International Journal of Anatomy and Research

296-304

Authors: A.Arun Kumar, Sudha Seshayyan, V.Tamilalagan, M.Sindou

Background: The main purpose of this study is to determine the detailed morphometric data of Dorsal Root Entry Zone (DREZ) of cervical spinal nerves. This knowledge is necessary for diagnosis, treatment and surgical management of pain due to many conditions like brachial plexus avulsion injury, post-herpetic neuralgia, phantom pain and cancer pain involved in cervical myelo-radiculopathy. There are fewer studies reported in this field of DREZ. Materials and Methods: Twenty five adult formalin fixed cadavers are taken for this study. Conventional Spinal cord dissection is followed as per Cunningham’s Dissection Mannual. Findings: The parameters included are Number of dorsal rootlets, Longitudinal Length of DREZ, Distance between two successive DREZ, Length of dorsal rootlets, Distance between right and left DREZ, Distance between DREZ and Ligamentum denticulatum, Cranial angles of Superior & inferior rootlets. Results: Results were noted for all the parameters and are compared with the previous studies. The significant observations are obtained. Conclusion: Surgical anatomy of Dorsal Root Entry Zone (DREZ) of cervical spinal nerves will be useful for the neurosurgeons doing Drezotomy procedure, in which the nociceptive fibres alone are specifically severed with preservation of other sensations. KEYWORDS: DREZ, Dorsal Root Entry Zone, Cervical Spinal Nerves, Pain.

310-314

Authors: Sachin Patil, Madhu Sethi, Smita Kakar

Background: The liver is largest abdominal viscera located in right hypochondrium ,epigastrium and left hypochondrium in upper abdominal cavity. Although the segmental anatomy of the liver has been extensively researched, very few studies have dealt with surface variations of the liver. The major fissures are important landmarks for interpreting the lobar anatomy and locating the liver lesions. Purpose: The purpose of our study was to determine gross anatomical variations of liver and their clinical and surgical implications. Methods and Results: Present morphological study was conducted on 50 embalmed human livers in the Department of Anatomy, Maulana Azad Medical College, New Delhi,India. Different variations in lobes, fissures and accessory lobes or fissures were observed. The liver specimens were also classified according to netter’s six types of liver variations. Conclusion: The findings of our study may be helpful for surgeons and radiologist to avoid possible errors in interpretations and subsequent misdiagnosis, and to assist in planning appropriate surgical approaches. KEYWORDS: Liver, Quadrate, Caudate, Segment, Hepatectomy.

318-324

Authors: Amrish Tiwari, D. C. Naik, P. G. Khanwalkar, S. K. Sutrakar

Anorectal malformations are the congenital condition, seen in approximately 1 in 5000 live births. It affects male and female in the ratio of 1.3:1. Anorectal malformations include a wide range of malformations, that not only involves the anus and rectum, but it also involves urinary and genital tract. Aims and objectives of the study, was to understand the structures involved in anorectal malformations by histological study of surgically excised segments of involved part of neonatal intestine and to understand the degree and cause of possible structural impairment in different segments of involved parts of neonatal bowel that may help in the surgical management of anorectal malformations. Present study was conducted on surgically excised segments of fifteen cases of anorectal malformations, that have been collected from Department of Paediatrics Surgery, IMS, BHU. After that processing of the samples have been done and blocks have been prepared. Then after sectioning and staining with Hematoxyline and Eosin, findings have been noted under the microscope. Histopathological examination revealed the abnormalities of varying degrees. To conclude this study supports that the malformed segments should be excised, regarding controversial issue of preserving or excising the distal segment of anorectum for better functional outcome. KEYWORDS: Anorectal malformations, neonatal bowel, histological study.

328-332

Authors: Saif Omar, Mehre Darakhshan Mehdi, Provas Benerjee

Cryptorchidism refers to hidden testicle. It is a clinical condition where one or both testicles have been retained from entering the scrotum during the later part of the foetal period. Along with irreversible damage at both gross and cellular levels there is impairment of endocrine and reproductive functions of the testicles. As the incidence of cryptorchidism is very low and previously reported research and data on comparative findings between cadaveric and cryptorchid testes in the state of Bihar was not available this study was undertaken. KEYWORDS: Cryptorchidism, testicle, scrotum, comparative.

336-339

Authors: Gayathri Matheswaran, Ranganath Vallabhajosyula

Relationship that exists between different part of the body and height had been of great interest to anthropologists, forensic and medical scientists for many years. This is because of the increase in the number of catastrophic events causing mass deaths from natural or manmade errors. Such disasters like flooding, tsunamis, earthquakes, plane crashes, train crashes , terrorist attacks usually requires the identification of victims from fragmentary and dismembered human remains. In present paper, study on stature estimation from digit length has been reported. In the present study, 200individuals (96 males and 104 females) belonging to age group of 18 to 25years having no disease or deformity were examined anthropometrically in respect to their height and digit lengths (2D, 3D, 4D, 5D) have been measured. The regression equations have been drawn from the data collected. It has been observed that stature can be estimated from the digit lengths. KEYWORDS: Digit Length, Stature, Sexual Dimorphism, Estimation, Linear Regression Analysis, Significance.

344-353

Authors: Bishwajeet Saikia, Akash Handique, Pranjal Phukan, Donboklang Lynser, Amitav Sarma

Background: The circle of Willis is a large arterial anastomotic ring present at the base of the brain uniting the internal carotid and the vertebrobasilar systems. Branches from the internal carotid and vertebral arteries anastomose to form an arterial circle in the basal cisterns and then distribute to supply the brain. The anatomy of the circle is known to vary significantly; the vessels may be absent or sufficiently narrowed altering the hemodynamics of the circle of Willis and affecting its role as a collateral route. These variant forms can be correlated to their phylogeny and embryology. Prior knowledge of these variant forms is important in pathologies and treatment (e.g. parent artery occlusion for carotid aneurysms) resulting occlusion of carotid and vertebral arteries. Context and purpose: Our study was undertaken to observe and compare the morphology of circle of Willis using two entirely different methods; gross dissection (GD) and Magnetic resonance angiography (MRA) and to correlate the variant patterns encountered with the possible underlying developmental events. Gross dissection was carried out in 70 human cadavers and equal numbers of MRA’s of healthy individuals were studied retrospectively. Results: Only 31 cases (22.14%) presented with a complete circle of Willis, out of which 14 (20%) were cadaveric specimen and 17 (24.18%) were in MRA group. Unilateral hypoplastic posterior communicating artery was the most common variation observed in our study (19.28%). Conclusions: The wide variation in completeness of the circle of Willis in general population is similar to earlier observations. Review of phylogeny and embryology makes us familiar with variant forms which would be otherwise difficult to recognize and may be misinterpreted. MRA and gross dissection findings despite certain variations are comparable. KEYWORDS: Internal carotid artery, vertebral artery, Collateral flow.

358-362

Authors: Pavan P Havaldar, Sameen Taz, Angadi A.V, Shaik Hussain Saheb

Background: The internal iliac artery is the “artery of the pelvis”. It supplies most of the blood to the pelvic viscera, gluteal region, medial thigh region and perineum. A severe and potentially lethal complication in pelvic surgeries is arterial bleeding commonly involving the branches of internal iliac artery. While operating on pelvic organs, the knowledge of internal iliac artery and its variations is important for surgeons. The present study was conducted to study of morphology of internal iliac artery. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: The classification of branching pattern of internal iliac artery was based on modified Adachi classification. Out of the 50 specimens studied, Type Ia arrangement was found in 52% of the specimens, Type III in 34%, Type IIa and type V was found in 2% each, Type IV was not found in any of the specimens and 10% of the specimens could not be classified because of the absence of inferior gluteal artery in them. Adachi Type Ia arrangement was the most frequent finding. The obturator artery took origin most frequently from the anterior division of internal iliac artery. Middle rectal artery was not constant. Conclusion: The internal iliac artery morphology shows multiple variation the knowledge is very helpful during pelvic surgeries. KEYWORDS: Internal iliac artery, Obturator artery, Middle rectal artery, Internal pudendal artery.

369-374

Authors: C.Krishnaveni, Roopa Kulkarni, Kishore Kumar B.N, M.B.Sanikop, K.V. Venkateshu

Objectives: To know the pelvicalyceal anatomy by radiological method that helps in localizing the calculi or tumors in kidneys. Materials and method: The study was conducted in Sri Devaraj Urs Medical College, Tamaka, Kolar from 2011 to 2013. Forty four adult, formalin embalmed cadaveric kidneys (20 right and 24 left) were injected with 8 to 10 ml of 10% radio opaque barium sulphate solution into the renal pelvis and calyces and radiographs were taken in anteroposterior view. Results: The observations were statistically analyzed. There were 14 extra renal pelves and 30 intra renal pelves. The major calyces were classified into three categories [Double (D), Three (T) and Multiple (M) divisions]. Out of 44 kidneys 20 were right and 24 left.. 23 kidneys presented multiple (more than 4) calyces, 12 had two major calyces and only 9 presented with three major calyces). Typical ‘Y’ arrangement in 03 out of 12 and typical multiple in 03 out of 23 kidneys. There were 14 kidneys (31.8%) presented with extra renal pelvis whereas 30 kidneys (68.2%) presented intrarenal formation of the renal pelvis. Conclusion: Due to the variation in the number of major and minor calyces, position of renal pelvis (intrarenal and extra renal), the knowledge of pelvicalyceal anatomy will help the urologist and nephrologists to pin point the position of renal calyceal calculi or malignant growth for the surgery to be carried out. KEYWORDS: Renal pelvis, renal calyces, Ureter, Kidneys, Barium sulphate, contrast radiography.

380-382

Authors: Pavan P Havaldar, Maheshwari Myageri, Shaik Hussain Saheb

Background: The proper knowledge of the course and ramification of blood vessels of lower limbs is very important for surgeons and interventional radiologist. Medial circumflex femoral artery usually originates from posteromedial aspect of the profunda femoris, but often originates from femoral artery itself. It has an important role in supplying blood to femoral neck and head, fatty tissue in acetabular fossa and used in flaps reconstructive surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origins of medial and lateral circumflex femoral artery and their prevalence were studied. Results: Out of 50 extremities, Medial circumflex femoral artery took origin from profunda femoris in 41 specimens and from femoral artery in 9 specimens. Conclusion: The knowledge of normal origin and variation of medial circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle. KEYWORDS: Medial circumflex artery, Femoral artery, Lower limb arteries.

386-389

Authors: Sangeeta Wazir.

Background: Lumbar backache is a very common problem nowadays. Sacralisation of lumbar vertebrae is one of the cause for that. During routine osteology teaching a sacrum with incomplete attached lumbar 5 vertebrae is seen. Observation: Incompletely fused L 5 vertebrae with sacrum is seen. The bodies of the vertebrae are fused but the transverse process of left side is completely fused with the ala of sacrum.But on the right side is incompletely fused. Conclusion: The person is usually asymptomatic or may present with symptoms which include spinal or radicular pain, disc degeneration, L4/L5 disc prolapse, lumbar scoliosis and lumbar extradural defects. In transitional lumbosacral segmentation, it was observed that the lumbosacral intervertebral disc is significantly narrowed. The incidence of disc herniation is found to be higher and can occur even at young ages. There was also relationship established between transitional vertebrae and the degree of slippage in spondylolytic spondylolisthesis. In addition, this anomaly has known implications in the field of disc surgery. KEYWORDS: Radicular Pain, Scoliosis, Herniation, Spondylolytic.

394-396

Authors: Banani Kundu, Isita Ghosh, Satabdi Sarkar, Gairik Sengupta

Background: To show the anomalous origin of right inferior phrenic artery from right renal artery and to discuss the embryological basis and surgical significance of such variation. Method: This was found during routine dissection of abdomen in a 61 year old adult male cadaver in the department of anatomy, R.G.Kar Medical College. Results: It was seen that right inferior phrenic artery(RIPA) took its origin from right renal artery. Further distribution of RIPA was normal. Left inferior phrenic artery (LIPA) arose normally from abdominal aorta. Conclusion: Accurate knowledge regarding this is important for carrying out vascular and reconstructive surgery and for evaluation of angiographic images . The RIPA is a major source of collateral arterial supply to hepatocellular carcinoma, second only to the hepatic artery. So a surgically inoperable HCC can be treated by transcatheter embolization of not only the right or left hepatic arteries, but also by embolization of a RIPA, if involved. KEYWORDS: Right Inferior phrenic artery (RIPA), Right Renal Artery, Left inferior phrenic artery (LIPA).

400-402

Authors: S. K. Rathee *1, Sanjay Gupta 2, Shelja 3, Usha Dhall 4, P Raghavan

Shape of crania is seen by measuring cranial index in 150 (115 male and 35 female) crania. Crania were obtained from the department of Anatomy, Pt. B.D. Sharma PGIMS Rohtak. In males, 91.07 % crania were found dolichocephalic while in females 97.14% crania were dolichocephalic. Few crania were found mesocephalic (6.25% in males and 2.85% in females) in both sexes. None of female crania was seen as brachycephalic. Percentage obtained in present study is quite different from any other population studied as most of the crania were dolichocephalic. So it can be used as a tool to identify crania of this region.

406-409

Authors: Pooja Jain *1, Shashi Raheja 2, Anita Tuli 3, Preeti Shrivastava 4.

An ideal education system is in-separable from the evaluation system. There has always been a need for an evaluation system which can determine whether predetermined educational objectives have been achieved. As an exercise last 10 years annual MD question papers (anatomy) of university of Delhi were given to the residents and the Post graduate students of anatomy department, Lady Hardinge Medical College, New Delhi. The analysis of question papers reflected that the emphasis on different parts of the syllabi was not uniform. All the questions were of long and short essay type. Multiple choice questions that are based on recall and problem solving attitude of the students were not at all included. There is need to revise the pattern in which question are being asked that will develop cognitive skills and problem solving attitude among the students. An ideal question paper should give equal weight-age to different content areas/topics and it should include all analytical, objective, long and short answer type questions with an uniform marking scheme for all students. When it comes to medical education, evaluation becomes very important because here lays the responsibility of bringing out the best doctor amongst the best.

413-417

Authors: Manoj Kumar Sharma *1, Hemlata Sharma 2, Neelam Bapna 3.

Background: In India, especially in Rajasthan people drink water containing high level of nitrates and concentration up to 500 mg of nitrate ion per liter is not unusual. The ingested nitrate is converted to nitrite in the digestive system and absorb in blood causing methemoglobinemia. The peak of methaemoglobin is observed at 45-95 mg/liter of nitrate concentration in water.. Aims and Objects: To find out the correlation between drinking water nitrate concentration and histopathological changes in kidneys of rabbits of different groups. Materials and Methods: An experimental study was conducted in 10 rabbits between three and half month to four month of age having weight ranging 1.310 kg to 10720 kg. Five groups A, B, C, D and E were formed having two rabbits in each group. The control group A was administered water orally having 06 mg/liter. Group B to E (experimental groups) were administered water orally having concentration of 100mg/liter, 200mg/liter, 400mg/ liter & 500mg/liter of nitrate respectively for 120 days. Then all rabbits were anaesthetized & sacrificed according to guidelines of ICMR and kidneys were removed & processed for paraffin sections. Hemotoxyllin and eosin staining was done for microscopic observations. Results: During experiment, animals were lethargic on 75th day .Intake in quantity of food and water was not altered in the rabbits. Rabbits of all group i.e. A to E showed continuous increase in heart rate (up to 218/ minute in group E) and respiration rate (up to 84/minute in group E) respectively. The microscopic study of kidney showed focal collection of lymphocytes in interstitial tissue, particularly in pericapsular area of kidney which appeared in rabbits of group B. The changes were more pronounced in group C &D in the form of focal collection of plasma cells. The hyaline and cellular casts were observed in proximal & distal tubules which started appearing in animals of group C. The congestion of blood vessels and damaged tubular epithelium were observed in tubules of group E rabbits. Discussion and Conclusion: The Results occurred possibly due to cytochrome b5 reductase activity and its adaptation with increasing water nitrate concentration to compensate methaemoglobinemia.

421-430

Authors: Vladimir N. Voloshin *1, Vladimir G. Koveshnikov 2, Irina S. Voloshina 3.

Background: Spleen is a secondary lymphoid organ that is highly sensitive to different chemicals. Toluene is an aromatic hydrocarbon commonly used as an industrial solvent and can be considered as a potential immunotoxin. Aims and Objects: We aimed to investigate the organometry and histology of spleen from rats exposed to toluene. Materials and Methods: The toxicity of toluene was evaluated in male albino rats (6/group) via whole-body exposure. The animals were exposed to target concentrations of 0 (air control) and 133 parts per million (ppm) of toluene in air for 5 hours/day, 5 days/week, for 2 month. The animals were weighted and decapitated at different time points (one, seven, sixteen, thirty one and sixty one day) post-exposure. The weight, length, width and thickness of the spleen were measured. It was studied absolute and relative weight of the spleen. Histological examination of the spleen was made by light microscope. Results: Statistically significant difference between the mean of body weight from the control and experimental animals was observed seven days after last exposure to toluene. Thus, the body weight of animals exposed to toluene was 254.17 g, that was 7.18% (p = 0.048) below control data. The histological findings showed increased area of the white pulp of spleen from rats exposed to toluene had increases compared to that from the control. The numbers of siderophages were higher in the spleen from rats exposed to toluene. The relative area of germinal centre in the structure of the splenic lymph follicles of rats exposed to toluene increased. We found that in the first and second experimental groups of animals the indication was at the level 10.86% and 10.26% respectively. These are 24.11% (p = 0.002) and 26.04% (p <0.001) above control data, respectively. Inhalation exposures to toluene vapor at 133 ppm produces hyperplasia of lymphoid tissue of the rat spleen. Conclusion: Our data demonstrated that whole-body exposures to low-level of toluene led to hypertrophy of white pulp of the spleen.

434-436

Authors: Sarita Behera *1, Bijaya Kumar Dutta 2, Mamata Sar 3.

Right lung is divided into upper (superior), middle and lower (Inferior) lobes by an oblique and a horizontal fissure.Oblique fissure passes spirally from posterior border to inferior border deep into the lung separating the lower lobe from upper and middle lobes. A short horizontal fissure passes horizontally forwards from the oblique fissure at midaxillary line to meet the anterior border at 4th costochondral junction. This separates the upper lobe from the middle lobe. During routine dissection in 2010-11 undergraduate batch, we came across two cases of right lungs where an accessory fissure was extending horizontally backwards from the oblique fissure at mid axillary line towards the vertebral part of medial surface. In the 1st case, this accessory fissure was not meeting the normal horizontal fissure where as in the 2nd case it was meeting. This accessory fissure separates the lower lobe into a superior and an inferior segment. Knowledge of different types of accessory fissures is important because it may mislead the radiological findings, may act as a barrier to spread of infection creating a sharply marginated pneumonia which can wrongly be interpretated as atelectasis or consolidation. Identification of completeness of fissure is important prior to lobectomy, because individuals with incomplete fissures are more prone to develop postoperative air leak. Considering the clinical importance of such anomalies, anatomical knowledge and prior awareness of accessory fissures in the lungs may be important for clinicians and radiologists.

443-445

Authors: Meril Ann Soman 1, Ramakrishna Avadhani 2, Meera Jacob 3, Rani Nallathamby 4, Charly Chacko Joseph *5.

Anomalies of the urinary system constitute approximately 30% of all the congenital malformations. There are various associated anomalies involving number, size, shape, position and vascularity of the kidneys. Unascended kidneys refers to a halt in the migration of the kidneys during their normal embryological development. Defect in the ascent of the kidneys are closely related with variations in the branching pattern of aorta. Here we report a case of an unilateral unascended right kidney in a male cadaver encountered during routine medical dissection. A left sided ureteric calculi was also seen as an incidental finding in the same cadaver. Ureterolithiasis occurs worldwide in all sets of population with 80% of the stones found in the male sex in the age group of 30- 60 years. There are various factors which favour the formation of ureteric calculi which includes geographical, socio-economical as well as the mineral content of water consumed and some general medical causes. An attempt has been made to document the causes for this variation and the preventive measures that can be adopted to prevent the formation of ureteric calculi.