ABSTRACT
Background and objective: The acute appendicitis is a common and serious cause of acute abdominal pain. Oftentimes, the surgeons could not find the vermiform appendix in its usual position. A detailed study of variation positions of the vermiform appendix is necessary for an appropriate treatment. The data could also contribute to the collection of the world such as the World Health Organization from a population of the Northeast Thailand. This study aims to study and accumulate the gross anatomical data on position variation of the vermiform appendix in the Northeast Thailand cadavers. The incidence and morphometry of the structure were established.Design: A detailed dissection is the descriptive study.Materials and Methods: A total number of 102 cadavers donated by the Northeast Thailand population were carefully dissected. The identification of the urinform appendix site was done by following the three teniae coli caudally to its base where the three muscular lands meet to form a complete longitudinal, smooth muscular tube. The length was measured using the venire caliper and the percentage was calculated.Results: Among 102 specimens, the most common type of vermiform appendix is the post-ileal at 37.25% while the least common (called the pre-ileal and paracecal types) is at 3%. The approrimate length of 6 cm is the most frequent group. The average length + SD of both genders is 6.127 + 2.028 cm.Conclusion: This study discovered that the most common type of position variation of vermiform appendix is the post-ileal type at 37.25%. The average length in male and female cadavers are 6.329 + 2.012 cm. and 5.688 + 2.023 cm., respectively.Keywords: cecum, gut rotation, rotation axis, vermiform appendix, position variation, morphometry, mesoappendix, teniae coli, situs inversus
ABSTRACT
Background: The vertebral column in general is made up of 33 vertebrae of different shape and size, although all of which share typical features. There are 7 cervical, 12 thoracic, 5 lumbar, 5 sacral vertebrae that fuse into one at the age of about 20 years, and 4 coccygeal vertebrae that become one piece at middle age. The study of human skeletons in the Gross Anatomy Laboratory, Faculty of Medicine, Khon Kaen University from 1975 to 2004 totalled 480 skeletons which we found a case with 6 lumbar vertebrae. The first and the sixth presented anatomical variations from the typical and normal lumbar vertebrae. We are interested in reporting the case that has never been reported in Thai.Objectives: 1.To study anatomy of the six lumbar vertebrae in Thai skeletons. 2.To study the articulation between the sixth lumbar vertebra and sacrum.Results: The skeleton of a 57 year old male presents anatomical variations of lumbar vertebrae. He has six, in contrast to normal five lumbar vertebrae whereas the other levels are normally, 7 cervical, 12 thoracic, 1 sacral and 1 coccygeal vertebrae. The first lumbar vertebra is obviously differently from others in that its transverse processes are short and articulated with the malformed ribs. The pair of this malformed ribs is the 13th, an extra pair additional to the normal 12 pairs. The right one is 4 centimeters long while the left is 3.5 centimeters. Additional malformed of pair of ribs in this case made 3 pairs of floating ribs. Anatomy of the second to fifth lumbar vertebrae are similar to the typical lumbar vertebrae. The sixth lumbar vertebra situated below the fifth and articulated to the first sacral vertebra. Although in general the body of the sixth lumbar vertebra configuration is similar to the other lumbar vertebrae but its spinous process projected posterior, is short with a shape of plump ridge. The left transverse process is slender and longer than the right transverse process. The upper border of the body that is articulated to the intervertebral disc below the fifth lumbar vertebra is rough and extended around its rim. The lower border that articulated to the sacrum has a smoother surface than the upper. The inferior surface of the both transverse processes are the extended tubercles that projected downward anteriorly and articulate to the upper surface of ala of sacrum completely. The inferior articular process on inferior surface of both transverse processes were seen but the processes looked very small and short with tubercles that articulated to the small and short superior articular processes of the sacrum.Conclusion: The sixth lumbar vertebra is the anomaly of the skeletal system that found in our study. This abnormality can be ascribed to the over-splitting of the embryonic somite and the subsequently complicated development process starting from the cellular level up to the naked eye observation. This is the first report on sixth lumbar vertebra in 480 skeletons. The incidence of this anomaly in Thai should be further researched.
ABSTRACT
Background : The variable structures and pattern of the organs in the body are normally found during dissection of formalin-embalmed cadavers in the practical class of Gross Anatomy. The variation of the right subclavian artery is one of the variable structures. Normally, this artery is a branch from brachiocephalic trunk, which is the first branch of the arch of aorta. The observation on mediastinum dissection of the male cadaver, 89 years of age in the Gross Anatomy Laboratory, Department of Anatomy, Faculty of Medicine, Khon Kaen University, it has been found that the right subclavian artery is a branch arising from posterior aspect of the distal part of the arch of aorta, it runs behind esophagus and directly to the right upper extremity, called retroesophageal right subclavian artery (RRSA). This finding is the first case in our laboratory since the year 1997 to 2004 totalled 480 cadavers. The variable of the RRSA is highly investigated in case of abnormal development of the arch of aorta thus, the surgeon and related physician should be always aware. Objectives1. Describe the anatomical characteristics of the RRSA in these aspects: the position of the origin, the diameter, the length and the course of this artery.2. Describes the surrounded structures related to this artery. Result : The observation while carefully dissecting the mediastinum of the male cadaver, 89 years old of age. It had been found that the brachiocephalic trunk is absent. The first branch of the arch of aorta is the right common carotid artery, the second is the left common carotid artery, the third is the left subclavian artery and the fourth branch is the RRSA. The RRSA arises from the posterior of the distal part of the arch of aorta, next to the left subclavian artery. The course of this artery is behind the esophagus traversing the mediastinum to supply the right upper extremity. However, there is no variable of the branches from RRSA. Measurement with the digital vernier caliper was done and revealed the length of the RRSA is 8.86 centimeters, the diameter at the proximal and distal part of RRSA are 0.99 and 0.83 centimeters respectively. Furthermore, from this study, the right recurrent laryngeal nerve does not hook around the RRSA as normal.Conclusion : The RRSA is a defective development of the right fourth aortic arch and/or part of the right dorsal aorta, a segment between the right fourth aortic arch and the right seventh intersegmental artery which may be degenerated during embryological development. This is the first report on the RRSA in Thai. The incidence of this anomaly in Thai should be further researched and accumulated.