ABSTRACT
Variation in anatomy of brachial plexus is important for surgeons working in the upper limb area. It is equally important for anaesthetists performing brachial plexus block as well as neurologists assessing neuronal pathology. The present study was conducted to find the anatomical variations in formation and branching of brachial plexus in adult human cadavers of West Bengal. A total of 54 upper limbs in 27 cadavers were included in this study and were assessed for its course from its formation in cervical region to its termination into branches in the upper extremity. Four plexus were prefixed in origin. Middle and lower trunk were fused in one limb. Lateral cord variations included absence of musculocutaneous nerve in three limbs and extra lateral root of median nerve in one case. Posterior cord variation included two thoracodorsal nerves in two cases. Communicating branch between musculocutaneous nerve was found in three limbs and between radial and ulnar nerve in one limb. In one case, high division of radial nerve was seen. The present study indicated that there are variations in anatomy of brachial plexus and awareness of its pattern is important for those dealing with procedures involving brachial plexus.
ABSTRACT
Background: Femur is the longest and strongest bone of the body. It transmits body weight from hip bone to tibia in standing position. Femoral neck is a constricted part connecting head with shaft at an angle of about 125°- known as angle of inclination or neck shaft angle (NSA); this facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal femoral neck angle (FNA) may be associated with various clinical problems ranging from harmless in toeing gait in childhood to disabling osteoarthritis in adults. The current study attempted to find out if a co-relation exists between those parameters and other clinically measurable variables like inter-epicondylar distance or distance between greater trochanter to lateral epicondyle. This may help to predict the risk of fracture neck femur without any risk of radiation exposure and proper prophylactic measures can be undertaken (Vit-D, calcium) to decrease risk of fracture. Results: Measurements were taken in dry femora mostly in East Indian population. Variables that were measured in 158 dry femora (85 femora from left side and 73 from the right side) are: - a) Neck shaft angle of femur, b) Neck length of femur, c) Neck circumference of femur, d) Inter-epicondylar distance of femur, e) Distance between lateral epicondyle and greater trochanter of femur. No significant difference was found between the right and left sided femoral groups regarding any of the study variables. From the analysis it was revealed that no positive or negative correlation exists between the study variables. Therefore, it is not possible to predict the value of one or more of them from the magnitude of the other variable(s). Conclusions: Our study attempted to find out if it was possible to predict the risk of fracture neck femur by simple clinical procedure without exposing the subjects to radiation hazards associated with a radiological imaging. A screening test and subsequent prophylactic measures could have been suggested to prevent the fracture. However, at the end of the study, no suitable alternative to the radiological assessment was detected.
ABSTRACT
Background: Dissection of right and left upper limbs and demonstration of the origin and the course ofmedian nerve. Result: Median nerve in the right upper limb is formed normally but it supplies brachialis muscle and both head of the biceps in the armwhich is anomalous. In the left arm of the patient the course and supply of median nerve is normal. Conclusion: The patient has unilateral anomalous supply of median nerve in the arm – this can result in trauma to this nerve while undergoing any surgery in right arm.