheath of these tendons. Despite their clinical relevance, their arrangement and configuration in each of the triphalangeal fingers have been little studied and with small sample sizes. 192 triphalangeal fingers belonging to 48 fresh body donors' hands were dissected. Multivariate analysis was carried out. Twenty-five cases (52%) were left hands, and 26 of the 48 hands belonged to female donors (54.2%). The results were analyzed by fingers for each of the 5 annular pulleys, the 3 cruciform pulleys and the gaps between them. In addition, the most and least frequent configurations of the pulleys in each of the fingers were studied, observing that the classic pattern with all the pulleys appeared only in 3 fingers (1.56%), while the most frequent pattern was A1-A2-C1-A3-A4, which was seen in 35 fingers (18.22%). CONCLUSIONS: The flexor pulleys in the triphalangeal fingers of the hand have shown enormous variability in arrangement and shape, and also rarely appear all in the same finger. This peculiar anatomical arrangement can help the different professionals who perform their clinical work in this region.Item 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, MichałThe 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.Item Classification of the popliteofibular ligament(Clinical Anatomy, 2022) Olewnik, Lukasz; Gonera, Bartosz; Kurtis, Konrad; Zielinska, Nicol; Ruzik, Kacper; Aragonés Maza, Paloma; Sañudo Tejero, José Ramón; Danowska-Klonowska, Dominika; La Prade, Robert F.The purpose of this study was to characterize the morphological variations in the distal attachment of the popliteofibular ligament (PFL) and create an accurate classification for use in planning surgical procedures in this area and in evaluating radiological imaging. One hundred and thirty-seven lower limbs of body donors fixed in 10% formalin solution were examined for the presence and course of the PFL. The PFL was present in 88.3% of cases. We propose the following three-fold classification: type I (72.3%), the most common type, characterized by the attachment onto the apex of the head of the fibula, type II (8.7%), characterized by a bifurcation, with the dominant band inserting on the anterior slope of the styloid process of the fibula and the smaller band onto the posterior surface of the styloid process of the fibula and type III (7.3%), characterized by a double PFL: the first PFL (main) originated from the popliteus tendon and inserted onto the anterior slope of the styloid process of the fibula, while the second originated from the musculotendinous junction of the popliteus muscle and inserted on the posterior surface of the styloid process of the fibula. The PFL was characterized by high morphological variation, as reflected in our proposed classification. This variation may present clinical and biomechanical issues for both medical personnel and researchers. Our proposed classification may be valuable for clinicians who evaluate and perform surgical procedures within the knee joint area.Item A Proposal for a New Classification of the Supernumerary Heads of the Biceps Brachii Muscle(BioMed Research International, 2022) Szewczyk, Bartłomiej; Sañudo Tejero, José Ramón; Podgórski, Michał; Zielinska, Nicol; Bettencourt Pires, Maria; Aragonés Maza, Paloma; Olewnik, LukaszIntroduction. The anterior compartment of the arm consists of three muscles: the biceps brachii (BB), brachialis, and coracobrachialis muscle. The aim of the present study was to characterize possible variations in the supernumerary heads of the biceps brachii and use these to prepare an accurate classification of the area that could be used for planning surgical procedures in the region. Material and Methods. One hundred (51 left and 49 right, 52 females and 48 males) upper limbs fixed in 10% formalin solution were examined. Results. Four types of supernumerary BB heads were identified, with subtypes. Type I was the most common type, characterized by the two heads (64%); this was subdivided into Type IA, with a single muscle belly, and Type IB with two muscle bellies. The second most common type was Type II, which was characterized by the three BB heads (26%). This type was divided into four subtypes (A-D): Type IIa characterized by attachment to the middle part of the shaft of the humerus; Type IIb characterized by the origin to the coracoid process together with the short head of the BB; Type IIc characterized by origin to the tendon of the pectoralis major muscle; and Type IId characterized by the attachment to the capsule of the humeral joint. The third most common type was Type III, which was characterized by four heads (6%); this was divided into Type IIIa, where two heads originated from the humerus bone, and Type IIIb, where one head originated from the short heads and the second from the long head of the BB. The rarest type was Type IV (4%) which was characterized by five heads: the short head originated from the coracoid process and the long head originated from the supraglenoid tubercle, the third and fourth head originated from the shaft of the humerus, while the fifth head originated from the pectoralis major muscle. Conclusion. The biceps brachii is characterized by very high morphological variability. The new classification proposes four types of supernumerary head arrangement (I-IV), divided into subtypes. This classification has both clinical and anatomical significance.Item 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, MichalPurpose 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.Item The relationship between additional heads of the quadriceps femoris, the vasti muscles, and the patellar ligament(BioMed Research International, 2022) Olewnik, Lukasz; Ruzik, Kacper; Szewczyk, Bartłomiej; Podgórski, Michal; Aragonés Maza, Paloma; Karauda, Piotr; Shane Tubbs, R; Sañudo Tejero, José Ramón; Bettencourt Pires, Maria; Polguj, MichalThe quadriceps femoris consists of four muscles: the rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis. However, the effect of additional quadriceps femoris heads on the vasti muscles and patellar ligaments is unknown. The aims of the present study are to determine the relationship between additional quadriceps femoris heads and the vasti muscles and patellar ligaments and to review the morphology of the vastus lateralis, vastus medialis, and vastus intermedius. Materials and Methods. One hundred and six lower limbs (34 male and 19 female cadavers) fixed in 10% formalin were examined. Results. On all lower extremities, the vastus lateralis consisted of superficial, intermediate, and deep layers. The vastus medialis, on the other hand, consisted of only the longus and obliquus layers. The quadriceps head had one or more supplementary heads in 106 dissected limbs from 68 cadavers (64.1%). The distal portion of the patella was wider in lower limbs without supplementary heads than in type IA but narrower than in type IIIA. In general, the distal portion of the patella was narrower in specimens with a supplementary head than in those without (19.03 SD 3.18 mm vs. 20.58 SD 2.95 mm, p = 0:03817). Other patellar ligament dimensions did not differ significantly. Conclusion. The quadriceps femoris muscle is characterized by high morphological variability. Occurrence of extra heads is at the level of 64.1%. The vastus lateralis consists of three parts (superficial, intermediate, and deep), and vastus medialis consists of two (longus and oblique).Item A new type of the coracobrachialis muscle(Folia Morphologica, 2022) Zielinska, Nicol; Aragonés Maza, Paloma; Sañudo Tejero, José Ramón; Łabętowicz, P.; Shane Tubbs, R.; Olewnik, LukaszThe coracobrachialis muscle belongs to the anterior group of the brachial region. Its main functions are flexion and adduction at the glenohumeral joint. It is highly morphologically variable, especially in the number of bellies, place of origin or insertion, and its relationship to the musculocutaneous nerve. Accessory structures associated with the coracobrachialis muscle include the coracobrachialis brevis or coracobrachialis longus muscle. The present case describes a three-headed coracobrachialis muscle with two such additional structures. One of these has a tendinous origin connected to the periosteum and located on the surgical neck of the humerus. Its insertion is fused with the third head of the coracobrachialis muscle. The other has a proximal attachment fused with the capsule of the shoulder joint, and its distal attachment is fused with the third head of the coracobrachialis muscle in place of its connection with the short head of the biceps brachii. This could result in better stabilisation of the glenohumeral joint; on the other hand, it could limit operational access during treatment of subscapularis tearsItem 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. ShaneThe 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.Item The fifth head of quadriceps femoris: for sure?(Surgical and Radiologic Anatomy, 2020) Aragonés Maza, Paloma; Olewnik, Lukasz; Polguj, Michal; Quiñones, Sara; Sañudo Tejero, José RamónPurpose The quadriceps femoris has been described as a muscle composed by four heads: rectus femoris, vastus lateralis, vastus medialis and vastus intermedius. Each head fuse with the other ones making up the quadriceps tendon, which inserts into the patella. Nevertheless, there has been described a fifth component of the quadriceps muscle in recent anatomical publications. Understanding this fifth head may be important for orthopedics and radiologist. Methods Cadaveric dissection of left thigh of a female 83 years old was performed to demonstrate a fifth head of the quadriceps femoris muscle. Results In this study, a fifth head of the quadriceps femoris muscle was found in the left thigh of a female cadaver 83 years old. This fifth head was made up by four independent muscular fascicles attaching in a common flat tendon that joins distally with the lateral border of the quadriceps tendon. The fifth head found was supplied by branches of the ascending branch of the lateral femoral circumflex artery and by branches of the deep lateral division of the femoral nerve. Conclusions The incidence of this fifth belly in cadaveric studies has been reported as a range from 29 to 100%. However, no published articles refer an anatomical finding such as this multi-bellied fifth head. The knowledge of the existence and location of the fifth belly is necessary to make accurate diagnosis of QF muscle strains. Its anatomical course may be involved in patellar tracking.Item 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 RamónThe 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.