RESUMO
The sciatic nerve has a long course right from the pelvis to the apex of the popliteal fossa. The point of division of the sciatic nerve into tibial and common peroneal nerves is very variable. The variation in the division of the sciatic nerve described in the present study should be helpful for anaesthetists and orthopaedic surgeons. While doing the dissection and teaching of the gluteal region in the Post Graduate Department of Anatomy, government medical college, Jammu, it was found that on the left side tibial nerve and common peroneal nerve were present instead of sciatic nerve. It meant that the main nerve that is the sciatic nerve had already been divided into its terminal branches in the pelvis region. Both tibial and common peroneal nerve were seen coming out of the pelvis below the piriformis muscle, while on the right side there were no variation. The sciatic nerve was seen coming out of the pelvis below the piriformis muscle as usual. Because of this high division of the sciatic nerve in the pelvis, there are many complications like failed sciatic nerve block during anaesthesia while performing surgery, but high division of the sciatic nerve may result in escape of either tibial nerve or common peroneal nerve. The gluteal region, back of the thigh and leg of the lower limb were dissected to study further course of tibial nerve and the common peroneal nerve. Photographs were also taken.
RESUMO
Background: Ligamentum teres is the ligament of the hip joint. It is flat and triangular in shape. The ligamentum teres starts developing in the fetal life during 10-11 weeks. The present work was undertaken chiefly to gain insight into the pattern of sequential development of ligamentum teres and to compare the findings of other authors with the observations made in the present study and to correlate these findings clinically to find out the function of ligamentum teres.Methods: The present study was undertaken on 40 fetuses of varying gestational periods collected from the operation theatre, labour room and obstetrics wards of department of Gynaecology and Obstetrics, Government Medical College, Jammu and other areas of Jammu, 10% Formalin was used as preservative. The hip joints of both the sides were dissected carefully. 5% solution of Gooding and Stewart’s was used for decalcification. Paraffin wax embedding method was used for preparing the tissue for section cutting. Staining was done by Harri’s Hematoxylin and Eosin stain and Masson’s Trichrome stain. The slides were then examined under microscope for important findings.Results: The ligamentum teres is seen by 10½ weeks. Blood vessels appear in 12½ weeks. Ramification of blood vessels in this ligament is seen by 21½ weeks. Through this ligament, the blood vessels are seen limited up to the fovea capitis femoris by about 16½ weeks and by 18½ weeks they penetrate deep into the head of femur. Ligamentum teres is lined by thin synovial membrane at 19th week.Conclusions: The ligamentum teres develops by 10½ weeks. It arises in-situ as it develops in the same position as it occupies in the adult but as age advances, it shows much differentiation and resembles the adult features.