A Cadaveric Study On Division Of Sciatic Nerve To Acheive Its Complete Nerve Blockage

Background: The sciatic nerve arises within the pelvis from the sacral plexus, enters into the gluteal regionthrough the greater sciatic notch and divides into two terminal branches at variable level in the posteriorcompartment of thigh. The variable level of division of sciatic nerve in the thigh leads to failure of sciatic nerveblockage. Considering this clinical problem, the present study has been undertaken with the object to measurethe distance of division of sciatic nerve from the popliteal crease.Materials and Methods: 32 embalmed formalin fixed cadavers were dissected in the gluteal region, back of thighand popliteal fossa and the sciatic nerve were exposed and the distance of division of sciatic nerve weremeasured from the popliteal crease.Results: Out of 32 cadavers dissected the sciatic nerve divides at a distance range of 5 cm–20 cm in malecadavers and 4 cm–11 cm in female cadavers. In 2 cadavers the sciatic nerve divides within the pelvis itself.Conclusion: So, to achieve complete blockage of sciatic nerve in most of the patients the needle should be insertedabout 14 cm (mean distance) above the popliteal crease in males and 8 cm (mean distance) above the poplitealcrease in females

Mondor’s Disease.

Mondor’s disease is the chronic inflammation (thrombophlebitis) of superficial veins of thoracoabdominal or thoraco epigastric region. Very few cases have been reported so far. The causes are numerous and have been mentioned as trauma, inflammation of skin, following breast surgery in cancerous condition, excessive physical activity, compressive bandages, tight clothing, infections and benign or malignant breast tumours. In the present case there was chronic thrombophlebitis of lateral thoracic vein, which was observed on the right pectoral region in middle aged male cadaver. It appeared as a thick, bluish coloured, cord like structure, seen in place of lateral thoracic vessels. When traced proximally, it was opening into the right subclavian vein immediately deep to the right clavicle. Histopathological examination confirmed the vein which was showing destruction of tunica intima as in chronic inflammatory condition. The lumen showed presence of clot. The complication of Mondor’s disease may lead to the spread of inflammation to other regions, clot formation, detachment of the clot leading to thrombo embolism.