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Journal of the Anatomical Society of India

Abstracts 51 - 100

Author(s): Members

Vol. 55, No. 1 (2006-01 - 2006-07)

51. Anomalous Facial Artery, A Case Report:

Sudipa Biswas, Samar Deb, Karabi Baral, North Bengal Medical College, Sushrutanagar,
Darjeeling, West Bengal.

During routine dissection of the face of a cadaver of about 60 yrs of age, anomaly of facial arteries on both sides was detected. On the right side, facial artery terminated as inferior labial artery and on left side, its sides has been taken over by the transverse facial artery, which revealed unusual tortuosity like normal facial artery. There was no venous anomaly seen. Such vascula malformations are of immense surgical importance, especially during plastic reconstructive surgery of the face. Terminated as inferior and superior labial arteries. In addition, it has been detected that the place of distal, deficient part of facial artery on both the sides has been taken over by the transverse facial artery, which revealed unusual tortuosity like normal facial artery. There was no venous anomaly seen. Such vascular malformations are of immense surgical importance, especially during plastic reconstructive surgery of the face.

52. A Rare Human Variation of Superficial Palmar Arch-A Case Report:

Karabi Baral, Samar Deb, Sudipa Biswas,
North Bengal Medical College Sushrutanagar Darjeeling, West Bengal.

A case of bilateral incomplete superficial palmar arch was reported in a female cadaver of about 70 yrs of age. Here incomplete superficial palmar arch was formed only by superficial division of ulnar artery. An unusually prominent median artery was found to continue in the palm to supply digital branches for lateral two and half fingers instead of radial artery which was absent in palm. This type of anomaly may therefore be developmentally explained as persistence of median artery in limb bud. Accurate knowledge about unusual patterns of superficial palmar arch is important, in order to be aware of hidden hazards during diagnostic (angiography) and therapeutic measures (bypass grafting) in connection with ischemic changes of hand which is non-responsive to conservative management. So, this knowledge of anatomical variation has immense importance for vascular surgery of hand.

53. Variation In Bifurcation Of The Brachial Artery A Case Report:

Deb S., Sarkar A., Ray A.
North Bengal Medical College, Sushrutanagar, W.B.

During a routine gross anatomy dissection of the superior extremity in an adult female cadaver, an unusual branch of the brachial artery was found in the right upper limb. The brachial artery terminated in the cubital fossa into an ulnar branch passing deep to the ulnar (deep) head of the pronater teres and a prominent lateral muscular branch entering into the brachio-radialis muscle in the forearm. The usual radial artery, which should have been found at the level of bifurcation of the brachial artery below the bend of the elbow was found to arise directly from the brachial artery in the middle of the arm and continued distally as usual. Found to arise directly from the brachial artery in the middle of the arm and continued distally as usual.

The embryological relevance of the variation is to be discussed.

54. Abnormal Course Of Testicular Arteries In Nepalese Cadavers:

Sukhendu Dutta, L. Chandramani Singh,
Sikkim Manipal Institute of Medical Sciences, Sikkim.

During routine dissection at the Manipal College of Medical Sciences, Pokhara, Nepal from the year 1999 to 2001, 19 cadavers (male- 13 and female – 06) were dissected of which there was difference in origin and course of the testicular arteries among the five cadavers but there was no such difference was found among the female cadavers except in one, on which there was no difference in the origin or the course but on the left ovarian artery was tortuous.

55. Persistent, Enlarged Median Artery, A Case Report:

Smita. D. Joshi,
Seth G.S. Medical College and K.E.M Hospital Parel, Mumbai.

During routine dissection of an adult male cadaver a prominent median artery was seen to be arising from common interosseous artery. It was found to run along the median nerve and then it entered the palm superficial to flexor retinaculum. It was found to complete the superficial palmar arch by joining the ulnar artery in the palm. Superfical palmar branch of radial artery was absent.

The embryological basis and the clinical implication of this interesting anatomical variation will be discussed.

56. An Unusual Variation In The Arterial Pattern Of A Human Upper Limb:

Preeti R. Bolwar,
Seth G.S.M.C., and K.E.M.H. Mumbai.

The brachial artery, as we all know, is a continuation of axillary artery and begins at the lower border of teres major. This artery in its upper part lies on the medial aspect of the arm. As it descends, it gradually passes forwards, so that its lower end lies in front of the elbow. Here it terminates by dividing into the radial and ulnar arteries.

During routine dissection of the upper limb, in an embalmed cadaver an unusual variation of the arterial pattern was observed. The brachial artery after giving off profunda brachii artery, divided in its upper one third into two equal sized arteries. These arteries were found to run parallel to each other. One of the brachial arteries was possibly a high origin persisting radial artery, while the other was the high origin of the common interosseous artery.

Till today. the literature has shown many variations in the course of the brachial artery. Most of these documentation were pertaining to the gross anatomy of the brachial artery. This paper deals mainly with the embryological basis and clinical implications of such variation.

57. Variations In The Branching Pattern Of Internal Iliac Artery-a Case Report:

Pushpa M.S., Roopa Kulkarni, Sheshgiri C. and R.N. Kulkarni,
M.S.Ramaiah Medical College, Bangalore.

During the routine dissection of the human cadaver an anomalous branching pattern of Internal iliac artery was observed which showed origin of Ilio-lumbar artery arising from the stem of Internal iliac artery instead of arising from the posterior division of Internal iliac artery.In the same cadaver the obturator artery was arising from the posterior division instead of arising from anterior division of Internal iliac artery. The details of course and distribution will be discussed during presentation.

During the routine dissection of the human cadaver an anomalous branching pattern of Internal iliac artery was observed which showed origin of Ilio-lumbar artery arising from the stem of Internal iliac artery instead of arising from the posterior division of Internal iliac artery.In the same cadaver the obturator artery was arising from the posterior division instead of arising from anterior division of Internal iliac artery.The details of course and distribution will be discussed during presentation.

58. Anomolous Suprarenal Arterial Supply In Nepalese Cadavers:

Sukhendu Dutta, L. Chandramani Singh,
SMIMS, Sciences, Tadong, Sikkim.

Suprarenal (adrenal gland) is one of the most important organs to maintain internal environment of the body. During routine dissection it was found that there is anomalies in arterial supply of the gland. Out of 17 cadavers (male – 11 and female – 6) right superior suprarenal artery of all cadavers was getting origin from the right inferior phrenic artery (IP A). There was variation in the origin of left superior suprarenal artery: 76% were £Tom left IPA, 18% directly from abdominal aorta (AA) and 06% from two sources were left IP A and spleenic artery. There was variation in the origin of middle suprarenal artery (MSA): on the right side 53% from AA and 47% was from different sources and/or absent of which 18% from accessory renal artery, 29% cases MSA were absent. It was observed that all 29% cadavers there was aberration in the inferior suprarenal artery (ISA). On the left side the MSA of all cadavers were getting origin from the AA of the respective side except in one cadaver, where it was getting origin as a common stalk along with the accessory renal artery from the AA. The ISA of right side 70% cases were getting origin from the right renal artery (RRA), 06% there was two branches one ! Tom the RRA and other one from the junction between the RRA and AA, 06% was from the right testicular artery (RTA) as a single branch, 12% from the RRA and also from the RTA, 06% both from the RRA and right ovarian artery. On the left side 35% of cadavers there was absence of ISA, 59% cases from the left renal artery and 06% from the left testicular artery. This finding shows that there is a variation in the arterial supply pattern in the Nepali population.

59. Anomalous Circle of Willis:

V. Rajaram
Institute Of Anatomy, Madurai Medical College, Madurai.

The brain is supplied by a pair of internal carotid and a pair of vertebral arteries.They form an an anastomosis called circle of willis.The circle of willis lies in interpeduncular fossa.

When the circle of willis was studied in 20 cadaver brains,an interesting anomaly was seen in the posterior segment of one of the specimens. The right posterior cerebral artery was seen to arise from the right internal carotid artery.

The basilar artery divides in to a left posterior cerebral artery and a small thin right which joins with the anomalous RT. Posterior cerebral artery arising from the internal carotid artery.

60. Variation In Origin Of Obturator Artery – A Case Report:

M. Krishnaiah, T.V. Ramana chary, T. Rajashree,
OMC, Koti, Hyderabad, A.P.

A routine cadaveric dissection presented a comparitively rare variation in origin of obturator artery from external iliac artery whose incidence is 1.1%. Course, relation and branches of obturator artery are important during surgery of femoral hernia.

Origin, course, relations, clinical significance of the variation will be discussed.

61. Formation Of Superficial Palmar Arch By Median Artery- A Case Report:

Samata R. Padala, T.V. Ramana Chary, T. Rajashree
Department Of Anatomy Osmania Medical College Koti, Hyderabad, A.P.

A routine cadaveric dissection revealed a variation in the formation of superficial palmar arch.Though variation in superficial palmar arch are common; its formation by median artery is comparitively rare. Origin, course, embryological explanation, significance of median artery superficial arch and termination of radial artery are disscussed in detail. Termination of radial artery are disscussed in detail.

62. Bilateral Asymmetry Of The Intracranial Internal Carotid Artery In Man:

Rustogi S.M., Bharihoke V., Sangari S.K.
University College Of Medical Sciences and G.T.B. Hospital, New Delhi.

The internal carotid arteries, one of the feeder vessels of the brain are commonly implicated as the site of atherosclerotic lesions in cerebrovascular accidents. Recent advances in radiological techniques make it imperative for us to know their normal parameters in the Indian population.

The intracavernous part of human internal carotid artery was studied in hundred autopsy cases in U.C.M.S and G.T.B. Hospital, Delhi. The cases were grouped according to age-Group I 20 years, Group II, 20-40 years and Group III 40 years. The arteries were exposed by dissecting the cavernous sinus. Various patterns of tortuosities of the internal carotid artery were observed on the lateral side of body of sphenoid.

Following measurements were taken, a) length from apex of petrous temporal to where it pierced the dura mater and b) external diameter at its midpoint. The volume was calculated.

The length was found to be significantly more on left side in Groups II and III (21.57mm ± 2.46 and 21.70mm ±2.24 respectively) as compared to the right side (21.12 mm ± 2.46 and 21.09 mm ± 2.15 respectively) with p values 0.013 and 0.002 respectively.

The outer diameter was found to be significantly more on left side in Groups III (5.12 mm ± 0.57) as compared to right side (5.03 mm ± 0.49) with p value 0.018.

The volume was found to be significantly more on left side in Groups II and III (p=0.017 and p=0.006 respectively. These observations suggest left sided dominance.

63. A Study Of Circle Of Willis And Variations Including Cerebral Arteries:

A. Prasanna Veera Kumar, K.S.N. Prasad,
Siddhartha Medical College, Vijayawada, A.P., India.

Aim of study is to measure vessels forming circle of willis and record variations. To study whether left hemisphere has a better blood supply and configuration of bifurcation formed by posterior communicating artery (PCA), Pre communicating (P1) and Post communicating parts of posterior cerebral artery (P2).

17 specimens from dissecting room cadavers are studied. A caliper graduated to measure upto 0.02 mm used. Detailed diagrams drawn and photographs obtained.

Arteries of less than 1 mm diameter are considered abnormal and in case of communicating arteries of less than 0.5mm (Alpers, 1959). Internal Carotid Artery measured between posterior communicating and anterior cerebral. Anterior and posterior cerebral at their origin and where they are joined by the comm unicating. Communicating arteries in cntirety (S. Kamath, 1981).

Diameter of PI is subtracted from the diameter of corresponding PCA. A negativc rcsult is Adult type. A positive result is fetal type. And a zero result is transitional type. (J.J. Overbeeke and Others, 1991).

Abnormally small arteries observed in 5 arteries. The finding of most frequent in posterior cerebral concur with (Windle 1887; Faucet, 1905; S. Kamath, 1981). Blood supply is almost similar to both the hemispheres. This aspect is differing from S. Kamath’s observation. Regarding configuration, Adult type 73%, Fetal type 18% and Transitional 9% are close to (JJ. Overbeeke’s Adult 84%, Fetal 14% and Transitional 2% and Ovcrbeeke’s analysis of Kamath’s se’ries i.e. Adult 73.5%, Fetal 25 OK) and Transitional 1.5%).

  1. Double anterior communicating in 2 specimens.
  2. One closely joing anterior cerebrals.
  3. Segmental duplication of anterior cerebral at distal segment of A I on both sides.
  4. Posterior communicating artery not joining posterior cerebral instead passing posterolaterally on left side.
  5. Posterior communicating absent on left side in two specimens.

64. An Unusual Variation In The Arterial Supply Of Face – A Case Report:

Ms. Susan Joseph,
ASM, Amrita Vishwavidyapeetham Cochin,Kerala.

Variations in the arterial supply of face are quite common but important to the plastic surgeons for the design and creation of certain local facial flaps, following is a case report on an anomalous pattern of the face.

During routine dissection of an adult male cadaver the facial artery on the left side of the face was found arising from the lingo facial trunk at the level of the greater cornua of the hyoid bone. After giving the usual branches here, it then was found to wind around anteroinferior angle of masseter to enter the face. The vessel was not tortuous and it had a thin caliber and continued further forwards to terminate by piercing the buccinator. Before termination it give rise to small inferior labial branch.

A highly tortuous transverse facial artery was found to arise from superficial temporal artery and passed parallel above the parotid duct crossing masseter, facial vein and then continued as the superior labial artery and lateral nasal artery. No such variations were found in the opposite side of face.

The clinical and embryological significance of the above anomalies will be further discussed.

65. An Unusual Branching Pattern Of The Axillary Artery – A Case Report:

Sandhy A. Kurup,
Amrita School of Medicine, Amrita Vishwavidyapeetham, Cochin, Kerala.

Variation in the branching patterns of the axillary artery have been reported widely.

During routine dissection of the left upper limb of a male cadaver, an anomalous branch of the axillary artery was observed. The branch arose opposite the origin of thoracoacromial artery (under cover of Pectoralis minor) and gave rise to the lateral thoracic, subscapular, anterior and posterior circumflex humeral branches and a few other branches. The main trunk of the axillary artery continued distally beyond the lower border of Teres major as the brachial artery as in the normal course.

No such variation was found in the opposite upper limb. The details and course of the significant branches will be discussed later.

66. Morphometric Study Of The Radial Artery:

Nitin R. Mudiraj, (Mrs.) Rajgopal Lakshmi*, Praveen Iyer*
Dept. of Anatomy, Bharati Vidyapeeth Medical College and Hospital, Sangli. *Seth G. S. Medical College and KEM Hospital, Parel, Mumbai.

After reviewing the literature thoroughly, it was found that even though radial artery can be used in a wide-ranging clinical applications there is depth of literature pertaining to the anatomy of radial artery in Indian subjects So, this study was undertaken with i following aims and objectives.

  1. To measure the length of radial artery.
  2. To measure the diameter of radial artery at the origin, midway and at anatomical snuffbox on the right and the left sides and to compare them.
  3. To apply these findings to various clinical situations in their diagnosis and treatment.

90 upper limbs from 45 formalin-fixed cadavers, were dissected meticulously to expose the radial artery from its origin to its termination. The length of radial artery from its’ origin to 1st dorsal interosseous space was measured and noted, the’ diameter of radial artery at its origin, midway (at the mid-point of its length) and the anatomical snuffbox was measured. The measurements on the right and left side were compared and; conclusions drawn.

  1. The mean length of radial artery on the right side was round to be 26.73 cm and on the left side it was fond to be 2658 cm.
  2. The mean diameter of right radial artery at the level of its origin was found to be 2.61 mm and that of the left radial artery was found to be 2.59 mm.
  3. The mean diameter of right radial artery at midway was found to be 2.37 mm and the same on the left side was found to be 2.24 mm.
  4. The mean diameter of right radial artery at the anatomical snuffbox was found to be 2.07 mm and the same on the left side was found to be 2.09 mm.

67. Anomaly Of Ulnar Artery:

K. Gopinathan,
Amrita School of Medicine, Amrita Vishwavidyapeetham, Cochin, Kerala.

An interesting case of double ulnar artery was observed in the right upper limb of a female cadaver used for teaching in our department.

One ulnar artery was seen arising from the terminal end of the brachial artery in the cubital fossa and gave the ulnar recurrent arteries, common interosseous, anterior and posterior interosseous arteries and terminated by giving muscular branches. The second ulnar artery was seen arising from the middle of the brachial artery in the arm and continued in the superficial fascia of the arm and forearm on the medial side and reached palm to form the superficial palmar arch. In the arm this artery gave the superior and inferior ulnar collateral arteries. This superficial ulnar artery is more prone for injury and is of particular interest to the surgeons.

68. Variations In The Origin, Course And Supply Of Inferior Thyroid Artery

L. Hema,
J.J.M. Medical College, Davangere, Karnataka.

In the present study the origin of inferior thyroid artery has been observed in 90 cadavers. But 60 cases showed variations. 10% of the cases showed variations in the subclavian artery where in 8 were on the right side and 7 were on the left side. In 3.33% of cases, the origin has been from brachiocephalic trunk in which 3 were observed on left side. In 10% cases, the origin was observed from first part of the axillary artery in which 9 were on the right side and 4 cases on left side.

In 6.66% of cases, inferior thyroid artery was absent, with 6 cases on the right side and 4 cases on the left side.

Variations observed in the course of inferior thyroid artery revealed that the course was oblique and medial in 10% of cases and vertical in 3.3% of cases. The course has been found to be horizontal, medial and obliquely upwards towards lower pole of the right lateral lobe of the thyroid gland in 10% of cases.

However, in all the cases that were studied for variations showed that all the branches to the thyroid gland were normal and anastamosed with descending of inferior thyroid artery and contralateral inferior thyroid artery.

69. Anomalous testicular Vasculature – A Case Report:

Thangaraj S.P.,
PIMS, Pondicherry.

Dissection in an adult male cadaver revealed the presence of an accessory left renal artery (in addition to the presence of normal left renal artery) which gave origin to left testicular artery. On the right side there was no testicular artery arising from the aorta, renal artery or iliac arteries, where as a small artery accompanying the vas deferens (? Artery to vas) replaced right testicular artery.

The left testicular vein drained into the left renal vein, whereas on the right side, the pampiniform plexus gave rise to 5-6 efferent veins which ultimately ended in the right renal vein and into the inferior vena cava at various levels. The embryologic cause and clinical significance of this anomalous vasculature will be discussed. Embryologic cause and clinical significance of this anomalous vasculature will be discussed.

70. Anomalous Origin Of The Left Coronary Artery from the Pulmonary Artery (ALCOP A) -A Case Report:

Thangaraj S.P. and Ezhilian J.,
IMS, Pondicherry.

Instead of dual coronary arteries from the aorta, one on more segments of the coronary arterial circulation can originate from the pulmonary trunk. Anomalous origin of the left coronary artery from the pulmonary trunk is the most common clinically important congenital malformation of the coronary circulation. This interesting finding was observed in a 18 years old young female in the Department of Cardiology, Pondicherry Institute of Medical Sciences, Pondicherry. Routine coronary angiogram study of this patient revealed retrograde flow of contrast medium from right coronary artery into left coronary artery which ultimately drained into the pulmonary trunk. The clinical significance and the possible embryologic cause for this congenital anomaly will be discussed.

71. Variation in the Termination of External Jugular Vein – A Case Report:

Shailaja C.Math, K.Sandhya, G.B. Rairam,
M.R. Medical College, Gulbarga.

The knowledge of variations occuring in the vascular system is of great importance to the surgeons and professionals who work with imaging. The following variation in the termination of external jugular vein was found in a cadaver during our routine dissection. In a male cadaver of .55-58 year old, we found the right external j ugular vein draining into the internal jugular vein instead of draining into the subclavian vein (Rt). The termination of the left external jugular vein was normal. The case will be discussed in detail during the paper presentation.

72. Anomalous Origin Of Subclavian Steal Syndrome A Case Report:

Jnanesh. R. S. *, Timothy Lopez, Jason Brown, Boyenpalli Madanmohan, Almazan Gerald,
JJM Medical College, Davanagere, Karnataka, India and Dept. of At!atomy, Saba University School of Medicine, Saba, Netherlands, Antilles.

Anomalies of arteries are common and clinically important. Vertebral artery anomalies are particularly important in vertebral artery steal syndrome and vertebral insufficiency. In this particular specimen right vertebral artery was larger than the left. Left vertebral artery was found to arise from the arch of aorta. Left vertebral artery was smaller than the right. The right Vertebral artery origin was from the first part of subclavian artery. Both right and left vertebral artery entered the foramen transversarium of the 6th cervical vertebra. The size of the right vertebral artery was 3 times larger than the left. Findings will be discussed with their clinical significance.

73. Duplication And Absence Of The Inferior Thyroid Artery:

L. Hema,
Department of Anatomy, J.J.M. Medical College, Davangere, Karnataka.

In the present study in about out of 90 cadavers showed duplication of the inferior thyroid artery was observed. The inferior thyroid artery was found to arise from the subclavian artery of the right side (10) while sa second branch was found to be crossing the right side entered into the left lobe of the lower pole of the thyroid gland.

In another case, the two inferior thyroid arteries were arising from the thyrocervical trunk.

The details will be discussed in during presentation.

74. Study Of Circle Of Willis – Anterior Part:

Vohra H., Singh P., Sood V.
Dayanand Medical College and Hospital, Ludhiana (PB)

The study of arteries forming anterior part of the Circle of Willis was conducted in the department of Anatomy, DMCandH, Ludhiana using 30 brains from cadavers and 30 MR angiograms of patients not suffering from any cerebrovascular disease. Calibre of arteries in gross specimens was measured using fine divider and ruler, whereas the caliber was measured in MR angiograms from theMRI machine. The caliber of lumen of Al and A2 segment of anterior cerebral artery was found to be between 0.5­2.5mm in gross specimens and 1.02.5mm in MR angiograms (AI segment) and 0.6-2.5mm(A2 segment). The caliber of lumen of anterior communicating artery was found to be between 0.5-1.5mm in gross specimens and 0.5­1.7mm in MR angiograms. The caliber of lumen of internal carotid artery seen in gross specimens was 2.0-4.0mm and 2.2-4.2mm in MR angiograms. Hypoplasia of anterior communicating artery was seen in 6.11 . Duplication of anterior communicating artery was seen in 3 gross specimens. Hypoplasia of internal carotid artery was seen in 10 in gross specimens and 3.37% in MR angiograms comparison of the results with other studies will be discussed in the paper.

75. Hepatic Veins Reviewed:

Joshi S.D., Joshi S.S., Siddiqui A.U. and Athavale S.A.
Dept. of Anatomy,Rural Medical College, Loni, Ahmednagar.

Segmental anatomy of liver has assumed greater significance due to the fact that in many institutions liver transplantation and surgical segmentectomies have become common. Hence a good knowledge of anatomy of liver is a prerequisite for surgery of liver. A large amount of information is available regarding the segmentation of liver into various lobes depending on the distribution of hepatic pedicles. Some of the best known and most widely employed concepts of hepatic segmentation are Couinand (1954), Healy and Schroy (1953),Goldsmith and Woodbume (1957) and Bismuth (1982). Majority workers have classsified eight hepatic segments. As the hepatic veins mostly occupy intersegmental planes,some workers have described four fissures, only one is represented superficially – the portoumbilical fissure. The other three fissures are related to the three large hepatic veins.

There is no comformity of opinion regarding the number of hepatic veins in the superior and inferior sets. The data regarding the size of superior hepatic veins is also not available. We have undertaken a detailed study of retro-hepatic segment of inferior vena cava and the termination of hepatic veins in 50 livers.

The superior set of hepatic veins comprise of 2 veins in 60% cases and 3 veins in 40% cases. Right hepatic vein had a greater diameter (average 1.43 cm) than the left (average 1.20 cm) and, when present, the intermediate vein (average 0.91 cm.). The number of veins in the inferior set varied from. 3 to 15 veins. Average length of retrohepatic part of IVC was 5.9 cm and its diameter 1.96 cm In 32% the inferior set of veins were dispersed throughout the length of this segment of NC terminating in its anterior and lateral walls. In the inferior set,large veins were formed in 32%.

Findings of the present work will be discussed in the light of available literature.

76. Medial Circumflex Femoral Artery-a Rare Anomaly

G. Ravindranath, N. Jayasree, N. Ratnakar Rao, Ranadheer. Reddy, Mariakala, Teresa Rani,
Kakatiya Medical College, Warangal, A.P.

During routine dissection of cadavers, In the Department, only one case of total absence of Medial Circumflex Femoral Artery has been observed. Such variation has been considered as rare incidence when the literature was reviewed.

Other branches of profunda femoris Artery has been observed and will be discussed.

77. Anomalous Origin And Course Of The Right Radial Artery – A Case Report

Minnie Pillay, Mr. Gracemon Kuriakose,
Amrita School of Medicine, Amrita Vishwavidyapeetham Cochin, Kerala.

Though variations in the branching pattern of brachial artery are quite common, we observed an unusual variation in the origin and course of radial artery during routine dissection of the right upper limb of a male cadaver. The radial artery arose from the medial side of the brachial artery in the arm, crossed over the ulnar artery and the median nerve from medial to lateral side, and continued on to the elbow and forearm. At the elbow, the artery is joined to the ulnar artery by a short arterial arch. The details of the branching pattern and the clinical implications are discussed in the paper.

78. Observation of Modes of Brachial Artery Termination In South Indian Cadavers:

Jnanesh R.S., Gowri Shankar,
J.J.M Medical College, Davanagere, Kamataka.

Radial artery approach for percutaneous coronary interventions has been proved efficacious. The high division of brachial artery is a hidden hazard in percutaneous brachial catheterization. In this background, twenty specimen of upper limb have been studied for their termination pattern. All cadavers come from south Indian population. Three specimens showed anomalous division in the arm. The relation of radial artery to other structures was markedly different in two specimens.

79. Superficial Ulnar Artery – A Case Report:

Latika Arora, Rima Dada,
AIIMS, Delhi.

Variation in the arterial system of the upper limb is well documented. The superficial ulnar artery is well known but very rarly encountered abnormality. Superficial positions of the ulnar and radial artery make them more vulnerable to trauma and thus to hemorrhage but at same time more accessible for cannulation if necessary. Thus we have tried to study literature on variations in this area.

80. Superior Thyroid Artery:

Maria Kala, N. Jayasree, N. Ratnakar Rao, Ravindranath, Ranadheer Reddy and Rani,
Kakatiya Medical College, Warangal. A.P.

Foetuses from Government Hospitals namely Government Maternity Hospital, Hanamkonda, and Chandra Kantha” Memorial Hospital, Warangal and other private Nursing Homes were collected and preserved in 10% formaline.

In the present study only 50 foetuses out of 62 with gestation stage varying from 24 to 32 weeks and systematic dissection was carried to expose external carotid artery. Superior thyriod artery with its origin, course and termination has been observed on both sides. Variations of this artery, with review of literature will be discussed in detail.

81. Anomalous Origin Of Vertebral Artery:

BN.Rao, Venu Madhav
Maharaja Institute Of Medical Science Nellimorla, Vishakhapattanam.

Departure from usual plan of arrangement of blood vessel are among the commonest of developmental irregulrities due to variety of causes. In the dissection hall, during the regular dissection at anatomy department of MIMS, the anomalous origin of vertebral artery has been found. The vertebral artery on right side are from subclavian artery. But on the left side the vertebral artery is arising separately from arch of aorta. The course of vertebral artery has been traced and further consideration of anomalous origin of vertebral artery will be discussed.

82. Rare Variaton Of Radial Artery:

Md. Abid Ali, K.V. Vijaya Sarathi, S.S., Sarada Devi,
Bhaskar Medical College Yenkapally Moinabad, Ranga Reddy.

Variations in origin of the radial artery are commonly observed phenomena, but its high origin and reinforcement of it with an additional branch is comparatively rare. In a male cadaver of about 65 years radial artery has a high origin from brachial artery on left side. It is joined by an extra vessel in the cubital fossa. The course, relations and clinical significance are discussed.

83. Main And Accessory Renal Arteries – A Morphological Study:

Kumud Lall and Puspha Dhar,
All India Institute of Medical Sciences, New Delhi.

Comprehensive dissection carried out in the dissection hall of Anatomy Department of All India Institute of Medical Sciences (India) on forty cadavers over a period of five years revealed a single main renal artery on either side in 80% of the specimens. The mean length of the main renal artery was 31.05+- 12 and 25.0 +- 9.5mm on the right and left side respectively. Multiple (accessory) renal arteries were observed in 20% of the specimens with unilateral anomaly (15%) being more commonly encountered than the bilateral anomaly (5%). The mean length of the accessory renal artery was 36.4 +- 10 and 36.6 +-11 mm on the right and left side respectively. The accessory artery when present, invariably crossed the anterior aspect of the ureter.

The present work was undertaken to document the incidence of accessory renal arteries in kidney specimens obtained from subjects of Indian origin. Familiarity about the possible variations in the renal arterial pattern are especially important for the personnel dealing with kidney retrieval and transplantation, various endourologic procedures and innumerable interventional techniques. In the majority of such situations, it is the comprehensive knowledge of the renal arterial pattern which remains the key issue in determining the technical feasibility of surgical interventions as well as the post operative management.

84. Human Laryngeal Nerve Plexus:

R.S. Humbarwadi, Mamata P. Chimmalagi, Vishal Bhat, Miss. Shalini Hegde.

Aim of the study was to check the neural premise of the laryngeal innervation by simple dissection method with modification including submarine dissection.

Internal laryngeal nerves (ILN) were dissected in 46 cadavers. The arrangement of the Internal Laryngeal Nerve and its branches with swellings (Ganglia) was studied in detail.

An irregular loosely arranged ganglionated nerve plexus was observed in the wall of larynx. This can noticeably be divided into a superficial thyrohyoid part and a deep sacculo-piriform part.

There is an unequivocal presence of an integrated neural plexus in the wall of larynx. This emphasizes the importance of the role of sensation in swallowing and establishes the presence of Human Laryngeal Nerve plexus like other visceral plexuses.

85. Variation In The Formation Of Ulnar Nerve:

V. Ravikumar, Gourishankar Ganga,
J.J.M.M.C. Davangere.

In the cadaveric dissection of the 16 upper limbs which were studied a variation was observed in a single upper limb in the formation and composition of ulnar nerve.

Ulnar nerve is a branch of medial cord and normally it gets a contribution from C7 nerve root through lat. cord of brachial plexus.

In the present study the lateral cord has given a major contribution in one upperlimb in the formation of ulnar nerve and diameter of the nerve communication from lateral cord is significantly large.

The relatively larger contribution of lateral cord in the formation of ulnar nerve crossing the third part of axillary artery from lateral to medial side was observed.The diameter of the nerve contributing to the ulnar nerve is significantly large,hence the surgical procedures in this area should be carefully dealt with this type of nerve variation.

The details of the study regarding this type of nerve variation will be discussed during the presentation.

86. Variation In The Course of Musculocutaneous Nerve – A Case Study:

Shaguphta, Tasnim Shaikh,
Seth G.S.M.C and K.E.M.H. Parel Mumbai.

Variations of the brachial plexus are not rare. They have been commonly reported in the literature. Anomalies of a single branch arising from a cord or of an entire cord maybe present. The musculocutaneous nerve arises from the lateral cord opposite the lower border of the pectoralis minor and its root value is from the fifth to the seventh cervical ventral rami. It pierces the coracobrachialis muscle and descends laterally between the biceps and brachialis along the lateral side of the forearm. It supplies coracobrachialis, both heads of biceps brachii and a major part of the brachialis muscle. The branch to the coracobrachialis muscle arises before it pierces it.

During routine dissection of an embalmed male cadaver it was found that the musculocutaneous nerve did not pierce the coracobrachialis muscle bilaterally.

This paper deals with the development, comparative, functional and clinical anatomy of the musculocutaneous nerve as also the law enunciated by Prof. R.J Last that a nerve usually bribes a muscle before getting the sanction to pass through the muscle.

87. Variation In The Mode Of Innervations By The Muscul – ocutaneous And Median Nerve – A Case Report:

Deb S., Santra B., Ray A.
North Bengal Medical College, Sushrutanagar, West Bengal.

Variations in the formation and distribution of musculocutaneous nerve and median nerve in the infraclavicular part of the brachial plexus are common. During a routine gross anatomy dissection of the axilla and superior extremity in an adult female cadaver, the musculocutaneous nerve was seen to be absent and the motor branches to the flexor muscles of the upper arm and the lateral cutaneous nerve of the forearm seemed to arise in common from the median nerve. After the common fascial sheath was separated, the muscular branches to the coracobrachialis, biceps brachii, and brachialis were found to arise directly from the median nerve and the lateral antebrachial cutaneous nerve was detected to arise from the median nerve in the middle of the arm 19.8 cm distal to the coracoid process.

Several variations have been reported in literature and the frequency of anomalies found in the nerves of this region emphasizes the clinical complications in case of surgical approaches.

88. Bilateral Additional Lateral Root In The Formation Of Median Nerve – A Case Report:

Deshmukh A.G, Kulkarni P.R., Devarshi D.B.
Govt. Medical College, Nanded.

Variation of peripheral nerve are of interest to the clinician especially to the surgeons. During routine cadaveric dissection in Dept. of Anatomy Govt. medical college Nanded, a 50 year old male revealed with abnormality in the formation of median nerve on both right and left side.

In present case both median nerves in addition to normal root are joined by an unusual large contributory root from the lateral cord .This additional root from lateral cord joins the medial root in front of axillary artery. Then medial root with additional lateral root and lateral roots join to form main trunk in front of brachial artery.

Knowledge of such kind of variations are useful for surgeons particularly in surgical procedures of axillary region.

89. Variation In The Brachial Plexus – A Case Report:

Varsha, P. Dahiphale, Bahetee B. H.,
S. R. T. R. Medical College, Ambajogai

Variations in the formation of lateral cord of brachial plexus and communication between its branches are observed commonly, but the variation of fusion of the lateral cord with the medial cord of brachial plexus is not reported previously.

The present case report describes unilateral variation in the formation of brachial plexus in the supraclavicular part. Lateral and medial cords of brachial plexus unites above the clavicle. The common trunk formed by fusion of lateral and medial cords gives rise to branches which are normally given by two cords separately.

Normally median nerve is formed by two roots from the two cords, but in this case the median nerve arises directly from the common trunk with the absence of two roots of it.

The frequency of variations in formation and distribution of branches of brachial plexus makes this anatomic region complicated with regard to surgical approach

90. Unusual Origin And Variation In The Topographical Relation Of Inferior Alveolar Nerve In The Infratemporal Fossa – A Case Report:

Sharma A., Vohra H., Soni A., Singh P., Sood V. Dayanand Medical College and Hospital, Ludhiana, Punjab.

A case is reported in which unusual variation in the origin of inferior alveolar nerve was found during routine dissection of infratemporal fossa in the Dept. of Anatomy, DMCandH, Ludhiana. The inferior alveolar nerve in this case originated from the mandibular nerve by two roots. Its relationship with the maxillary artery also showed variation. The second part of maxillary artery was passing between the two roots of inferior alveolar nerve. An embryological basis of this variation and its potential clinical significance are discussed.

91. Anomalous Formation of Sciatic Nerve: A Case Report:

M.A. Rahman, D.B. Dcvarshi,
Govt Medical College, Nanded.

During the routine cadaver dissection of one adult male in the department of Anatomy at Govt. Medical College, Nanded, anomalous formation of Sciatic Nerve was found in both inferior extremities. Usually sciatic nerve is formed in the, pelvic region and its division occurs above the popliteal fossa. But in this case sciatic nerve was formed in the gluteal region. Ventral and dorsal division have come Separately in the gluteal region, separated by fibres of piriformis muscle. Their division is in the popliteal fossa. As the anomalous formation of sciatic nerve is rare, this case is reported.

92. Unusual Nerve Supply Of Biceps From Ulnar Nerve And Median Nerve; A Third Head Of Biceps:

Latika Arora, Renu Dingra
AIIMS, Delhi.

Variation in branching pattern of brachial plexus are common and have been reported by several investigators (Ken 1918, Poynter 1920 and Linell 1921). Of the four main nerves traversing the arm, namely median, ulnar, radial and musculocutaneous, the ulnar and median nerve do not give any branches to muscles of arm (Hollinshead 1976). Ulnar nerve after taking origin from medial cord of brachial plexus, runs distally through axilla on medial side of axillary artery till middle of arm, where it pierces the medial intermuscular septum and enters the posterior compartment of arm. Ulnar nerve enters forearm between two heads of flexor carpi ulnaris from where it continues further to supply flexor carpi ulnaris, flexor digitorum profundus and intrinsic muscles of hand (Grays Anatomy 39 ed). We recently observed dual supply of biceps muscle from ulnar and median nerves in arm. Musculocutaneous nerve was absent. Although communications between nerves in arm is rare, the communication between median nerve and musculocutaneous nerve were described from nineteenth century (Testut1864; Villar 1888 and Haris 1904) which could explain innervation of biceps from median nerve. But no accurate description of ulnar nerve supplying biceps could be found in litrature. Knowledge of anatomical variation of these-nerves at level of upper arm is essential in light of the frequency with which surgery is performed to transfer nerve fascicles from ulnar nerve to biceps in case of brachial plexus injuries.

We also observed third head of biceps which have also been reported by: Nakatanietal 1998 and Naggar et al. Our aim is to describe the exact topography of this variation and to discuss its morphological and clinical significance.

93. Triceps Of Anterior Compartment Of Arm!!? A Study Of Variation Of Biceps Brachii Muscle:

T.S. Gugapriya, Dr. N. Rajasekaran,
Institute of Anatomy, Madras Medical College, Chennai.

Biceps brachii is not an uncommon muscle to go in for variation with respect to presence of more than 2 heads, this variation ranges from 2.3%-21.5% as reported by various authors.

To study the presentation of biceps brachii muscle.

20 upper extremities from 10 formalin fixed human cadavers.

A 50 year old male cadaver presented bilaterally with 3 heads of origin of biceps muscle with normal mode of insertion.On examination of other arm and forearm muscles showed associated variation in the presentation of pronator quadratus muscle.

The probable genesis of such a combination of variation has been discussed in this paper tracking back our footsteps towards our remote ancestors.

94. Triangular Fibrocartilage Complex (TFCC): Some Anatomical Considerations:

Jadhav S.D., Joshi, S.S, Joshi, S.D., Athavale, S.A. And Waghmode, P.S.
Rural Medical College, Loni, Ahmednagar.

The head of ulna is excluded from the formation of wrist joint and there is interposed a triangular fibrocartilagenous disc complex (TFCC) that separates the head from the carpal bones. What could be the functional significance of such a mechanism? It has been suggested that TFCC functions both as a cushion for the ulnar carpus and as a major stabilizer of the distal radio-ulnar joint. Significant loads are transmitted to the forearm unit through the distal ulna via TFCC. Many workers have carried out a detailed study of this complex using the various techniques like gross dissection, histology, sonography and MRI in different positions of hand. While carrying out the dissection of wrist and inferior radio-ulnar articulation it is obvious that TFCC is posed like a link between the two joints and is an important factor to allow for and limit the movements of pronation and supination between the lower ends of radius and Ulna. While reviewing the literature we did not come across any study on Indian subjects. Therefore detailed investigation of this complex has been carried out in hundred limbs.

The data so collected from the present study will be compared with that of other workers. The functional and clinical relevence of study will be discussed.

95. Metrical And Nonmetrical Study of Lower End of Ulna:

Joshi, S.D., Joshi, S.S., Athavale, S.A., Jadhav, SD And Waghmode, P. S., Rural Medical College, Loni, Rahata, Ahmednagar.

The anatomic relationship between the distal radius and ulna and ulnar carpus are precise; and even minor modifications in these relationships leads to significant load changes and resultant pain syndromes.

Although ulna is separated from the wrist proper by a fibrocartilagenous disc; ulna is an important functional element of the wrist integral to the normal function of forearm and hand. The articular surface on the circumference of head of ulna is known as the seat. This varies in shape and curvature. The distal aspect o f ulna consists of three parts; the ulnar styloid process, the fovea and the pole. The pole is described to be ‘U’ shaped for articulation with the fibrocartilagenous disc; and the fovea gives attachment to the apex of triangular fibrocartilagenous disc. The distal radio-ulnar joint allows the large excursions of forearm pronation and supination as well as ulnar deviations of wrist that enhance the manipulating skills of the hand. The differences in the size,shape, inclination and area between the various components will account for dexterity or otherwise of movements exhibited by the hand.

Considering the above mentioned facts a detailed metrical and nonmetrical study of lower end of ulna has been conducted in our department on 150 ulnae ( Rt- 75; Lt-75 ).

The seat showed variable extension on the anterior and the posterior surfaces, although it was mainly on the lateral surface of circumference of head. Sloping seat was found in 63.84% and it was flat in 36.15%.

Pole was found to be projecting in approximately 37%cases. There was a great variability in the shape of pole observed, varying from semilunar to semicircular to comma shaped or reniform.

The size of the fovea showed great variations which, in the present study, is compared with the size of the pole along the longitudinal axis. Fovea showed the presence of vascular foramina. The findings of the present work will be compared with the scanty data that is available on the subject and the relevance and significance of the study shall be highlighted.

96. A Study of The Morphology of The Lumbricals And Interossei In The Upper Limb:

Mutalik. A.M.,
Department of Anatomy J.N. Medical College, Belgaum.

Lumbricals and interossei show anomalous origins, insertions and nerve supply.Hence understanding the muscular architecture of hand is of significant value in the design of surgical procedures such as tendon transfer, biochemical modeling, prosthesis design and analysis of functions.

This study was done on 30 cadavers. The tendons of flexor digitorum superficialis and profundus were reflected distally to observe lumbricals. Adductor pollicis and deep palmar arch were dissected and deep branch of ulnar nerve was exposed.On the dorsum of the hand intermetacarpal spaces were explored for dosal interossei. Later dorsal interossei were seperated from two adjacent bones and reflected distally to expose palmar interossei.The following observations were made 75% of the lumbricals had normal origin and insertion pattern while 10% of 3rd lumbricals showed split insertion,10% of 4th lumbricals inserted on ulnar side of ring finger,83.3% of palmar interossei had normal pattern while 3.3% of 2nd and 3rd palmer interossei were bipennate,91.5% of dorsal interossei showed normal pattern,while 3.3% of 2nd,3rd and 4th dorsal interossei showed split insertion.

97. The Pectorodorsalis Muscle And Its Clinical Importance – A Case Report:

Rashmi Avinash Patil,
Seth G.S.M.C and K.E.M.H. Parel, Mumbai.

The pectorodorsalis, an accessory muscle, is also known as axillary arch or Langer’s muscle. One such accessory muscle slip was encountered during routine dissection in an embalmed male cadaver. The slip measured 7×1.5 cm and extended from the pectoralis major to the latissimus dorsi muscle.

The literature shows a number of accessory muscle slips, with various names, to be often present in the axilla. These slips can remain dormant or may create problems varying from cosmetic considerations to the difficulties in the staging of metastatic lymph nodes.

This paper reviews the literature and deals mainly with the gross anatomy, embryology and the clinical aspects of the pectorodorsalis muscle.

98. Pulley-Mechanism For The Long Palmer Tendons:

K.D. Khushale, M.L. Kothari, Lopa Mehta.
Seth G.S.Medical College, Parel, Mumbai.

Aim of study is prepare the specimens of the flexor sheath and detail the dissection steps to bring into broad visual relief the pulley mechanism underlying the efficient functioning of the long flexor tendons of the hand.

During workshop on the hand surgery in our department, we noticed that the important pulley mechanism subserving long tendon functions were ignored not only by the anatomists but the hand surgeons as well. We therefore decided to undertake careful dissection of the fibrous pulleys to bring them into a broad field of vision of dissector.

The dissected specimen is adequate enough to demonstrate the important role played by the pulley mechanism.

Fibrous pulleys serve the most important role of directing the pull of the of long tendons in the desired, and efficient manner. It’s not generally appreciated that the pulleys also serve as the restraining mechanism that prevents herniation of the tendons especially during powerful action.

99. An Axillary Arch:

Sharada R.,
M.R. Medical College, Gulbarga.

The right upper limb of an adult male cadaver had a musculo-tendinous arch from lower border of latissimus dorsi to pectoralis minor, the tendon inserted to the tip of coracoid process of the scapula. The thoracodorsal nerve supply was normal. Splitting of the axillary vein was seen. T1 and T3 lateral cutaneous branches were seen in the intercostal spaces 1 and 3 with T2 being absent..

100. Dorsal Digital Expansion Of Thumb:

Joshi S.S., Joshi S.D. Athavale S.A. Waghmode P.S.
Rural Medical College, Loni, Ahmednagar.

During routine dissection of dorsum of thumb we had observed the variations of size and attachment of the two extensors of thumb. In the majority we could find a dorsal digital expansion of thumb comparable to extensor expansion of other digits. Going through the literature we find that there is no unanimity amongst the various authors. Sinnatamby (1999) stated that there is no extensor expansion on the thumb. Similar view was expressed by Schafer et al.(1923). Although many other workers in this field recognized the presence of dorsal digital expansion of thumb.

Hunter, Mackin and Callahan (2002) have described the presence of dorsal hood fibres from the thumb intrinsic muscles. The adductor pollicis on the ulnar side and abductor pollicis brevis (APB) on the radial side contribute to dorsal expansion. The extensor apparatus of the thumb displays obvious structural variations in its proximo-distal expansion – this is an expression of different tropographical zones of stress. APB is likened to the lumbricals for the thumb and is inserted into the extensor expansion. There are variations reported in the mode of tennination of extensor pollicis brevis. This muscle may be occassionally absent or may have multiple tendons.

Keeping this in mind we undertook a detailed study of the mode of termination of two extensor tendons as well as the formation of dorsal digital expansion of thumb.

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