Determination of Dimensions of Glenoid Cavity from other Scapular Parameters in North Indian Population

Background: The Glenoid cavity dimensions can help to predict the incidence of glenohumeral dislocations in a population. Purpose of study: The present study involved the measurements of the body of the scapula and the glenoid cavity and to draw the relationship of them to predict the chances of glenohumeral dislocations in North Indian Population. Methods: A total number of 130 adult scapulae of unknown sex showing complete ossification and without any damage were included in the study. The various shapes of glenoid cavities both on right and left sides were noted and analysed. A digital Vernier calliper was used to measure all the dimensions of scapula as well as glenoid cavity. The data was analysed and regression formulae to estimate the glenoid cavity dimensions were drawn. Results: Most common shape of the glenoid cavity in the present study was pear shaped (52.30%) followed by inverted comma shaped (33.07%) and least common was oval shaped (14.63%). Mean maximum height of scapula (MSH) was 142.45± 2.32 mm, mean maximum width of scapula (MSW) was 102.65± 0.21mm. Mean maximum glenoid height (MGH) was 38.77± 3.15mm, mean maximum glenoid width I (MGW I) was 23.82± 2.11 mm, mean maximum glenoid width II ( MGW II) was 14.78± 9.11mm. Mean scapular index (SI) was 71.32± 0.61(60-<73) % and mean glenoid index (GI) was 60.43± 5.43%( 60-69%). Bilateral differences in these parameters were statistically insignificant. Mean maximum scapular height was significantly correlated with both mean maximum glenoid height and mean maximum glenoid width. There was also found highly significant interglenoid dimension correlation. Conclusion: Glenohumeral dislocations are expected if indices are <50% or > 89%. A deviation from the normal relation between maximum glenoid width and maximum glenoid length also indicates glenohumeral instability.

Introduction of SDL in Department of Anatomy: Evaluation of Learning and SDL Readiness

Background: Self-directed learning (SDL) is a process in which individuals assume the responsibility of identifying their learning needs, setting goals, locating sources, developing and implementing proper strategies, and evaluating the outcomes of learning both individually and collectively. The advantages of SDL include, but not limited to, gaining more autonomy in learning, having higher motivation for it, acquiring lifelong learning skills, and developing greater self-control, self-confidence, and self-management. SDL has become popular in medical curricula and has been advocated as an effective learning strategy for medical students to develop competence in knowledge acquisition. Aim and Objectives: To introduce self directed learning in the Department of Anatomy, to encourage faculty members to accept SDL as a Teaching Learning method and encouraging students to develop an attitude of self directed learning & to become lifelong learners. Methodology: After proper sensitization of the faculty & students regarding SDL, two sessions were conducted during the Anatomy Dissection Hall timings of the First Year students. The performance of the students, in the SDL topics was assessed using the MCQ & SAQ tests. Feedback regarding the SDL methodology was taken both from the students as well as the faculty. Also the Questionnaires were given to students applying Fischer’s Self Directed Learning Readiness Scale (SDLRS) & Jefferson Scale of Life Long learning –Health Profession Version (JeffSLL-HSP) & the results were statistically analyzed. Results: A total of 126 MBBS students of the first semester participated in SDL session and most students scored more than mean score in the tests after SDL sessions, there was a fourfold increase in the number of students scoring more than 80% in the two SDL tests. Also participating students showed high readiness towards SDL and were oriented to become Life Long Learners. Conclusions: SDL can be effectively implemented in the Department of Anatomy and it motivates students to become life long learners.

Morphometric analysis of palmaris longus muscle belly and its tendon: a cadaveric study in north india

Background: The Palmaris Longus Muscle is the first option in tendon graft procedures, for it fulfills the necessarycriteria of length, breadth and easy surgical accessibility. Therefore, the present study was performed with thepurpose to determine the morphometry of PL in North Indian population.Materials and methods: Material for the present study consisted of 40 limbs of different age group andsex(28Males&12Females). The limbs were made available in the Anatomy department for dissection purpose atSGRDIMSAR, Amritsar, Punjab. The length and width of the PL-Muscle Belly(PL-MB) and PL-Tendon(PL-T) weremeasured with the help of digital Vernier caliper. The unpaired t test was used to study the significance of thedifferences in male and females and right and left PLM.Results: The mean MBL and MBW of the PL was more (6.195+1.788cm & 2.095+0.723cm) on right side than(5.895+1.748cm & 1.920+0.740cm) on the left side. The mean TL on left side (15.690+1.336cm) was slightly morethan the right side (15.625+1.489cm) whereas TW on right side (0.435+0.099cm) was found to be slightly morethan the left side (0.426+0.108cm). It was also observed that the mean MBL, MBW, TL and TW was more in malecadavers as compared to female cadavers.Conclusion: PLM has importance in medical clinic, surgery, radiological analysis and has great significancewhen used as a donor tendon in reconstructive surgeries. Thus there are advantages to know the length and widthof the PL tendon for being the ideal choice for tendon graft procedures.

Does feedback have a role in improving the learning and assessment in first professional medical students: a questionnaire based study in anatomy

Introduction: Feedback is considered as a potential instrument for revamping the system of education, and playsa major role in learning. It is the specific information about the comparison between a students’ observedperformance and a standard, given with the intent to improve the students’ performance. Thus it is intended toimprove skills or change behaviour, rather than being an estimate of the students’ worth.Materials and Methods: This observational study was performed on 150 first-year medical students in theDepartment of Anatomy. Three sets of questionnaires were developed. First set of questionnaire included questionsto assess the students’ perception about the importance and need for feedback in the learning process, secondset contained questions about the contents of feedback and third set had questions about the process of feedback.The data were compiled and analyzed.Results: In General, 48.66% of students indicated receiving some sort of feedback, 28% not receiving feedbackand 23.33% could not decide whether they had received any kind of feedback. 82.66% students indicated thatfeedback was important for their learning and 86.66% expressed their need for regular feedback. Majority of thestudents expressed their interest in receiving feedback after their formative and summative assessments. 92.66%agreed with the statement that feedback is more effective when negative information is sandwiched betweenpositive information. 85.33% and 76.66% preferred receiving one-to-one and interactive feedback respectively.Conclusion: Feedback simplifies the improvement process of self-assessment in learning, provides theopportunities to exercise regulating students’ own learning standards.

A morphometric study of body, lamina, spinous process and vertebral foramen of vertebra prominens (c7) in north indian population: a clinico-anatomical approach

Introduction: Anatomical and morphometric aspects of seventh cervical vertebra are important for considerationof ventro-lateral approach in cervical spine surgery. Therefore, a detailed anatomical information of thedimensions of the vertebral elements is very important for successful surgical management in the degenerative,traumatic and neoplastic diseases of the cervical spine. Ethnic variations have also been reported in thesedimensions and there have been no morphometric studies performed in this area in the North Indian population.Materials and Methods: 60 dry Vertebra prominens vertebrae (C7) were obtained by maceration of the cadavers,made available for the purpose of dissection. Dimensions of vertebral body, lamina, spinous process andvertebral foramen of vertebra prominens(C7) were quantified for each vertebra. Morphological features includedmacroscopic appearance of Shape of vertebral foramen of vertebra prominens.Results: The length (VBL), superior width(VBSW), inferior width(VBIW), anterior height(VBAH) and posteriorheight(VBPH) of vertebral body of vertebra prominens (C7) was 14.21+2.95mm, 25.17+3.45, 24.89+3.25mm,11.72+1.88mm and 12.61+1.87mm respectively. Height(LH), length(LL) and width(LW) of lamina of were measuredas 14.47±1.72 mm, 22.23±2.46mm and 3.74±0.46mm. Length of the spine of vertebra prominens was found to be28.59+3.72mm. Maximum(widthmax) and minimum(widthmin) width of spine were 12.15+1.99mm and 6.22+1.53mm.Foramen diameter anteroposterior (FDAP) and transverse (FDT) was found to be 12.97+1.66mm and 22.85+2.46mmrespectively.Conclusion: Taking these measurements of vertebra prominens(C7) into consideration with combined effects ofaxial computed tomography, the diameters are valuable in correct estimation of spinal deformities and are ofinterest from anatomical, anthropological aspect and also from medicolegal point of view

Partial Lateral Bridges And Supratransverse Foramen In Human Atlas Vertebrae: An Osteological Study In Punjab

Background: The lateral outgrowth from the superior articular facet(SAF) to the posterior root of the transverseprocess of the atlas forms the partial lateral bridge(PLB) and when complete forms the supratransverse foramen(STF). Presence of such bridges may predispose to vertebrobasilar insufficiency. Since there are fewer studies onthe lateral bridge therefore the present study was aimed to know the incidence of lateral bridges and STF and alsoto know the dimensions of STF as the knowledge about such dimensions helps in interpretation of radiologicalfindings, provide guidance for neurosurgical intervention.Materials and methods: A total of 80 undamaged, dry human atlas vertebrae were obtained from the Departmentof Anatomy, Government Medical College and SGRDIMSAR, Amritsar, Punjab, India. The Partial lateral bridge(PLB)and Supratransverse Foramen(STF) were identified following the criteria used by Mitchell (1998a, 1998b).Measurements were taken of the maximum dimensions of the STF in (Supero-inferior and Medio-lateral planes)and ipsilateral Foramen Transversarium (FT) in (Ventro-dorsal and Medio-lateral planes). The cross-sectionalarea of STF and ipsilateral FT was calculated.Results: Total 7 (8.75%) lateral bridges in atlas vertebrae occurred. 6 (7.5%) lateral bridges occurred in associationwith the posterior bridges and 1(1.25%) isolated partial lateral bridge occurred on the left side. Partial lateralbridges were found in 2 bones(2.5%) on right side and 4(2.5%)bones on left side. 1 (0.625%) Complete lateralbridges forming STF was observed on right side. Rt. Supra-Transverse Foramen Height (STFH) and Width (STFW)was found to be 5.4mm and 6.2mm. Ipsilateral Foramen Transversarium Length (FTL) and Width (FTW) was foundto be 6.4mm and 5.9mm. The cross-sectional area of Rt. STF was 26.28mm2 and the cross-sectional area ofipsilateral FT was 29.64mm2 and ipsilateral FT area was smaller than STF.Conclusion: The findings in the present study indicate a higher prevalence of lateral bridges on the left side.Difference in the cross sectional area of STF and ipsilateral FT may lead to compression of V.A and this compressionbecomes evidently symptomatic in extreme manipulations of the neck. Patients presenting with vertebrobasilarinsufûciency or cervicogenic syndromes should be evaluated to explore the possibility of the presence of lateralatlas bridges as etiological factor

Variation in the Number and Position of Nutrient Foramina of Long Bones of Lower Limb in North Indians.

Aims and Objectives: The major blood supply of the long bones is through the nutrient arterywhich enter through the nutrient foramina leadinginto an oblique nutrient canal. The presence, number, position and distances from the various prominent landmarks on the bone have medical as well as surgical significance. The present study was done on the long bones of North Indians to know the mean values of the number, position of nutrient foramina and distance from various landmarks on the bones and ultimately to compare with other populations. Materials and Methods: The present study consists of 180 long bones of lower limb (60 femora, 60 tibiae, 60 fibulae) which were taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India and studied carefully for the number, position and distance of nutrient foramina in relation to length and from the proximal epiphysis of the long bones. Also the anteroposterior and lateromedial diameter of the bone at the level of nutrient foramen were studied. Main outcome measure: Variations in number, position and distance in relation to length and from proximal epiphysis of long bones was seen. Results: The nutrient foramen of femur was located on the linea aspera in 76.50% of cases(39% in interstice 9.5% on the lateral lip and 28.00% on the medial lip of the linea aspera), 18.50 %on the medial surface and 5%.on the lateral surface. Nutrient foramen of tibia was located in 95.50% of cases under the soleal line at the average distance of 119.8 mm from intercondylar eminence to the nutrient foramen, on the soleal line in 4%and on the lateral border in 0.50% of cases. Nutrient foramen of fibula was found on the posterior surface in 65 % of cases, in 15% on the medial surface, on the interosseous border in 10% ,on the lateral surface in 7% and on the posterior border in 3% of cases. Conclusion: This study will provide the ethnic data for comparison among various populations. It is also helpful in various surgical procedures and in interpretation of radiological images.

Variation in the Number and Position of Nutrient Foramina of Long Bones of Lower Limb in North Indians.

Aims and Objectives: The major blood supply of the long bones is through the nutrient arterywhich enter through the nutrient foramina leadinginto an oblique nutrient canal. The presence, number, position and distances from the various prominent landmarks on the bone have medical as well as surgical significance. The present study was done on the long bones of North Indians to know the mean values of the number, position of nutrient foramina and distance from various landmarks on the bones and ultimately to compare with other populations. Materials and Methods: The present study consists of 180 long bones of lower limb (60 femora, 60 tibiae, 60 fibulae) which were taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India and studied carefully for the number, position and distance of nutrient foramina in relation to length and from the proximal epiphysis of the long bones. Also the anteroposterior and lateromedial diameter of the bone at the level of nutrient foramen were studied. Main outcome measure: Variations in number, position and distance in relation to length and from proximal epiphysis of long bones was seen. Results: The nutrient foramen of femur was located on the linea aspera in 76.50% of cases(39% in interstice 9.5% on the lateral lip and 28.00% on the medial lip of the linea aspera), 18.50 %on the medial surface and 5%.on the lateral surface. Nutrient foramen of tibia was located in 95.50% of cases under the soleal line at the average distance of 119.8 mm from intercondylar eminence to the nutrient foramen, on the soleal line in 4%and on the lateral border in 0.50% of cases. Nutrient foramen of fibula was found on the posterior surface in 65 % of cases, in 15% on the medial surface, on the interosseous border in 10% ,on the lateral surface in 7% and on the posterior border in 3% of cases. Conclusion: This study will provide the ethnic data for comparison among various populations. It is also helpful in various surgical procedures and in interpretation of radiological images.

Pterion formation in North Indian population: an anatomico-clinical study / Formación del pterion en una población del norte de India: un estudio anátomo-clínico

Pterion is a point of sutural confluence seen in the norma lateralis where frontal, parietal, temporal and sphenoid bones meet. This craniometric point is related to various structures in the cranial cavity like middle meningeal artery, anterior pole of insula and Broca's area. This study was done to find most common variation in its shape and presence of epipteric bones and to compare with other racial groups from previous study. Fifty adult human skulls of unknown sex taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Rsearch, Vallah (Amritsar, India) were examined on both sides for the type and position of the pterion. Four types of pterion formation were noted. Sphenoparietal was observed in 89%, frontotemporal in 7%, stellate in 4% and epipteric in 12% of cases. The pterion was found to be 3.1±0.44 cm on the right side, 3.4±0.40 cm on the left side from the frontozygomatic suture and 4.1±0.45 cm on the right side and 4.4±0.32 cm on the left side from the centre of zygoma. These variations in the sutural morphology is comparable to other population. Its position is of interest to anthropologists, forensic pathologists and surgeons who deserve further investigation in population of different area.

El pterion es un punto correspondiente con el extremo posterior de la sutura donde se ubican los huesos frontal, parietal, temporal y esfenoides. Este punto métrico del cráneo se relaciona con diversas estructuras en la cavidad craneal como la arteria meníngea media y polo anterior de la ínsula en el área de Broca. Este estudio se realizó para determinar la variación más común de la forma y presencia de huesos epiptéricos y comparar estos con otros grupos raciales. Cincuenta cráneos humanos adultos de sexo desconocido obtenidos en el departamento de anatomía, Sri Guru Ram Das Instituto de Ciencias Médicas e Investigaciones, Vallah (Amritsar, India) fueron examinados en ambos lados para el tipo y posición del pterion. Se observaron cuatro tipos de formación. Esfenoparietal en el 89% de las muestras, fronto temporal en el 7% de las muestras, estrelladas en 4% y epiptérico en el 12% de los casos. Desde la sutura frontocigomática el pterion se encontraba a 3,1±0,44 cm en el lado derecho, 3,4±0,40 cm en el lado izquierdo y desde el centro del hueso cigomático a 4,1±0,45 cm en el lado derecho y 4,4±0,32 cm en el lado izquierdo. Estas variaciones en la morfología de la sutura son comparables a otras poblaciones. Su posición es de interés para los antropólogos, patólogos forenses y cirujanos, y merece una mayor investigación en poblaciones de diferentes regiones.

Anthropometric measurements of hand length for estimation of stature in North Indians.

Stature or body height is one of the important and useful anthropometric parameter that determines the physical identity of an individual. The present study was done in department of Anatomy, Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar on 400 (200 males and 200 females) healthy, asymptomatic medical subjects belonging to various regions of North India. The subjects were measured for stature and hand length of left side with standard anthropometer and a sliding caliper respectively and data was subjected to statistical analysis for deriving regression equations. The regression equations were derived both for male and female North Indians separately by means of which living stature can be accurately estimated when fragmentary or mutilated portion of upper extremity is recovered. The present study showed significant (p< 0.001) positive correlation between stature and hand length.