An Anatomical Study of Foramen Spinosum in South Indian Dry Skulls with its Emphasis on Morphology and Morphometry.

Aim: To study themorphological details and to evaluate themorphometry of the Foramen Spinosum in the base of dry human skulls in South Indian population. Methods: 82 dry adult human skulls of unknown sex and of South Indian origin were obtained and variations in appearance were observed. The length and width of the Foramen Spinosum on both sides were determined using vernier calipers and area (A) was calculated and analyzed. Also, its mean distance from the midline on both the sides was noted and analyzed. Results: The values for the right side were 3.425± 0.637mm, 2.687± 0.487mm and 7.357 ± 2.195 mm2 and for the left side the values were 3.339 ± 0.660mm, 2.675 ± 0.465 mm and 7.110± 2.103 mm2 respectively, for the mean length,mean breadth andmean area of the Foramen Spinosum. Also, the shape of the Foramen Spinosum was typically round in most of the skulls studied (53.65%) and it was little away from midline on the left side. Conclusion: By analyzing the length, width and area of the Foramen Spinosum on both the sides, there was no statistical difference for the values obtained and these values were comparable with the studies done in the past.

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.

Case report of high origin of radial, ulnar, and profunda brachii arteries, its clinical implications and review of the literature / Relato de caso de origem alta das artérias radial, ulnar e braquial profunda, suas implicações clínicas e revisão de literatura

Arterial variations in the arm are of potential clinical implications as it is a frequent site of injury and also involved in many surgical and invasive procedures. During a dissection of the right upper extremity, an abnormal high origin of the radial and ulnar arteries was found. The brachial artery had a very short segment without any branches, divided into the radial and ulnar arteries at the upper third of the arm. The course and branching pattern of these radial and ulnar arteries in the arm are discussed. It was also observed that the profunda brachii artery was represented by two separate branches arising from the posterior circumflex humeral artery. Accurate knowledge of these variation patterns is of considerable clinical importance in the conduct of reparative surgeries around the shoulder and fracture management of the humerus. These additional data of arterial anomalies to contemporary anatomical literature are of interest to clinicians, in particular vascular and plastic surgeons and radiologists.

As variações arteriais no braço têm potenciais implicações clínicas já que o braço é um sítio de lesões frequentes, além de estar envolvido em muitos procedimentos cirúrgicos e invasivos. Durante a dissecção da extremidade superior direita, uma origem alta anormal das artérias radial e ulnar foi encontrada. A artéria braquial apresentava um segmento muito curto sem quaisquer ramos, dividindo-se nas artérias radial e ulnar no terço superior do braço. O curso e o padrão de ramificação das artérias radial e ulnar no braço são discutidos. Também se observou que a artéria braquial profunda estava representada por dois ramos separados, surgindo da artéria umeral circunflexa posterior. O conhecimento preciso sobre esses padrões de variação é de considerável importância na realização de cirurgias reparadoras na região do ombro e no manejo de fraturas de úmero. Estes dados adicionais sobre as anomalias arteriais para a literatura anatômica contemporânea são de grande interesse para os médicos, especialmente para cirurgiões plásticos e vasculares e radiologistas.

Origem das artérias dos nós sinoatrial e atrioventricular em população do sul da Índia: um estudo angiográfico / Origin of the sinoatrial and atrioventricular nodal arteries in South Indians: an angiographic study / Origen de las arterias de los nódulos sinusal y atrioventricular en población del Sur de la India: un estudio angiográfico

Fundamento: Estudar o suprimento arterial do sistema condutor e sua correlação com a dominância das artérias coronárias em população do sul da Índia. Objetivo: Determinar angiograficamente as origens da artéria do nó sinoatrial (AnSA) e artéria do nó atrioventricular (AnAV) em indianos.Métodos: O estudo incluiu 300 pacientes consecutivos (114 do sexo feminino e 186 do sexo masculino; idade média, 55 anos), habitantes da região costeira ao sul da Índia, submetidos a cineangiocoronariografia devido a sintomas como dor no peito, angina pectoris ou teste ergométrico positivo. As angiografias incluíram ambas as artérias coronárias (direita e esquerda) em posição oblíqua anterior direita e esquerda. A origem da AnSA e AnAV a partir das artérias coronárias foi observada e correlacionada à dominância arterial. Resultados: O nó SA (sinoatrial) recebeu suprimento pela artéria coronária direita (ACD) em 53% dos casos, pelo ramo circunflexo (Cx) da artéria coronária esquerda (ACE) em 42,66% dos casos, e em 4,33% dos casos esse nó foi irrigado por ambas as artérias coronárias. O nó AV (atrioventricular) também recebeu suprimento sanguíneo com mais frequência da ACD (72,33% dos casos) do que do ramo Cx da ACE (27,66%). Surpreendentemente, em nenhum caso este nó recebeu suprimento de ambas as artérias coronárias. Conclusão: Os resultados do presente estudo podem auxiliar os cirurgiões cardíacos, sobretudo em cirurgias relacionadas a valvopatias, devido à franca proximidade entre os ramos nodais e o complexo valvar.

Background: To study the arterial supply of the conducting system and its correlation with the dominance of the coronary arteries in the South Indian population. Objective: To determine angiographically the origins of the sinoatrial nodal artery (SAna) and atrioventricular nodal artery (AVna) in Indians. Methods: The study included 300 consecutive patients (114 females, 186 males; mean age, 55 years) living in the southern coastal region of India, who underwent coronary angiography either for the symptoms of chest pain, angina pectoris or positive Treadmill Test. The angiograms contained both coronary arteries (right and left) in the right and left anterior oblique position. The origin of SAna and AVna from the coronary arteries was observed and correlated with the arterial dominance.Results: The SA (sinoatrial) node was supplied by the right coronary artery (RCA) in 53% of the cases, by the circumflex (Cx) branch of left coronary artery (LCA) in 42.66%, and by both coronary arteries in 4.33% of cases. The AV (atrioventricular) node was also more often supplied by the RCA (72.33% of cases) than by the Cx branch of the LCA (27.66%), and surprisingly in none of the cases was this node supplied by both coronary arteries. Conclusion: The results of the present study may help cardiac surgeons, particularly in surgeries related to certain valvular disorders, due to the proximity of the nodal branches to the valve complex.

Fundamento: Estudiar el suministro arterial del sistema conductor y su correlación con la dominancia de las arterias coronarias en población del Sur de la India. Objetivo: Determinar angiográficamente los orígenes de la arteria del nódulo sinusal (AnSA) y la arteria del nódulo atrioventricular (AnAV) en indios. Métodos: El estudio incluyó 300 pacientes consecutivos (114 del sexo femenino y 186 del sexo masculino; edad promedio, 55 años), habitantes de la región costera al Sur de la India, sometidos a cineangiocoronariografía debido a síntomas como dolor en el pecho, angina pectoris o test ergométrico positivo. Las angiografías incluyeron ambas arterias coronarias (derecha e izquierda) en posición oblicua anterior derecha e izquierda. El origen de la AnSA y AnAV a partir de las arterias coronarias se observó y se correlacionó con la dominancia arterial. Resultados: El nódulo SA (sinusal) recibió suministro por la arteria coronaria derecha (ACD) en el 53% de los casos, por la rama circunfleja (Cx) de la arteria coronaria izquierda (ACI) en el 42,66% de los casos, y en el 4,33% de los casos este nódulo fue irrigado por ambas arterias coronarias. El nódulo AV (atrioventricular) también recibió suministro sanguíneo con más frecuencia de la ACD (72,33% de los casos) que la rama Cx de la ACI (27,66%). Sorprendentemente, en ningún caso este nódulo recibió suministro de ambas arterias coronarias.Conclusión: Los resultados del presente estudio pueden auxiliar a los cirujanos cardíacos, sobre todo en cirugías relacionadas a valvulopatías, debido a la franca proximidad entre las ramas nodales y el complejo valvular.

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.

A study of anatomical variability of the omohyoid muscle and its clinical relevance

OBJECTIVE: The omohyoid muscle is a long, thin muscle consisting of superior and inferior bellies and an intermediate tendon, which runs obliquely in the lateral cervical region. The omohyoid is important in neck dissections because it is the surgical landmark for level III and IV lymph node metastases. METHODS: In the present study, the anterior and posterior triangle of the neck was dissected in 35 male cadavers and observed for variations in the omohyoid bilaterally. Observations were focused on variations in number, attachments, and position of omohyoid. RESULTS: Among the 35 cadavers studied, double omohyoid was present in one cadaver, inferior belly originated from the clavicle in three cadavers, superior belly merged with the sternohyoid in two cadavers, and the omohyoid received additional slips from the sternum in one cadaver. Standard attachment and position of the omohyoid was observed in the remaining cadavers. CONCLUSION: Variations of this muscle are important because of its close relation to the large vessels and brachial plexus. Because of the direct adhesion of the intermediate tendon to the anterior wall of the internal jugular vein and its connection with it through a thin lamina of the pretracheal layer of the cervical fascia, the contraction of the omohyoid muscle has a direct effect on the lumen of this vessel.

Anatomical variation of radial wrist extensor muscles: a study in cadavers

OBJECTIVE: The tendons of the extensor carpi radialis longus and brevis muscles are quite useful in tendon transfer, such as in correction of finger clawing and restoration of thumb opposition. Knowledge of additional radial wrist extensor muscle bellies with independent tendons is useful in the above-mentioned surgical procedures. METHODS: The skin, subcutaneous tissue, and antebrachial fascia of 48 (24 on the right side and 24 on left side) male upper limb forearms were dissected. The following aspects were then analyzed: (a) the presence of additional muscle bellies of radial wrist extensors, (b) the origin and insertion of the additional muscle, and (c) measurements of the muscle bellies and their tendons. RESULTS: Five out of 48 upper limbs (10.41 percent) had additional radial wrist extensors; this occurred in 3 out of 24 left upper limbs (12.5 percent) and 2 out of 24 right upper limbs (8.3 percent). In one of the right upper limbs, two additional muscles were found. The length and width of each additional muscle belly and its tendon ranged between 2 - 15cm by 0.35 - 6.4cm and 2.8 - 20.8cm by 0.2 0.5cm, respectively. The additional radial wrist extensor tendons in our study basically originated either from the extensor carpi radialis longus or brevis muscles and were inserted at the base of the 2nd or 3rd metacarpal bone. CONCLUSION: The present study will inform surgeons about the different varieties of additional radial wrist extensors and the frequency of their occurrence.