Deepthinath Reghunathan

Tendinous flexor carpi radialis: a case report

Introduction:Flexor carpi radialis is a muscle of the superficial group of muscles, in the anterior compartment of the forearm. Normally, it takes origin from the medial epicondyle of humerus and is inserted into the palmar aspect of the base of second metacarpal bone and gives off a slip to the third metacarpal in the same aspect. Case report:Here we present a case with most of FCR (except for few muscle fibres close to the origin) being replaced with tendinous portion. Discussion:The action of FCR is in combination with the other muscles acting at the wrist joint. Some of the actions include flexion, abduction and circumduction that involve FCR. Any change in the normal anatomy of the muscle would affect the normal actions at the wrist. The knowledge regarding the variations in this muscle would prove beneficial to physiotherapists and also clinicians. Other main clinical implications of FCR is in grafts. The clinical and applied aspects have been discussed in the report.

Terminal bifurcation and unusual communication of left testicular vein with the left suprarenal vein

Abstract Variations of the testicular veins are relevant in clinical cases of varicocele and in other therapeutic and diagnostic procedures. We report herein on a unique variation of the left testicular vein observed in an adult male cadaver. The left testicular vein bifurcated to give rise to left and right branches which terminated by joining the left renal vein. There was also an oblique communication between the two branches of the left testicular vein. A slender communicating vein arose from the left branch of the left testicular vein and ascended upwards in front of the left renal vein and terminated into the left suprarenal vein. The right branch of the testicular vein received an unnamed adipose tributary from the side of the abdominal aorta. Awareness of these venous anomalies can help surgeons accurately ligate abnormal venous communications and avoid iatrogenic injuries and it is important for proper surgical management.

Erratum to “Descendens vagohypoglossi: rare variant of the superior root of ansa cervicalis” [Br J Oral Maxillofac Surg 55 (2017) 834–5]

Please cite this article in press as: Nayak SB, et al. Erratum to “Descendens vagohypoglossi: rare variant of the superior root of ansa cervicalis” [Br J Oral Maxillofac Surg 55 (2017) 834–5]. Br J Oral Maxillofac Surg (2017), https://doi.org/10.1016/j.bjoms.2017.10.007 he publisher regrets that S. B. Nayak’s initial appeared incorrectly in the original article. It appears correctly above. The publisher would like to apologise for any inconvenience caused.

Descendens vagohypoglossi: rare variant of the superior root of ansa cervicalis

Knowledge of variants in the formation and position of the ansa cervicalis is important in head and neck surgery, specifically in reconstructions of the tongue that use the infrahyoid muscles, and in the anastomosis of the ansa cervicalis to the recurrent laryngeal nerve when the laryngeal muscles have been paralysed. We describe a rare variant of the superior root of the ansa cervicalis, which had a contribution from the vagus and hypoglossal nerves. The inferior root was formed by the C2 and C3 ventral rami, but it passed medial to the internal jugular vein before it joined the superior root to form the loop.

Y-shaped axillary arch muscle: A case report

The axillary arch is a rudimentary part of the latissimus dorsi. Generally it has a single insertion either into tendon of the pectoralis major, coracobrachialis or fascia over the biceps. Clinically, this anomalous muscular slip is known to cause neurovascular compression of nearby structures. The present case reports an unusual bifurcated fibrous insertion of an axillary arch with Y-shaped limbs. The stem of this muscle was a fleshy belly measuring 7.8 cm. The upper limb of this muscle, measuring 5.6 cm, was attached to the fascia covering the short head of biceps brachii and the coracoid process while its lower limb, measuring 5.1 cm, ended by merging with the brachial fascia over the biceps brachii below the deltoid muscle. The persistence of such a Y-shaped anomalous axillary arch might restrict the hyperabduction of the arm and compress the neurovascular structures passing below it.

Rare combined variation of left suprarenal vessels associated with retroaortic left renal vein

Suprarenal vascular variations should be known to surgeons performing laparoscopic adrenalectomy, partial nephrectomy, living donor nephrectomy and renal transplantation. A rare case of vascular variation of the left suprarenal gland was observed, in which the left suprarenal vein was draining into the inferior vena cava after crossing the abdominal aorta anteriorly, just below the origin of the superior mesenteric artery. The left inferior suprarenal artery was originating from the left gonadal artery, which originated from the abdominal aorta in front of the left renal artery. Besides this, the left renal vein passed obliquely downwards behind the abdominal aorta and drained into the inferior vena cava. The retroaortic left renal vein may lead to unilateral hematuria, left varicocele and could be a cause of infertility in men.

Clinical importance of a star shaped branch of internal iliac artery and unusual branches of an abnormal obturator artery: rare vascular variations

Abstract The internal iliac artery (IIA) is one of the branches of the common iliac artery and supplies the pelvic viscera, the musculoskeletal part of the pelvis, the gluteal region, the medial thigh region and the perineum. During routine cadaveric dissection of a male cadaver for undergraduate Medical students, we observed variation in the course and branching pattern of the left IIA. The artery gave rise to two common trunks and then to the middle rectal artery, inferior vesicle artery and superior vesicle artery. The first, slightly larger, common trunk gave rise to an unnamed artery, the lateral sacral artery and the superior gluteal artery. The second, smaller, common trunk entered the gluteal region through the greater sciatic foramen, below the piriformis muscle and presented a stellate branching pattern deep to the gluteus maximus muscle. Two of the arteries forming the stellate pattern were the internal pudendal artery and the inferior gluteal artery. The other two were muscular branches.

Absence of the celiac trunk and trifurcation of the common hepatic artery: a case report

Abstract Anatomical variations of the celiac trunk and its branches are particularly important from a surgical perspective due to their relationships with surrounding structures. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery. These variations were found in an adult male cadaver. We perform a review of the literature and discuss the clinical and embryological significance of these variations. Recognition of celiac trunk and hepatic artery variations is of utmost importance to surgeons and radiologists because multiple variations can lead to undue complications.

Inhabitation of an accessory renal artery in a cratered hilum of a malrotated kidney

Structural variations of the kidney and its abnormal vascular architecture make the kidney unsuitable for transplantation. We report here a case of malrotated left kidney with cratered hilum and presence of an accessory renal artery. A lumbar vein was seen to loop under the accessory renal artery on the way of its termination into the left renal vein. The kidney appeared to have failed to rotate from its fetal position. Thus, the hilum was placed ventrally. The hilum was crater-like in shape, wide, and allowed passage of the hilar structures. The shape of the kidney itself had undergone slight modification as it appeared more ovoid than its typical bean shape. The poles, but not the surface or borders were distinguishable. The variations described in the current observation are of a unique pattern of congenital malformation having surgical, urological, and radiological implications.

Three lateral roots of median nerve: A case report

Introduction:The median nerve is formed by the union of a lateral and a medial root from the lateral and medial cords of brachial plexus. Reports on the existence of variations in the formation, branching and communication of median nerve are seen in the literature. However, there are very few reports on the involvement of two additional lateral roots in the formation of the median nerve. Such variations are of considerable importance for surgeons, physiotherapists and other clinicians. The details regarding the formation of the median nerve, developmental considerations and its importance have been discussed here. Case report:Apart from the normal roots, two additional lateral roots were given off from the lateral cord at the level of the second part of the axillary artery. These roots then coursed superficial to the axillary artery from the lateral to medial side to join the medial root, on the medial side of the axillary artery. The medial root then crossed on to the lateral side of the axillary artery to join the lateral root to form the median nerve. The rest of the course of the median nerve was found to be normal. Conclusion: Surgeons during surgeries of the axilla and physiotherapists during rehabilitation would require knowledge of such variations in the axilla, along with use for other clinicians too.