Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications / 대한해부학회지

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications / 대한해부학회지

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

A Novel Method for Coloring and Labeling Specimens in the Anatomy Museum.

Introduction: In today’s medical educational programs in various institutes anatomy is an essential part of the curriculum in the first year of the medical course. An attractive and innovative anatomical museum forms a vital role in furthering the interest and educating a medical student. Once a specimen has undergone fixation it is essential to color and label the specimens in order to ensure better visualization of required structures and for its proper placement in the museum. Materials and methods: We have utilized a novel method of using commercially available nail polish as a coloring agent and as a part of the labeling of museum specimens. Results: Nail polish being non- toxic and readily available can be used without causing any complications. Discussion: Commercially available nail polish is cost effective and non-toxic. Its various usages are described along with the techniques of labeling done in our anatomy museum.

Morphological study of styloid process of the temporal bone and its clinical implications / 대한해부학회지

The objective of this study was to study the morphometry of the styloid process of temporal bone and prevalence of elongated styloid process. The morphology of elongated styloid process along with its embryological and clinical importance are discussed. The present study included 110 human dry skulls which were procured from the bone collections of the department of anatomy. The styloid process was observed macroscopically on both sides of all the skulls, the elongations if any were noted. All the styloids were measured for their length, thickness at different levels and interstyloid distance at various levels. Out of 110 specimens, only 5 skulls (4.5%) exhibited the elongated styloid process. Among them, 3 skulls (2.7%) had unilateral elongation and 2 skulls (1.8%) had bilateral elongation of the styloid process. The mean length of the styloid process was 17.8+/-9.3 mm and 18.2+/-5.6 mm for the right and left sides, respectively. The prevalence of elongated styloid process in the present study was 4.5%. The clinical anatomy of this congenital variant is important to the neurosurgeon and radiologist, while interpreting the computed tomogram and magnetic resonance image scans. The morphological knowledge of elongated styloid process is clinically important since the course of the vertebral artery may be distorted in such situations.

Morphometric parameters of the human adult kidney: an anatomical study / Parámetros morfométricos del riñon humano adulto: un estudio anatómico

The purpose of this study was to determine the anatomic parameters of the kidney in adults. The Renal lengths, width at superior and inferior poles, thickness at the superior and inferior poles were measured in 151 adult cadaver kidneys. A digital vernier caliper was used for performing the measurements. The data were statistically analyzed. The mean renal length was 8.9 ± 0.9 cm on the right side and 9.1 ± 0.9 cm on the left side. The mean width of the superior pole of the right kidney was 4.9 ± 0.6 cm and the left kidney was 5 ± 0.7 cm. The width of inferior pole of the right and left kidneys were 4.8 ± 0.6 cm and 4.5 ± 0.7 cm respectively. The mean thickness of the superior pole of the right kidney was 3 ± 0.4 cm and left kidney was 3.2 ± 0.5 cm. The mean thickness of the inferior pole of the right and left kidneys were 3.1 ± 0.4 cm and 3.2 ± 0.5 cm respectively. There was no statistical significance with respect to the length of both the kidneys. However there was some data on width and thickness among the right and left side showed the difference which was significant statistically. The present study has provided additional information on the renal morphometry which will be of use to the surgeons and radiologists.

El propósito de este estudio fue determinar los parámetros anatómicos del riñon en los adultos. La longitud renal, ancho de los polos inferior y superior, y grosor de los polos superior e inferior se midieron en riñones de 151 cadáveres adultos. Se utilizó un caliper vernier digital para realizar las mediciones y los datos fueron analizados estadísticamente. La longitud media renal fue 8,9±0,9 cm en el lado derecho y 9,1±0,9 cm en el lado izquierda. El ancho promedio del polo superior del riñón derecho fue 4,9±0,6 cm y del riñón izquierdo fue 5±0,7 cm. El ancho promedio del polo inferior del lado derecho e izquierdo riñones fueron 4,8±0,6 cm y 4,5±0,7 cm, respectivamente. El grosor promedio del polo superior en el riñón del lado derecho fue 3±0,4 cm y el izquierdo 3,2±0,5 cm. El grosor promedio del polo inferior del riñon del lado derecho e izquierdo fueron 3,1±0,4 cm y 3,2±0,5 cm, respectivamente. No hubo diferencia significativa en relación con la longitud de los riñones. Sin embargo hubo algunos datos en ancho y grosor entre el lado derecho e izquierdo que mostraron diferencia significativa. El presente estudio ha proporcionado información adicional sobre la morfometría renal que puede ser de utilidad para los cirujanos y radiólogos.

Accessory neurovascular foramina on the lingual surface of mandible: Incidence, topography, and clinical implications.

Context: It was suggested that the accessory neurovascular foramina of the mandible might be of significance in relation to the effectiveness of local anesthesia following the routine inferior alveolar nerve block. Aims: To investigate the incidence of neurovascular foramina over the lingual surface of the mandible in South Indian population. Settings and Design: The study was conducted at the department of anatomy. Materials and Methods: The study included 67 human adult dry mandibles, the exact ages and sexes of which were not known. The location and number of neurovascular foramina were topographically analyzed. Statistical Analysis Used: Descriptive statistics. Results: The foramina were observed in 64 mandibles (95.5%) and were often multiple in most of the cases. They were located between the two medial incisors in 8 mandibles (1.9%), between the medial and lateral incisor in 34 mandibles (50.7%; 25-bilateral; 7-right; 2-left), between the lateral incisor and canine in 7 mandibles (10.4%; 2-bilateral; 3-right; 2-left), between the canine and first premolar in 6 cases (8.9%; 3 on each side). Foramina were also present around the genial tubercle in 56 mandibles (83.6%). Among them, 52 mandibles showed a single foramen just above the genial tubercle, 34 mandibles had foramina below the tubercles, 13 mandibles had foramina on the right side of genial tubercle and 17 were having on the left side. Conclusion: Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.

Lumbosacral transitional vertebrae: a case report and clinical implications / Vértebras lumbosacras de transición: reporte de un caso e implicancias clínicas

A lumbosacral transitional vertebra is a rare congenital anomaly which occurs because of defect in the segmentation of the lumbosacral spine during development. During routine osteology classes for the medical students at the Kasturba Medical College, Mangalore, India, one of the sacra showed the fusion of the fifth lumbar vertebra with the sacrum. The specimen showed an incomplete fusion (sacralization) on the left side and the transverse process was of the large butterfly shape, while on the right it was about the usual size. Though this variation is well known, the details of this anomaly are rarely reported in the anatomical literature. Since there is a strong relationship between the lumbosacral transitional vertebrae and low back pain, this anomaly has gotten increased clinical interest. So this case was studied in detail with relevant review of literature and its surgical, radiological implications are discussed.

Una vértebra de transición lumbosacra es una anomalía congénita rara que se produce debido a defectos en la segmentación de la columna lumbosacra durante el desarrollo. Durante una clase de osteología para estudiantes de medicina en Kasturba Medical College, Mangalore, India, una de las regiones sacras mostró fusión de la quinta vértebra lumbar con el sacro. El especimen mostró fusión incompleta (sacralización) en el lado izquierdo y el proceso transverso tenía forma de mariposa grande, mientras que en el derecho se observó de tamaño normal. A pesar que esta variación es conocida, los detalles de esta anomalía rara vez son reportados en la literatura anatómica. Puesto que existe una fuerte relación entre las vértebras de transición lumbosacra y el dolor de espalda baja, esta anomalía tiene gran interés clínico. Este caso fue estudiado en detalle con la revisión pertinente de la literatura, y son discutidas sus implicancias quirúrgicas y radiológicas.

Morphometric study of the humerus segments in Indian population / Estudio morfométrico de los segmentos del húmero en población india

The aim of the present study was to obtain the measurements of the different humerus segments and to estimate the length of humeri from them. For this purpose 100 (51 left and 49 right) sex-aggregated, adult dry humerus from Indian population, were taken to analyze the morphometric details of the humerus segments. The distance between five different segments viz: most proximal point of the humeral head and greater tuberosity (HA), head of the humerus and surgical neck of humerus (HB), proximal and distal point of olecranon fossa (HC), the distal point of olecranon fossa and trochlea of humerus (HD), proximal point of olecranon fossa and distal point of trochlea of humerus (HE) and finally the maximum length of humerus (HL) were obtained by means of an osteometrical board and an analogical caliper. Simples linear regressions (p < 0.01) were made to correlate each segment with the total length of the humerus. Positive results were obtained in segments HB and HE of right humerus. Regressions formulae were obtained to define these estimative. In conclusion, our study demonstrated that length of the humerus can be estimated from measures of different segments of humerus and this study helps in forensic, anatomic and archeological cases in order to identify unknown bodies and to determine stature of the individual and as well as for the orthopedic surgeons for the treatment of proximal and distal humerus fractures and for their reconstruction.

El objetivo del estudio fue obtener las medidas de diferentes segmentos del húmero y calcular la longitud del húmero a partir de ellos. Fueron seleccionados 100 (51 izquierdos y 49 derechos) húmeros adultos secos, separados por sexo, de población india para analizar los detalles morfométricos de los segmentos dle hueso. La distancia entre cinco segmentos diferentes fueron establecidos: punto más proximal de la cabeza humeral y la tuberosidad mayor (HA), cabeza del húmero y cuello quirúrgico del húmero (HB), punto proximal y distal de la fosa olecraneana (HC), punto distal de la fosa olecraneana y la tróclea del húmero (HD), punto proximal de la fosa olecraneana y punto distal de la tróclea del húmero (HE) y, finalmente, la longitud máxima del húmero (HL) medidas obtenidas por medio de una tabla osteométrica y un caliper análogo. Se realizaron regresiones lineales simples para correlacionar cada segmento con la longitud total del húmero. Se obtuvieron resultados positivos en los segmentos de HB y HE de húmero derecho. Fórmulas de regresión se obtuvieron para definir estimativos. En conclusión, nuestro estudio demostró que la longitud del húmero puede estimarse a partir de las medidas de los diferentes segmentos del hueso, ayudando en casos forenses, anatómicos y arqueológicos con el fin de identificar cuerpos desconocidos o para determinar la estatura de la persona, así como a cirujanos ortopédicos para el tratamiento de las fracturas proximales y distales del húmero o para su reconstrucción.

Macroinvertebrate diversity of Veli and Kadinamkulam lakes, South Kerala, India.

The diversity and distribution pattern of benthic macroinvertebrates in two backwaters viz., Veli and Kadinamkulam of Kerala were assessed using diversity indices. The samples were collected once in three months for a period of two years from six sampling sites (K1, K2, K3, V1, V2 and V3) and community variations were analyzed. Overall, 24 families were identified represented by mollusca, annelida and arthropoda (crustaceans and insects). Among this, dominant taxon was Mytilidae of molluscan family and site-wise dominance was maximum in sites V1 and V2. Richness and abundance were highest in site V2 and lowest in site K2. Diversity index ranged from 0.27 (K2) to 2.33 (V1). The diversity and distribution patterns of certain species were clearly related to water quality as evident from the present study.

Variability in the origin of the obturator artery

INTRODUCTION: General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper's ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported. MATERIALS AND METHODS: The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted. RESULTS: In 79 percent of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19 percent of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2 percent of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity. CONCLUSION: The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.

Hypoplastic posterior tibial artery and the enlarged peroneal artery supplying the posterior crural region: a rare variation / Artéria tibial posterior hipoplásica e a artéria peroneal aumentada suprindo a região crural posterior: uma variação rara

Arterial variations of distal parts of lower extremities are well-documented and can be demonstrated with the help of Doppler ultrasound or by arteriography. However, absence or variation of posterior tibial artery is considered a rare finding. We present a case of hypoplastic posterior tibial artery that terminated by supplying soleus muscle. The variant arterial supply to the sole was provided by the enlarged peroneal artery that continued as the lateral plantar artery. The awareness of these variations is important to vascular surgeons while performing arterial reconstructions in femorodistal bypass graft procedures, and also to orthopedists during surgical clubfoot release.

Variações arteriais de partes distais dos membros inferiores estão bem documentadas e podem ser demonstradas com o auxílio de ultra-sonografia Doppler ou por arteriografia. Entretanto, a ausência ou variação da artéria tibial posterior é um raro achado. Apresentamos um caso de artéria tibial posterior hipoplásica que terminava suprindo o músculo solear. Esse suprimento arterial variante foi fornecido pela artéria peroneal aumentada que continuava como artéria plantar lateral. Estar consciente dessas variações é importante para cirurgiões vasculares ao realizarem reconstruções arteriais em procedimentos de derivação femorodistal, bem como para ortopedistas durante correção cirúrgica do pé torto.

The scalenus accessorious muscle / El músculo escaleno accesorio

Many of the anatomical variations that are inadequately described or quantified are actually more clinically and surgically significant than being just anatomical curiosities. We report about such a variation where an aberrant slip existed in the scalene group, in a 56 year old embalmed female cadaver. This kind of variation may affect the size of the scalene triangle, and thus, may potentially result in varied signs and symptoms in patients vulnerable to thoracic outlet syndrome (TOS). Proximity of the scalene muscles to the brachial plexus, subclavian artery and vein, coexisting with aberrant slips or bundles may also predispose to compression syndromes.

Muchas de las variaciones anatómicas no están suficientemente descritas o cuantificadas y son actualmente clínica y quirúrgicamente significativas más que curiosidades anatómicas. Reportamos una variación anatómica en el grupo de los músculos escalenos, presente en un cadáver de una mujer de 56 años. Este tipo de variación puede afectar el tamaño del triángulo escalénico y por lo tanto, puede potencialmente resultar en variados signos y síntomas en pacientes vulnerables al síndrome de salida torácica. La proximidad de los músculos escalenos con el plexo braquial, arteria y vena suclavias, coexistiendo con fascículos aberrantes pueden predisponer a síndromes de compresión.

Multiple variations of extensor muscles of forearm in relation to the radial nerve: a case report and review / Múltiples variaciones de los músculos extensores del antebrazo en relación con el nervio radial: reporte de caso y revisión

During routine dissection in the Department of Anatomy, multiple variations of forearm muscles in relation to the radial nerve and its branches were observed on the right side of a 34 year old male cadaver. Brachioradialis close to its origin was receiving muscle fibers from the brachialis and the radial nerve was passing in between them. Extensor carpi radialis brevis was absent and the extensor carpi radialis longus was giving two tendons in the second compartment of extensor retinaculum before its insertion while passing deep to the abductor pollicis longus. Absence of extensor carpi radialis brevis can be explained with the arrangement in lower mammals, where the two extensores carpi radiales are represented by one muscle. Ontogeny repeats phylogeny and anatomical variations have developmental basis. Henee, the pattern of muscular arrangement in this case can be said to be less evolved than the usual arrangement. The course of radial nerve between the two heads of brachioradialis makes it highly vulnerable to compression and injury, which may manifest as wrist drop (radial nerve palsy) or radial tunnel syndrome (compression of posterior interosseous nerve).

Durante una disección de rutina en el Departamento de Anatomía, se observaron múltiples variaciones de los músculos del antebrazo, en relación con el nervio radial y sus ramos, en el lado derecho de un cadáver de 34 años de edad, de sexo masculino. Cerca de su origen el músculo braquioradial recibía fibras del músculo braquial y el nervio radial cruzaba entre ellos. El músculo extensor radial corto del carpo se encontraba ausente y el músculo extensor radial largo del carpo se continuaba con dos tendones en el segundo compartimiento del retináculo extensor, bajo el músculo abductor largo de pulgar, antes de su inserción. La ausencia del músculo extensor radial corto del carpo se puede explicar en mamíferos inferiores, donde los dos músculos extensores radiales están representados por un sólo músculo. La ontogenia repite la filogenia y las variaciones anatómicas inciden en su desarrollo. Por lo tanto, de acuerdo al patrón muscular se puede afirmar que en este caso existe menos evolución que lo habitual. El curso del nervio radial entre las dos cabezas del músculo braquioradial, lo hace muy vulnerable a la compresión y las lesiones, que pueden manifestarse son, caída de la muñeca (parálisis del nervio radial) o el síndrome del túnel radial (compresión del nervio interóseo posterior).

A comparison of vitamin A and leucovorin for the prevention of methotrexate-induced micronuclei production in rat bone marrow

INTRODUCTION: Methotrexate, a folate antagonist, is a mainstay treatment for childhood acute lymphoblastic leukemia. It is also widely used in a low dose formulation to treat patients with rheumatoid arthritis. In rats, methotrexate is known to induce micronuclei formation, leading to genetic damage, while vitamin A is known to protect against such methotrexate-induced genetic damage. Leucovorin (folinic acid) is generally administered with methotrexate to decrease methotrexate-induced toxicity. OBJECTIVES: We aimed to determine whether vitamin A and leucovorin differed in their capacity to prevent formation of methotrexate-induced micronuclei in rat bone marrow erythrocytes. The present study also aimed to evaluate the effect of combined treatment with vitamin A and leucovorin on the formation of methotrexate-induced micronuclei. METHODS: Male and female Wistar rats (n=8) were injected with 20 mg/kg methotrexate (single i.p. dose). The control group received an equal volume of distilled water. The third and fourth groups of rats received vitamin A (5000 IU daily dose for 4 successive days) and leucovorin (0.5 mg/kg i.p. dose for 4 successive days), respectively. The fifth and sixth groups of rats received a combination of vitamin A and a single dose of methotrexate and a combination of leucovorin and methotrexate, respectively. The last group of rats received a combination of leucovorin, vitamin A and single dose of methotrexate. Samples were collected at 24 hours after the last dose of the treatment into 5 percent bovine albumin. Smears were obtained and stained with May-Grunwald and Giemsa. One thousand polychromatic erythrocytes were counted per animal for the presence of micronuclei and the percentage of polychromatic erythrocyte was determined. RESULTS: Comparison of methotrexate-treated rats with the control group showed a significant increase in the percentage of cells with micronuclei and a significant decrease polychromatic...

Unilateral pectoralis minimus muscle: a case report / Músculo pectoralis minimus unilateral: reporte de caso

Presence of additional muscles in the pectoral region has often been reported. We report about the presence of Pectoralis Minimus muscle, in a male cadaver. It was present deep to the pectoralis major muscle and superomedial to the pectoralis minor muscle. The variant was closely related to the branches of thoracoacromial vessels where one of the branches was passing between the pectoralis minor muscle and the variant muscle. Hyperabduction of the arm may compress these vessels giving rise to certain vascular symptoms. Also these variations should be borne in mind during certain surgical procedures in the pectoral region

Presencia de músculos supernumerarios en la región pectoral han sido reportados. En un cadáver de un hombre se describe la presencia de un músculo Pectoralis Minimus. El músculo se localizaba profundo al músculo pectoral mayor y superomedial al músculo pectoral menor. La variación se relacionaba con las ramas de los vasos toracoacromiales donde una de las ramas pasaba entre el músculo pectoral menor y la variación muscular. La hiperabducción del brazo puede comprimir estos vasos provocando síntomas vasculares. Estas variaciones se deben tener en cuenta durante los procedimientos quirúrgicos en la región pectoral

Meckel's Diverticulum: A Case Report / Divertículo de Meckel: Reporte de Caso

Meckel's diverticulum is the most prevalent congenital anomaly of the gastrointestinal tract. It might remain completely asymptomatic or may mimic some disorders like Crohn's disease, Appendicitis and peptic ulcer diseases. A Meckel's diverticulum was found during routine dissection. A brief review of this anomaly, its embryological explanation, and probable clinical implications with its management is discussed in this report.

El diverticulo de Meckel es la anomalía congénita más prevalente del tracto gastrointestinal. Puede ser un remanente totalmente asintomático o puede provocar algunos desórdenes como la enfermedades de Crohn, apendicitis y úlcera péptica. Un diverticulo de Meckel fue encontrado durante una disección de rutina. Una breve revisión de esta anomalía, su explicación embriológica y probables implicaciones clínicas fueron discutidas en este trabajo.