Sn Somayaji

A Study on the Variations in the Formation of the Trunks of Brachial Plexus

EL plexo braquial muestra algunas variaciones en su formacion y patron de ramificacion. Las variaciones en la formacion de los troncos son muy raras. Se disecaron 44 especimenes para observar las eventuales variaciones en la formacion de los troncos del plexo braquial. Cinco cadaveres (11,3%) mostraron variaciones en la formacion de los troncos. Todas las variaciones fueron unilaterales. En un cadaver (2,27%), el tronco medio se formo por la union de las raices C7 y C8 y, parte inferior del tronco, estaba formado por la raiz de T1. En un caso (2,27%) los troncos superior y medio se fusionaron entre si. En 3 muestras (6,81%), la raiz de C5 cruzo el musculo escaleno anterior antes de unirse a C6 para formar la parte superior del tronco. El conocimiento de estas variaciones es importante para los cirujanos ortopedicos, los neurologos y anestesiologos.

Neuroprotective effect of Ascorbic acid and Ginkgo biloba against Fluoride caused Neurotoxicity

Excessive consumption of fluoride through drinking water or other sources lead to skeletal and dental fluorosis. According to the world health organization 23 nations are facing the problem of fluorosis. In the recent past researchers describe the non-skeletal fluorosis where soft tissues and major organs are the victims of fluoride toxicity. Hence in the present study we attempted to investigate the structural changes in various brain areas followed by fluoride exposure and to explore the protective effect of ascorbic acid and Ginkgo biloba against fluoride neurotoxicity. Animals were randomly divided into five groups. Control animals received ordinary water; fluoride animals received fluoride water; all the other animals in the study received gum acacia, ascorbic acid and Ginkgo biloba for first 15 days followed by the fluoride water for 30 days. The present experiment showed fluoride caused neurodegeneration in the form of dark, pyknotic neurons could be apoptosis/ necrosis. However the neurodegeneration is less severe in the ascorbic acid and Ginkgo biloba treated animals. Hence the ascorbic acid and Ginkgo biloba may help as alternate therapeutic strategy to treat fluorosis victims.

Costodorsalis ­ an Additional Slip of Pectoralis Major Muscle: a Case Report

Es poco frecuente la aparicion de variaciones de un fasciculo muscular desde el musculo pectoral mayor . En este trabajo, presentamos el caso de un fasciculo muscular aberrante asociado con el musculo pectoral mayor que denominamos costodorsal. Este fasciculo muscular se origino en la 6 costilla cerca de la union costocondral y corrio a lo largo del margen inferior del musculo pectoral mayor. Cruzo la axila de medial a lateral y se fusiono con el musculo latisimo del dorso. Este tipo de origen y la insercion es unico y no se ha informado anteriormente. El conocimiento de esta variacion muscular puede ser de especial importancia para los anestesistas, fisioterapeutas y cirujanos plasticos.

Bilateral additional slips of triceps brachii forming osseo-musculo-fibrous tunnels for ulnar nerves

Rare additional slips of triceps brachii muscle was found bilaterally in a sixty two year old South Indian male cadaver during routine dissection of upper limb for undergraduate students at Melaka-Manipal Medical College, Manipal University, Manipal, India. On left side, the variant additional muscle slip took origin from the lower part of the medial intermuscular septum about 4 cm proximal to the medial humeral epicondyle. From its origin, the muscle fibres were passing over the ulnar nerve and were joining the triceps muscle to get inserted to the upper surface of olecranon process of ulna. On right side, the additional muscle slip was larger and bulkier and was arising from the lower part of the medial border of the humerus about 4 cm proximal to the medial epicondyle in addition to its attachment to the medial intermuscular septum. On both sides, the additional slips were supplied by twigs from the radial nerve. On both sides, the ulnar nerve was passing between variant additional slip and the lower part of the shaft of the humerus in an osseo-musculo-fibrous tunnel. Such variant additional muscle slips may affect the function of triceps muscle and can lead to snapping of medial head of triceps and ulnar nerve over medial epicondyle and also can dynamically compress the ulnar nerve during the contraction of triceps leading to ulnar neuropathy around the elbow.

Preinguinal Splitting and Reunion of Femoral Nerve Entrapping the Fleshy Fibres of Iliacus Muscle - A Case Report

Division of nerves close to their origin and muscular entrapments by nerves in the limbs is not very common. Femoral nerve is the largest branch of the lumbar plexus and arises from dorsal divisions of ventral rami of L2 to L4 spinal nerves. During routine cadaveric dissection for first year medical students at Melaka Manipal Medical College (Manipal Campus), Karnataka, India, we observed a variation in the division and course of left femoral nerve in about 65-year-old male cadaver. The femoral nerve was split into two divisions above the inguinal ligament after its origin from the lumbar plexus. The lower division of the nerve passed deep to the iliopsoas muscle fibres and the upper division ran superficial to iliacus muscle deep to fascia iliaca. Both the divisions joined just above the inguinal ligament to form the trunk of the femoral nerve. Further course and distribution of the nerve was normal. The reports have shown that compression neuropathies of femoral nerve in the limbs are caused by neoplastic masses, vascular abnormalities and also by different anomalous muscles. Such neuropathies may also result from indirect compression of femoral nerve between the fibres of psoas major muscle and lateral pelvic wall. The potential clinical importance of above mentioned variations in the division of femoral nerve would emphasize the surgeons to diagnose the neuromuscular entrapments and consequent alterations of sensation in the anterior and medial aspects of the thigh.

Unique formation of sciatic nerve below the piriformis muscle - a case report.

Dorsal and ventral divisions of ventral rami of lower lumbar and sacral spinal nerve were found to pass ventral and dorsal to the piriformis muscle respectively. These divisions joined each other below the piriformis muscle to form sciatic nerve. This low formation of sciatic nerve was observed in distal part of left gluteal region of a 50-year-old male cadaver. The sciatic nerve thus formed passed caudally into back of thigh and divided into tibial and common peroneal nerves in the upper part of popliteal fossa. In addition, a communicating nerve from the sciatic nerve was found to join the common peroneal nerve in the popliteal fossa. Such variations may lead to piriformis syndrome or non-discogenic sciatica.

A Typical Branching Pattern of Axillary Artery in a South Indian Cadaver? A Case Report

Knowledge of vascular variations, especially arterial variations, is very important for surgeons, radiologists and to certain extent to the other clinicians. Awareness of the possible variations will reduce the risk of complications like bleeding during surgical procedures. Occasionally these anatomical variations of arteries may result in erroneous interpretation of angiograms by radiologists. Sometimes these variations may become advantageous for the plastic surgeons in preparation of pedicle grafts. Hence we report a rare variation of high origin of superficial brachial artery from the second part of axillary artery. Superficial brachial artery continued as the main brachial artery in the arm, and terminated as radial and ulnar arteries in the cubital fossa. However the radial artery was much narrower in diameter.

MERIT-BASED REARRANGEMENT OF STUDENTS FOR BETTER INTERACTIONS

We at Melaka Manipal Medical College (Manipal campus) have an integrated curriculum. The maximum student enrollment is 150 students per admission. However, the number of students per class varies from 125 to 150 students per year. The students joining the program have no university experience. They