Numbers Matter: Clinical Significance of Additional Belly of First And Second Lumbrical Muscles of the Hand.

In a routine dissection conducted in the Department of Anatomy, Amrita School of Medicine Kochi, additional origins of the first and second lumbricals were observed on the right hand of a male cadaver. The additional belly originated from the radial side of the tendon of flexor digitorum superficialis (FDS) of the index finger, deep to the flexor retinaculum. Distally the tendon of both bellies united and inserted to the dorsal digital expansion of the index finger. In the case of the second lumbrical the additional belly arose from the ulnar side of the tendon of Flexor digitorum profundus (FDP) of the index finger and inserted into the dorsal digital expansion of middle finger. Knowledge of possible variations helps the clinician find aetiology for various compressive syndromes so that treatment modality can be tailored and customised. This presentation will add to the compendium of information.

When the Left is left.

Persistent left superior vena cava is an uncommon vascular anomaly; however it is the most common anomaly of the thoracic venous system. It may be stand alone or associated with other congenital heart diseases and even other extracardiac anomalies. It is due to a lack of regression and adsorption of the left anterior cardinal vein. The persistence of this vessel renders a left subclavian approach for interventions on the right heart a challenge. It may be responsible for arrthymiias. We present a report of a persistent left superior vena cava draining into the coronary sinus with a coexisting normal right superior vena cava. Keeping in mind its widespread implications on cardiac procedures and a causative factor of cardiac disturbances we have considered its course, embryological source and clinical significance.