International Journal of Anatomy and Research

7589-7593

Authors: M.Sar 1, S. Behera 2, B.K. Dutta 3.

Introduction: The diaphysial blood supply to the long bones mostly depends on the nutrient artery. Multiple foramina in bones suggest that one of them would be the main foramen and others are the accessory foramina. The growth and repair of a long bone is dependent on its blood supply through nutrient artery. So any fracture passing through the foraminal area is likely to heal poorly. During any surgical procedure in this area, if the nutrient artery is damaged it will lead to a poor outcome.Keeping this fact in view this comprehensive study on morphometry of nutrient foramina of upper limb long bones was undertaken. Materials and Methods: A total number of 270 upper limb long bones (100 humerii, 90 radii and 80 ulnae) were studied to find out the number, direction and location of nutrient foramina in each bone. The total length of each bone and the distance of the nutrient foramen from its proximal end were measured to calculate the foraminal index using Hughes formula. The antero posterior and transverse diameters of the bones at the level of nutrient foramen were measured to assess the correlation between number of nutrient foramina and size of bone. Results: Multiple nutrient foramina were observed in 36% of humerus, 22.5% of ulnae and 3.3 % of radii. Nutrient foramina were mostly located in middle third of the bones (96.5% in humerus, 87% in ulna and 60% in radius). The commonest position of nutrient foramina was either medial border or anteromedial surface in humerus. In the radius and ulna they were situated mostly on the anterior surface. All foramina were found to be directed towards the lower end. CONCLUSION: This study will provide important morphological and topographical information about nutrient foramina for orthopaedics procedures in the upper limb.

1754-1757

Authors: Faria L.A.M 1, Ferreira W.S.M 1, Almeidinha D. L 1, Moraes L.O.C.*,1,2.

The inferior phrenic arteries are involved in many diseases, such as hepatocellular carcinoma, where they are the main vessels responsible for the collateral arterial supply of this type of tumor of hepatic cells which is highly malignant. During a routine dissection a vascular variant was found in the abdominal cavity of a 34-year-old black cadaver whose right inferior phrenic artery (RIPA) derived from the right renal artery. This finding is clinically important since the transcatheter embolization of hepatocellular carcinoma and other hepatic neoplasms, such as hepatoblastoma and capsular adenoma frequently involve studying the root of the RIPA. This way, angiography can be potentially beneficial for knowing how the origins of these vessels vary. KEY WORDS: Right inferior phrenic artery, Right renal artery, Hepatocellular carcinoma.

1765-1768

Authors: Shivaleela C 1 Anupama D 2 Lakshmi Prabha Subhash R 3.

Background: The thyroid gland is one of the ductless glands located in front and on the sides of the trachea opposite C5, C6, & C7 vertebra. The superior thyroid artery (STA) is the branch of the external carotid artery, and arises from the anterior surface of the external carotid just below the level of the greater cornua of the hyoid bone. The knowledge of these variations in the origin of STA is important for various surgical procedures in the radical neck dissection, thyroidectomy, and catheterization, reconstruction of aneurysm, carotid endarterectomy and interventional radiology. Materials and methods: This study was conducted on 42 cadavers of known age and sex in the department of anatomy Sri Siddhartha Medical College, Tumkur Karnataka, India.. The specimens were studied by gross anatomical dissection. Results: In our study the site of origin of superior thyroid artery from external carotid was 76.19%, 21.43% of the cases the origin was from the common carotid bifurcation and 2.38% of the cases the origin was from common carotid artery. In our study, in 88.9% of the cases the level of the origin of the superior thyroid artery was above the upper border of the cartilage and in 11.90% of the cases the origin of the superior thyroid artery was at the upper border of the cartilage. In our study the distance from upper pole of the thyroid gland to the level where external laryngeal nerve turn medially from Superior thyroid artery was more than one centimeter in 73.80% and in 26.19% of the cases the distance was less than one centimeter. Conclusion: A profound knowledge of the anatomic characteristics and variation of the superior thyroid artery such as its origin, course and branching patterns is an important value for a safe attempt in suitable position for catheterization and approach for surgeons in planning and performing procedure in neck region. The knowledge of relationship of superior thyroid artery to external superior laryngeal nerve is very important for surgeons during thyroid surgeries to avoid injuries to above nerves while ligating superior thyroid artery. KEY WORDS: Superior thyroid artery, Carotid artery, Thyroid.

1772-1776

Authors: Mahesh Vemavarapu 1, Jyothinath Kothapalli *2, Vijayendranath Kulkarni 3.

Background: The collo-diaphyseal angle (CDA) of femora appeared between the axis of neck and long axis of the femur having a great importance in complete understanding of the mechanics of the hip joint and serves as a basis for the treatment of pathological conditions of the hip and femur. Materials and Methods: For the present study the collo-diaphyseal angle was measured in 152 normal south Indian femora, out of which 83 are random unknown sex femora, 42 are known males and 27 are known females. Results: In this series, recorded minimum angle is 111.00 and the recorded maximum angle is 146.00 and the average being 128.090 in random femora. In the present series 42 known normal male femora are measured in which the lowest angle is 115.00 and the highest angle is 141.00, the average being 128.040. Among 27 known normal female femora the minimum angle recorded is 112.00 and maximum angle recorded is 139.0, the average being 127.200. Conclusion: The above findings revealed that the neck shaft angle of femur is greater in males than in females. KEY WORDS: Collo-diaphyseal angle (CAD), Martin’s dioptrograph, Femur.

1781-1788

Authors: Pushpalatha. K *1, Deepa Bhat 2, NM Shama Sundar 3.

Introduction: The anatomical variations of the Celiac trunk and its branches are due to developmental changes in the ventral splanchnic arteries. The arterial variations like other anatomical variations cannot be ignored during the operative procedures in abdomen. It is of great importance for the surgeon and radiologists during surgical and radiological procedures in upper abdomen. Main objective of the present study is to known the level of origin, length and variation in the branches of the Celiac trunk. Materials and Methods: Study included 35 embalmed cadavers and 15 post mortem specimens. After the student studied the Celiac trunk the finer dissection was done and all the branches were traced. Results: Length of Celiac trunk was between 0.4-2.9 cms. In 52% of cases it was between 1.1 – 1.5 cms, followed by 0.5-1m in 25% , 11% is between 1.6-2cms, only in 3 cases it was more than 2 cms. Celiac trunk with only 3 branches –Leftgastric, Common hepatic and Splenic artery was seen only in 72% of cases. In 20% of cases there was more than 3 branches. In 18% of cases Celiac trunk was giving origin to Inferior phrenic arteries. In 4% of cases the Celiac trunk was incomplete (gastro splenic trunk) giving only Leftgastric and Splenic, Common hepatic was directly arising from Aorta. Celiac trunk was absent in 4% of cases and all the 3 branches were arising directly from Aorta. Conclusion: Variation in the branches of Celiac trunk is very common. Knowledge about these variations is important for Surgeons during upper abdominal surgeries and for Radiologists during selective arteriography. KEY WORDS: Anatomical variations, Celiac trunk, Hepatic artery, Upper abdominal surgery, Selective arteriography.

1795-1801

Authors: Hima Bindu Nalluri *1, Parimala Sirikonda 2, Vasanta Leela 3.

Background: Biceps brachii muscle normally has two heads; the long head and the short head. Sometimes it has a third head or supernumerary head. Variations in the attachments of the third head of biceps brachii are clinically important. Aim: This study was undertaken to evaluate the incidence, attachments, relations and nerve supply of the third head of biceps brachii in a South Indian Population. Material and methods: Both the upper limbs of 40 formalin-fixed cadavers (80 upper limbs) were studied for the possible presence of supernumerary heads of biceps brachii. The anterior compartment of arm was dissected and the biceps brachii muscle was exposed. The attachments, relations and nerves supplying biceps brachii, were delineated. Results: It was found that Biceps brachii had two heads in 36 cadavers. A third head was observed in 4 cadavers. It was bilateral in one cadaver and unilateral in three cadavers. This third head of biceps brachii arose from the coracoid process along with its short head, bilaterally, in one cadaver. It originated from the medial surface of the shaft of humerus at the insertion of coracobrachialis, in left upper limb of one cadaver. The third head originated from the shaft of humerus along with the medial fibers of brachialis in the right upper limb of one cadaver; and both from shaft of the humerus and medial intermuscular septum in the right upper limb of another cadaver. In three cases it was innervated by the musculo-cutaneous nerve. In one case it was innervated by the branches of the median nerve, where the musculo- cutaneous nerve was absent. All the three heads fused before the formation of bicipital tendon and inserted into the radial tuberosity. But in one case, a few fibers of the third head inserted into the bicipital aponeurosis. Conclusion: In our study the incidence of third head was 10%. In published literature, its incidence varies from 0.18% to 21.5% in different populations. Variation in the attachments of third head of biceps brachii is important in surgical interventions, neurovascular compression syndromes and unexplained pain syndromes in arm and forearm regions. Key words: Biceps brachii, third head of biceps, supernumerary head, median nerve compression, brachial artery compression, absent musculo-cutaneous nerve

1806-1809

Authors: Rohinidevi M *1, Jeyasingh T 2, Vimala V 3.

Background: Knowledge about the morphometric measurement of the umbilical cord is important for better perinatal outcome. Materials and Methods: A total of 50 placentas with umbilical cord were collected from the Department of Obstretrics and Gynaecology in the Government Rajaji Hospital, Madurai. The study was conducted in the Institute of Anatomy, Madurai Medical College, Madurai. The length of the cord, diameter of the cord, cord coiling, presence of knots, vascular pattern and its microscopic structure were studied. Results: In the present study the total length of the umbilical cord from the fetal end to placental end were measured. The maximum length was 73.4cm and minimum length was 43.4cm. The maximum transverse diameter of the cord at fetal end was 1.4cm and minimum was 0.7cm. The maximum transverse diameter of the cord at placental end was 1.7cm and minimum was 1.2cm. The coiling of the cord was observed. Hypocoiling of the cord was seen in 70%, hypercoiling in 24% and straight in 6%. The coiling manner was also studied. Anticlockwise coiling was seen in 78%, clockwise coiling was seen in 16% and coiling was absent in 6%. In hypocoiling umbilical cord the maximum coiling index was 0.12 and minimum was 0.08. In hypercoiling umbilical cord the maximum coiling index was 0.18 and minimum was 0.14.The false knots were seen in 32%, absence of knots in 68% and true knots were not observed. Three vessel patterns were observed in all 50 umbilical cord specimens. The magistral type of vessel pattern was present in 62% and dispersal type was seen in 38%. Microscopic structure of cord at the fetal end and placental end were coincides with the standard textbook description. Conclusion: Knowledge about the variation in the morphometric measurements of umbilical cord is important for sonologists, obstetricians and pediatricians for preventing the intrauterine death and various abnormalities.

1819-1824

Authors: Suvarna A. Gulanikar *1, G.A. Shroff 2, A.R. kharkar 3, V.S.Mandhana 4.

Introduction: Changes in glomerular size play an important role in the initiation and progression of various glomerulopathies. There are few anatomical reports on the fetal glomerular size than on adult human renal glomerulus. Therefore, our study conducted, with an aim to estimate an average glomerular diameter in cortical zones of the kidney during 14th to the 28th weeks of gestation, to define periods of their most intensive growth, and to record differences of glomerular size between different cortical zones. Materials and Methods: Thirty normal human fetuses without any congenital anomalies in midgestational period ranging from 14 to 28 weeks were selected for the study. The glomerular diameters were evaluated in hematoxylin and eosin-stained microscopic sections of the kidneys by micrometry in outer, middle, and inner zones of renal cortex. Average diameter was calculated in different groups and relation of them in all three zones of the cortex was analysed. Results: The results showed that outer cortex glomerulus were smallest with the average diameter of 55.88 ±7.20 to 63.5±7.33 µm. At the deeper level, size of glomerulus increased. In the intermediate cortex average size of glomerulus is 69.85 ± 23.18 to 87.63 ± 9.37 µm. and the deepest juxta medullary glomerulus were largest in size with the average diameter of 94.61±14.18 to 117.47± 10.89 . Conclusion: The present study concluded that smallest diameter of glomerulus was seen in outer cortex, while the largest one in inner cortex. In all the age groups [14-28 weeks] the glomerular diameter remained nearly same in each zone of the cortex. The Changes in glomerular size played an important role in the initiation and progression of various glomerulopathies. The importance of this study lies in determining the average glomerular diameter, which could be used as baseline values for studies of glomerular diseases. It may be possible to define the pathological changes in fetal kidney based on the present study. KEY WORDS: Glomerulus, Cortex, Micrometry, Glomerulopathies

1828-1832

Authors: S.Dhivya *, Kalai Anbusudar.

Background: The sciatic nerve ,the principal nerve of the posterior compartment of the lower limb normally divides at the superior angle of popliteal fossa.Sometimes there could be higher division,the knowledge of which is important in avoiding inadvertent injury during surgeries in the gluteal region . Materials and Method: The study was conducted in 64 lower limbs at Government Stanley Medical College,Chennai and Government Mohan Kumaramangalam Medical College,Salem. Results: In 60 limbs, the sciatic nerve divided at superior angle of popliteal fossa.In 3 limbs,there was higher division at the level of upper part of the thigh.In 1 limb,there was intrapelvic division of nerve with split piriformis. Conclusion: Knowledge of these variations help during popliteal nerve blocks and in the management of nondiscogenic causes of sciatica. KEY WORDS: Tibial Nerve, Common Peroneal Nerve, Sciatica, Piriformis syndrome, Popliteal block.

1837-1842

Authors: Archana Srivastava 1, Jyoti Chopra *1, Hiralal 2, Garima Sehgal 1, PK Sharma 1, AK Srivastava 1.

Introduction: Kidney size reflects the health of the kidney. It is affected in a variety of acute and chronic renal diseases. Renal length is used in daily clinical practice to estimate kidney size. It acts as a surrogate for renal size and correlates well with renal function. To recognise the anatomical deviations in renal length it is important to have standard normal values for comparison. Currently, the data used for comparison is based on studies conducted in western population and therefore it is an incorrect representation of adult Indian population. The aim of present study is to determine a normal range of values for renal length in North Indian adult population and its correlation with age, height and body weight. Materials and Methods: CT scan of 100 normal adult (16 males and 84 females; mean age of 43.5±10.42 years), who were voluntary prospective kidney donors, were analysed. The CT images were taken in axial, coronal and sagittal sections and renal length was measured and it was correlated with age, height and body weight. Results: It was observed that the mean length of left kidney side was 99.2±9.71 mm and the right side was 95.3±8.47 mm. The left kidney significantly longer than the right kidney (p= 0.0028). In males, the left kidney length was 103.5±7.09 mm and right kidney length was 98.9±7.09 mm (p=0.08). In females the left kidney length was 98.4±9.96 mm and right kidney length was 94.6±8.56 mm (p=0.009). Renal length showed a positive correlation with the height. No correlation was seen with age, body weight and BMI. Conclusion: In present study it was observed that in North Indian population the renal length was smaller as compared to Western population and it had a positive correlation with only height. This study makes an attempt to define the standard reference values for renal length in Indian population. KEY WORDS: Renal length, Kidney Size, Chronic renal failure, CT scan.

1846-1850

Authors: Vishal Ramesh Jasuja*1, Prasad G. Kulkarni 2, Shabana M. Borate 3, Silky R. Punyani 4.

Background: The base of the skull has foramina and bony features that bear significant anatomical and surgical importance, foramen magnum and occipital condyles being two such important anatomical entities. Hence a clear understanding of their position, anatomy and dimensions is necessary. With this aim in mind the study was designed to: a) determine the distances between the anterior and posterior bony points of occipital condyles and assess the variation on the right and left side b) determine the dimensions of foramen magnum c) the differences of these measurements between the male and female genders. Materials and Methods: 100 (male-59; female-41) dry adult human skulls were obtained from the Dept. of Anatomy and Forensic Medicine & Toxicology of Grant Medical College in Mumbai, India. A millimetric sliding vernier caliper was used to measure the distances. The statistical analysis was done using the statistical package Graph Pad Prism 5 software. Results : The mean axial length of the occipital condyle (ALOC) was found out to be greater on the left side as compared to the right but the difference was not statistically significant . The measurements were greater in the male skulls than the female skulls, for both the sides and the difference was statistically significant. The anterior intercondylar distance was found to be higher in female skulls but the difference between the genders was statistically not significant. The average anteroposterior diameter of foramen magnum (ADFM) was greater in the male skulls; the difference between the genders was statistically not significant. As opposed to this the transverse diameter (TDFM) was found to be greater in the female skulls but the difference was statistically not significant. Conclusions: The study gives an insight about these dimensions in a subset of population in the western Maharashtra region of India. Further studies with larger sample size are required to validate these findings and its applicability in a clinical scenario. KEY WORDS: Skull Base, Morphometry, Foramen Magnum, Occipital Condyles.

1854-1858

Authors: Uday kumar *, Ratna Prabha J.

Aims and Objectives: Wormian bones are the accessory bones which are usually not present in all normal skulls. This study mainly aiming at the number, location of these accessory bones on human dry skulls. These bones should not be confused with fractures of skull. Material and Methods: 200 dry skulls were examined with a naked eye. These skulls were collected from department of Anatomy, Students of Ist MBBS and Dental Students. All the skull were cleaned, dried properly and were looked for the presence of wormian bones in respect to its location, number. The data collected was tabulated and statistically analysed. Results: In the present study, the incidence of wormian bones was seen in 113[56.5%] out of 200 skulls. We found maximum no. of wormian bones at lambdoid suture [64 skulls, 56.63%]. We also found such bones at Pterion[5.30%], Asterion[40.70%], ParietoTemporal suture[4.42%] and Occipitomastoid suture[6.19%] of skulls . In our study, we didn’t find any accessory bones at saggital, coronal suture and near bregma. Conclusion: This study proved that presence of wormian bones is not uncommon. Frequently seen at the lambdoid suture. Such presence of sutural bones should not be confused to fractures. Neurosurgeons should keep in mind about such bones before performing craniotomy surgeries. KEY WORDS: Cadaveric skulls, Extra bones, Sutures, Fontanella.

1864-1868

Authors: Parimala Sirikonda *1, Hima Bindu Nalluri 2.

Objectives: To document the variations in the termination of brachial artery with its high up division into radial and ulnar arteries in the arm and to establish embryological and clinico-anatomical correlations of such variation. Material and Methods: The findings were noted after thorough and meticulous dissection of the upper limbs of both sides (axilla, arm, cubital fossa and forearm) of 40 cadavers in the Department of Anatomy, Bhaskar medical college, India. Photographic documentation of the variation was also made. Results: Variations were reported in 4 cadavers. An unusually short segment of brachial artery was noted in two cadavers. This short segment brachial artery bifurcated more proximally just 2cm below the lower border of teres major into radial and ulnar arteries. Of these two, in one cadaver radial artery was thin, laterally placed and superficial throughout its course. Ulnar artery was medial and accompanied the median nerve. In the other cadaver, radial artery was medial initially and then wound round the median nerve to run lateral to it. It was medial to the ulnar artery throughout the arm and crossed it to course laterally in the cubital fossa. Ulnar artery was thin compared to radial artery. In other two cadavers the brachial artery divided into radial and ulnar arteries in the lower 1/3 of the arm. Further course and distribution of these two arteries was normal. Conclusion: The variation can be explained in the light of embryological development. In addition, knowledge of such variation is important for carrying out surgical procedures in the arm. KEY WORDS: Brachial Artery, High Division, Bifurcation, Ulnar Artery, Radial Artery, Cubital Fossa.

1874-1877

Authors: Y. Mamatha *1, Chaitanya Krishna Murthy 2, B. S. Prakash 3.

Background: The lungs are the essential organs of respiration. Fissures are an integral part of human lung. The fissures in lung enhance uniform expansion. These fissures may be complete, incomplete or absent. A detailed knowledge of variations of classical and accessory fissures is necessary for proper radiological interpretation. It is a guide to cardiothoracic surgeons performing segmental lung resections, lobectomies to have an uncomplicated perioperative outcome. Considering the clinical and anatomical importance of this topic, the present study is undertaken. Aim of the study: The cadaveric study was done to note the morphological variation of the fissures of lung and compared it with previous studies. Results: In the present study among 40 adult human cadaveric lungs, the following observation was made; right sided lungs had incomplete oblique fissure in3 lungs, incomplete horizontal fissure in 10 lungs. Left sided adult lungs had incomplete oblique fissure in 7, absent oblique fissure-1, accessory fissure-3 lungs. Conclusion: Knowledge of normal and abnormal morphological variation is very important for the clinicians, radiologist and surgeons in order to avoid misinterpretation and misdiagnosing and preventing the untoward incidents. KEY WORDS: Horizontal fissure, Oblique fissure, Lung, Accessory fissure.

1882-1885

Authors: Vijay Kumar Shinde *1, Siraj Ahmed Shirbadgi 2.

Background and Aims: The name os sacrum is direct translation from Greek hieron osteon. The dorsal surface presents a sacral hiatus which is produced by the failure of laminae of the fourth or fifth sacral vertebra to meet in median plane, leaving an inverted U shaped or V shaped gap called sacral hiatus. Materials and Methods: for the present study, dry unknown human sacra were obtained from North Karnataka. The level of apex of sacral hiatus was noted. Results: Many variations in the level of apex were found. The apex of sacral hiatus extended between 2nd to 5th sacral vertebrae. The sacral hiatus exhibits many variations in level of apex and base of sacral hiatus. Conclusion: In the present study, the rate of impossible caudal epidural anesthesia through sacral hiatus is 2% as the sacral hiatus was closed leading to absent hiatus, and needed to be considered before giving caudal anesthesia. The efficient and accurate caudal block depends upon the knowledge of degree and extent of variations in sacral hiatus especially in levels of apex & base. KEY WORDS: Sacral Hiatus Morphometry, Variations In Sacral Hiatus, Caudal Epidural Anesthesia, Painless Deliveries.

1892-1895

Authors: Dhanalakshmi V *1, Manoharan C 2, Rajesh R 3, Suba Ananthi K 4.

Introduction: Lungs are essential organs of respiration. Variations in lobes and fissures of lungs are clinically significant. Awareness of these variations is essential during segmental resections of lung. This study is conducted to observe the completeness of fissures, presence of accessory fissures and accessory lobes of lungs. Materials and Methods: 100 lungs (50 right and 50 left) from embalmed cadavers and autopsied bodies were studied for the presence of normal fissures, its variations including number of lobes, accessory lobes and accessory fissures. Results: The right lungs had complete oblique fissure and complete horizontal fissure in 68% and 30% respectively. The left lungs had complete oblique fissure 62 %. Oblique fissure was incomplete in 32 % of right lung and in 38% of left lung. Horizontal fissure was incomplete in 52 % and absent in 18%. 73.3% of incomplete oblique fissure of right lung showed incompleteness posteriorly. In the left lung oblique fissure showed incompleteness anteriorly in 26.3%, in the middle in 21.1% and posteriorly in 52.6%. Horizontal fissure of right lung was incomplete anteriorly in 96.2%. Accessory fissures were present in 4 specimens (8%) of right lungs and in 1 specimen (2%) of left lung and accessory lobes were present in 2 specimens (4%) of right lungs. Conclusion: The fissures in normal lungs enhance uniform expansion of lobes. Absence of fissures can affect the expansion of the lungs. Incomplete fissures may also alter the spread of disease within the lung. Knowledge of accessory fissure and variations in lobes and fissures of lung are important as it may mislead while interpreting in radiology. KEY WORDS: Accessory, Fissure, Lobes, Lung, Variation.

1901-1904

Authors: Sharma S *1, Wadhwa A 2, Bhardwaj S 3.

Introduction: Variation of nerve is not only of anatomical and embryological interest, but also of clinical importance, as these can be etiological factors behind various pathological conditions. Likewise, their adequate knowledge will help in increasing surgical precision and decreasing morbidity. In present study level of division of tibial nerve into medial and lateral plantar nerve was studied. Material and Methods: The material for the present study comprised of 60 lower extremities belonging to 30 adult human cadavers obtained from Dept of Anatomy, GMC, Amritsar. Tibial nerve was dissected and the level at which it divided into medial and lateral plantar nerve was studied. Result: Tibial nerve bifurcated into medial and lateral plantar nerve deep to flexor retinaculum in 93.33% of cases and proximal to flexor retinaculum in 6.67% of cases. Discussion: There are various clinical conditions associated with the involvement of tibial nerve. It is reported that an accessory flexor digitorum muscle is associated with high division of tibial nerve. Accessory flexor digitorum muscle can be one of causes of tarsal tunnel syndrome. Anatomical studies of the tibial nerve in the distal third of the leg and at the level of the tarsal tunnel began to take more importance with the establishment and definition of compression pathology of this nerve, in its osteofibrous tunnel. In an analogy with the upper limb, this syndrome resembles carpal tunnel syndrome, also sharing decompression surgery as one of the therapeutic approaches. KEY WORDS: Tibial Nerve, Medial Plantar Nerve, Lateral Plantar Nerve, Flexor Retinaculum, Accessory Flexor Digitorum Muscle.

1912-1915

Authors: P.Murali *1, S. Sundarapandian 2, Madhan Kumar S.J 3.

Background: The Greater Palatine Foramen is of great clinical significance, but the published descriptions about the position of this foramen in the adult human skulls have not been consistently reported. An understanding of the position of Greater Palatine Foramen in relation to adjacent anatomical land mark is important, as this foramen forms a precise site for injection of local anaesthetics to obtain optimal pain control in Dental surgeries. Materials and Methods: The present study was conducted in 137 dry adult unsexed south Indian skulls obtained from the Department of Anatomy, SRM Medical College Hospital and Research Centre, Tamilnadu. All the skulls studied were normal with fully erupted third molar and free from any pathological changes. We have measured the different parameters in each bone, following the Standard Methodology. Results: In our study we found that the perpendicular distance of the Greater Palatine Foramen to the mid maxillary suture in south Indian skull was about 13.7± 1.13(SD) mm and the distance of Greater Palatine Foramen to the incisive fossa was approximately 36.6± 1.95 (SD) mm. The distance of greater palatine foramen to the posterior border of hard palate was approximately 3.7 ± 0.92(SD) mm. Conclusion: To conclude that our study provides appropriate data about the relative anatomical position of GPF that is essential to achieve successful maxillary nerve block via GPF would be relatively easy and free from any complications. KEY WORDS: Greater Palatine Foramen, Incisive Fossa, Posterior border of Hard Palate.

1919-1921

Authors: Smita B. Shinde *1, G. A. Shroff 2, Savita Kadam 3.

Introduction: In the present study we measure antro-posterior and transverse diameter of cervical and lumbar enlargement at their maximum level in 20 spinal cord with Magnetic Resonance Imaging (MRI). Material and Methods: Study carried out in MRI section of Radiology Department in Mahatma Gandhi’s Medical college, Aurangabad. MRI was done on patients referred to MRI for backache. Patients are made to lie down in supine position on MRI table. Given specific coil & MRI performed in sagittal and coronal plane. Antero-posterior diameter measured at sagittal section was transverse diameter measure at coronal views. Results: In present study we find mean antero-posterior diameter and transverse diameter in 20 subjects, the antero-posterior diameter is less. Conclusion: This knowledge of comparison antero-posterior and transverse diameter not only assist surgeons to take care during interventions, but also facilitate to plan accordingly during various surgical procedures and management. KEY WORDS: Antero-posterior, transverse diameter, MRI, surgical interventions.

1927-1930

Authors: Komala B

Introduction: The vertebral bodies and intervertebral discs sustain all the vertebral compressive forces. Inferior body surface area and area of the two inferior articular facets have the quality of playing an important role in the relative magnitude of the compressive forces passing through the vertebral column through its two columns. This study has been attempted to find out the relative magnitude of the compressive forces passing through the vertebral column through its two columns so that this knowledge could be applied to explain some of the clinicopathological conditions of the spine. Material and methods: The 6 cervical and upper 5 thoracic vertebrae of 30 human adult male columns were selected for the study. The various parameters of inferior body surface area and area of the two inferior articular facets were measured for each of the 6 cervical and upper 5 thoracic vertebrae of 30 columns. Results: The mean inferior facet area showed a slow increase from C2 to C7 followed by a sharp decline at T1 level which gradually continued to decline till T5. The mean surface area of a single inferior articular facet area in relation to the body area showed a very slow decline from C2 to C7 level, but there was then a sharp decline at T1 level and a gradual further decline to T5 level. The percentage mean inferior body surface area showed a gradual increase from C2 to T5 vertebrae whereas percentage mean inferior articular facet area decreased from C2 to T5 vertebrae. Conclusion: The measurements obtained by the present study reveals the importance of articular facets in understanding the mechanics of spinal anatomy and its applications with respect to transmission of weight. The loaded articular facet joints is one of the reason for low back pain in addition to other reasons like root pain, muscular spasm etc. KEY WORDS: cervical vertebrae, upper thoracic vertebrae, articular facets.

1941-1944

Authors: Roopali D. Nikumbh *1, Dhiraj B. Nikumbh 2, Megha A. Doshi 3 , Manohar N Ugadhe 4.

Background: The Supracondylar process is a beak like bony spine/ projection that arises from the anteromedial surface of the Humerus. It is also called Supraepitrochlear, epicondylar, epicondylic process or Supracondylar spur. It represents a phylogenetic remnants of complete osseous bride found in climbing animals and many reptiles mostly marsupials, cats, lemurs and American monkeys. Materials and Methods: The two hundred and eighty dried humeri were studied in the Dept of Anatomy, KIMSDU, Karad and ACPM Medical College, Dhule, India. The bones were examined for any osseous projection from distal part under day light. On findings, the dimensions were recorded and photographed. Results: Out of 280 dried humeri examined, we found only 1 humerus of the right side with an osseous spine on the anteromedial surface. The incidence calculated in this study was 0.36%. Conclusion: The Supracondylar process is usually clinically silent but may become symptomatic by presenting as a mass or can be associated with symptoms of median nerve compression and claudication of brachial artery especially when associated with Struthers ligament. Hence the knowledge of the presence of variations in anatomy like Supracondylar process is important for anatomists, radiologists, anesthesiologists, surgeons, and anthropologists. KEYWORDS: Humerus, Supracondylar process, Struther’s ligament.

1954-1957

Authors: Alper Sindel, Eren Öğüt, Güneş Aytaç, Nurettin Oğuz, Muzaffer Sindel.

Objective: The aim of this study is to analyze dried skulls morphometrically to determine the prevalence of the pterion types and discuss their clinical significance. There are four types of sutural pattern: sphenoparietal, the sphenoid and parietal bones are indirect contact; frontotemporal, the frontal and temporal bones are indirect contact; stellate, all the four bones meet at a point; and epipteric, when there is a small sutural bone uniting all the bones. Material and Methods: A total number 150 adult dried skulls of unknown age and sex studied for the pterion types. For this study calvaria’s intact human skulls collected from the Akdeniz University Medical Faculty Department of Anatomy. We separated the pterions into 4 groups as sphenoparietal, frontotemporal, stellate and epipteric. We measured distances between the center of the pterion and some important points. Morphometrical measurements are taken with digital caliper. Results: In the present study all types of pterion are observed. Sphenoparietal type of pterion was 63%, frontotemporal type of pterion was 2%, stellate type was 19% and epipteric type of pterion was 16% in our study. According to measurements pterion was lying aproximately 3.98 cm above the arcus zygomaticus and 3.4 cm behind the frontozygomatic suture. Conclusion: The pterion has close relation with the branches of middle meningeal artery and Broca’s motor speech area on the left side. Therefore knowledge and understanding of the type and location of the pterion and its relation to surrounding bony landmarks is important, especially for neurologists, neurosurgeons, radiologists and anthropologists. KEY WORDS: Antero-Lateral Fontanelle, Stellate, Epipteric Bones.

1961-1966

Authors: Hemamalini *1, Rao M.S 2.

Introduction: Centella asiatica is a perennial herbaceous creeper, growing in moist soil. It has anti-thrombotic, antibacterial and antiinflammatory properties. In Ayurvedic medicine, Centella asiatica is used extensively as brain tonic to enhance the neural function, learning and memory. In the present study, the neuroprotective role of Centella asiatica (CeA) leaves extract on hippocampal CA3 neurons against stress induced neurodegeneration in mice was investigated. Materials and Methods: Three months old albino mice were divided into four groups and treated as follows: (i) Normal control (NC) - remained without any treatment, (ii) Saline control (SC) - treated with saline, (iii) Stressed group (S) - stressed in a wire mesh restrainer for 6 hours/day for 6 weeks, (iv) Stress + CeA treated group (S+CeA) - stressed and treated orally with CeA leaves extract throughout the stress period (n=6 in all groups). At the end of the experimental period, mice in all groups were anesthetised, perfused transcardially with 50ml of saline followed by 100ml of 10% formalin. Brain was removed and processed for paraffin sections, sections were stained with cresyl violet stain. Number of neurons in the hippocampal CA3 region was counted in ten randomly selected fields (1000μ2area each). Results: Neurons in the hippocampal CA3 region, S group was found to be shrunken, irregular in shape with pyknotic nuclei compared to NC and SC groups. However such neurodegenerative changes were not seen in S+CeA group. Number of neurons in S group was significantly less compared to control groups and S+CeA group (P<0.001). Conclusion: Oral intubation of Centella asiatica leaves extract can protect the hippocampal CA3 neurons from degeneration in stressed mice. KEY WORDS: Restraint stress, Hippocampal CA3 neurons, Neurodegeneration.

1972-1976

Authors: Somesh M.S. *1, Murlimanju B.V 2, Roshan S 3, Gautham Kamble 4.

Aim: To observe the occurrence of any anomalous muscle known as peroneus quartus in the lateral compartment of the leg. Materials and Methods: Forty seven (47) formalin fixed cadavers used for the routine dissection for the first year medical undergraduate students in Anatomy Dissection Laboratory at Srinivas Institute of Medical Sciences & Research Centre (SIMS& RC) and KMC, were chosen. Lateral compartment of the leg of these cadavers were chosen and neatly dissected. Results: Out of these cadavers studied, we incidentally noted the Peroneus quartus muscle in the lateral compartment of the leg in two cadavers. In first case, it originated from the Peroneus longus and attached to the eminence on the lateral aspect of the calcaneum just behind the peroneal trochlea and in the second case from that of the Peroneus brevis tendon and inserted into the fifth metatarsal bone antero-medial to the main tendon and muscles in all other cadavers followed normal pattern of origin and insertions. Conclusion: Incidence of this variant called the peroneus quartus is rare and the knowledge of such rare anatomical variations is important to Surgeons and Orthopedicians performing various procedures around the ankle joint. KEY WORDS: Peroneus Quartus, Peroneus compartment, Leg, Ankle joint

1981-1984

Authors: Rekha B S *1, Divya Shanthi D’Sa 2.

Objective: In this study one hundred dried intact human atlas vertebrae from Karnataka population were examined using direct anatomical measurements. Materials and Methods: Various dimension of the atlas vertebrae were quantitatively measured using a vernier caliper that provides accurate resolution up to 0.01 mm. The results were analyzed statistically using SPSS 12 version Results: The distance between the tips of transverse process of the atlas (atlas width TD), 72.45mm.Inner distance between medial margins of foramina transversaria, 43.88mm outer distance between the lateral margins of foramina transversaria 56.31mm.. Distance between the medial margin of the vertebral artery groove from the median plane [right -12.28 mm and left side- 11.54mm]. Distance between the lateral margin of the vertebral artery groove from the median plane [right side -22.80mm and left side- 22.87mm] and Thickness of the groove [right- 3.68mm and left side-3.70mm] Outer anteroposterior( AP)diameter of vertebral foramen -42mm and inner AP diameter of vertebral foramen 28.51mm and transverse diameter vertebral foramen -27.39mm were noted. Superior articular facet AP diameter [right-22.33mmand left-22.25mm] Superior articular facet transverse diameter [right-8.74and left 9.57mm] Inferior articular facet AP diameter [right 18mm and left-17.81mm] and inferior articular facet transverse diameter [right 14.83mm and left 14.49mm]. Height of the anterior arch -10.02mm and posterior arch -8.91mm was recorded Conclusion: The quantitative anatomy of atlas may be helpful for neurosurgeons in avoiding and minimizing the complications such as vertebral artery injury, spinal cord injury and cranial nerve damage during the operation close to atlanto-occipital area. KEY WORDS: Atlas, Morphometry, Vertebral artery groove.

1988-1993

Authors: Jeyanthi C Gnanadeepam 1, Anjana TSR *2, T Preethi Ramya 3.

Background: In the background of increased incidence of vascular diseases affecting lower extremities in diabetics and smokers, arterial revascularization procedures are performed to obtain maximal perfusion to the foot, thereby restoring normal arterial pressure to the target area. Hence knowledge of the branching pattern and course of posterior tibial artery bears much clinical relevance. Materials and Methods: The study material consists of twenty adult human cadavers (14 males and 6 females ) at the Institute of Anatomy, Madras Medical College, Chennai, Tamil Nadu, India. Results: In 85% of specimens, the posterior tibial artery arose from the popliteal artery at the lower border of popliteus. In 5% of specimens, the artery was replaced by peroneal artery. In 87.5% of specimens, three to five perforator branches arose from the posterior tibial artery. Mostly the perforators were located in the middle quarters of the leg and the last branch was located at an average of 8.9cm from the medial malleolus. Conclusion: The knowledge of the course and branching pattern of posterior tibial artery is essential for achieving successful wound healing and avoidance of amputation in pathologies involving lower extremities. Also, the location of perforator helps in retrieval of fasciocutaneous flaps in treating an infected wound. KEY WORDS: Posterior Tibial Artery, Branches, Wound healing.

1998-2001

Authors: V.Sailaja *1, Sudhakar Babu 2, M.Padmavathi 3.

Aims and Objectives: Assess the association of the congenital malformations with maternal age & analyse the congenital malformations, involving various systems of the body system wise. Materials and Methods: Foetuses of pregnant women attending government hospitals in Hyderabad were screened during a period of one year from October 2011 to September 2012 through ultrasonographic evaluation in the second trimester (12wks to 28wks) for congenital anomalies. Results: The central nervous system involving neural tube defects and musculoskeletal system involvement were the commonest among congenital anomalies affecting elderly maternal age group. Conclusion: Congenital anomalies are increasing in frequency with increasing maternal age & to prevent them more focus should be laid on maternal education, pre-marital counselling, antenatal care, supplementation with folic acid, prenatal ultrasonography & genetic studies in at-risk individuals. KEY WORDS: Congenital anomalies, maternal age, maternal education, neural tube defects, prenatal ultrasonography.

2007-2014

Authors: Deepti Arora *1, Shyam Sunder Trehan 2, Subhash Kaushal 3, Usha Chhabra 4.

its involvement in various injuries and entrapment, it is imperative to have a thorough knowledge about its formation, branching pattern and variations. Materials and Methods: The study was performed on 30 formalin embalmed cadavers in the department of anatomy, Government Medical College, Patiala. The muscles of the posterior abdominal wall were exposed. The fibers of psoas major muscle were dissected from the transverse processes of lumbar vertebrae and the nerves of lumbar plexus were exposed. Results: The variable origin of iliohypogastric nerve was found in 8.33% cases. It was not found in 8 specimens. Ilioinguinal nerve was not seen in 14.97% cases. Variations in morphological origin of genitofemoral nerve were seen in 13.36% cases and in case of femoral nerve , variations were in 43.32% cases. Lateral femoral cutaneous nerve was seen arising from femoral nerve in 8.33% cases and was not found in 16.67% cases. Psoas minor muscle was found unilaterally in 1 cadaver on the right side and bilaterally in 2 cadavers. Conclusion: Knowledge of the anatomy of the lumbar plexus is essential for the surgeon who wishes to perform a surgical intervention to this plexus. KEY WORDS: Lumbar Plexus, Psoas Major, Ilioinguinal Nerve, Iliohypogastric Nerve, Femoral Nerve, Obturator Nerve, Lateral Femoral Cutaneous Nerve, Genitofemoral Nerve.

2021-2028

Authors: Pooza 1, Priti Chaudhary *2, Zora Singh 3.

Introduction: Estimation of cranial volume is an important investigation used for reconstruction of skull in forensic anthropological studies. Analysis of cranial capacity exposes another aspect of growth and development and permits critical evaluation of unusually large, small or misshapen crania. Method: In the present study, an attempt was made to find out cranial capacity (cc) of 400 healthy adult (200 males and 200 females) individuals in Faridkot District of Punjab. Linear measurement of cranial length, width and height were measured and the cranial capacities were calculated. Result: It has been observed that mean cranial capacity for male was 1421.62 ± 93.46cc and for female was 1276.78 ± 92.74cc. The difference between male and female cranial capacity was significant (P < 0.001). The study will also explore the correlation of cranial capacity with cranial length, cranial width, cranial height, body weight, body height and BMI, and we have also compared our findings with the previous studies. Conclusion: In the present study, we have observed that mean values of all the observations are found to be higher in males than in females. Cranial capacity is also affected by racial factors as we have seen in present study that cranial capacity of males and females of punjab are different from the cranial capacity of different regions observed by different authors at different times. There is significant correlation between cranial capacity and cranial dimensions and body dimensions. The knowledge of cranial capacity is helpful in neurosurgical, anthropology and forensic practice. KEY WORDS: Cranial capacity, head length, head breadth, head height, body height, body weight.

2034-2036

Authors: D.Malar

Background: Tibial nerve in the distal part of the leg branches into the calcaneal branch, medial plantar nerve and lateral plantat nerve.These branches inervate calcaneal,the medialplantar and the lateral plantar areas of the foot, respectively and carry sensory information from these areas. Tibial nerve and its branches show variation in branching pattern, and level of bifurcation. Detail knowledge of the anatomical variation of tibial nerve and its branches is essential for diagnosis and therapy tarsal tunnel syndrome, fractures requiring external nailing and nerve blocks. Materials and Methods: Tibial nerve and its branches in the tarsal tunnel were dissected and studiedl in twenty adult cadavers. Bifurcation levels of tibial nerve in relation to the Medio-malleolar-calcaneal axis were noted. The ramification pattern of medial calcaneal nerve was observed and studied. Results: In the present study tibial nerve bifurcation occurred within the tunnel in 100% cases. According to the level of bifurcation, 85% cases was type I, 10% cases was type II and 5%cases was type III. Medial calcaneal branches showed variations in number and origin, one medial calcaneal nerve was observed in 50% case , two in 20% cases and three in 10% of cases. The medial calcaneal nerve originated from the tibial nerve in85% cases. Conclusion: The knowledge of these variations may help in diagnosis and therapy of tarsal tunnel syndrome and prevent damage to the structures in the tarsal tunnel during various surgical procedures in the tarsal region. KEY WORDS: Tibial nerve, branches, variations , tarsal tunnel syndrome.

2041-2046

Authors: Hima Bindu Nalluri *1, Parimala Sirikonda 2, Vasntha Leela 3.

Introduction: Umbilical arteries normally originate from a pair of allantoic arteries. A failure of allantoic vascular system in early fetal life results in substitution by the vitelline vascular system, an inherent safety mechanism. This gives rise to anomalous course and origin of the umbilical artery. In these cases, the umbilical artery originates from the abdominal aorta and continues as a single umbilical artery. Aim: The aim of this study is to elaborate upon our current understanding about the origin, course and associated anomalies of Type2 single umbilical artery. Material and Methods: Fifty five foetuses, terminated for severe congenital anomalies over a period of 10 years, were sent to the department of anatomy for academic evaluation of congenital anomalies. All the foetuses were dissected systematically to delineate the abnormalities. Results: Thirty fetuses had two umbilical arteries with normal course on either side of allantois (urachus) and urinary bladder. Single umbilical artery was observed in 25 cases. Twenty had type 1 single umbilical artery and coursed normally. Five cases had single anomalous origin and course of umbilical artery, which was similar to type 2 single umbilical artery (SUA). After opening the abdominal cavity, the umbilical artery was not seen beside the urachus: instead it coursed posteriorly between the coils of intestine. When it was traced further, its origin was from the abdominal aorta. The aorta was hypoplastic below the origin of the single umbilical artery. All these cases were associated with cardiac, gastro-intestinal, vertebral, renal and limb abnormalities. Conclusion: Very few cases of this abnormality have been described in literature. Only a few of these cases were diagnosed prenatally as a vitelline artery abnormality: our study will thus help refine prenatal diagnosis and management. KEY WORDS: Single Umbilical Artery, Vitelline Origin Of Umbilical Artery, Vitelline Artery, Type 2 SUA, Congenital Anomalies.

2052-2057

Authors: Geetanjali Srivastava *1, Mumal Nagwani 2, Navbir Pasricha 3, Vineeta Tewari 4, M.S. Siddiqui 5, Eti Sthapak 6.

Introduction: The yolk sac is the first extra embryonic structure that becomes sonographically visible within the gestational sac and acts as the primary route of exchange between the human embryo and the mother before the placental circulation is established. The yolk sac is a round structure that is made up of an anechoic center bordered by a regular well-defined echogenic rim. It is usually 2-5 mm in diameter. The yolk sac appears at 6 weeks, thereafter increases in size, attains its maximum diameter at 10 weeks and then it starts decreasing in size. It disappears at 12 weeks. Aims and Objectives of the present study is to measure the size of yolk sac in pregnancies of duration 6-12 weeks by Transvaginal sonography and also to measure the inner diameter of yolk sac and correlate it with pregnancy outcome. Materials and Methods: We studied 72 pregnant women of duration 6-12 weeks referred by Department of Obstetrics and Gynaecology. The inner diameter of yolk sac was measured by Transvaginal sonography and its correlation with pregnancy outcome was studied. Observations and Results: The mean yolk sac diameter was noted as 3.7±1.8 mm. The diameter of the smallest yolk sac was 1.25 mm and that of the largest was 8.96 mm. Yolk sac size was normal in 62 (88.57%) cases, it was smaller in size in one (1.4%) case. Further in another 7 (10%) cases, the yolk sac was found to be abnormally enlarged. In these cases where yolk sac was either enlarged or smaller in size, gestation terminated into abortion. KEY WORDS: Yolk sac, Gestational sac, Yolk sac diameter, Transvaginal sonography, Pregnancy outcome.

2062-2068

Authors: Raja Reddy Gangam *1, Sindhura Sadanandam Sharon 2.

Introduction: Inferior Mesenteric Artery (IMA) is a major anterior branch of the abdominal aorta and is responsible for supplying arterial blood to the organs of the hind gut. The present study was conducted to emphasize branching pattern of the inferior mesenteric artery, anatomical variations and its surgical significance. Knowledge of the arterial supply of the gut is essential for anatomists and surgeons for the safety and survival of patients in standard operative procedures. Materials and Methods: This study was conducted on 100 cases out of which seventy five were adult cadavers (40 - 70 years) and 25 fetuses (28 – 38 weeks) in the Dept. of Anatomy, Gandhi Medical College, Musheerabad, Secunderabad, Telangana, India. Results: the most common branching pattern of inferior mesenteric artery was into LCA in 74 (98.66%) cadavers and common sigmoid trunk gave off 3-4 sigmoid arteries. LCA was absent in one (1.33%) case of adult and one (4%) case of fetuses. Bifurcation of LCA has taken place close to its origin in 20% cases and in another 80% of the cases close to its splenic flexure. In 10.67% cases 1st sigmoid has taken origin from LCA and formed loop of anastomoses with ascending branch of LCA. Sigmoid arteries were 1-4 in number with variations observed in the mode of origin and their number. In 20% of cases one sigmoid has taken origin directly from IMA which later continued as superior rectal artery. Conclusion: The detailed knowledge of anomalous branching pattern of IMA and its distribution is of immense significance for surgeons particularly, when performing laparoscopic abdominal surgery. Knowledge of the arterial supply of the gut is essential for anatomists and surgeons for the safety and survival of patients in standard operative procedures. KEY WORDS: Abdominal Aorta, Inferior Mesenteric Artery, Sigmoid Arteries, Superior Rectal Artery.

2073-2075

Authors: Ashok K R *1, Kiran T V 2.

Background: Surgeons and radiologists need detailed anatomic vascular information. The color doppler flow imaging is a major diagnostic tool in preoperative assessment for laparoscopic splenectomy which helps in selecting the operative procedures and treatment modalities. Knowledge of splenic artery anatomy coupled with preoperative evaluation helps to reduce the operation time and intraoperative complications. Materials and Methods: 76 cadavers have been dissected to study the branching pattern of the splenic artery. Results: Splenic artery divides in distributed pattern or bundled pattern before entering the hilum of spleen. However in few cases splenic artery enters the spleen without dividing into terminal branches. In our study distributed pattern was seen in 55.3%cases, bundled type in 34.2% cases and splenic artery entered the hilum without branching in remaining 10.5% cases. Conclusion: As sepsis occurs as sequel in post splenectomy patients the spleen preserving surgeries are gaining importance. Spleen preserving surgeries can be performed in distributed and bundled type of splenic artery. KEY WORDS: Splenic artery, splenectomy, spleen preserving surgery.

2080-2084

Authors: Ashita Kaore*1, Ashish kamdi 2 , M.P Fulpatil 3.

Introduction: The anterior longitudinal ligament is a broad and strong band of fibrous tissue that runs along the anterior surfaces of the bodies of the vertebra extending from the axis to the upper, pelvic surface of the sacrum. Aim of the study: The present study was undertaken to evaluate the incidence of ossified anterior longitudinal ligament in adult dry human vertebra in central india. Materials and Methods: This study was carried out on 50 sets of dry human vertebral columns irrespective of age and sex at Government medical college, Nagpur ,Maharashtra ,India. Results: It was observed that out of 50 sets of vertebral columns, 8 (16%) vertebral columns showed ossification. Out of 8 vertebral columns, 2 (4 %) vertebral columns showed segmental type of ossification, 4(8%) vertebral columns showed continuous type of ossification and 3 (6 %) vertebral columns showed mixed type of ossification at different vertebral level. Conclusion: ossification of anterior longitudinal ligament in vertebrae noted in this study may increase the stiffness of the backbone and the restriction of thorax mobility for respiratory movements and may lead to development of pulmonary diseases. Such type of ossification in the lumbar region affects the biomechanics of the lumbar spine and results in low back pain, kyphosis, scoliosis. Ossification at the level of the 5th lumbar vertebra and sacrum may lead to increased risk for advanced disc degeneration or disc herniation above the vertebrae. Hence, knowledge of such abnormalities should be kept in mind to minimise serious complications in any surgical intervention or investigative procedures in the region. KEY WORDS: Ossification, Anterior longitudinal Ligament, Vertebrae, Thorax mobility, Respiratory movements.

2090-2095

Authors: Komala B *1, Samreen Panjakash 2, Rohini S. Kori 1.

Introduction: The pedicles act as struts and reinforce the vertical system of columns. The pedicle as this is the site where vertebral column fixation surgeries are most frequently implemented. Objective: This study has been attempted to find out the transmission of weight through pedicles in man of South Karnataka region, India so that this knowledge could be applied to explain some of the clinicopathological conditions of the spine. Materials and Methods: The 6 cervical and upper 5 thoracic vertebrae of 30 human adult male columns were selected for the study. The various parameters of inferior body surface area, pedicle index, body-pedicle angle and the ratio pedicle index to inferior body surface area were measured for each of the 6 cervical and upper 5 thoracic vertebrae of 30 columns. Results: The area of the inferior surface of T5 vertebra was more than double that of the body of C2 vertebra. The mean pedicle index was greater at C2, T1, and T2 levels, while it was smaller at the remaining levels. At C2 level, in relation to the body, pedicles were directed backwards, downwards and laterally while, at C4 level, pedicles were almost directed horizontal. From C6 level downwards, pedicles were directed upwards and backwards. Their lateral deviation gradually diminished and at T5, it was directed completely backwards. Conclusion: The measurements obtained by the present study reveals the importance of pedicle in understanding the mechanics of spinal anatomy and its applications with respect to transmission of weight. KEY WORDS: Pedicle, cervical region, thoracic region, South Karnataka.

2099-2101

Authors: Raja Sekhar Katikireddi *1, Siva Nageswara Rao Sundara Setty 2.

Introduction: Sutural or Wormian bones are usually small irregular ossicles in related with the cranial sutures. They are formed because of the extra ossification centers in the vicinity of sutures. Materials and Methods: Study conducted on 75 dried human skulls to find the incidence and type of of sutural bones at pterion in related to south Indian population. Results: Present study concluded 4% of prevalence out of 75 cases, Right side one case and left side 2 cases were noticed, all were epipteric type of sutural pattern. Conclusion: Anatomical Knowledge of this kind of variations are important for anthropologists, radiologists, orthopaedic surgeons, and neurosurgeons. KEY WORDS: Skull, Wormian bones, Sutural bones.

2108-2113

Authors: Roopali D. Nikumbh *1, Dhiraj B. Nikumbh 2, Sudhir Singhavi 3.

Background: Sacrococcygeal teratomas are tumors that arise from sacrococcygeal region containing tissue from all the three germ layers. Sacrococcygeal teratoma (SCT) is a relatively uncommon tumor affecting neonates, infants and children with an incidence of 1 in 40,000 live births with malignant transformation with increasing age. It is four times more common in females than males. Aim and Objectives: To evaluate histological features of congenital sacrococcygeal teratoma and to grade them. Add a note on embryological and clinical aspect of sacrococcygeal teratoma. Material and Methods: The present study was retrospective, descriptive analysis of 10 patients presented with sacrococcygeal mass over the period of 6 years from December 2009 to December 2015 in Department of Anatomy in KIMSU, Karad and Hi-Tech diagnostic center, Dhule. The cases were reviewed histologically and grading of SCT was done and comparisons with other studies were made. Results: We reviewed 10 patients of congenital SCTs. There were 07 girls and 03 boys with the age ranges from 2 months to 18 months. Majority of the cases were less than 3 months. There were 08 cases of mature and 02 cases of immature teratoma noted. The most common presentation was sacrococcygeal mass in both teratomas. Conclusion: Majority of the SCTs are benign on histology, when diagnosed at birth with fully differentiated tissues. Histologically meticulous and careful search for immature or malignant components should be instituted as it will helps in therapeutic decisions. Additionally embryological studies and chromosomal analysis of SCTs in large series may be warranted to predict the further prognosis. KEY WORDS: Sacrococcygeal Teratoma, Congenital, Histology, Mature, Immature.

2119-2124

Authors: Rajeev Mukhia*1, Aruna Mukherjee 2, Anjali Sabnis 3.

Introduction: Spleen is the organ of interest for research workers since a long time. Though, detailed study about embryonic development is there in the literature but microscopic structures of spleen at different stages in the fetal period is far less available. Hence, the present study attempted to find out the detailed histological changes of human fetal spleen during its development. Materials and Methods: The study was carried out on 50 human foetuses of known gestational age in the department of Anatomy, MGM Medical College, Navi Mumbai. The sections of the spleen were studied after staining with Haematoxylin and Eosin stain and were observed under compound light microscope. Observations and Results: At 12-14th gestational week of development there was irregular network of mescenchymal cells with thin capsule, reticular cells; lymphoblast’s and few blood vessels were present. Increased haematopoietic cells including WBC’s and RBC’s were seen at 15th week. Vascularity increased at 16-17th week. At 18th week the tissue started showing division of red pulp and white pulp. Clear-cut division was seen after 20th week stage. From 22nd weeks onwards the structure was almost similar to that of adult spleen. Germinal centre was not seen up to 38th week of gestation. Conclusion: The study provides a detailed knowledge about the histogenesis of human fetal spleen. It also suggests the functional status of spleen in fetal period. KEY WORDS: Spleen, Histogenesis, White pulp, Red pulp, Reticular cells.

2128-2133

Authors: Deepa G *1, Shrikrishna B H 2.

Background and objective: Several studies have shown that anatomical variations of the osteomeatal unit of nose predispose to sinusitis. Hence this study was aimed to know the various anatomical variations of the osteomeatal unit of the nose using computed tomography. Materials and Methods: A prospective study was done on 200 computed tomography scans of patients visiting ENT OPD for evaluation of headache. Results: The different anatomical variations observed in our study were concha bullosa, paradoxical middle turbinate, retroverted uncinate process, enlarged ethmoid bulla, haller cells, agger nasi cells, onodi cells and pneumatisation of vomer. The most frequent anatomical variation found was presence of concha bullosa (22%). Conclusion: Variations are common in the osteomeatal unit of the nose. These variations may predispose to paranasal sinus diseases. Also, awareness of these variations helps the otorhinolaryngologist and/or radiologist to evaluate the CT scans of paranasal sinuses better. This will, in turn, help in endoscopic examination as well as in surgery. KEY WORDS: Paranasal Sinuses, Anatomic Variation, Tomography, Concha Bullosa, Turbinates.

2139-2141

Authors: Anitha M R *1, Chaitra B R 2, V Rajitha 3, Bharathi D 4.

Introduction: Anthropometry the measurements of man provides scientific methods and techniques for taking various measurements and observation on the living man and the skeleton. Height is one of the important parameter in the Anthropometric study of humans. Materials and Methods: In 300 adult males ulnar length on both right and left side was measured and height of individuals was measured. Observations and Results: The observations were analysed separately for both right and left ulna in male students. The correlation coefficient (r) of height and length of right ulna is 0.689 and left ulna is 0.790. Discussion: The values obtained from the present study are correlating with other studies and it will be most useful for medico-legal investigations and anthropological studies. Conclusion: simple regression formula was derived showing the correlation between ulnar length and stature of an individual. KEY WORDS: Ulnar length, Height, Anthrapometry, Regression formula.

2148-2150

Authors: Sonare Shilpa *1, Nikam Praful 2, Dofe Madhuri 3.

The present study shows abnormally fused axis & third cervical vertebra. The study was conducted in the department of Anatomy, GMC, Nagpur. Bodies, pedicles & laminae of two vertebrae are completely fused on right side but on left side only bodies are partially fused while pedicles & laminae are separate. On the right side, the intervertebral foramen is also very narrow but it appears to be normal on the left side. This abnormality may be associated with neurological signs & symptoms. Therefore the case has been studied. KEY WORDS: Cervical vertebrae, pedicles, laminae, intervertebral foramen.

1456-1462

Authors: Himabindu. N *1, Asra Anjum 2, S.Saritha3, Ramani 4, D. Nagajyothi 5, P. Gayathri 6.

Introduction: A variety of malformations are included under the description of Neural tube defects (NTDs). These are abnormalities of the embryonic neuralization process. The congenital malformations of human structure and are of great interest to anatomists, obstetricians, pediatricians and radiologists. NTDs are among the commonest and most severe disorders, affecting 0.5-2 per 1000 established pregnancies, and are second commonest group of birth defects, after congenital heart defects. A valuable contribution of this study, the neural tube defects aimed at clinical methods and refined for the prenatal diagnosis in utero. Materials and Methods: This comprehensive study was undertaken to know the incidence of detail knowledge of neural tube defects in KIMS Narketpally and KAMS & RC Hyderabad, among 1000 births during the period of two years. We found seven fetuses with neural tube defects involving brain and spinal cord. A detailed study was done emphasizing on embryology and genetic and non-genetic concepts. Results & Conclusion: The seven fetuses were stillbirths and aborted babies between 20 to 40 weeks, presented with neural tube defects (0.7%). Five fetuses were females and two fetuses were males. The spinal defects were 0.4%, cranial defects 0.2% and complete neural tube defects is 0.1%. This review article discusses the classification, clinical research and epidemiological understanding of NTDs and correlated with the available literatures. KEY WORDS: Neural tube defects (NTDs), Alpha Feto Protein (AFP), Ultra Sonography (USG), Spina Bifida, Hydrocephalus and anencephaly, craniorachisis.

1466-1470

Authors: Subhalakshmi Wahengbam *1, Renuca Karam 2, Kalpana Thounaojam 3, Elizabeth Remei 4.

Background: The biceps brachii is one of the muscles of the anterior compartment of the upper arm. It is characteristically described as a two-headed muscle that originates proximally by a long head and a short head. The present study was carried out to find the occurrence of a third head of biceps brachii among a sample Indian population. Materials and Methods: The arms of 35 adult cadavers were dissected and observed for variations in the origin and insertion of biceps brachii muscle bilaterally. Results: Among the 70 arms studied, three had 3-headed biceps brachii, 2 on the left and 1 on the right side. All the third heads were of humeral origin, which inserted into the radial tuberosity by a common tendon with the long and short heads. Conclusion: Knowledge of the existence of the third head of biceps brachii may enhance pre-operative evaluation, facilitate surgical intervention within the arm and improve postoperative outcomes. KEY WORDS: Biceps brachii, Scapula, Humerus, Radial tuberosity, Coracobrachialis.

1476-1480

Authors: Roopali D. Nikumbh *1, Dhiraj B. Nikumbh 2, Megha A. Doshi 3.

The variety of multiple morphological variations in the thyroid gland is found as a result of disturbed organogenesis in humans as agenesis, hypoplasia, accessory, ectopy and hemiagenesis. In the routine undergraduate dissection of the thyroid gland, multiple anomalies of the thyroid gland were encountered in 50 and 60 years old female and male cadaver respectively. These were in form of absent isthmus with accessory thyroid lobe in between two lateral lobes, pyramidal lobe arising from left lobe of thyroid with levator glandulae thyroidae in first case. Second case showed narrow isthmus related to first tracheal ring and levator glandulae thyroidae arising from left lobe. In these case studies, we highlight various developmental anomalies of the thyroid gland as absent isthmus, pyramidal lobe and accessory lobe with levator glandulae thyroidae. Hence a thorough knowledge of such morphological variations of thyroid gland helps the surgeons in better planning of safe, effective and uncomplicated operative procedures in resection of thyroid and tracheotomy procedures. KEY WORDS: Thyroid gland, Pyramidal lobe, Isthmus, Accessory thyroid lobe, Levator glandulae thyroidae, Variations.

1491-1496

Authors: Somesh M.S. *1, Sridevi H.B 2, Murlimanju B.V 3.

Aim: To study the various morphometric parameters of the dry sacra of unknown sex in South Indian population in detail and to determine their demarcating points in order to increase the efficiency of sexing in the given population. Methods: 87 dry adult human sacrum of known sex (42 males and 45 females), belonging to South Indian (Karnataka) region were obtained. Various parameters like Length (L), breadths (B), Transverse diameter of the body of the 1st sacral vertebrae (TS1) & Curved Length of Sacrum (CL) were obtained. From these parameters, Sacral Index (SI), Curvature Index (CI) and Corporo-basal Index (CBI) were calculated & from the obtained values demarking points (D.P) were calculated. The values were stastically analyzed. Results: Among these parameters, the values for the Length (L), Curved Length (CL) and Sacral Index (SI) were stastically significant Conclusion: Length (L), Curved Length (CL) and Sacral Index (SI) were useful parameters and by obtaining their demarking points, it helps in sexing the sacrum with greater accuracy. KEY WORDS: Sacrum, Sexing, Morphometry, Sacral Index, Karnataka.

1505-1509

Authors: Seema *1, Poonam Verma 2, Anupama Mahajan 3, Deepinder Gandhi 4.

Aims and Objectives: The major blood supply of the long bones is through the nutrient arterywhich enter through the nutrient foramina leadinginto an oblique nutrient canal. The presence, number, position and distances from the various prominent landmarks on the bone have medical as well as surgical significance. The present study was done on the long bones of North Indians to know the mean values of the number, position of nutrient foramina and distance from various landmarks on the bones and ultimately to compare with other populations. Materials and Methods: The present study consists of 180 long bones of lower limb (60 femora, 60 tibiae, 60 fibulae) which were taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India and studied carefully for the number, position and distance of nutrient foramina in relation to length and from the proximal epiphysis of the long bones. Also the anteroposterior and lateromedial diameter of the bone at the level of nutrient foramen were studied. Main outcome measure: Variations in number, position and distance in relation to length and from proximal epiphysis of long bones was seen. Results: The nutrient foramen of femur was located on the linea aspera in 76.50% of cases(39% in interstice 9.5% on the lateral lip and 28.00% on the medial lip of the linea aspera), 18.50 %on the medial surface and 5%.on the lateral surface. Nutrient foramen of tibia was located in 95.50% of cases under the soleal line at the average distance of 119.8 mm from intercondylar eminence to the nutrient foramen, on the soleal line in 4%and on the lateral border in 0.50% of cases. Nutrient foramen of fibula was found on the posterior surface in 65 % of cases, in 15% on the medial surface, on the interosseous border in 10% ,on the lateral surface in 7% and on the posterior border in 3% of cases. Conclusion: This study will provide the ethnic data for comparison among various populations. It is also helpful in various surgical procedures and in interpretation of radiological images. KEY WORDS: Femur, Fibula, Linea aspera, Nutrient, Tibia.

1515-1519

Authors: Bharat J. Sarvaiya *1, Jagdish S. Chaudhari 2, S. M. Patel 3, S. V. Patel 4.

Introduction: The ATD angle and finger ridge count, are palmar dermatoglyphics features of an individual. During the first & second trimester of pregnancy epidermal growth occur in stages and result in an increase epidermal thickness. Epidermal ridges begin to appear in embryos at 10th week and are permanently established by 17th weeks. The types of pattern develop in palm & soles are genetically determined. They are of considerable clinical interest because they affected by certain anomalies of early development including genetic disease. Objective: There are certain genetic (Chromosomal), Non chromosomal & metabolic disease shows particular palmer dermatoglyphics features so in this study we were trying to find out the difference in dermatoglyphics features in leprosy patient and control group. Materials and Methods: The sample consists of 100 cases of leprosy in age group of 18-60 year from Bhavnagar district. The finger print and palm print were taken by using ink & pad method and Compared with Control group of 18-60 years. The dermatoglyphics parameter like ATD angle, TFRC & AFRC were studied and evaluated for statistical significance. Results and Conclusion: There was statistically significant difference was observed in ATD angle as compared with control. There was no statistically significant difference observed in TFRC & AFRC as compared with control. The dermatoglyphics features can be useful diagnostically to differentiate the leprosy patient and control group. KEY WORDS: Dermatoglyphics, Leprosy, Genetic, finger ridge count, ATD angle.

1525-1528

Authors: Moono Silitongo *1,2, Kasonde Bowa 2, Elliot B. Kafumukache 3, Krikor Erzingatsian 4.

Anatomical variations in the origin of the branches of the arch of the aorta are frequent. In this case report the left common carotid artery arose as a branch from the brachiocephalic artery. The left common carotid artery arose at a distance 11mm from the arch of the aorta and had an internal diameter of 9mm. KEY WORDS: Aortic Arch, Brachiocephalic Artery, Left Common Carotid Artery, Variation.

1533-1535

Authors: Shruthi B.N 1, Pavan P. Havaldar 2, Shaik Hussain Saheb *3.

Background: The jugular foramen is difficult to understand and to access surgically; the difficulties in exposing this foramen are created by its deep location and the surrounding structures, such as the carotid artery anteriorly, the facial nerve laterally, the hypoglossal nerve medially and the vertebral artery inferiorly, all of which block access to the foramen and require careful management. It is difficult to conceptualize because it varies in size and shape in different crania, between the two sides the same cranium, from its intracranial to extracranial end in the same foramen and because of its complex irregular shape, its curved course, its formation by two bones and the numerous nerves and venous channels that pass through it. The present study is concentrated to study morphological features of jugular foramen. Material and Methods: The present study was undertaken in 250(500 sides) adult south Indian skulls from different regions of south India, from different medical colleges. We have observed the size of foramen and presence of jugular fossa. Result: Out of 250 skulls in 20.8% of cases the right foramina were larger than the left, in 24.8% of cases the left foramina were larger than the right and in 8% cases were equal on both sides. The jugular fossa present bilaterally in 60%, on the right only in 21.6% cases, on the left only in 7.6% cases and was absent in 10.8% cases. Conclusion: The present study concludes that there is no significance different between size of foramen in right and left side. The jugular fossa or bulb present bilaterally in majority of cases. KEY WORDS: Jugular foramen, Jugular fossa, Compartments, Separation.

1543-1547

Authors: Siddharth Shankar Roy *1, Abhijeet Yadav 2.

In the 19th and early 20th century, nasal shape, size and nasal indices were the most commonly measurement to differentiate races. A detailed study has been carried out in a random sample of 180 males in age group 18-24 years to neglect the affect of facial parameters in subject above 18 years of age. The study is aimed to determine a set of comparative standard values of the form of the North Indian young male nose and of its relevance to forensic science and clinical anthropometry. A highly significant comparison was found in the nasal indices of two ethnic groups, in the present study. The data revealed that the M.P. male had leptorrhin nose while U.P. male had mesorrhin nose. Various other parameters were also compared in a sample of 90 Madhya Pradesh and 90 Uttar Pradesh males. KEY WORDS: Nasal Index, Nasal Indices, Mesorrhin, Leptorrhin, M.P.(Madhya Pradesh), U.P.(Uttar Pradesh), Ethnic Groups.

1551-1554

Authors: Gyan Prakash Mishra *1, Mirza R.U. Beg 2, Shobha Bhatnagar 3, Brijendra Singh 4.

Aim: To assess the arterial pattern of middle segmental artery and its relation with collecting system in the human kidneys. Materials and Methods: We studied 50 fresh human Kidneys by corrosion cast techniques. We used different colour coded moulding granules of butyl butyrate, red for artery, blue for vein and black for collecting system of the human kidneys. 20% solution of butyl butyrate in acetone was injected into renal vessels and ureter of each kidney. Injected kidneys were kept immersed in concentrated Potassium Hydroxide solution for corrosion to obtain the endocasts. These endocasts were cleaned under the running tap water and observed macroscopically. Results: We observed three types of variations in arterial pattern of middle segmental artery namely Middle Segmental Artery Type-1 (MSAT1), Middle Segmental Artery Type-2 (MSAT2), Middle Segmental Artery Type-3 (MSAT3) and they were seen in 29(58%), 14(28%), 6(12%) kidneys respectively. We also observed three different variations in relation between middle segmental artery and collecting system namely Middle Segmental Artery Group-1 (MSAG1), Middle Segmental Artery Group-2 (MSAG2), Middle Segmental Artery Group-3 (MSAG3) and they were seen in 32%, 24%, 42% kidneys respectively. Conclusion: Anatomical knowledge of these variations is of valuable contribution for uro-surgeon in performing more and more conservative renal surgeries which lead to preservation of healthy and functional renal parenchyma and prevent intraoperative and post-operative complications. KEY WORDS: Kidney, Middle Segmental Artery, Collecting System, Variations, Corrosion Cast, Conservative Renal Surgeries.

1559-1567

Authors: Subhra Mandal *1, Amrita Gupta 2, Manjari Chatterjee 3, Prabir Mandal 4.

Anatomy and dissection have long been considered a cornerstone in medical education, irrespective of nation, racial background or medical school. By learning gross anatomy, medical students get a first “impression” about the structure of human body which is the basis for understanding pathologic and clinical problems. Anatomy teaching methodology has been revolutionized in the 2Ist century, due to time constraints, less availability of cadavers, stress on computer aided learning, scarcity of qualified teachers, changes in the demands of medical profession and neglect of vertical integration of anatomy teaching. Until recently, dissection and didactic lectures were its sole pedagogy, worldwide. But over the last few decades, traditional anatomy teaching based on topographical structural anatomy taught in lectures and gross dissection classes has been replaced by a vivid range of study modules like problem based learning(PBL) and computer assisted learning(CAL),and curricula integration. Though the anatomy curriculum is undergoing international reformation but it lacks uniformity among institutions. The available modern international literature, describing various methodologies for teaching/learning anatomy conclude that Anatomists are constantly debating over the following questions-How much to teach, when to teach and how to teach gross anatomy. We endeavor to answer these questions and contribute to the debate on the ideal methodology for teaching /learning anatomy. Alternative strategies and resources are also discussed so that we can re establish more effective teaching /learning tools while maintaining the beneficial values of orthodox dissection .If we are not concentrating on optimum anatomy education, it will inevitably lead to incompetent anatomists and healthcare professionals, leaving patients to face unwanted consequences of medical error. KEY WORDS: Dissection, gross anatomy, Problem based learning (PBL), Computer assisted learning (CAL), curriculum.

1573-1577

Authors: Deepa Bhat.

Introduction: Femur is the most richly vascularised long bone which derives its nourishment from various arteries of the lower limb. The quantum of blood supply is determined by the number and calibre of these arteries. Shaft of this bone is supplied by the vessels from perforators of the thigh which gives nutrient branches to it. Femoral shaft fractures are severe disabling injuries that demand critical evaluation as to the method of treatment. Since the success of these operations depends on a minimal interference with the blood supply of the bone, the knowledge of anatomy of the nutrient vessels is of considerable importance. Materials and Methods: The study was conducted on 300 adult femora available in the department of Anatomy. The study was undertaken to collect information on the variations in number, location, size of the nutrient foramina and if correlation exists between the length of femur and number of nutrient foramina. Results: 60% of the bones had double, 39.33% had single and only 0.67% had single nutrient foramina (NF). 52% of them were on medial lip of linea aspera followed by 41%on lateral lip and the rest scattered. 80% of NF was located on upper and middle segments of shaft and very meagre number in lower segment. No correlation was noted between number of NF and length of the bone. Discussion and Conclusions: The findings in the present study are compared and analyzed with previous researchers. The magnitude of care to be imparted while dealing with fractures of femoral shaft is discussed. The detailed knowledge on vascular anatomy of shaft would allow surgeon to preserve them during procedures. KEY WORDS: Nutrient foramina, Femur, Linea Aspera, Perforating Arteries.

1597-1602

Authors: Md. Jawed Akhtar *1, Nasreen Fatima 2, Ritu 3, Vinod Kumar 4.

BACKGROUND: The first cervical vertebra, atlas plays a vital role in the movement of skull & neck. The anatomy of atlas is complex due to its three dimensional structure. There is a groove on superior surface of posterior arch of atlas for passage of 3rd part of vertebral artery and first cervical spinal nerve (suboccipital nerve). Sometimes the oblique ligament of atlas which is present at the lower border of posterior atlanto-occipital membrane may ossify and convert this groove into a foramen. This foramen may be complete or incomplete, which is commonly known as ponticulus posterior or retroarticular canal. In some cases a bony bridge also extends from lateral masses of atlas to the posterior root of transverse process and form an additional foramen through which vertebral artery travels which is known as ponticulus lateralis. The vertebral artery is prone to compression in its entire course between foramen transversarium and foramen magnum during extreme rotation movement of head & neck. This condition may be aggravated by the presence of these ponticuli & results in compromised blood flow and causes vertebrobasilar insufficiency presenting with dizziness, fainting, vertigo, transient diplopia & various neurological disturbances. AIMS & OBJECTIVES: To study the incidence of ponticulus posterior as well as lateralis on atlas vertebra in the population of Bihar and compare the incidence of such type of variation in atlases of various races of world. MATERIALS & METHODS: The present study was carried out on 118 (Male-62, Female-56) dried fully ossified adult human atlas of known sex for the presence of complete or incomplete ring for vertebral artery i.e. different ponticuli on the superior surface of the atlas vertebra. RESULTS: We observed 21.17% cases of ponticulus posterior in which 7.62% specimens had complete ring while 13.55% specimens had incomplete ring & ponticulus lateralis was reported only in 5.93% cases (unilateral: 2.54% & bilateral: 3.39%). Incidence of ponticulus posterior as well as lateralis were more common in male as compared to female. Complete ponticulus posterior was more common in right side, while incomplete ponticulus posterior as well as ponticulus lateralis were more commonly bilaterally. CONCLUSION: As indicated by our study, ponticulus posterior as well as lateralis are not so rare anomaly in the population of Bihar. So, the detail knowledge about these variations is very helpful to the neurophysicians, neurosurgeons, orthopedicians & otolaryngologists who faces regularly the patients complaining about the symptoms of vertebrobasilar insufficiency. These informations are also important for the spine surgeons to prevent vascular complications during spinal surgeries especially in those patients who required screw placements in the lateral mass of atlas. KEY WORDS: Ponticulus Posterior, Ponticulus Lateralis, Arcuate Foramen, Atlas Vertebra.

1607-1610

Authors: Pradip Chauhan *1, Girish Rameshbhai Chauhan 2, Bhoomika Rameshbhai Chauhan 3, Jayesh Vrajlal Vaza 4, Suresh Punjabhai Rathod 5.

Background: Single best-answer multiple-choice questions (MCQs) consist of a question (the stem) two or more choices from which examinees must choose the correct option (the distracters) and one correct or best response (the key). Item analysis is the process of collecting, summarizing and using information from students’ responses to assess the quality of test items. Classical test theory for item analysis is most followed method to determine the reliability by calculating Difficulty Index (P score) and Discriminating Index (D score) and Distracter effectiveness Aim: This Study was aimed to calculate P scoreand distracter effectiveness; to find out relationship between P score and distracter effectiveness. Material and methods: In this Cross Sectional study 65 items responded by 120 Students of first year M.B.B.S were studied for Item Analysis. Difficulty Index, and Distracter Effectiveness were calculated for each item. Distracters were identified and classified as Functioning and Non- functioning distracter. Interrelationship between P Score, and Distracter Effectiveness was calculated and analyzed by Epinifo 7 software Result: We found Items with two functioning distracters were more difficult than that of others followed by items with three functioning distracters. Conclusion: Distractors affect the item difficulty index and by the means also affects quality of the assessment. KEY WORDS: Item Analysis, Difficulty Index, Distracter Effectiveness, Multiple Choice Question.

1615-1619

Authors: Indra Kumar, Vinay Sharma 2, Rekha Lalwani 3, C.S.Ramesh Babu 4*, Naresh Chandra 5.

Background: Spinal stenosis is defined as the narrowing of central spinal canal or its lateral recesses. Stenosis of spinal canal becomes important only when it results in interference with the normal functions of the contents of the canal. Narrowing of spinal canal seems to be a normal part of advancing age but certain uncertainties persist as regards to radiological definition of lumbar spinal canal stenosis. Material & Method: The present study was aimed to evaluate the clinical relevance of stenosis of spinal canal through the most recent technique, MRI. Fifty symptomatic and 18 asymptomatic subjects were included. Antero-posterior and transverse diameters of vertebral canal were compared between symptomatic and asymptomatic subjects and statistically analyzed Results & Discussion: The present study clearly shows that in both symptomatic and asymptomatic subjects there is a gradual decrease in the antero-posterior diameter from above downwards . The minimum antero-posterior and maximum transverse diameter was seen at L4L5 level making this level susceptible to compressive symptomatology. Apparent stenosis was observed in some asymptomatic subjects. Conclusion: Radiological evaluation alone is not sufficient to define lumbar spinal canal stenosis KEY WORDS: Lumbar canal, Radiological Study, Stenosis.

1624-1628

Authors: Gargi Soni *1, Vivek Singh Malik 2, Ravindra Kumar Boddeti 3.

The suprascapular notch which is located on the lateral part of the superior border of the scapula, medial to the coracoid process, is bridged by the superior transverse scapular ligament. The notch serves as a passage for suprascapular nerve to pass to supraspinous fossa. Suprascapular nerve entrapment may be due to the variable morphology of the suprascapular notch or due to ossification of the superior transverse scapular ligament. Morphometric studies of suprascapular notch have been done in various populations. The aim of the present study is to review the morphometric studies of suprascapular notch, identify the most common type of notch and compare the morphometry in different populations. KEY WORDS: Suprascapular notch, Entrapment, Morphometry, Scapula.

1635-1637

Authors: Bassem Abou Hussein *1, Houssam Abtar 1, Ibrahim Al Shaghoury 1, Amjad Zaaroura 2, Ahmad Zaaroura 1, Mustafa Oweidat 1.

Ectopic liver is a rare entity identified most commonly during abdominal exploration for other indications. Liver ectopia is less common than accessory liver and can be associated with multiple other congenital anomalies. We present a case of a fourty-nine year old female, who presented for elective laparoscopic cholecystectomy for symptomatic cholelethiases. Abdominal exploration showed an ectopic liver segment attached to gall bladder and draining through it with no other connections to the liver. KEY WORDS: Ectopic, Liver, Choristoma, Conginital Anomalies.

1642-1645

Authors: Pushpa N.B *1, Roshni Bajpe 2.

Back ground: Suprascapular notch (SSN) is present along the superior border of the scapula. It is bridged by the supascapular ligament. Suprascapular nerve passes inferior to it. Suprascapular nerve entrapment frequently occurs at the suprascapular notch. A narrow notch or the ossified suprascapular ligament is the frequently encountered culprits. Aim: To study the morphology of suprascapular notch among 176 dry scapulae. Materials and Method: The study was conducted on 176 adult dry human scapulae in the department of Anatomy, KIMS, Bangalore. Among 176 scapulae 88 were right sided & 88 left sided. Various shapes of scapular notches were noted & classified into 6 types based on Rengachary classification. Results: The most common type of suprascapular notch in the study is Type II (R-24, L-37) & least common is Type VI (R-5, L-5). Suprascapular notch was absent in 8 Scapulae. Conclusion: We could find all the 6 types of scapular notches, most common type being type II ((34.65%) and least common type - type VI. This study is an attempt to know the various shapes of suprascapular notch. KEY WORDS: Suprascapular notch, completely ossified, suprascapular nerve.

1651-1654

Authors: Amar Singh L *1, Sujatha K 2, Ramachandra Bhat 3.

Introduction: A rare type of variation of extensor muscles on the dorsum of hand is extensor digitorum brevis manus (EDBM).It is a small muscle rarely present on the dorsum of the hand which can be misinterpreted a pathological mass on the dorsum of the hand. Aim: Aim of the present cadaveric study is to observe the incidence, anatomical morphology of EDBM and to study its phylogenetic significance. Material and Methods: Present study was conducted on 32 adult human cadaveric hands of which 24 were of male and 8 were of female cadavers. Results: The EDBM was observed in one incidence (3.1%) of the specimens. EDBM was found to be between the tendons of extensor digitorum for index and middle fingers. It was of Anatomical variant type I. Conclusion: The knowledge of incidence and morphology of EDBM is of greater relevance in clinical practice to rule out any pathological mass on the dorsum of the hand. KEY WORDS: Extensor digitorum brevis manus, dorsum of hand, incidence, variations.

1660-1664

Authors: Shikha Sharma*1, Tejendra Singh 2, Ekramuddin 3, Bhawani Shankar Modi 4.

Introduction: The variations in the intrahepatic pattern of portal vein within liver are mandatory factors while dealing with hepatic surgery. The variations in the intrahepatic portal vein branching need to be recognized when contemplating for ligation of the vessel at the porta hepatis during partial hepatectomy. Materials and Methods: This study was done in 50 dogs liver specimen by corrosion cast technique. Results and Discussion: In this study in the entire cases bifurcation pattern was found and in all the cases left branch of portal vein extended transversly to the left and turned in the caudolateral direction and divided into transverse portion and oblique portion and right divided into superior and inferior branch. In 88% cases caudate process received branch from the right portal trunk while the papillary process received branch from the left portal trunk. Conclusion: The knowledge of the portal vein and its intrahepatic branching is important to ensure surgical success pertaining to different surgical procedures. KEY WORDS: Bifurcation, Hepatic Vein, Caudate Lobe, Portahepatis, Quadrate Lobe.

1669-1674

Authors: Parimala Sirikonda *1, Nalluri Himabindu 2.

Sirenomelia also known as mermaid syndrome, characterized by fused lower limbs, is a lethal and rare congenital abnormality. This is an extreme example of caudal regression syndrome caused by vascular steal of single umbilical artery. Sirenomelia is found approximately one in 100,000 live births and is usually fatal because of complications associated with pulmonary hypoplasia, abnormal development of the kidneys and urinary bladder. Most of the cases are associated with maternal diabetes and single umbilical artery. We report a case of sirenomelia terminated at 21weeks of gestation due to multiple congenital abnormalities. Antenatal scan of a25-year old primi revealed a single live fetus of 21 weeks gestation with severe olighydramnios, non-visualization of kidneys and bladder and lower part of the spine. This pregnancy was terminated and the specimen sent to the department of anatomy for fetal autopsy. On external examination,a tail like rudimentary single midline lower limb without foot was noted. There were no external genitalia and anal orifice. Internal examination revealed hypoplastic lungs, atrial septal and ventricular septal defects, aberrant right subclavian artery, hypoplastic abdominal aorta distal to the single umbilical artery, complete agenesis of urinary system, rectal agenesis and rudimentary indeterminate gonads. We would like to discuss the clinical features, etio- pathogenesis and review of literature of sirenomelia. Early diagnosis and termination of this lethal congenital anomaly results in minimizing the trauma related to the termination of pregnancy at advanced gestation. KEY WORDS: Sirenomelia, Caudal regression syndrome, vascular steal, maternal diabetes, single umbilical artery

1680-1684

Authors: M.S.Rajeshwari *1, M.S.Pushpa ².

Background: Lateral pterygoid muscle plays an important role in the mandibular movements and dynamics of temporomandibualr joint. Anterior displacement of the disc and temporomandibular dysfunction has been related to the insertion of upper head of LPM in the TMJ disc. Materials and Methods: A study was conducted on forty specimens from formalin fixed cadavers in the department of Anatomy , BMCRI, Bangalore. Results and Discussion: In 72.5% of cases the upper head of LPM insert to the disc and blend with the capsule and lower head inserts to the inferior aspect of the disc, to the capsule and the condyle of mandible. Conclusion: Though there is no clear demarcation between the heads of LPM majority of the upper fibers insert to the disc and to the capsule. KEY WORDS: Lateral pterygoid muscle, Articular disc, Temporomandibular joint.

1697-1699

Authors: Sriambika K *1, Nutan Nalini Bage 2, V.K. Nim 3.

During the routine cadaveric dissection, the presence of accessory heads of Sternocleidomastoid was observed on right side. i.e., additional bellies from sternal and clavicle were observed on the right side. These additional slips were innervated by the spinal accessory nerve. These additional slips could have been formed due to unusual splitting in the mesoderm of post-sixth branchial arch during organogenesis. The awareness of variations of sternocleidomastoid muscle is important for Anaesthetists, Plastic surgeons, Orthopaedicians and Dental surgeons while taking muscle flap in reconstructive surgeries and is also important for radiologists while interpreting MR images of this region. KEY WORDS: Sternocleidomastoid, Clavicular head, Sternal head.

1704-1709

Authors: Sakthivel *, Swathi Priyadarshini.

Background: Obturator artery is a branch of anterior division of internal iliac artery. It normally runs anteroinferiorly on the lateral wall of pelvis to the upper part of the obturator foramen and leaves the pelvis by passing through the obturator canal. On its course, the artery is accompanied by the obturator nerve and vein. It supplies the muscles of the medial compartment of the thigh. A severe and potentially lethal complication in pelvic injuries is arterial bleeding commonly involving the branches of the internal iliac artery, namely the lateral sacral, iliolumbar, obturator, vesical and inferior gluteal arteries. A sound knowledge of retro-pubic pelvic vascular anatomy is pivotal for successful performance of endoscopic procedures such as total extra-peritoneal inguinal hernioplasty or laparoscopic herniorraphy. The context and purpose of the study: This study is an attempt to analyse the origin, course, distribution of obturator artery in pelvis and their clinical implication. Result: out of 60 formalin fixed pelvic halves 36.6% of the specimens, (26.67% in males and 10% in females) the origin of obturator artery was found to be normal from anterior division of internal iliac artery. About 63.63% from various other sources. Conclusion: This knowledge of variation in the origin of obturator artery is important while doing pelvic and groin surgeries requiring appropriate ligation. Such aberrant origins may be a significant source for persistent bleeding in the setting of acute trauma. Knowledge regarding the variations of obturator artery is useful during surgeries of fracture and direct or indirect inguinal, femoral and obturator hernias. KEY WORDS: Internal Iliac Artery, Obturator Artery, Superior Gluteal Artery, Iliolumbar Artery, External Lilac Artery, Inferior Epigastric Artery.

1716-1720

Authors: Subhra Mandal *1, Moumita Saha 2, Prabir Mandal 3, Ramprasad Saha 4.

Neural variations of the brachium constitute important anatomical and clinical entity.Abnormal variations of median nerve, musculocutaneous nerve and their communicating branches have been reported very frequently by the anatomists in the past. The nerves of the extremities are particularly vulnerable to injury because of their long course and superficial distribution. Present report describes a case of a single abnormal communication between median and musculocutaneous nerve encountered in a 55 year old Indian male cadaver during routine undergraduate dissection. Knowledge of such anatomical variations is important while planning surgery in the region of axilla or arm as these nerves are more liable to be injured during surgical procedures as well as may result in unusual entrapment neuropathies. Clinical significance of such type of variation in the light of its developmental origin has been discussed. KEY WORDS: Median nerve, Musculocutaneous nerve, Anatomical variations.

1726-1731

Authors: Roshan S *1, Nivedita Pandey 2, Varsha Bhivate 3, Rahul P Kharate 4.

Background: Thyroid gland is one of the vital organs in neck region. It is highly vascularized and variations of the thyroid arteries are frequent and have been well documented in literature. This fact increases the significance of being cautious about thyroid gland while performing surgery in neck region. Objective: To study the morphological anatomy of Inferior thyroid artery and to report the origin of the Inferior thyroid artery, to measure the length of the Inferior thyroid artery from its origin to its entry into the gland, to measure the distance from the midline of the neck to the entry of the Inferior thyroid artery into the thyroid gland and to trace its branches. Method: A total of fifty human cadavers were dissected at anatomy department dissection hall of MGM Medical College, Navi Mumbai, Maharashtra and the measurements were taken as per objective of the study. Results: Inferior thyroid artery originated from the thyrocervical trunk in all cases on the left side. On right side in 48 out of 50 cadavers, it originated from thyrocervical trunk (96%) and in rest two cases it originated from the subclavian artery (4%). Statistically significant variation (p<0.001) of mean length of inferior thyroid artery between the right and left side of cadaver was found, indicating mean length was more on left side. Statistically significant variation (p<0.001) of mean distance from midline to entry of inferior thyroid artery into gland between the right and left side of cadaver was found signifying mean distance from midline was more on the right when compared to the left side. Conclusions: Variations of inferior thyroid arteries are well documented in literature. To keep morbidity to minimum, surgeons should have extensive knowledge of the topographic anatomy and its variations. KEY WORDS: Thyroid Gland, Morphology, Inferior thyroid artery, Cadaver.

1737-1740

Authors: K G Prakash *1, S Viveka 2.

Background: Foramen Vesalius a small inconsistent foramen in the base of skull for passage of emissary vein from pterygoid plexus of veins to cavernous sinus. Variations in incidence and morphology are reported in literature. The objective of this study as to estimate its incidence in south Indian population and to evaluate the morphometric variations. Materials and Methods: Twenty-two dry skulls belonging to department of anatomy, Azeezia Institute of Medical Sciences, Kollam was studied with respect to base of the skull foramens. Wherever the foramen Vesalius was noted, the specimens were photographed and incidence, laterality was noted. Maximum, minimum and perimeter were noted. Any difference between male and female skulls and differences in right and left side were studied for statistical significance. P<0.05 was considered as significant. Results: We found foramen Vesalius in 40.9% of 44 sides examined. Six skulls had this foramen bilaterally. Three specimens had foramen Vesalius unilaterally and six specimens had it bilaterally. Average diameter of foramen was 1.35 (±0.56) mm from extra cranial aspect. The average diameter and perimeter of foramen in males were significantly lower than females. The average distance between foramen Vesalius and foramen ovale was significantly more in females than in males. Conclusion: Foramen ovale is an inconsistent and asymmetrical foramen in base of skull near foramen ovale. Forty percent of the skulls studied had foramen Vesalius. There is significant difference measurements of right and left side foramens. Considering these variations in infratemporal fossa decreases complications while approaching mandibular nerve and trigeminal ganglion. KEY WORDS: Foramen Vesalius, base of skull, foramen ovale, emissary veins, mandibular nerve.

1745-1748

Authors: Kusum Rajendra Gandhi *1, Rajendra Namdeo Wabale 2, Mujeebudeen Samsudeen Farooqui 3.

Tensor fascia suralis muscle is an anomalous muscle located in popliteal fossa. The muscle may arise from any of the hamstring muscles and is inserted into the crural fascia or tendoclacaneus. We found tensor fascia suralis muscle in a male cadaver taking origin from medial side of tendon of biceps femoris muscle. The tendinous origin was then transformed into a well defined fusiform belly in the roof of popliteal fossa. After traversing downwards and medially the muscle again became tendinous to get inserted into deep fascia of leg. Bilateral presentation of the anomalous muscle is not yet documented in literature. The anatomical relation of the muscle explains its great clinical importance. The tendinous origin was anteriorly related to sciatic nerve and the muscle belly to the tibial nerve. Sural nerve and short saphenous vein were in lateral relation to the muscle. Contraction of muscle in the roof of popliteal fossa may lead to sciatic, tibial or sural nerve neuropathy. The muscle can confuse the physician of a soft tissue mass or an aberrant vessel. Hence, the bilateral presence of tensor fascia suralis muscle is documented for further references. Clinical Significance: The precise knowledge of anatomy of popliteal region is mandatory for the surgeons to perform safe and uncomplicated surgery in and around popliteal fossa and also for radiologist for correct radiographic interpretations. KEYWORDS: Tensor Fascia Suralis Muscle, Anomalous Muscle, Neuropathy, Aberrant Vessel.