International Journal of Anatomy and Research

3

Authors: Shifan Khandey

Background: Though rare but variations of brachialis muscle insertion have been reported. Material and Methods: The study was conducted on 115 upper limbs over a period of 4 years. The dissection of arm and forearm was done carefully to preserve all minute details ,observing the morphology of insertion pattern and nerve supply. Observation: Out of 115 specimens, 2 specimens showed insertion of brachialis into bicipital aponeuroses. Accessory slips were seen in 4 specimens which are mixed with main fibers at insertion point. Rarest of all was insertion of an accessory brachialis muscle on radial tuberosity in 2 specimens. The muscle originated from lateral border of shaft of humerus and shared a few fibers with main Brachialis muscle. The muscle was inserted into radius just below the radial tuberosity. Conclusion: The identification of an inter-nervous plane may allow for improvement in the current anterior and anterolateral surgical approaches to the humerus. This could be one of a possible etiology of Radial tunnel syndrome.

4

Authors: Vinayachandra P H, Viveka S, Sudha M J, Balakrishna Shetty, Santhosh Kuriakose, Srinivasa Sagar

Background: Ossicular morphology and morphometric considerations play cornerstone importance in reconstructive surgeries. An attempt is made to have an insight into such morphological variations and evaluate the morphometric values of malleus in south Indian population through cadaveric dissection. Materials and methods: 25 human head specimens taken from the dissection hall, after removal of brain and duramater, subarcuate fossa and arcuate eminance of the petrous part of the temporal bone were chipped off with help of fine edged chissel and hammer. With help of bone cutter the tegmen tympani forming the remaining roof was removed, till the middle ear cavity and three ossicles are properly exposed and identified. Results: Malleus height ranged from 6.94 mm to 7.78 mm on both sides with average of 7.37mm on right and 7.51 mm on left. Weight ranged from 16.85 mg to 19.25 mg with average of 18 mg on right side and 18.52 mg on left both side. Length and weight of left malleus bones were statistically more than their right counterparts. Conclusions: Morphologically malleus showed lesser variations in comparison to stapes. The left sided malleus dominated the right sided ones in both length and weight.

202-207

Authors: S. Havila Hasini, Subhadra Devi Velichety, K. Thyagaraju, K. Jyothirmayi, Ch. Jaipal

Introduction: Thymus is one of the central lymphoid organs. It plays an important role in the differentiation, selection and maturation of T-lymphocytes. In the recent years morphology and morphometry of the thymus gland in the newborn is gaining significance as it demonstrates great variability between individual infants and in the same infant at different times. Materials and methods: In the present study 45 thymus specimens from aborted human fetuses of 16 to 40 weeks gestational age and both sexes were studied by autopsy for morphological and morphometric features. The morphometric parameters were measured using pachymeter. Results: The thymus gland was located in the superior mediastinum. 60% (27/45) specimens showed cervical extensions. Brachiocephalic vein anterior to thymus was observed in 3 cases which is an important anomaly to be observed in thymectomy procedure. Thymuses were greyish pink to greyish brown in colour. Variations were also observed in the number of lobes of glands in which one is single lobed, most of the glands are bilobed and few are trilobed. There is progressive increase in all morphometric dimensions of the thymus in relation to gestational age. Most of the specimens were less than 4cm in length. Half of the specimens were below 2cm in width and other half were 2.0 to 5.0 cm in width. For 90% of the specimens thickness of the organ was less than 0.5cm. The thymus gland was 0.2% of fetal body weight. Conclusion: The morphological observations of thymus gland shows great variations which has to be considered in thymectomy. In addition to anthropometric parameters of fetus, morphometric parameters of thymus glands present significant relation to the gestational age of fetuses. It is possible to determine the thymic morphometric parameters in relation to gestational age.

213-220

Authors: Lakshmi Kantha.B.M, Roopa Kulkarni

Aim: To obtain the lengths of the humeral segments and compare with total length of humerus in South Indian population, That helps in estimating the stature of individual using standard regression formulae and to compare these data with the study conducted in other countries for the use in forensic and archeological studies. Materials and Methods: 150 (75 left and 75 right) adult, fully ossified, dry and processed humerii were taken to analyze the morphometric details of the humeral segments which were measured using osteometric board and scale. The length of six different segments namely, from most proximal point in the head to most distal point of the circumference of the head (segment-1), from most distal point of the circumference of the head to the convergence of two areas of muscle attachment (segment-2),the convergence of two areas of muscle attachment to the deltoid tuberosity (segment-3), from deltoid tuberosity to upper margin of the olecrannon fossa (segment- 4), from upper margin of olecrannon fossa to lower margin of olecrannon fossa (segment-5), from lower margin of olecrannon fossa to most distal point on the trochlea (segment-6) and maximum length of humerus were measured to the nearest millimeter. Results: The values obtained in mm (mean±S.D) in total length of humerus segments -1,2,3,4,5 and 6 were recorded. The proportion of segments to the total length was also calculated which will help for the stature estimation using standard regression formulae. Conclusion: This study helps in forensic, anatomic and archeological fields in order to identify unknown bodies as well as for the orthopedic surgeons for the treatment of proximal and distal humerus fractures for their reconstruction in case of extensive damage to those parts of the humerus.

225-233

Authors: Priti Chaudhary, Rajan Singla, Kamal Arora, Gurdeep Kalsey

BACKGROUND: The anatomical variations in the different parts of brachial plexus in human have been described by many authors. These variations have clinical significance for the surgeons, radiologists and the anatomists. A lot of work has been done on the morphology of branching pattern of the different cords of brachial plexus but almost all the workers are silent about their morphometry. That’s why this study is planned on morphology & morphometry of branching pattern of different cords of brachial plexus. MATERIAL AND METHODS: The present study was conducted on 60 upper limbs belonging to 30 cadavers (Male:Female = 28:02), (Right:Left = 30:30) obtained from Department of Anatomy, Govt. Medical College, Amritsar. These were dissected to expose the different components of brachial plexus. OBSERVATIONS: Out of 60 limbs, the lateral and the medial cords were formed in the usual way in 56 limbs, while the posterior cord was normal in 57 limbs. The average lengths of lateral, medial & posterior cords were 3.37 cm, 4.05 cm & 1.95 cm respectively. The branches of lateral cord depicted more variations in the form of origin as compared with those of medial & posterior cords. The distance of different branches of all the cords from the point of origin to parent cord varied between the two sides of same cadaver as well as on the same side of different cadavers. DISCUSSION & CONCLUSION: The present study on the adult human cadavers is an essential prerequisite for the initial built up of the data base at the grass root level. The anatomy has always provided a bedrock for the sound surgical endeavors. It definitely has an upper edge to widely and indiscriminately used radiological and sophisticated CT and MRI observations which carry a margin of error inherent to any diagnostic procedure because no doubt the machines are a good bet but the eyes see the best.

239-241

Authors: Gyan Prakash Mishra, Shobha Bhatnagar, Brijendra Singh

A precise knowledge of the vascular variations of human kidney is essential for the surgeon and radiologist to avoid complication during interventional radiological procedure, renal transplantation, renal trauma and other urological procedures. The present case report is regarding unilateral variation of renal vein and bilateral variation of renal artery. During routine cadaveric dissection of abdominal region, we observed three renal veins in right kidney. All right renal veins were emerging from hilum of kidney and drained in inferior vena cava where as in left Kidney venous drainage is normal. In right Kidney both main and accessory renal artery arose from abdominal aorta. Left main renal artery arose from abdominal aorta with left accessory renal artery arising from left middle suprarenal artery which is branch of coeliac trunk. In this case right ureteropelvic junction is seen to be compressed in between right accessory renal artery and right lower renal vein which crossed anteriorly with right middle renal vein crossing posteriorly this condition may cause hydronephrosis. The above finding to be reported in a single case is rarely seen. This is a valuable contribution from anatomical knowledge to operative procedures.

249-255

Authors: Muralidhar P Shepur, Magi M, Nanjundappa B, Pavan P Havaldar, Premalatha Gogi, Shaik Hussain Saheb

Background: Diameters of foramen magnum are important because vital structures passing through it and for sex determination of skulls. The dimensions of the foramen magnum are clinically important because vital structures passing through it may endure compression such as in cases of foramen magnum herniation, foramen magnum meningiomas and foramen magnum achondroplasia. The knowledge of foramen magnum diameters is needed to determine some malformations such as Arnold Chiari syndrome, which shows expansion of transverse diameter. Objectives: To study longitudinal diameter, transverse diameter and area of foramen magnum in relation to sex. Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Diameters of foramen magnum were measured by vernier calipers and its area was calculated by formula. Diameters and area of foramen were measured automatically. Results: The mean longitudinal diameter of foramen magnum in male was 33.4mm and female was 33.1mm and by CT Imaging method in male was 38.5mm and female was 35.2mm. The mean transverse diameter of foramen magnum in male was 28.5mm and female was 27.3mm and by CT Imaging method in male was 29.1mm and female was 27.6mm. Conclusion: longitudinal and transverse diameters and area of foramen magnum of male skulls were greater than females.

259-261

Authors: Vrushali S. Kolte, Seema Khambatta, M. V. Ambiye

Lumbricals as a part of intrinsic musculature of hand, are important for precise movements of digits. They perform flexion at metacarpo-phalangeal joints and extension at inter-phalangeal joints. During routine dissection of an adult male cadaver we observed a rare variation of lumbricals of the right hand. The first lumbrical was unusually arched, making a sinuous appearance instead of being linear. The other lumbricals were also showing a sinuous pattern. In addition, the second lumbrical was bipennate in origin. This variation was accompanied by an incomplete superficial palmar arch where the radial and ulnar sides of the arch were separated. Though it’s a case report but we can’t deny a role of evolution process of human being or any occupational impact for better proprioception for such a variation. Clinicians and surgeons should be aware of such variations of lumbricals and superficial palmar arch while dealing with hand surgeries.

266-269

Authors: Vatsala A R, Ajay K T, G F Mavishettar, Sangam

The vascular anatomy of the human upper limb which is man’s important earning tool, is a complex and challenging area. The arterial supply of the upper limb is mainly maintained by brachial artery through its branches. Recent progress in vascular surgery has engendered a need for precise knowledge of the frequency of anatomical variations in the branching pattern of axillary artery. Upperlimb injuries are the most frequent occupational accidents. Awareness of variations in the anatomy of brachial artery and its branches is important to avoid serious complications while treating the cases of arterio-venous fistulae, aneurysms and abscess drainage in the region of axilla, arm and cubital fossa. The present study was undertaken on 54 upper limbs of both sexes from embalmed adult human cadavers . The specimens were studied by detailed dissection method. In the present study, 59.3% of specimens showed variations of axillary artery. Better anatomical knowledge about the branches of brachial artery and their variations are important for surgeons, physicians, radiologists and interventionists, because based on anatomical study, new diagnostic and therapeutic approaches can be proposed.

273-278

Authors: Muralidhar P Shepur, Magi M, Nanjundappa B, Pavan P Havaldar, Premalatha Gogi, Shaik Hussain Saheb

Background: Endocranial capacity is an important parameter in the study of human evolution, race and sex determination of skull. Diameters of foramen magnum are important because vital structures passing through it may endues compression and for sex determination of skulls. Correlation between endocranial capacity and area of foramen magnum was reported in mammals. This relation in human can be used to determine sex of damaged skulls. Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Endocranial capacity of skulls was measured by modified Breitinger’s method. Diameters of foramen magnum were measured by vernier calipers and its area was calculated by formula endocranial capacity of CT scan images measured by planimetry. Diameters and area of foramen were measured automatically. Results: The Mean endocranial capacity of male and female skulls were 1367.3ml and 1255.2ml respectively by modified Breitinger’smethod and by CT scan image planimetry method were 1347.1ml and 1130ml. The mean longitudinal diameter of foramen magnum in male was 33.4mm and female was 33.1mm and by CT Imaging method in male was 38.5mm and female was 35.2mm. The mean transverse diameter of foramen magnum in male was 28.5mm and female was 27.3mm and by CT Imaging method in male was 29.1mm and female was 27.6mm. Conclusion: Endocranial capacity, transverse diameter and area of foramen magnum of male skulls were greater than females. A significant positive correlation was observed between endocranial capacity and area of foramen magnum in male and female skulls, but highly significant positive correlation was observed when both sexes were considered together. Living subjects showed a significant positive correlation between endocranial capacity and area of foramen magnum when both sexes were considered together.

283-286

Authors: S. Saritha, Gouri

A lithopaedion or lithopedion is ancient Greek word meaning a stone baby. It is a rare phenomenon which occurs most commonly when a fetus dies during an ectopic pregnancy or during an abdominal pregnancy. The chance of abdominal pregnancy is one in 11,000 pregnancies. If the dead fetus is too large to be re-absorbed by the mother’s body it becomes a foreign body to the mother’s immune system. To protect from possible infection, the mother’s body will encase the fetus in a calciferous substance. The fetus is gradually mummified becoming a stone baby. Lithopedion may occur from 14 weeks’ gestation to full term. It is not unusual for a stone baby to remain undiagnosed for decades and found incidentally when taking plain x-rays films for various other investigations. This paper describes the known case of this phenomenon. The present case was about a 70 year old post-menopausal woman attended the Gynecology OPD with the complaints of mass per vaginum since 5 years. X-ray and Ultrasound scan of abdomen and pelvis revealed a lithopaedion.

289-291

Authors: Ashfaq Ul Hassan, Zahida Rasool, Nissar Chaudhary, Muneeb Ul Hassan

Portal vein contributes to more than 70 % blood flow to the liver the significant increases in portal venous blood pressure is associated with major systemic manifestations. Having a knowledge about Portal Blood supply is important tio any clinician, gastroenterologist or any Hepatic Surgeon. The Article outlines the rare development of Portal Cavernoma in a patient who had Portal Hypertension. Portal cavernoma is a consequence of portal vein thrombosis. We Present a case of a lady with mild Right hypochondriac pain who on evaluation was found to have Cavernomatous transformation of Portal vein without any other abnormality.