International Journal of Anatomy and Research

456-458

Authors: Veena Vidya Shankar, Roopa Kulkarni

During the routine dissection of abdomen, two adult male cadavers, aged 55 & 67years, presented with unilateral and the bilateral undescended testes respectively. One of them presented with unilateral and the other with bilateral undescended testes. In both cases the testes were found at the superficial inguinal ring. The histological examinations indicated normal testicular tissue. Undescended testis is the inability of the testis to reach the scrotum. In living, it has to be differentiated from testicular agenesis, ectopic testis and retractile testis. The genetic sex of the male is determined at the time of fertilization but the phenotypical sex starts as early as 4th month of intrauterine life and completed along with the descent just before birth. The embryological basis and clinical significance has been explained.

462-469

Authors: Henrietta Redebrandt Nittby, MD, PhD, Tom Bendix, MD, Dr Med Sci

Background: Nerve-root related dermatomes have been considered to have quite solid anatomical framings. However, especially in the lumbar region, studies have questioned such firm anatomy. Regarding the cervical nerve roots, many studies have shown an overlap between different dermatomes, which of course affects decisions taken in the clinical work. All the same, dermatome drawings with clear borders are still widely used. Context and purpose of the study: We conducted a literature review in order to find today’s state of the art, including the methods on which the anatomical atlases have been based. The overall pragmatic thoughts were to create summarized guide for clinicians when trying to correlate an MRI-demonstrated prolapse/recess stenosis to pain and neurologic findings, particularly if the nerve root’s peripheral neurology does not follow conventional anatomy. Results: We isolated 24 studies that sufficiently dealt with the issue of cervical dermatomes. Pain and sensory disturbance caused by cervical root affection could deviate from the dermatomal patterns. We found indications that sometimes no paralysis or anaesthesia would be seen after section of a single root. Because the fraction of cases without classical fit between nerve root and anatomical level cannot be given, studies should go into this issue. Conclusion: There are many studies showing that dermatomal distributions are varying, and not only overlapping. We therefore mean that new studies, with modern imaging and surgical techniques, are much needed.

474-477

Authors: Mohini M Joshi, Subhash D Joshi, Sharda S Joshi

Background: Text-books in Anatomy describe the presence of ‘small and unimportant cartilage triticea (like a wheat grain)’. The lateral portion of thyrohyoid ligament is round cord like and very elastic and in its upper part contains a small nodule. The cartilage triticea probably reinforce the thyrohyoid ligament. It presumably adds to the strength of ligament. Objective: The objective of this study was to determine the prevalence of triticeous cartilage and to study its shape, dimensions and weight. Material and method: The study was carried out on 50 Laryngeal preparations from cadavers of both sexes. Presence/Absence of cartilage triticea was observed. The cartilages were cleaned and preserved in 5% formalin. Dimensions (length and diameter) of triticeous cartilages were measured with the help of digital Vernier caliper. The measurements were taken to the nearest 0.01 mm. The cartilages were weighed on Single pan electronic balance (sensitive to 0.01 gm). Result: In the present study prevalence of triticeous cartilages was 58 % (40% bilaterally and 18% unilaterally). The shapes varied from oval (44%) to spindle shaped (8%). Its length varied from 3.37 to 13.94 mm. Its diameter 2.4 to 4.79 mm.In one case unilaterally two cartilage triticea were found. Very interesting variation in lateral thyrohyoid ligament were observed varying from its complex absence due to the union of superior cornu of thyroid to greater cornu of hyoid. The weight of cartilage triticea was varying from 11 mg to as much as 109 mg. Conclusion: It seems that the prevalence of triticeal cartilage is quiet variable in studies carried out in the different population. Knowledge of shape size and location of cartilage triticea can be of great help in differentiating it from carotid atheroma and other dystrophic calcifications of soft tissue.

481-484

Authors: Jyothi K C, Anupama K, Shailaja Shetty, Radhika P M

Introduction: The axillary arch muscle of Langer is the most common anatomical variant of axillary musculature which is of clinical and surgical importance. It may lead to neurovascular compression syndrome in the cervicoaxillary region and can be misinterpreted while examining axilla and also impairs movements of shoulder joint. Observation: During routine dissection of axilla for undergraduate teaching, an unusual muscular slip in the left axilla was observed .The muscular slip was extending from lattisimus dorsi muscle to undersurface of pectoralis major muscle, arching over axillary vessels and cords of brachial plexus. Conclusion: The axillary arch may cause obstruction to axillary vessels and nerves and may be involved in thoracic outlet syndrome and shoulder instability. The knowledge of this muscular variant could help to minimize intraoperative complications related to surgeries in or nearby axilla such as mastectomy, breast reconstruction and axillary lymphadenectomy or lymph node biopsy.

489-493

Authors: Ainory Peter Gesase, Gabriel J. Mchonde, Alfred Meremo, Mange Manyama

To date seven different types of atrial septal defects (ASD) have been described and they include septum primum, septum secundum, superior vena cava, inferior vena cava, coronary sinus and patent foramen ovale types of ASD. One feature in common among these ASD’s is that they all present with a hole that may allow communication between the left and right atria. The current observation reports what appears to be a new type of ASD that is characterized by the presence of an oblique septal canal that opens into the right and left atria. The right atrial opening was D-shaped and measured about 0.9 cm wide and the left atrial opening was crescent-shaped and measuring about 0.5 cm wide. In addition to this the left atrial opening was associated with five luminal bands; the last three bands lies on the roof of the oblique septal canal. The action of pulling the first luminal band resulted into closure of the left atrial opening an indication that the bands prevented blood coming from the lungs from entering into the right atrium. The presence of oblique septal canal and luminal bands has not been reported in relation to the ASD’s. Continued documentation of such anomalies remains clinically important particularly in African settings where unexplained illnesses are easily attributed to endemic diseases.

497-502

Authors: Harish A. Wankhede, Hosmani P.B., Dipti A. Nimje

Background: The basilar artery is the large median and major artery of the posterior circulation of the brain. Many variations are seen in the basilar artery, majority of them in position, origin and shape of the artery. Many authors have documented various anomalies as well as differences of the anatomy in this area in the Indian population as compared to the Western literature. Context and purpose of study: Many studies are available on the anterior circulation of the brain i.e. on vessels of the circle of Willis but studies on the posterior circulation are very few. And such studies so far had been done mostly in the American and European races and are mostly based on imaging techniques. Studies in the Indian population have been few. Hence the present study is concentrated on the morphological study of the basilar artery of human adult brain, to show the frequency and type of variations in the morphology of the basilar artery. Results: The basilar artery most commonly takes origin from the vertebral artery where left vertebral artery is greater in size than the right vertebral artery (72.5%). Level of formation of the basilar artery is most commonly observed at the ponto-medullary junction (62.5%). Length of the basilar artery varied from minimum 2.4cm to maximum 3.6cm. More commonly artery lies in the range of 2.6-3.0cm (57.5%). Diameter of the basilar artery at origin ranges from 3.2-4.2mm, at mid level from 3-4mm and at termination 3.1-4mm. Level of termination of the basilar artery is more commonly at the mid brain-pons junction (50%). Most of the basilar arteries are of straight type (55%) and next common is bent or curved type (37.5%). Fenestration of 4mm is seen in proximal part of the one basilar artery (2.5%). Conclusion: Variations of the basilar artery are common. Neurosurgical importance of this study lies during the exposure of the region for different purposes. Knowledge of the vascular variations will increase the success of the surgical procedures and radiological procedures used in interventional radiology.

507-510

Authors: P. Devi Raja Rajeswari, K. Aruna, Raja Sankar S

Context: The comparative morphological and anatomical study on thymus was carried out in human and primate. The prenatal stage of Macaca radiata was selected for the present study. Study Design: Cross sectional analytical type of study. Place and Period of study: Department of Anatomy, Dr. A.L.M. PG Institute of Basic Medical Sciences, Chennai from July 1999 to June 2000. Materials: The comparative morphology and anatomy of thymus of human embryonic, 10 weeks, 15 weeks and prenatal foetuses, and monkey foetus was carried out. Methods: Comparative micro-anatomical study was done by paraffin processing method. The sections were stained as per the method published by Culling (1974). Results: In monkey foetus, the thymus gland is slightly elongated, whereas in human foetuses it is not elongated and oval in shape. The size of the thymus is larger in human foetuses than monkey foetus. In both cases cells are parenchymal in nature. Due to spatial organization in human foetuses, the lymphocytes aggregation is more in cortex than in medulla. In monkey foetus the lymphocyte aggregation is simpler in arrangement through spatial organization is much less.

515-520

Authors: Kanika Sachdeva, Rajan Kumar Singla, Gurdeep Kalsey

Background: The use of coxal elements for age & sex identification is primary and most widespread way of bringing us closer to the identity of dead individuals in archaeological & certain forensic scenarios. It is well known that there is metric & morphologic variation in expression of sexual dimorphism between racial phenotypes and populations. Therefore, the purpose of present research is to assess metric differences in the pubo-ischial region of hip bones amongst North Indian Population. Material & Methods: Material for the current investigation comprised of 100 hip bones [(M: F=80:20) & (R: L=50:50)] obtained from Department of Anatomy, Government Medical College, Amritsar, Punjab, India. Pubic Length & ischial length were measured and Pubo-ischial index was calculated. All the data thus obtained was compiled, tabulated and statistically analyzed. Results: All the three parameters showed statistically significant sex differences. Ischium was longer in males, pubis in females & pubo-ischial index was also more in females. Conclusion: These variables can be used to determine sex from human hip bone or its fragments.

524-532

Authors: Kanika Sachdeva, Rajan Kumar Singla, Gurdeep Kalsey

Introduction: Sex estimation of skeletal remains is an important issue in both forensics and bioarchaeology. Many mammalian species display sexual dimorphism in the pelvis, where females possess larger dimensions of the obstetric canal than males. This is contrary to the general pattern of body size dimorphism, where males are larger than females. Pelvic dimorphism is often attributed to selection relating to parturition, or as a developmental consequence of secondary sexual differentiation. Current opinion regards the hip bone as the most reliable sex indicator because it is the most dimorphic bone, particularly in adult individuals. Material & Methods: In the present study, an attempt has been made to find the base line data of thirteen parameters pertaining to ilia of 100 hip bones of known sex and side. Variables studied were: Total length of iliac crest, lengths of its ventral & dorsal segments; distance between Anterior Superior Iliac Spine & Iliac Tubercle; Iliac height; Ventral, Sacral, Direct, Lower & Upper iliac heights; Iliac breadth; Lower, Ventral & Sacral iliac breadths, Length of pelvic & sacral parts of Chilotic Line. Results: The results obtained were tabulated, statistically analysed & compared to the earlier literature. It was seen that almost all the parameters except Sacral Iliac Height, Lower Iliac Height & Pelvic parts of Chilotic line were longer in males. Conclusion: To conclude, the morphometry of ilium also constitutes an important mean of sexual dimorphism. However its parameters are longer in males as it does not form a part of birth canal so is independent of sex hormones & is akin to general rule that male bones are larger than female bones.

537-540

Authors: Surya E, V. Anitha

Background and aim: Arterial disarrangements within the thorax are common and assume many diverse forms. The anatomic and morphologic variation of the origin and course of the prevertebral segment of the vertebral artery is necessary for vascular radiology, planning of aortic arch surgery or endovascular interventions. The present study is aimed at finding the origin and course of the left vertebral artery from the arch of aorta between left common carotid and left subclavian arteries. Materials and methods: Present study was done on six formalin fixed cadavers during routine dissection allotted for the first year students of Kanyakumari Government Medical College Asaripallam, Nagercoil (2012-2013). The direct dissection method was used. A comparative analysis was done with previous studies. Result: Usually the vertebral artery arises from supero-posterior aspect of the first part of the subclavian artery. But in a 60 yrs old adult female cadaver showed a variation, that the arch of aorta gave off four branches in which the left vertebral artery arose as 3rd branch between the left common carotid and left subclavian arteries. Conclusion: Variation observed in the study is in par with variation observed in previous studies. The knowledge about the variant origin of left vertebral artery is necessary for interventional radiologists and surgeons to avoid complications in the head and neck region.

545-548

Authors: Bermio V.S, Jos Hemalatha.G.A

Background:The knowledge of sternal variations is important as this bone is usually chosen for bone marrow aspiration.One such developmental anomaly is the presence of foramina, of varying dimensions, in manubrium or body or xiphisternum.Usually, the defect occurs in the lower third of sternum,in the body, as a single midline foramen (oval or round) and is usually asymptomatic and can be demonstrated only by CT scanning. The observation and knowledge of these foramina are of utmost importance in clinical, forensic and acupuncture techniques.Hence, this observation could be a useful one. Materials and methods: During a routine osteology class in the Department of Anatomy,Kanyakumari Government Medical College,an adult sternum of unknown sex and age was found to have a foramen in the lower part of body at the level of articular facets for fifth costal cartilages. Results:The following observations were made: (1)The sternum presented an oval foramen in the lower part of the body. (2) It was located in midline at the junction between third and fourth sternebrae.(3) Its margins were smooth and measured 5mm×6mm. Conclusion:Embryologically,sternum is formed by the craniocaudal fusion of two sternal bars,which are condensations of mesenchymal tissue which get converted to pre-cartilage before fusion. Any defect in this fusion may cause cleft sternum or sternal foramina(single or multiple). The single sternal foramen presented here could have clinical implications. Its knowledge helps in preventing fatal cardiac tamponade following needle insertion during bone marrow biopsy or acupuncture performed in this region. Forensic misinterpretation of this defect is also possible.

553-556

Authors: Meera Jacob, Ramakrishna Avadhani, Bindhu.S, Rani Nallathamby, Meril Ann Soman

Retromolar foramen is found in the triangular area behind the lower last molar tooth and it allows the passage of neurovascular bundle that contribute to the nutrition and innervations of the pulp and periodontium of the lower teeth. In the present study one hundred and twenty mandibles were examined for the presence of retromolar foramen .Retromolar foramen was found in two mandibles bilaterally and in thirteen mandibles unilaterally (in 10 on the right side and in 3 on the left side). The distance between posterior third molar to the retromolar foramen was found to be an average of 9.8mm on the right side and 8.05mm on the left side. Distance between anterior border of ramus to retromolar foramen was found to be an average of 5.68mm on the right side and 5.77 on the left side. Retromolar foramen is surgically very significant. Knowledge of this anatomical variation can prevent complications in anaesthesia and surgical procedures in this area.

561-565

Authors: N. Shakuntala Rao, K. Manivannan. Gangadhara, H. R. Krishna Rao

The external carotid artery normally divides into two terminal branches at the level of the neck of the mandible. The terminal branches are usually the superficial temporal and maxillary arteries. The maxillary artery is described to be in three parts in relation to the lateral pterygoid muscle as the mandibular (first), pterygoid (second) and the pterygopalatine (third) parts. The second part passes behind the muscle. The branches that arise from the first part of the maxillary artery are the deep auricular, anterior tympanic, the middle meningeal, accessory meningeal and inferior alveolar arteries. The middle meningeal artery normally arises at the lower border of lateral pterygoid muscle from the first part of maxillary artery. It then ascends upwards, passes between the two roots of the auriculotemporal nerve and enters the foramen spinosum in the base of skull. During routine dissection of a male cadaver in the department of anatomy while teaching medical students variations were observed in the termination of the external carotid artery on the right side. The artery gave three branches at the termination, superficial temporal, maxillary and between the two the middle meningeal artery was seen arising close to the end of the external carotid artery. The middle meningeal artery did not pass between the two roots of the auriculotemporal nerve. The branches of first part of maxillary artery were variable. The deep auricular branch was absent and its territory may have been supplied by the posterior auricular and anterior auricular arteries. The anterior tympanic and accessory meningeal arteries arose from the middle meningeal artery. There were two inferior alveolar arteries 1.5 cm apart arising from the first part of maxillary artery. The first artery went to the mandibular canal along with the inferior alveolar nerve. The second artery accompanied the lingual nerve to the last molar tooth. Probably this artery may have been an additional supply to the gingiva around the last molar tooth. The other variations that were noted were the absence of mylohyoid branch from the inferior alveolar artery. To the best of our knowledge these variations in the arteries have not been previously reported.

571-576

Authors: Takkallapalli Anitha, Sanjay H Kalbande

Human embryonic stem cells are derived from the inner cell mass of the blastocyst at the pre implantation stage of the embryo. The present review is done to describe the derivation, culture method, directed differentiation of the human embryonic stem cells with particular emphasis on their clinical applications, and their role in the field of research and regenerative medicine

580-582

Authors: Prajkta A Thete, Mehera Bhoir, M.V.Ambiye

Routine dissection of a male cadaver revealed the presence of bilateral double renal arteries. On the right side the accessory renal artery originated from the abdominal aorta just above the main renal artery. On the left side the accessory renal artery originated from the abdominal aorta about 1 cm above the main renal artery. Knowledge of the variations of renal vascular anatomy has importance in exploration and treatment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal aortic aneurysm and conservative or radical renal surgery

589-593

Authors: Raviprasanna.K.H, Dakshayani K.R

Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%). All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6%) took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2%) directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction.

597-600

Authors: S.V.Venugopal, Venugopal Rao, Ravindra Kumar B, Gargi Bhasin

Knowledge of relationship between the facial artery and submandibular salivary gland is essential for the surgeon operating in the submandibular region. This study has been under taken to have the knowledge of this relationship. Submandibular region has been dissected on 20 male cadavers in the Department of Anatomy, Sree Narayana Institute of Medical Sciences, Kerala. The course of the facial artery and its relationship to submandibular salivary gland has been followed carefully. The standard description of ascent of the facial artery along the entire length of posterior border of the submandibular salivary gland was seen in 15 out of the 20 sides studied. In 4 out of 20 sides dissected the facial artery reached only the upper part of the posterior border of the gland. The facial artery arose high on the external carotid artery near the angle of the mandible in one specimen. It reached the gland only at its postero-superior angle, pierced through the gland and emerged on the upper part of the lateral surface of the gland. Our study shows that only 1/5 of instances facial artery courses along the posterior border of the gland. In 4/5 of instances it reaches only the upper part of the posterior border.