Thejodhar Pulakunta

Thanatophoric Dysplasia: A Rare Entity

Thanatophoric dysplasia is the lethal skeletal dysplasia characterized by marked underdevelopment of the skeleton and short-limb dwarfism. The child will be having a short neck, narrow thoracic cage and protuberant abdomen. Other anatomical features include a relatively enlarged head with frontal bossing, prominent eyes, hypertelorism and the depressed nasal bridge. The diagnosis is usually made with the ultrasonography in the second trimester. In this study we report a case of this rare entity with emphasis on its anatomical features, abnormalities and clinical profile with relevant review of literature.

Accessory Head of Flexor Pollicis Longus Muscle and its Significance in Anterior Interosseous Nerve Syndrome: Case Report and Review

Durante una diseccion en el laboratorio se encontro en el antebrazo derecho de un cadaver de sexo masculino una cabeza accesoria del musculo flexor largo del pulgar. Esta se originaba de la superficie profunda del musculo flexor superficial de los dedos, inmediatamente distal al origen de este musculo en el epiconddilo medial. El vientre accesorio se dirigia hacia abajo medial al tendon del musculo flexor largo del pulgar hasta su insercion. Se discute detalladamente su posible rol en el sindrome interoseo anterior

Morphometric analysis of the menisci of the knee joint in South Indian human fetuses

Los datos morfometricos relacionados con los meniscos de los adultos han sido reportados por algunos autores, mientras que en fetos estos aun no han sido descritos. El objetivo del estudio fue analizar, en fetos, el grosor de la circunferencia externa, ancho, y longitud de los margenes interno y externo, asi como la distancia entre los cuernos anteriores y posteriores. Ademas, comparar las dimensiones del menisco fetal con los parametros de adultos disponibles en la literatura. Fueron analizados los meniscos de 106 articulaciones de rodillas fijadas en formalina, pertenecientes a fetos del sur de la India, obtenidos desde el Departamento de Anatomia. Los fetos con anomalias musculoesqueleticas fueron excluidos del estudio. Un pie de metro de 0,02 mm de precision junto a hilo de algodon no elastico fueron utilizados para la morfometria. Despues de comparar las dimensiones del menisco del presente estudio con los parametros de meniscos adultos se establecio que los meniscos fetales son totalmente diferentes a los adultos. Estas diferencias pueden deberse a la diferenciacion mesenquimal o la variabilidad de temprana vasculatura en la vida embrionaria. Creemos que nuestro estudio prestara apoyo a la anatomia fetal, en relacion con los procedimientos quirurgicos y la artroscopia de la rodilla. Los estudios morfometricos no han informado datos en meniscos fetales, por lo que esta investigacion puede ser considerada novedosa y requiere seguir siendo estudiada con diferentes grupos de fetos en las diversas etapas del desarrollo intrauterino. Ademas el estudio de ser importante para los cirujanos ortopedicos, tambien lo es para morfologos y embriologos.

The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of the literature

CONTEXTO: Considerando a escassez de informacoes atualmente disponiveis sobre arterias frenicas inferiores, umestudo mais definitivo nos pareceu apropriado e necessario, tanto por suas potenciais aplicacoes clinicas quanto para fornecer dados adicionais a literatura anatomica contemporânea. OBJETIVO: A maioria dos livros-texto de anatomia oferece muito poucas informacoes referentes a anatomia e distribuicao da arteria frenica inferior (AFI). Por este motivo, a origem da AFI foi investigada e a literatura disponivel foi revisada. METODOS: Trinta e dois cadaveres humanos adultos preservados em formol e obtidos dos departamentos de anatomia do Kasturba Medical College, Manipal and Mangalore foram dissecados, e a origem da AFI foi investigada. RESULTADOS: A AFI teve sua origem habitual na aorta abdominal em 28 casos; no entanto, nos quatro casos restantes, duas originavam-se do tronco celiaco, uma da arteria gastrica esquerda e uma da arteria renal direita. CONCLUSAO: A AFI geralmente origina-se da aorta ou arteria celiaca, e menos frequentemente das arterias renal, hepatica ou gastrica esquerda. A AFI e a maior fonte de fornecimento arterial colateral ou parasitado para carcinoma hepatocelular, ficando atras somente da arteria hepatica. A literatura sobre a origem da AFI e as implicacoes clinicas de variacao em sua origem foram revisadas neste artigo.

Anomalous origin of the lumbrical muscles: a study on South Indian cadavers.

Although variations in the attachments of the lumbrical muscles have been commonly reported, these have been seen mainly in the Caucasian population. The present study has been undertaken in South Indian population. The upper extremities of 24 South Indian (20 male and four female) cadavers were examined. Three instances of variant origins of the lumbrical muscles (two instances of the second and one of the first lumbrical) were seen. The muscles were unusually long extending to the level of the proximal border of the flexor retinaculum and in two of the cases it was taking origin from the flexor digitorum profundus tendon and its accessory belly. In one case it was taking origin from the flexor digitorum profundus and superficialis tendons. An anomalous origin of the lumbrical from muscles in the forearm has the potential to cause compression of the median nerve in the carpal tunnel.

Anomalous formation of the portal vein: a case report

The knowledge about the formation and relations of the portal vein is important for surgeons and radiologists. The variations in the level of formation and the pattern of formation of portal vein might lead to confusions during radiological and surgical procedures. Here we present a rare variation in the formation of the portal vein as found during the cadaveric dissections. The portal vein was formed by the union of splenic vein, superior mesenteric vein and inferior mesenteric veins. The abnormal termination of left gastric vein into superior mesenteric vein before the formation of portal vein was also seen in the same cadaver. Identification of these variations is useful in managing traumatic rupture of the mesentery.

Unusual external branch of the superior laryngeal nerve: a case report

IntroductionThe knowledge of the branching pattern of external branch of the superior laryngeal nerve and its relationship with the superior thyroid artery is the key point for identifying the external branch of the superior laryngeal nerve during surgeries of the neck.Case presentationDuring routine dissection of the left head and neck region of a 50 years old female cadaver, we observed a variation of the external branch of the superior laryngeal nerve around the superior thyroid artery. The external branch of the superior laryngeal nerve has presented one medial and three lateral branches. The medial branch was running on the surface of the inferior constrictor and pierced it; where as the lateral three branches are located laterally to the superior thyroid artery. The medial two lateral branches were piercing the substance of the thyroid gland, where as the lateral most branch was communicating with the left sympathetic chain.ConclusionIt is very important that surgeons carefully dissect the region of the superior pole of the thyroid gland to expose the abnormal branching pattern of external branch of the superior laryngeal nerve prior to ligation of individual thyroid vessels.

Anomalous azygos venous system in a south Indian cadaver: a case report

IntroductionThe posterior thoracic wall, an area drained by the azygos venous system, is a common site for surgical intervention. Since the venous part of the cardiovascular system is subject to most common variation, abnormalities in the azygos venous system are often reported.Case presentationDuring routine dissection classes for undergraduate medical students, we encountered a variation in the azygos venous system in a 65 years old south Indian male cadaver. We observed that there was no accessory azygos vein, and left 4th, 5th, 6th and 7th posterior intercostal veins terminated directly into azygos vein.ConclusionIdentifying these types of variations is important during imaging this region and surgical operations of mediastinum.