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Introduction: Entrapment of the neurovascular bundle in the neck may occur in scalene triangle and costoclavicular region; by abnormal muscular architecture. Case report: During routine dissection we found an anatomical variation of muscular boundaries of posterior triangle of the neck. The upper part of trapezius is broader and is attached to medial half of superior nuchal line and is mostly fibrous in origin. Upper part of sternocleidomastoid is also broader and is attached to the lateral half of superior nuchal line. As a result, both trapezius and sternocleidomastoid muscles are in contact forming a single muscle sheet in the upper half of the neck. At their junction the posterior external jugular vein was descending to enter the posterior triangle. The apex of the posterior triangle does not extend above the middle of the neck. Attachments of the two muscles to the clavicle is more extensive and results in the reduction of the size of the posterior triangle. Both the muscles had greater connective tissue components between the muscular fasiculi. Conclusion: The cleido-occipitalis part of the trapezius in our case was larger and it over laps the third part of subclavian artery and lower trunk of brachial plexus. This can entrap the lower trunk of brachial plexus leading to "thoracic outlet syndrome". The upper part of brachial plexus is overlapped by the upper expanded part of sternocleidomastoid, it can compress the plexus, leading to "cervical outlet syndrome". Chronic tension type headache usually arises from the trigger points in the upper half of the trapezius muscle, because of the fusion of trapezius and sternocleidomastoid muscles in their upper half. It may also arise from certain trigger points in the sternocleidomastoid muscle. Such abnormal muscular variation may lead to torticollis of the neck and subluxation of the atlantooccipital joint on that side [ABSTRACT FROM AUTHOR]

Introduction: The aim of this report is to refine further knowledge on the cutaneous distribution pattern of the superficial peroneal nerve in the lower 3rd of the leg and in the dorsum of the foot. Case report: Superficial peroneal nerve after supplying the peroneal muscles, gave a medial cutaneous branch which pierced the deep fascia between the flexor digitorum longus and peroneous longus tendons to emerge in the middle of the anterior compartment of the leg. This branch descended in front of the middle of the ankle to the dorsum of the foot and branched to supply the whole of the medial side of the great toe, the medial side of the 1st metatarsal region and the 1st web space. Superficial peroneal nerve continued in the peroneal tunnel in the anterior intermuscular septum, about 2.5cm, above the ankle joint it pierced the deep fascia to descend in front of the lateral malleous to enter the lateral aspect of the dorsum of the foot. It divided into medial and lateral terminal branches to supply the adjacent sides of the 2nd, 3rd, 4th, 5th toes and lateral side of the little toe. Conclusion: Identifying and locating the Superficial Peroneal nerve in this region is mandatory: a) when either the deep or superficial peroneal nerve must be resected in the treatment of pain on the dorsum of the foot. b) whenever neurolysis is required. c) during fasciotomy, done for compression syndromes of the branches of common peroneal nerve frequently occurring primary or secondary to trauma or surgery. d) during elevation of fasciocutaneous flaps or fibular flaps. Clinical implication of anatomical variations of Superficial peroneal nerve are of utmost importance to surgeons during surgery as they must be aware of such variable branching pattern of the nerve and its distribution in the leg and dorsum of the foot. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge of the vascular patterns of the hand has gained more importance with improvements in microsurgical techniques in reconstructive hand surgery. During routine dissection of the hand of a male cadaver we had observed a novel variation of the Group I type of Superficial Palmar Arch (SPA) in the left hand and a variation of the arterial supply of the right thumb forming a unique arterial circle at its base. Such unique arterial variations on both the hands, to our knowledge have not been reported so far. Case Report: The left ulnar artery after giving off the deep branch continued as the SPA with normal branches but gave arteria radialis indicis and princeps pollicis branches. The arteria princeps pollicis was uniquely tortuous at its beginning and was supplemented by the 1st dorsal metacarpal branch of the radial artery at the wrist. The thinned out terminal part of the SPA supplied the thenar muscles to compensate the absence of the superficial palmar branch from the radial artery. The right SPA had usual branches in the palm, but its terminal part anastomosed with an enlarged superficial palmar branch of the radial artery which also furnished princeps pollicis and radialis indicis branches. The princeps pollicis branch was joined by an unusual supplementary branch from the 1st dorsal metacarpal artery thereby constructing a unique arterial circle at the base of the thumb. Conclusion: Thus the left SPA was completed by the 1st dorsal metacarpal artery at the base of the left thumb forming a novel subtype of Group I Type of SPA and indicating a classic ulnar dominance. Arterial circle at the base of the right thumb is a special source of information for vascular surgeons harvesting radial arteries (which could be regarded as a safe with the presence of collaterals around the thumb) and while performing arterial interventions including radial artery cannulation, for plastic surgeons in forming radial forearm flaps and orthopaedicians in thumb surgery. [ABSTRACT FROM AUTHOR]