International Journal of Anatomy and Research

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.