ABSTRACT
Objective: The cubital fossa is a common site for the withdrawal of venous blood for analysis, fluid and blood transfusion, and intravenous therapy. The superficial venous return from the upper limb follows a number of superficial veins which are extremely variable; these include the cephalic, basilic, median cubital and antebrachial veins and their tributaries. To determine the patterns of superficial venous arrangement in the cubital fossa of adult Jordanians
Methods: 264 males and females were randomly selected from the students of the University of Jordan. All subjects were Jordanian, aged between 18 and 25 years. The students consent was taken, the superficial veins of the cubital fossa were made prominent by applying a tourniquet about 10 cm proximal to the crease of the elbow and by active movements of the hand. The veins were marked on the skin and the pattern of veins in each case was accurately diagrammed on a sheet of paper
Results: Six venous patterns were observed. There were no significant differences between the venous patterns on the right and left sides in males or females. The commonest pattern was that the median cubital vein arose from the cephalic vein a few centimeters below the elbow, joined the basilic vein a few centimeters above the level of the elbow joint and received tributaries from the front of the forearm. This pattern was more common in males [51.5%] than in females [45.4%]. The less commonly observed patterns was the absence of communication between basilic and cephalic veins [in 13.6% males and 12.8%females]; an arched median cubital vein [in 9.8% males and 12.8 %females]; absence of the cephalic vein [in 5.3%males and 13.6% females] and two median cubital veins [in 2 males only, 1.5%]
Conclusions: Awareness of these cubital venous patterns and their approximate incidence would be very useful for those performing venepuncture or venesection in Jordanians, especially under emergency conditions
ABSTRACT
Despite the availability of expert surgeons and preoperative imaging investigations, some patients require re-operation for persistent or recurrent hyperparathyroidism. Ectopic Parathyroid Glands [PGs] are a cause for failed parathyroid exploration. To evaluate the prevalence and location of normal parathyroid glands and diseased glands taken from subjects with End-Stage Renal Disease [ESRD]. A total of 410 parathyroid glands were recovered from 116 postmortem subjects of whom 37 were diagnosed as suffering from ESRD. In the rest, the death had resulted from disease unrelated to parathyroid disorder. 155 [69.3%] of both normal left and right superior PGs were located at cricothyroid junction; 46 [29.3%] were behind the upper pole of thyroid gland; 2 [2.6%] were behind pharyngoesophageal junction. 68 [47.1%] of the normal inferior PGs were found at the lateroposterior surface of the lower pole of thyroid gland; 62 [43.7%] were within the thymic tongue and 14 [9.7%] along the carotid artery. The normal ectopic PGs were found only in 22 cases. The superior PGs were 4 [18.2%] in an extracapsular posterior position, 2 [9.1%] intrathyroidal and 1 [4.5%] retropharyngeal. The inferior ectopic PGs were 15 [68.2%] and were found within the mediastinal thymus. 19 [51.4%] of the enlarged PGs were found within the thyroid parenchyma, 8 [21.6%] within the thymic tongue, 6 [16.2%] within the thymus, 2 [5.4%] were within the carotid sheath and 1 [2.7%] in the retropharyngeal or retroesophageal position. The presence of ectopic PGs in secondary hyperparathyroidism is sufficiently important to justify their exhaustive search. As the preoperative image exams present low sensibility to locate them, it is necessary to develop an exploratory routine embracing the most common sites of location