Sub-hepatic Caecum with Extra-pelvic Looped Sigmoid Colon: An Embryological and Clinical Perspective

Introduction: We encountered variation in the placementof large intestine in abdominal cavity of a 76-years-old malecadaver during dissection of abdominal cavity. The workwas performed in Department of Anatomy during routineMBBS teaching sessions. The aim of this paper is to reportco-existence of error of mid-gut development and alongwith variant topo-morphology of sigmoid colon in the samecadaver.Case Report: Sub-hepatic caecum with high riding vermiformappendix with absent ascending colon was seen on the rightside of abdominal cavity. Concomitantly on the left side of theabdominal cavity dilated, looped sigmoid colon occupied theleft hypochondrium, left lumbar region and left iliac fossa. Wereport these findings along with the embryological basis andclinical significance.Conclusion: An insight about the errors in development ofmid-gut resulting into the variant topography of caecum willfacilitate surgeons and radiologists in prompt diagnosis andquick modification of the protocol during invasive procedures.

Unusual Formation Of Median Nerve And Occurrence Of Musculo-Aponeurotic Band In The Course Of Median Nerve In Arm: A Clinico-Anatomical Study

Median nerve is one of the commonly involved nerves in peripheral neuropathy of the upper limb. Peripheral neuropathies may occur due to various intrinsic (medical conditions like diabetes mellitus & Guillian Barre syndrome) and extrinsic (nerve entrapment) causes. This study reports an unusual course of median nerve which can be considered as cause of such entrapment neuropathy. During routine MBBS dissection on a 76 years old male cadaver unusual formation and variant course of median nerve was noted. In present study unusual relation of the medial root of median nerve with axillary artery was found at the origin and secondly the nerve was found coursing under the musculo-aponeurotic band located on the antero-medial side of lower one-third of the right arm. These observations are important as the aponeurotic band may compress the median nerve and may results in entrapment neuropathy. The comprehensive knowledge of possible variant anatomical relations of median nerve are of great importance to understand the cause of symptoms and to facilitate early diagnosis and prompt management of patient presenting with median nerve compression.

Klingler’s Fiber Dissection Method- An Assisting Approach Towards Teaching Neuroanatomy

Background and Objective: The Klingler fiber dissection technique is a simple and less complicated method foridentifying the fine structure of the white fiber tracts of brain. In this study, we have used classical fiber dissectiontechnique by Klinger’s to produce white matter specimens which can be used for explaining anatomy of variouswhite matter tracts to students.Materials and Methods: Five brains specimen removed from formalin fixed human cadavers (3 males and 2female) were used in this study. Klinger’s fibers dissection method was used to obtain white fibers specimen.Dissection of the cerebrum was performed using wooden spatulas, fine curved metal spatulas, fine forceps. Thewhite fibers were exposed by peeling brain with help of wooden spatula to expose the fibers. The dissectionmicroscope was used to isolate small structures.Results: Using the classical Klinger’s technique, we were able to obtain a brain specimen depicting organizationof various white fibres such as corona radiata, superior longitudinal bundle, association fibres with fibrespassing in relation to lentiform nucleus. In another specimen, dissection of right cerebral hemisphere medial tolentiform nucleus showed continuity of white projection fibres of corona radiata as internal capsule. Fibres ofcorpus callosum were delineated in two specimens which displayed spatial disposition of its various parts.Conclusion: White matter fiber of brain are very important for understanding of function of the central nervoussystem function. The Klingler’s fiber dissection technique with other study material can successfully serve thepurpose of the teaching of complex brain architecture of white matter. These dissected specimens will be moreattractive to students, than the mere imagination of white fiber tracts during neuroanatomy classes.

Anomalous branching pattern of common hepatic artery: a case report.

A number of hepatic artery variations exists which is continuously proving a hindrance for the surgeons and radiologists. During routine dissection in the subhepatic region in 50 year old male cadaver for undergraduate teaching, a variation in the branching pattern of common hepatic artery was noticed. We observed an unusual branching of the common hepatic artery into seven terminal branches, of which two were left hepatic arteries, two were right gastric arteries and the remaining three were right hepatic artery, cystic artery and gastroduodenal artery. Hepatic artery proper was absent. Embryological basis of these variations were discussed. The present case is a rarity and will further throw light on the knowledge of the hepatic artery variations, thus assisting surgeons and radiologists in various surgical and diagnostic procedures.

Unilateral Variation in the Branching Pattern of Axillary Artery: A Cadaveric Study.

During routine dissection of upper extremity in a 55-year-old male cadaver we noted a rare variation in the branching pattern of the axillary artery on the left side. The second part of the axillary artery was the source of all the branches of the axillary artery which arise normally from second and third part. The third part of axillary artery was related to the branches of brachial plexus and without giving any branches continued as brachial artery at the lower border of teres major. This finding has an embryological basis and clinical relevance. These variations in the branching pattern of axillary artery may be due to deviation in the development of the vascular plexus of the limb bud. Awareness of variation of axillary artery may serve as a guide for both radiologists and vascular surgeons. During surgeries for lymph nodes in the axilla and pectoral region, presence of such variations must be kept in mind.

Subcutaneous Course of Saphenous Nerve In Midthigh Region.

Saphenous nerve is a pure sensory nerve which may get compromised as a result of complication of a surgical procedure or entrapment leading to pain and numbness in the medial side of thigh, knee and leg. Secondly, adductor canal block is given very frequently now days to anaesthetize the saphenous nerve for providing analgesia after knee surgeries. During routine cadaveric dissection of the front of thigh, we observed an interesting finding that the saphenous nerve did not follow the usual course in the adductor canal. The saphenous nerve pierced the sartorius in the middle of adductor canal and became subcutaneous. This variant course of the saphenous nerve through the sartorius can be the site of entrapment or it may be the cause of failure of adductor canal block. Although saphenous nerve is a purely sensory nerve, in this condition there is possibility of having motor fibres also which may supply Sartorius while passing through it.

Unusual presentation of spermatic cord cyst in an adult cadaver.

There are many lesions found in the inguinoscrotal region. The awareness and histopathological confirmation of masses in the inguinal scrotal region is necessary as some of them have prolonged clinical course with late recurrences. During routine dissection of the inguinal region of undergraduate teaching in Department of Anatomy a lump was found on the spermatic cord of a 45-50 year old male cadaver. This lump was found close to the left superficial inguinal ring, after dissection it was seen as protruding out of superficial inguinal ring and was attached to the spermatic cord which was thicker than those seen during routine dissection.

Vascular pattern of chorionic blood vessels of placenta and its correlation with the birth weight of neonate / Patrón vascular de los vasos sanguíneos coriónicos de la placenta y su correlación con el peso al nacer del recién nacido

Two hundred fresh full term placentae of normal pregnancies were collected from the department of Obstetrics and Gynaecology, RIMS, Ranchi, Jharkhand, India to observe the incidence of vascular pattern of chorionic blood vessels of placenta and to note the relationship between vascular pattern of placenta and the birth weight of neonate. Dye was injected into umbilical vessels under normal physiological pressure and diameter of chorionic blood vessels were taken at the centre and periphery. Two types of vascular pattern of chorionic blood vessels of placentae were observed- Dispersal and Magistral. Dispersal pattern was found in 63 percent cases and magistral pattern was observed in 37 percent cases. An interesting observation was noted that the birth weight of neonate was higher in magistral pattern in comparison to dispersal pattern in both sexes...

Doscientas placentas de término de gravidez normales frescas fueron recogidas del departamento de Obstetricia y Ginecología, RIMS, Ranchi, Jharkhand, India. Se observó la incidencia del patrón vascular de los vasos sanguíneos coriónicos de la placenta y la relación entre el patrón vascular de ésta y el peso al nacer del recién nacido. Se inyectó tinta dentro de los vasos umbilicales bajo presión fisiológica normal, y se tomaron los diámetros de los vasos sanguíneos coriónicos en el centro y la periferia. Dos tipos de patrón vascular coriónicos se observaron en la placenta, disperso y magistral. El patrón disperso se encontró en el 63 por ciento de los casos y el patrón magistral se observó en 37 por ciento de los casos. Una observación interesante mostró que el peso al nacer de los recién nacidos fue mayor en el patrón magistral en comparación con el patrón disperso en ambos sexos...

Cellular changes in the placenta in pregnancies complicated with diabetes / Cambios celulares en la placenta en embarazos complicados con diabetes

Placenta is the most accurate record of the infant prenatal experience. After delivery if the placenta is examined minutely, it provides much insight into the prenatal health of the baby and the mother. In diabetic pregnancy, placental weight is higher in comparison to normal pregnancy. To study the cellular differences that might contribute to larger size of placenta, light microscopic analysis was performed on 25 full term placentas, out of which 20 were of Gestational diabetes mellitus (12 controlled on diet, 8 controlled on insulin) and 5 control group. Tissue sections were processed and analyzed. Birth weight of neonate, placental weight, vascular pattern of chorionic blood vessels and site of attachment of umbilical cord were recorded. In the placenta of diabetic pregnants, gross abnormalities were uncommon but microscopic examination exhibited, to a varying degree, lesions like syncytial knots, fibrinoid necrosis, villous edema, villous fibrosis and capillary proliferation. These findings indicate that control of hyperglycemia only partially prevents the development of placental abnormalities which must be due to some other constituent factor of diabetic state.

La placenta es el registro más preciso de la experiencia prenatal infantil. Después del parto, si la placenta se examina minuciosamente, esta proporciona una visión de la salud prenatal del bebé y la madre. En el embarazo con diabetes, el peso de la placenta es mayor en comparación con el embarazo normal. Para estudiar las diferencias celulares que podrían contribuir al mayor tamaño de la placenta, se realizó el análisis en microscópico de luz en 25 placentas de término, de las cuales 20 fueron diabetes mellitus gestacional (12 controladas por dieta, 8 controlodas por insulina) y 5 del grupo control. Los cortes fueron procesados y analizados. El peso al nacer de los recién nacidos, el peso de la placenta, el patrón vascular de los vasos sanguíneos coriónicos y el lugar de inserción del cordón umbilical fueron registrados. En la placenta de las embarazadas con diabetes, alteraciones graves fueron poco frecuentes, pero el exámen microscópico mostró, en grado variable, lesiones como nudos sincisiales, necrosis fibrinoide, edema de las vellosidades, vellosidades fibrosas y proliferación capilar. Estos resultados indican que el control de la hiperglucemia sólo en parte impide el desarrollo de anormalidades de la placenta las cuales deben producirce por algún otro factor constituyente del estado diabético.