Clinically important left superior polar artery giving rise to a left inferior suprarenal artery and an aberrant left inferior polar artery: a case report / Artéria polar superior esquerda de importância clínica dando origem à artéria suprarrenal inferior esquerda e artéria polar inferior esquerda aberrante: relato de caso

Abstract The renal arteries arise from the lateral side of the abdominal aorta at the L2 vertebral level, just below the origin of the superior mesenteric artery. Multiple aberrant renal arteries can pose difficulties in renal transplantation, interventional radiological and urological procedures, renal artery embolization, angioplasty, or vascular reconstruction for congenital and acquired lesions. We present a case of a left kidney supplied by the left renal artery along with superior and inferior polar arteries, arising from the aorta and inferior mesenteric artery respectively. The inferior mesenteric artery was crossed by the left ureter and inferior mesenteric vein. The superior polar artery gave rise to an inferior suprarenal artery making the variation important for clinicians and surgeons.

Resumo As artérias renais originam-se do lado lateral da aorta abdominal, no nível da vértebra L2, logo abaixo da origem da artéria mesentérica superior. A presença de múltiplas artérias renais aberrantes pode representar dificuldades para transplante renal, procedimentos radiológicos e urológicos intervencionistas, embolização da artéria renal, angioplastia e reconstrução vascular para lesões congênitas e adquiridas. Apresentamos um caso de rim esquerdo vascularizado pela artéria renal esquerda e pelas artérias polares superior e inferior, as quais se originavam da aorta e da artéria mesentérica inferior, respectivamente. A artéria mesentérica inferior era cruzada pelo ureter esquerdo e pela veia mesentérica inferior. A artéria polar superior dava origem à artéria suprarrenal inferior, o que torna essa variação importante para clínicos e cirurgiões.

An Unusual Termination of Facial Vein and Anterior Division of Retromandibular Vein into External Jugular Vein: A Case Report

Facial vein, being the largest vein of the face forms the common facial vein after joining with the anterior division of retromandibular vein below the angle of the mandible. Usually, it drains into the internal jugular vein. During routine dissection of head and neck region of a male cadaver, aged approximately 50 years, an unusual pattern in the termination of veins on the left side of the neck was observed. The formation, course and termination of external jugular vein were normal. The anterior division of retromandibular vein joined with external jugular vein about 5 cm above the clavicle and the facial vein opened into the external jugular vein about 2.5 cm above the clavicle. In addition, there was a thin venous communication between anterior division of retromandibular vein and external jugular vein. The superficial veins of the neck are often used for cannulation; either for intravenous infusion or for central venous pressure monitoring. Furthermore, these venous segments are used as a patch for carotid endarterectomies. Hence, a thorough knowledge of the normal anatomy and their variations may be useful for performing these procedures.

Anthropometric analysis of palpebral fissure dimensions and its position in south Indian ethnic adults

The morphology and anatomical relationship of periorbital features vary according to age, sex and ethnicity Standard database regarding periorbital region is available for other ethnic groups. Since there is no data available in the literature, specifically for south Indian ethnic adults, the present study was carried out to determine the normal average values for South Indian ethnic population related to gender, Anthropometric measurements of both eyes were done on standardized frontal view photograph of 200 South Indian ethnic adults aged 18 to 26 years Parameters included were palpebral fissure width [PFW], palpebral fissure height [PFH], palpebral fissure inclination [PFI], outercanthal distance [OCD], interpupillary distance [IPD], intercanthal distance [ICD] and comparisons were made between the genders using the independent t test, Significant sexual dimorphism was noted in the given parameters, Palpebral fissure width [male: 31.08 mm; female: 29.90 mm], palpebral fissure inclination [male: 5.053°; female: 6.102°], outercanthal distance [male: 95.55 mm; female: 92.44 mm] and interpupillary distance [male: 66.72 mm; female: 62.59 mm]. The palpebral fissure height [male: 11, 30 mm; female: 11.58 mm] and intercanthal distance [male: 34.27 mm; female: 33.41 mm] showed no significant sexual differences, Statistically significant differences were found between South Indian ethnic males and female in certain key parameters, The present study suggests that ethnicity and gender should be considered in orbital surgery. To individualize the treatment planning and diagnosis, it is important for the surgeons to have knowledge of these local norms

Variant course of posterior circumflex humeral artery associated with the abnormal origin of radial collateral artery: could it mimic the quadrangular space syndrome?

Variations in the origin of axillary artery branches are common. But, distinctly abnormal course of its posterior circumflex humeral branch is rare. We are reporting a case of posterior circumflex humeral artery [PCHA] originating from the axillary artery, passing through lower triangular space to reach the scapular region where it accompanied the axillary nerve and posterior circumflex humeral vein to pass around surgical neck of humerus, deep to the fibers of deltoid. Other variations observed in this specimen were the radial collateral artery arising from the PCHA, middle collateral artery arising directly from the brachial artery and absence of profunda brachii artery. PCHA forming a hair pin loop, traversing through lower triangular space instead of quadrangular space taking a long course is being reported for the first time. Further, the clinical and surgical importance of this case especially in relation with quadrangular space syndrome and relevant literature is discussed.

High Origin of Ulnar Artery with Unusual Superficial Course and Abnormal Additional Branches from the Superficial Palmar Arch

Though ulnar arterial variations are rare, superficial ulnar artery (SUA) is one of its commonest variations. During routine dissection in our department, we observed a unilateral case of SUA in a 70-year-old male human cadaver. It originated from the left brachial artery in the middle of the arm, 13cm above the medial epicondyle of humerus (15cm below the outer margin of first rib). From its origin, it passed downwards in the medial part of arm and forearm in a superficial plane compared to normal ulnar artery. In the hand, the SUA anastomosed with the superficial palmar branch of the radial artery, creating the superficial palmar arch. The superficial palmar arch gave additional branches to the thumb and index finger. Brachial artery divided into the radial and common interosseous arteries in the cubital fossa. The normal ulnar artery was absent. The existence of a SUA is undeniably of interest to the clinicians as well as to the anatomists. We hereby present a case of unilateral SUA along with a brief review of the literature and analysis of its clinical significance.

Variant structures potent to compress the median nerve in the arm

The most commonly known nerve compression syndrome is carpal tunnel syndrome, in which the median nerve is compressed at the wrist. Along with the pathological processes, some of the anatomically variant structures can also compress the nerves and often leads to confusion in the diagnosis and treatment if one is unaware of such possible anatomical variants. Here, we present a case of possible median nerve compression by an additional belly of coracobrachialis and a fascial sheet from the brachialis, and we also discuss the other possible structures that can compress the median nerve