Rajanigandha Vadgaonkar

A study of anatomical variability of the omohyoid muscle and its clinical relevance

OBJECTIVE The omohyoid muscle is a long, thin muscle consisting of superior and inferior bellies and an intermediate tendon, which runs obliquely in the lateral cervical region. The omohyoid is important in neck dissections because it is the surgical landmark for level III and IV lymph node metastases. METHODS In the present study, the anterior and posterior triangle of the neck was dissected in 35 male cadavers and observed for variations in the omohyoid bilaterally. Observations were focused on variations in number, attachments, and position of omohyoid. RESULTS Among the 35 cadavers studied, double omohyoid was present in one cadaver, inferior belly originated from the clavicle in three cadavers, superior belly merged with the sternohyoid in two cadavers, and the omohyoid received additional slips from the sternum in one cadaver. Standard attachment and position of the omohyoid was observed in the remaining cadavers. CONCLUSION Variations of this muscle are important because of its close relation to the large vessels and brachial plexus. Because of the direct adhesion of the intermediate tendon to the anterior wall of the internal jugular vein and its connection with it through a thin lamina of the pretracheal layer of the cervical fascia, the contraction of the omohyoid muscle has a direct effect on the lumen of this vessel.

The accessory heads of flexor pollicis longus and flexor digitorum profundus: Incidence and morphology

Kiloh–Nevin syndrome caused by compressive neuropathy of the anterior interosseous nerve in the forearm is believed to occur because of its compression by the accessory head of flexor pollicis longus (FPLah). Gantzer described two accessory muscles, the more frequent is the FPLah and the less frequently observed is the flexor digitorum profundus accessory head (FDPah). Many studies have reported the prevalence, origin, insertion, nerve supply, and relations of these accessory muscles, most of them focusing on the FPLah. This study was designed to investigate the prevalence, morphology, relation to median and anterior interosseous nerve, and also the coexistence of both the accessory heads. A total of 126 upper limbs of the embalmed cadavers were examined in this study. Fifty‐eight limbs (46.03%) showed the presence of the FPLah and 18 limbs (14.28%) had the FDPah. The most common origin of both the accessory muscle bellies was from the under surface of the flexor digitorum superficialis. The FPLah inserted into the FPL muscle at varying levels with 80% inserting into the proximal third of FPL, whereas the FDPah in all cases ended near the level of the wrist joining with one or more tendons of the FDP. Clinical implication of the variation is discussed. Clin. Anat. 21:252–258, 2008.

Pterygospinous bar and foramina in Indian skulls: incidence and phylogenetic significance

Incomplete or complete ossification of the pterygospinous ligament is uncommon. Entrapment of mandibular nerve and its branches was reported due to this anatomical variation, when found. The aim of the present study is to investigate the incidence of the pterygospinous bony bridges in Indian dry skulls. A total of 416 adult dry skulls of Indian origin were studied. In 9.61% of the samples the pterygospinous bony bars were found, out of which 5.76% was complete and 3.84% was incomplete. Such variations are of clinical significance while dealing with mandibular nerve and its branches and various clinical symptoms related to it.

Abnormal Branching of the Axillary Artery: Subscapular Common Trunk. A Case Report

Una inusual variacion unilateral en el patron de ramificacion de la arteria axilar se observo en un cadaver embalsamado de 60 anos de edad. La arteria axilar tuvo solo dos ramas derivadas de su parte proximal (primera) y no otorgo ramas de su parte distal (segunda y tercera). Las ramas son superiores toracica (habitual) y otra gran rama colateral (inusual). Esta rama colateral es el origen de varias arterias importantes como la circunflej a escapular, toracodorsal, circunflej a humeral posterior, taraco-acromial y toracica lateral. Proponemos el nombre variacion arterial como tronco comun subescapular. El curso de este tronco comun subescapular y sus ramas y tambien el significado clinico de esta variacion son discutidas en este trabajo.

Accessory neurovascular foramina on the lingual surface of mandible: Incidence, topography, and clinical implications

CONTEXT It was suggested that the accessory neurovascular foramina of the mandible might be of significance in relation to the effectiveness of local anesthesia following the routine inferior alveolar nerve block. AIMS To investigate the incidence of neurovascular foramina over the lingual surface of the mandible in South Indian population. SETTINGS AND DESIGN The study was conducted at the department of anatomy. MATERIALS AND METHODS The study included 67 human adult dry mandibles, the exact ages and sexes of which were not known. The location and number of neurovascular foramina were topographically analyzed. STATISTICAL ANALYSIS USED Descriptive statistics. RESULTS The foramina were observed in 64 mandibles (95.5%) and were often multiple in most of the cases. They were located between the two medial incisors in 8 mandibles (1.9%), between the medial and lateral incisor in 34 mandibles (50.7%; 25-bilateral; 7-right; 2-left), between the lateral incisor and canine in 7 mandibles (10.4%; 2-bilateral; 3-right; 2-left), between the canine and first premolar in 6 cases (8.9%; 3 on each side). Foramina were also present around the genial tubercle in 56 mandibles (83.6%). Among them, 52 mandibles showed a single foramen just above the genial tubercle, 34 mandibles had foramina below the tubercles, 13 mandibles had foramina on the right side of genial tubercle and 17 were having on the left side. CONCLUSION Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.

Hypoplastic posterior tibial artery and the enlarged peroneal artery supplying the posterior crural region: a rare variation

Variacoes arteriais de partes distais dos membros inferiores estao bem documentadas e podem ser demonstradas com o auxilio de ultra-sonografia Doppler ou por arteriografia. Entretanto, a ausencia ou variacao da arteria tibial posterior e um raro achado. Apresentamos um caso de arteria tibial posterior hipoplasica que terminava suprindo o musculo solear. Esse suprimento arterial variante foi fornecido pela arteria peroneal aumentada que continuava como arteria plantar lateral. Estar consciente dessas variacoes e importante para cirurgioes vasculares ao realizarem reconstrucoes arteriais em procedimentos de derivacao femorodistal, bem como para ortopedistas durante correcao cirurgica do pe torto.

Morphological study of styloid process of the temporal bone and its clinical implications

The objective of this study was to study the morphometry of the styloid process of temporal bone and prevalence of elongated styloid process. The morphology of elongated styloid process along with its embryological and clinical importance are discussed. The present study included 110 human dry skulls which were procured from the bone collections of the department of anatomy. The styloid process was observed macroscopically on both sides of all the skulls, the elongations if any were noted. All the styloids were measured for their length, thickness at different levels and interstyloid distance at various levels. Out of 110 specimens, only 5 skulls (4.5%) exhibited the elongated styloid process. Among them, 3 skulls (2.7%) had unilateral elongation and 2 skulls (1.8%) had bilateral elongation of the styloid process. The mean length of the styloid process was 17.8±9.3 mm and 18.2±5.6 mm for the right and left sides, respectively. The prevalence of elongated styloid process in the present study was 4.5%. The clinical anatomy of this congenital variant is important to the neurosurgeon and radiologist, while interpreting the computed tomogram and magnetic resonance image scans. The morphological knowledge of elongated styloid process is clinically important since the course of the vertebral artery may be distorted in such situations.

The Subclavius Posticus Muscle: its Phylogenetic Retention and Clinical Relevance

Durante una diseccion de rutina, un musculo supernumerario fue encontrado en el lado derecho de la region infraclavicular de una cadaver de sexo masculino. Este musculo se originaba de la superficie superior de la primera costilla y cartilago costal y se insertaba en un grueso ligamento que se extendia desde la parte medial de la incisura supraescapular a la capsula de la articulacion acromioclavicular. Este musculo estaba inervado por un ramo del nervio subclavio. De acuerdo a su localizacion e inervacion el musculo aberrante fue considerado como el musculo subclavio posticus. Las relaciones anatomicas del musculo tienen significancia clinica

Anatomical and morphometric analysis of accessory infraorbital foramen.

Abstract The aim of the present study was to analyze the anatomical and morphometric variation in shape, frequency of occurrence, direction, and position of accessory infraorbital foramen (AIOF) in relation to infraorbital foramen (IOF) in cadaveric dry skulls to minimize clinical complications and aid in surgical maneuvering in the maxillofacial region and implementing the regional block anesthesia. The IOF is an important anatomical landmark in these surgical manipulations. Because there is limited literature available on AIOF, which transmits accessory branch of the infraorbital nerve, the present study was designed. In the current study, 45 human dry skulls and 20 disarticulated maxillae have been used irrespective of sex. The other parameters included measuring the distance of AIOF from anterior nasal spine, frontomaxillary suture, infraorbital margin, IOF, and zygomaticomaxillary suture. The transverse and vertical diameter of foramen was also noted. All these measurements were taken using a digital caliper. The result of our study reveals that the presence of AIOF is more on the right side compared with the left side. Because the presence of accessory infraorbital nerve needs to be taken care of during maxillofacial surgical interventions, knowledge regarding the presence of AIOF should be taken into consideration for preoperative evaluation.

Accessory brachialis muscle: a case report.

Variations of arm flexors are not uncommon with the exception of brachialis muscle. The role of brachialis is critical as it is the primary flexor of the elbow joint. Variations of brachialis are rare in literature. We present a case of an accessory-brachialis muscle (AcBr), found during routine cadaveric dissection. The AcBr originated from the lateral aspect of the brachialis muscle and lateral intermuscular septum. During its course towards the elbow, it crossed over the radial nerve and the distal tendon splits into two. The medial slip ran over the ulnar artery and merged with the deep fascia covering the pronator teres muscle, whereas lateral slip was inserted to the fascia covering the supinator. In the ipsilateral arm, an additional lateral cutaneous nerve of forearm (LCNF) was found coursing over the brachialis muscle medial to the LCNF. Clinical consideration of the present variations has been discussed. The present variation should be considered in the etiology of radial-tunnel syndrome (RTS).