Jyoti Arora

A RARE quADRupLIcATE ARRAngEmEnT Of AbDucTOR pOLLIcIs LOngus TEnDOns - AnATOmIcAL AnD cLInIcAL RELEvAncE

. Familiarity with the variations in extensor tendons of the hand and fingers is vital for appropriate diagnosis of neurological disorders. Anatomical comprehension is particularly essential for clinical situations related to extensor tendon injuries and inflammatory diseases. The main objective of this report is to illustrate in detail the variant insertion pattern of APL tendon slips and to discuss their functional and clinical relevance.

Accessory Tendon and Tripartite Insertion Pattern of Fibularis Longus Muscle: A Case Report

Los musculos fibulares son los que evierten el pie y juegan un importante rol en la estabilizacion de los movimientos subtalares. En el presente caso detectado accidentalmente, reportamos un caso de un tendon accesorio e insercion trifurcado del musculo fibular largo en la pierna izquierda, dos de los cuales estaban fijados en las caras plantar y lateral de la base del primer hueso metatarsiano y el tercero fue encontrado mezclandose con el primer musculo interoseo dorsal. El exacto conocimiento de estas variaciones anatomicas son importantes para los cirujanos en los procedimientos reconstructivos

Accessory muscle belly of peroneus tertius in the leg – a rare anatomical variation with clinical relevance – utility in reconstructions

We report here a rare muscular anomaly of the lower leg in an adult male cadaver observed during routine cadaveric dissection. Peroneus tertius (PT) is peculiar to man, being a hallmark of bipedal locomotion and erect posture. During the course of gross anatomy dissection, a rare finding of accessory belly of PT muscle was discovered. A meticulous dissection was performed and the observations were noted. The PT displayed two distinct bellies of origin. Both the bellies were substantial in size and were eventually fused close to their insertion at the base of the fifth meta-tarsal bone. Innervation of both the bellies was derived from the deep peroneal nerve. Soft tissue defects of the leg may be effectively covered by local muscles in the vicinity of the wounds. PT has been reliably used in the past for local transposition flaps in the lower extremities. The relations of the superficial nerve and the PT during placement of the anterolateral portal in ankle arthroscopy are vital to avoid inadvertent neuromuscular injuries. The presence of two bellies of the PT muscle has been discussed in the comparative perspective. A precise and detailed knowledge of the anatomical details of the crural muscles is important for performing reconstructive surgeries.

A new variant in the brachium musculature with reinforced innervation from a median-musculocutaneous nerve communication

Neural variations of the brachium constitute an important anatomical and clinical entity. Although frequently reported, if accompanied by other anomalies, they deserve special mention in anatomical literature. The goal of this present study is to report a communication between the median (MN) and musculocutaneous nerve (MCN), concomitant with an accessory muscle belly. Interestingly, an important proximal connection between the lateral and medial roots of the MN was also observed. The MCN joined the MN at mid humeral level. The peculiarity of the current report arises due to the presence of a twig passing from the site of communication between the two nerves, to supply the coracobrachialis. Concomitantly, an accessory muscle measuring 5cm in length originating from the short head of biceps brachii, fusing with the coracobrachialis was seen in the mid brachium. The observations of the current study may cause a perplexing situation for anesthetists attempting brachial plexus blocks and for surgeons who operate on this vital anatomical arena.

Unilateral Quadripartite Composition of Pectoral Major Muscle: Anatomical Description and Clinical Implications

Una disposicion anomala unilateral de los vientres musculares del musculo pectoral mayor se observo en un cadaver adulto de sexo masculino durante una clase de rutina de anatomia. El musculo pectoral mayor mostro una configuracion inusual y presentaba cuatro partes delimitadas por tres depresiones intramusculares. Ademas, la parte esternocostal se encontraba dividdida en dos fasciculos. El origen y la insercion del musculo pectoral mayor era normal. Curiosamente, la inervacion de los musculos, presentaba una importante variacion anatomica. Los fasciculos clavicular y esternocostal del musculo pectoral mayor recibieron una rama directa del fasciculo lateral del plexo braquial, ademas de su inervacion normal de los nervios pectoral lateral y medial. La multiple inervacion del musculo pectoral mayor como se encuentro en el presente estudio, probablemente, haga aumentar su idoneidad para el uso en procedimientos reconstructivos. Tambien se observo un fasciculo adjunto anomalo adicional del musculo pectoral menor, que se originaba de la segunda costilla, ademas de su origen en la tercera, cuarta y quinta costillas. Estas variaciones de los musculos pectorales tambien puede tener implicancias en estudios biomecanicos, ya que probablemente alteran la cinematica.

An Assembly of Anomalous Extensor Tendons of the Hand - Anatomical Description and Clinical Relevance.

Innumerable descriptions about variations in the pattern of extensor tendons are recorded in the literature. The dorsum of the hand in an adult male cadaver revealed an unusual pattern of extensor arrangement during a gross anatomical practical session. The extensor digitorum, extensor indicis and extensor digiti minimi tendons displayed a variant pattern. Extensor digitorum contributed tendons only to the middle and ring fingers, with junctura tendinum present between the extensor digitorum for the ring finger and extensor digiti minimi. Interestingly, an accessory muscle was observed arising from the common extensor origin passing to the index finger, in addition to the usual extensor indicis. The origin and insertion of extensor digiti minimi was as usual with an accessory slip contributed from the extensor carpi ulnaris to the proximal phalanx of the fifth finger. The plethora of variations in this region is of paramount importance for the reconstructive surgeon, who may utilize the accessory tendons to restore functional capacity of the fingers.

Clinico-embryological perspective of a rare accessory brachial muscle with possible musculocutaneous nerve compression

Both brachialis and biceps brachii are primary flexors of the arm and elbow from the biomechanical perspective. Numerous reports exist in anatomical literature regarding accessory heads of biceps brachii, although such accessory bellies in relation to brachialis muscle are less frequently elucidated. We report a unilateral case of a rare accessory muscle interposed between the biceps brachii and brachialis, having the musculocutaneous nerve (MCN) entrapped between the two. Furthermore, the muscle divided into two slips, upper slip was attached to biceps brachii and the other gained insertion to the brachial fascia. Innervation to this accessory muscle was derived from MCN. The embryological basis for such supernumerary muscle is discussed. Additionally, the case is considered under surgical and clinical perspective, highlighting the importance of familiarity with such variations. Anatomical variations of the brachial musculature may cause diagnostic perplexities while interpreting MRI or CT scans.

Bipartite clavicular attachment of the sternocleidomastoid muscle: a case report

Morphological variations of the sternocleidomastoid (SCM) muscle assume relevance during attempted surgical interventions in the cervical region. The present study reports bipartite clavicular attachment of the SCM in the neck of an adult male cadaver during performance of a routine anatomy demonstration. The anomaly was unilaterally observed on the left side of the neck. The clavicular head of the muscle exhibited two bellies, one medial and one lateral. While the medial belly was fused with the sternal head, the lateral belly appeared to blend with the medial. Cranially, the SCM attached to the mastoid process and superior nuchal line. We have attempted to elucidate the embryological basis of the above muscular variant. Additionally, we discuss its clinical relevance, highlighting the utility of the SCM in various reconstructive procedures. We assert that detailed anatomical knowledge of such SCM variants is of utility not only to the gross anatomist, but also for neck and orthopaedic surgeons and anaesthetists. Moreover, radiologists require familiarity with such aberrations to decipher magnetic resonance imaging scans of the cervical region.