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JOURNAL OF
THE ANATOMICAL SOCIETY OF INDIA

Vol. 49, No. 2, December, 2000


In this issue :

Editorial
Dr. Patnaik V.V.Gopichand

Gross Anatomy of the Caudate Lobe of the Liver
Sahni, D., Jit, I., Sodhi L. Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Branching Pattern of Axillary Artery - A Morphological Study
*Patnaik V.V.G., Kalsey, G; Singla Rajan, K. Department of Anatomy, Government Medical College, Amritsar, *Patiala. INDIA

The Course, Relations and The Branching Pattern Of The Middle Meningeal Artery In South Indians
Manjunath, K.Y. & Thomas, I.M. Department of Anatomy, St. John�fs Medical College, Bangalore-560 034 INDIA

Morphometry of the Human Inferior Olivary Nucleus
Dhall, U; Chhabra, S. & Rathi, S.K. Department of Anatomy, Pt. B.D. Sharma P.G.I.M.S., Rohtak. INDIA

Management of Turner Syndrome in India Using Anthropometric Assessment of Response to Hormone Replacement Therapy.
Sehgal R. and Singh A. Department of Anatomy, Maulana Azad Medical College and Associated Lok Nayak, G.B. Pant & G.N.E.C. Hospitals, New Delhi ? 110 002 INDIA.

Insertion Of Umbilical Cord On The Placenta In Hypertensive Mother
Rath* G, Garg** K, and Sood*** M. *Department of Anatomy, ***Department of Obstetrics & Gynaecology, Lady Hardinge Medical College, New Delhi-110001 **Department of Anatomy, Santosh Medical College, Gaziabad. INDIA

Utility Of Finger Prints in Myocardial Infarction Patients
Dhall, U; Rathee, S.K; *Dhall, A; Department of Anatomy & *Medicine, Pt. B.D. Sharma, PGIMS, Rohtak. INDIA

The Prenatal Parotid Gland
Fouzia Nayeem, Sagaff S., *Krishna G., **Rao S. Department of Anatomy, K.A.A.U. Jeddah. Department of *Pediatrics & **Surgery, Osmania Medical College, Hyderabad. INDIA

Possibility of Cell Death Induced Skeletal Malformations Of The Upper Limb
Sinha, D.N. Department of Anatomy, B.R.D. Medical College, Gorakhpur?273013 INDIA,

Efficacy of Manual Bladder Expression in Relieving Urine Retention After Traumatic Paraplegia In Experimental Animals.
Preeths, T.S., Sankar, V. Muthusamy, R. Department of Anatomy, Dr. A. Lakshmanasamy Mudaliar Postgraduate Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, India.

Stress And Serum Cholesterol Levels-An Experimental Study
Jain, S.K. *Pandey, S.N. *Srivastava, R.K. Ghosh, S.K. Department of Anatomy, D.R.P.G. Medical College, Kangra at Tanda. * Department of Anatomy, G.S.V. Medical College, Kanpur.

Effect of Ibuprofen On White Cell Series of Bone Marrow Of Albino Rats
* Bhargava, R., Chandra, N., Naresh, M., *Sakhuja S. * Department of Anatomy, M.L.N. Medical College, Allahabad * Lady Hardinge Medical College, N. Delhi, India.

JB4 An Embedding Medium For Flourescent Tracer Technique
*Gupta, M; **Mishra, S., ***Sengupta P. Department of Anatomy, *PGI, Chandigarh; **AIIMS, N. Delhi; ***UCMS, New Delhi. INDIA

Comparative Anatomy of Cardiac Veins in Mammals
Kumar Keshaw Department of Anatomy, Institute of Medical Sciences B.H.U., Varanasi?5. INDIA

Aplasia Cutis Type 9 With Trisomy-13 Syndrome ? A Rare Association
Adhisivam, B, Narayanan, P, Vishnu Bhat, B, *Ramachandra Rao. R*, *Rao. S*, Kusre, G.* Department Pediatrics & *Anatomy, JIPMER, Pondicherry - 605 006

Absence of Musculocutaneous Nerve And The Innervation of Coracobrachialis, Biceps Brachii And Brachialis From The Median Nerve
Sud, M.; Sharma A. Department of Anatomy, Christian Medical College, Ludhiana. Punjab INDIA.

A Rare Pseudo Ansa Cervicalis: A Case Report
Indrasingh I. and Vettivel S. Department of Anatomy, Christian Medical College, Vellore, India

A Rare Variation In The Relation Of Omohyoid Muscle: A Case Report
Vettivel, S. Korula, A. and Koshy S. Department of Anatomy, Christian Medical College, Vellore, India

Surgical Incisions ? Their Anatomical Basis Part II - Upper Limb
1Patnaik V.V.G., 2Singla Rajan. K., 3 Gupta P.N. Department of Anatomy, Government Medical College, Patiala1, Amritsar2, 3Department of Orthopedics, Government Medical College, Chandigarh. INDIA

Anatomy Of Temporomandibular Joint?A Review
1Patnaik V.V.G., 3Bala Sanju; 2Singla Rajan K. Department of Anatomy, Govt. Medical College, 1Patiala, 2Amritsar, 3Department of Oral & Maxillofacial Surgery, Pb. Govt. Dental College, Amritsar


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J Anat. Soc. India 49(2) 180-181 (2000)
A Rare Variation In The Relation Of Omohyoid Muscle: A Case Report

Vettivel, S. Korula, A. and Koshy S. Department of Anatomy, Christian Medical College, Vellore, India

Abstract : Omohyoid muscle has two bellies united at an angle by an intermediate tendon. Its superior belly is in the anterior cervical triangle and its inferior belly in the posterior cervical triangle. The variable intermediate tendon is usually near and lateral to the internal jugular vein. The omohyoid presented a rare variation in the relation of the superior belly along with the intermediate tendon lying medial instead of lateral to the internal jugular vein and piercing through the carotid sheath.

Keywords : Carotid sheath, Cervical fascia, Omohyoid

Introduction :

Omohyoid (Salmons, 1995) is one of the infrahyoid (Strap) muscles. It has two bellies united at an angle by an intermediate tendon. Its superior belly is in the anterior cervical triangle and its inferior belly in the posterior cervical triangle. The variable intermediate tendon is usally near the internal jugular vein. It is ensheathed by a band of deep cervical fascia that descends to the clavicle and maintains the angle between its bellies. Over the posterior triangle, inferiorly between the trapezius and sternomastoid muscles, the general investing layer of the deep cervical fascia has superficial and deep layers, the deep layer surrounding the inferior belly of omohyoid and, deep to the sternomastoid, its intermediate tendon, finally blending with the periosteum on the posterior aspect of the clavicle and first rib and the fascia around the subclavius muscle. A variation of the omohyoid was observed.

Material and Method :

In a routine dissection in the Department of Anatomy, a variation in the relation of the omohyoid was noticed. The two bellies of the omohyoid were dissected and its direction, course, and the variation in the relation were established. The specimen was photographed.

Observations :

The omohyoid as usual had two bellies, which were connected by a short intermediate tendon. The superior and inferior bellies were in the anterior and posterior cervical triangles, respectively. The cmohyoid presented a rare variation (fig. 1) of the superior belly along with intermediate tendon lying medial instead of lateral to the internal jugular vein and piercing through the carotid sheath.

Discussion :

The general investing layer of the deep cervical fascia (Hollinshead, 1958), on the deep surface of sternomastoid muscle, gives off two sheets of fascia, the pretracheal fascia and prevertebral fascia, between which, near their origin, are found the common and internal carotid arteries, internal jugular vein, and vagus nerve. These two fasciae surround this neurovascular bundle and form the carotid sheath.

Pretracheal fascia (Hollinshead, 1958) passes across the front of the carotid system, and then splits to enclose the thyroid gland deep to the strap muscles. It gives off one single fascial process, the fascia of the depressors, which passes in front of the sternohyoid, sternothyroid, and omohyoid. It is this layer, which binds down the intermediate tendon of the omhyoid to the clavicle.

From the under surface of the superficial layer of the deep cervical fascia (Dwight et al. 1923), a middle layer (pretracheal fascia) passes forward, assists in the formation of the sheath for the carotid artery and internal jugular vein, and then divides to enclose the omohyodi and the other depressors of the hyoid bone, special thickening of it extending downward from the intermediate tendon of the omohyoid to the clavicle. The omohyoid and sternohyoid are derived from a muscular sheet, which in the lower vertebrates, invests the anterior portion of the neck region and, in man, is represented by the two muscles and middle layer of the deep cervical fascia (Dwight et al. 1923).

In the present case, the rare anomalous variation in the location and medial instead of lateral relation of the omohyoid to internal jugular vein and

Fig. 1. Superior belly of the omohyoid muscle between the common carotid arery and internal jugular vein.
O - Superior belly of omohyoid
T - intermediate tendon
A - common carotid artery
V - internal jugular vein
F - common facial vein
S - Sternomastoid muscle

the passage of the omohyoid through the carotid sheath between the internal jugular vein and common carotid artery can be explained as an unusal splitting of the deep cervical fascia. The pretracheal fascia, which forms the anterior wall of the carotid sheath and gives a process of enclose the strap muscles, in the present case, splits also individually to enclose the superior belly and intermediate tendon medial to the internal jugular vein. It results in the omohyoid appearing to pierce through the carotid sheath somewhat as a content of that sheath.

Reference

1. Dwight, T., Hamann, C.A., McMurrich, J.P., Pierso, G.A. and White, J.W. : Human Anatomy In : The Muscular System. 8th Edn; J.B. Lippincot. Philadelphia. pp 542-3. (1923).
2. HOllinshead, W.H. : Anatomy for surgeons In : The Fascia and Fascial Spaces of the Head and Neck. 1st Edn. Vol 1. Hoebar-Harper. New York. pp 282-8. (1958)
3. Salmons, S. : Gray's Anatomy In : Muscle 38th Edn. Churchill Livingstone. New York. pp 536-7 (1995).



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