Morphometric analysis of the mandibular ramus and its clinical and medicolegal significance

Background: During natural calamities entire skeleton of single person could not be found. In such case, determination of sex with fragments of the bone available required range of data with proven accuracy. Hence this study is aimed at to provide range of data for minimum number of parameters of the ramus of the mandible.Methods: Three hundred dry mandibles of known sexes and bearing all teeth or intact alveolar margin were included in the study. Vertical height; maximum and minimum breadths of the ramus of the mandible were measured. All the data were analyzed for significance of the occurrence in relation to sex and laterality by means of paired t-test.Results: On the basis of all the three parameters together, we got 95% accuracy in determination of sex. Statistically significant differences were found in all parameters between male and female mandibles. The laterality distributions for all the parameters were found to be insignificant.Conclusions: Accurate determination of sex from the available bone fragments such as the ramus of the mandible required wide number of data from the least parameters that could be utilized medicolegally.

Study Of Pattern Of Distribution Of Mylohyoid Bridging And Their Clinical Implications

Background: The occurrence of mylohyoid bridges in mandible resulting compression of inferior alveolar andmylohyoid nerves, and vessels, is important cause of neuropathy in this region.Aim and objective: The present study was aimed at analyzing influence of sex and laterality in the occurrence ofmylohyoid bridging in Indian population, and establishing a clue to the underlying causes of paraesthesia ofidiopathic origin, in the territory of inferior alveolar and mylohyoid nerves.Methods: We studied 300 human mandibles (141 female and 159 male) for location and degree of mylohyoidbridging.Results: We found mylohyoid bridges in 15.66% mandibles. The proximal bridging was found more frequentlythan the distal bridging. The mylohyoid bridges were found in 7.8% female and 13.2% in male mandibles studied.We found mylohyoid bridges on 5% on right side and 5.66% on the left side, bilateral bridging was found in 5.33%mandibles.Conclusion: The frequency of occurrence of mylohyoid bridging was higher in male; however, laterality was not tobe significant amongst the mandibles studied. The location and degree of mylohyoid bridging are one of theimportant etiological factors of paraesthesia in the region of inferior alveolar and mylohyoid nerves distribution.

Clinical relevance of morphological variations in origin and insertion of lumbricals of hand in South Gujarat population.

Background & objectives: Lumbrical muscles, though small in size, have a significantly greater role to play in the intricate movements of the fingers.The great functional significance and morphological variations of lumbrical muscles as described in the literature, prompted us to undertake a detailed study of these muscles to know more about it and its significant value in the design of surgical procedures. Methods: We dissected lumbricals of hands of 40 human adult cadavers which were available from the Department of Anatomy. In the present study, variation in origin (include architecture), insertion (include split insertions, misplaced insertions or absence of muscles), the lengths of muscle belly and tendon of all lumbricals were studied and noted. Results: We found variations were more common on the right side. The second lumbrical was bipennate in 12.5% cases. The third lumbrical showed split insertion in 15% cases. The fourth lumbrical showed misplaced insertion in 10% cases. The proximal attachment of lumbricals can extend into the carpal tunnel (specially first and second) in 15% cases. Conclusion: The study provides valuable information to surgeons thus avoiding complications from local anesthetic, surgical and other invasive procedures.

Clinical relevance of variations in the origin of inferior phrenic arteries.

Introduction: The inferior phrenic arteries are major source of collateral arterial supply to hepatocellular carcinoma second only to the hepatic artery. The right inferior phrenic artery is one of the chief postoperative bleeding sources in liver transplant recipients. The aim of the present study was to identify the variations in origin of inferior phrenic arteries. Methods: We dissected inferior phrenic arteries in 100 human adult cadavers (75 males and 25 females) for the origin of both inferior phrenic arteries. Results: We found variant origin of left inferior phrenic artery in 22 male cadavers and in 7 female cadavers. The variant origin of right inferior phrenic artery was found in 27 male cadavers and in 8 female cadavers. Conclusion: The higher incidences of variant origin of inferior phrenic arteries have major clinical implications in the transcatheter arterial chemoembolization in hepatocellular carcinoma patients.

Clinical significance of occurrence of osteophytes and its effect on sagittal diameter of the cervical spinal canal in indian population: morphometric and radiological analysis of cervical spinal canal.

Backgroud: Osteophyte occurrence in cervical vertebral column is leading cause of cervical spondylosis. The aim of the present study was to estimate the average anatomical changes in cervical vertebral column due to occurrence of osteophytes and changes in the sagittal diameters of the cervical vertebral canal in Indian population to establish a clue to the underlying causes of the neck pain of unknown etiology. Methods: We dissected the cervical part of the vertebral column of 50 human adult cadavers (25 males and 25 females) and obtained 200 plain X-rays of lateral view of cervical spine of living patients (100 males and 100 females) for both morphometric and radiological analyses. Results: We found posterior osteophytes more frequently than anterior. The highest frequency of posterior osteophytes was found in the fifth cervical vertebra and of anterior osteophytes in the sixth cervical vertebra. The mean sagittal diameter of the cervical vertebral canal of cadavers ranged from 29.6 mm at C1 to 15.2 mm at C7 in males and 26.6 mm at C1 to 14.5 mm at C7 in females. The mean sagittal diameters of the cervical spinal canal in lateral radiograph of the cervical spine were ranged from 20.7 mm at C1 to 14.4 mm at C7 in males and from 19.9 mm at C1 to 13.4 mm at C7 in females. In general the sagittal diameters in female were less than that of male at all vertebral levels. The canal-body ratio at all vertebral levels was found to be less than 0.8 and was significant to develop cervical spondylotic myelopathy.Conclusion: This study has shown the effects of occurrence of osteophytes in cervical vertebra column and its impact on cervical spondylotic myelopathy.

Variations in branching pattern of the axillary artery: a study in 40 human cadavers / Variações na ramificação do padrão da artéria axilar: um estudo em 40 cadáveres humanos

BACKGROUND: Variations in the branching pattern of the axillary artery are a rule rather than an exception. The knowledge of these variations is of anatomical, radiological, and surgical interest to explain unexpected clinical signs and symptoms. OBJECTIVE: The large percentage of variations in branching pattern of axillary artery is making it worthwhile to take any anomaly into consideration. The type and frequency of these vascular variations should be well understood and documented, as increasing performance of coronary artery bypass surgery and other cardiovascular surgical procedures. The objective of this study is to observe variations in axillary artery branches in human cadavers. METHODS: We dissected 80 limbs of 40 human adult embalmed cadavers of Asian origin and we have studied the branching patterns of the axillary artery. RESULTS: We found variations in branching pattern of axillary artery in 62.5% of the limbs. Anatomical variations included: origin of lateral thoracic artery from the subscapular artery; absent thoracoacromial trunk and all its branches arose directly from the second part of the axillary artery; division of thoracoacromial trunk into deltoacromial and clavipectoral trunks, which were divided into all branches of thoracoacromial trunk; origin of subscapular, anterior circumflex humeral, posterior circumflex humeral and profunda brachii arteries from a common trunk from the third part of the axillary artery; and origin of posterior circumflex humeral artery from brachial artery in addition to third part of the axillary artery. CONCLUSIONS: The study was carried out to show important variations in the branching pattern of axillary artery, in order to orient the surgeons performing angiography, coronary bypass, and flaps in reconstructive surgeries.

CONTEXTO: As variações no teste padrão de ramificação da artéria axilar são preferencialmente uma regra do que uma exceção. O conhecimento destas variações é de interesse anatômico, radiológico e cirúrgico para explicar os sinais e sintomas clínicos inesperados. OBJETIVO: O grande percentual de variações no padrão de ramificação da artéria axilar deve ser levado em consideração. O uso crescente de procedimentos invasores e intervencionistas em procedimentos cirúrgicos cardiovasculares e em cirurgias reconstrutivas da região axilar faz com que seja mais importante que o tipo e a frequência destas variações vasculares sejam entendidos e documentados. MÉTODOS: Oitenta membros de 40 cadáveres adultos embalsamados de origem asiática foram dissecados, e os testes padrões de ramificação da artéria axilar foram estudados. RESULTADOS: Foram encontradas variações no padrão de ramificação da artéria axilar em 62,5% dos membros. Variações anatômicas incluíram: origem da artéria torácica lateral da artéria subescapular; tronco toracoacromial ausente e todos os ramos surgiram diretamente a partir da segunda parte da artéria axilar; divisão do tronco toracoacromial em troncos deltoacromial e clavipeitoral, que foram divididos em todos os ramos do tronco toracoacromial; origem do subescapular umeral circunflexo anterior, umeral circunflexo posterior e artérias braquiais profundas a partir de um tronco comum da terceira parte da artéria axilar; e origem da artéria umeral circunflexa posterior da artéria braquial, além de terceira parte da artéria axilar. CONCLUSÕES: O estudo foi realizado para mostrar as importantes variações no teste padrão de ramificação da artéria axilar para orientar os cirurgiões que realizam angiografias, pontes de safena e retalhos em cirurgias reconstrutivas.

How can we prevent birth of fetus with holoprosencephaly? anatomical and embryological aspects of holoprosencephaly.

Objectives: Holoprosencephaly is a rare condition characterized by different degrees of fused ventricles of the brain resulting from impaired midline cleavage of the embryonic forebrain. The present study aimed to identify cases of holoprosencephaly over a period of three years, to assess the incidence of this malformation, and if possible, prevention of birth of such malformed fetus or infant through genetic counseling. Methods: Diverse features of holoprosencephalic fetus or infant and incidence of holoprosencephaly were studied at GSL Medical College, Rajahmundry; Andhra Pradesh. Results: Incidence found for holoprosencephaly is 2.58 per 10,000 births. Out of total four cases of holoprosencephaly two cases were of alobar and there was each case of semilobar and lobar holoprosencephaly. In two cases there was association between holoprosencephaly and gestational diabetes and in another two cases; there was a familial distribution of holoprosencephaly. Conclusion: Prenatal diagnosis of this rare disorder and genetic counseling has immense importance to prevent holoprosencephaly.

Anatomical variations in formation and branching pattern of the femoral nerve in iliac fossa: A study in 64 human lumbar plexuses.

Femoral nerve is used for nerve block in several surgeries and is vulnerable to compression in tight ilio-psoas compartment. The knowledge of origin and variations of femoral nerve in iliac fossa is important for anatomists, anesthetists and surgeons to prevent iatrogenic femoral nerve palsy. We dissected 32 human cadavers to study the anatomy of the femoral nerve. We dissected the lumbar plexus bilaterally; dissected the psoas major muscle to see formation of the femoral nerve. We measured the length of the femoral nerve from its formation to inguinal ligament; and recorded variations of the femoral nerve with digital photography. The average length of the femoral nerve was 144 mm. Anatomical variations of the femoral nerve were found in 25% lumbar plexuses. These variations included abnormally long L2 root, early division of the femoral nerve, origin of lateral cutaneous nerve of thigh from the femoral nerve, origin of nerve to pectineus from the femoral nerve in iliac fossa, splitting of the femoral nerve into two slips by psoas major or accessory slips of iliacus muscle. The aim of this study was to highlight variations in branching pattern of the femoral nerve in iliac fossa for appropriate exposure of the femoral nerve.