study of the anatomical course of the lateral femoral cutaneous nerve and its susceptibility to compression

The anatomical course of the lateral femoral cutaneous nerve was studied by dissecting twenty cadavers. The skin and subcutaneous tissue was removed from the anterior and lateral sides of the anterior abdominal wall and the thigh. The results of the dissection of the specimens revealed that the lateral femoral cutaneous nerve originated from the first and second roots of lumbar plexus and coursed laterally and downwards across the iliacus muscle to leave the abdomen into the thigh. The site at which the nerve emerged from the abdomen was variable and recorded at five different sites in relation to the anterior superior iliac spine, inguinal ligament and origin of sartorius muscle. Depending on these anatomical sites of exit of the nerve, five types were recorded: Type I: The nerve crossed the iliac crest posterior to anterior superior iliac spine and constituted about 5% of the dissected specimens. Type II: In which the nerve pierced the inguinal ligament just medial to anterior superior iliac spine and constituted about 40% of specimens. Type III: The nerve pierced the tendinous origin of sartorius and constituted about 20% of specimens. Type IV: The nerve passed into the thigh in the fibro-fatty tissue in the interval between sartorius and iliopsoas muscles deep to inguinal ligament and constituted about 15% of specimens. Type V: The nerve passed behind the inguinal ligament in the fibro-fatty tissue in front of iliopspas muscle and constituted about 15% of specimens dissected. Combined types IV and V: Were noticed in 5% of specimens. These results showed that the nerve in the first three types [type I, II, and III] was liable to compression against bone [in type I], between slips of inguinal ligament [in type II] or between slips of sartorius muscle [type III]. But in the last two types [type IV and V], the nerve was not liable to compression because it passed through loose fibro-fatty tissue behind the inguinal ligament. The determination of the course of the lateral femoral cutaneous nerve and possible anatomical variations is important to avoid its injury during intramuscular injection, surgery around inguinal region, harvesting bone graft and introducing local anaesthesia

Surgical anatomy of scarpa's fascia of the anterior abdominal wall and its arterial vasculature

The surgical anatomy of the Scarpa's fascia and its blood supply was studied by dissecting fifteen adult cadavers. Six cadavers were injected with red latex through common iliac artery to demonstrate the arterial supply of the fascia. The results of the present dissection revealed that: the Scarpa's fascia is a well defined single membranous sheet within subcutaneous tissue layer at the lower part of the anterior abdominal wall. It is thick and well developed inferiorly and thinned out superiorly. Histological study revealed that: the Scarpa's fascia is composed of multiple connective tissue vascularized sheets, loosely adherent to one another and it contains abundant elastic tissue. Cadaveric dissections revealed that the arterial supply of the fascia comes from the principle arterial vascular pedicle through the superficial epigastric artery which arises from femoral artery, pierces the Scarpa's fascia and ramifies on the superficial surface of the fascia. This artery has a wide caliber suitable for microvascular free transfer. Additional blood supply to the fascia were found in form of fine perforating blood vessels from the anterior wall of the rectus sheath. Depending on the present results, the Scarpa's fascia is a thin elastic vascular membrane and provides a reliable donor site for free and pedicled flap transfer in plastic surgery

Anatomical study for the infraorbital foramen

One hundred and twenty Egyptian adult skulls were examined to ascertain the location of the infraorbital foramen and the direction of the infraorbital canal to the face. Fifty halves head and neck of adult male cadaveric specimens were dissected to study the locational relationship of the infraorbital foramen to the angles of the eye and to study the contents of the foramen. Dry skulls were differentiated into 62 males, 46 females and 12 of undetermined sex. Bony results demonstrated that the most common position of the infraorbital foramen was opposite the second upper premolar tooth. The most common direction for the infraorbital canal into the face was downwards, forwards and medially. The mean distance between the center of infraorbital foramen and the midsagittal plane was 30.9 mm on the right side and 30.6 mm on the left side in males; while this distance was 29.6 mm on the right side and 29.7 mm on the left side in females. The mean distance between the center of the infraorbital foramen and the inferior orbital margin was 8.6 mm on the right side and 9.2 mm on the left side in males; while this distance was 7.0 mm on the right side and 7.3 mm on the left side in females. The mean distance between the center of the supraorbital notch and the midsagittal plane was 24.5 mm on the right side and 24.8 mm on the left side in males; while this distance was 24.2 mm on the right side and 24.3 mm on the left side in females. The mean distance between the center of the supraorbital notch or foramen and the center of the infraorbital foramen was 43.2 mm on the right side and 42.9 mm on the left side in males; while this distance was 40.8 mm on the right side and 41.0 mm on the left side in females. The mean angle between the line joining the supraorbital notch and the infraorbital foramen and the vertical line parallel to the midsagittal plane was 7.3 degrees on the right side and 7.2 degrees on the left side in males; while this angle was 8.8 degrees on the right side and 8.9 degrees on the left side in females. These locational relationship would be helpful clinically to determine the location of infraorbital foramen by palpation of supraorbital notch. Dissection of 50 halves head and neck revealed that in most specimens [80%] the infraorbital foramen was present exactly at a vertical line passing at the middle of the horizontal line passing between the lateral and medial angles of the eye. These findings may be helpful in anaesthetic block of infraorbital nerve at its passage through infraorbital foramen

Anatomical study of the extensor caropi radialis muscles

This study was conducted on 94 fresh and preserved upper limbs. Twenty of them were injected with red latex through the axillary artery to study the arterial supply of the extensor carpi radialis muscles. Careful dissection was done to demonstrate the arterial and nerve supply of these muscles. The aim of this work was to study the attachment, length, breadth, thickness and anatomical variations of the extensor carpi radialis muscles as-well as their arterial and nerve supply. The extensor carpi radialis longus [ECRL] muscle was found to have a single arterial pedicle from the radial recurrent artery, which entered the proximal part of the muscle together with its nerve supply. The arterial supply to the extensor carpi radialis brevis [ECRB] muscle was formed of multiple arterial pedicles [3-5] from the radial artery that entered the muscle through its medial surface. The ECRL muscle was found to have a good arc of rotation either medially or anteriorly or anteriorly and more suitable for tendon transfer than ECRB muscle. Several anatomical variations were found in the form of extra muscle belly and extra tendon arising from either ERCL muscle and inserted with ECRB muscle and vice versa; also two extra tendons were found to arise from both ECRL and ECRB muscles. These muscles and extra tendons are valuable source for tendon transfer in reconstructive surgery

Origin, course, distribution of the superior gluteal nerve and its relation to the superior gluteal artery and gluteal muscles

Ten pelvic halves of five Egyptian male cadavers were dissected in order to obtain a precise anatomical knowledge of the origin, course and distribution of the superior gluteal nerve and its relation to the corresponding artery. The more anterior parts of the glutei medius and minimus were innervated by branches of the superior gluteal nerve that were revealed to originate more cranially, and the tensor fasciae latae was innervated by the cranialmost element of the nerve. Based on these findings, it might be proposed that the course and distribution of the superior gluteal nerve are directly influenced by the anterior rotation of the gluteus medius

Surgical anatomy of the subgaleal fascia of the scalp and its arterial vasculature

The surgical anatomy of the fascial layers and vascularization of the scalp was studied by dissecting ten adult cadavers and two still births. This article is organized as follows: first, a description of the layers and fasciae of the scalp and their relationships with the main vascular structures. Then special attention was directed to the layer of "loose connective tissue" that lies beneath the entire galea and above the cranial periosteum centrally, and the temporalis fascia laterally. It has been named the "subgaleal fascia" which is discrete anatomical entity, thin, malleable and well vascularized. A description of the histological structure of the subgaleal fascia "composed of multiple connective vascularized sheets loosely adherent to one another". Cadaveric dissections revealed its blood supply from the principal vascular pedicles of the scalp [axial blood supply] and from major perforant vessels to the subgaleal fascia as follows: in the temporal region, perforant vessels from the superficial temporal artery near and about ten centimeter above zygomatic arch, and in the fronto-parieto-occipital region, many small perforant vessels evenly entering the subgaleal fascia every five to ten mm. These findings could lead to greater use of fascial or composite flaps from the scalp region