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Background: The foramen ovale is an oval opening in the greater wing of sphenoid bone transmitting the mandibular nerve as its major content. It serves as an important landmark for neurosurgeons in certain procedures as to gain access to trigeminal nerve. Therefore, its topographic position in relation to adjacent bony landmarks provides useful tool during these procedures. Aim: To analyse the morphometric measurements of the foramen ovale among South Indian population. Material and Methods: Morphometric analysis was carried out on 104 foramina ovalia of 52 dry human skulls from South India. Following dimensions of foramen ovale were measured: anteroposterior length, transverse width, distance (d1 ) from tubercle of root of zygoma to the centre of the foramen (CF) and distance (d2 ) from the midline of the base of the skull to CF. Results: The mean antero-posterior length was 7.0±2.17mm on right side and 6.8±1.40mm on left side, mean transverse width was 5.0±0.42mm and 4.70±0.91mm on right and left side respectively. Mean d1 was 32.58±1.72mm on right side and 32.75±1.76mm on left side. Mean d2 was 25.83±1.26mm on right side and 25.08±1.31mm on left side. Conclusion: Regional variations in the morphometric measures may be useful in neurosurgical procedures like administration of anaesthesia involving the mandibular nerve.

Background: The foramen ovale is an oval opening in the greater wing of sphenoid bone transmitting the mandibular nerve as its major content. It serves as an important landmark for neurosurgeons in certain procedures as to gain access to trigeminal nerve. Therefore, its topographic position in relation to adjacent bony landmarks provides useful tool during these procedures. Aim: To analyse the morphometric measurements of the foramen ovale among South Indian population. Material and Methods: Morphometric analysis was carried out on 104 foramina ovalia of 52 dry human skulls from South India. Following dimensions of foramen ovale were measured: anteroposterior length, transverse width, distance (d1) from tubercle of root of zygoma to the centre of the foramen (CF) and distance (d2) from the midline of the base of the skull to CF. Results: The mean antero-posterior length was 7.0±2.17mm on right side and 6.8±1.40mm on left side, mean transverse width was 5.0±0.42mm and 4.70±0.91mm on right and left side respectively. Mean d1 was 32.58±1.72mm on right side and 32.75±1.76mm on left side. Mean d2 was 25.83±1.26mm on right side and 25.08±1.31mm on left side. Conclusion: Regional variations in the morphometric measures may be useful in neurosurgical procedures like administration of anaesthesia involving the mandibular nerve. [ABSTRACT FROM AUTHOR]

Testicular arteries arise from the abdominal aorta and the inferior suprarenal artery from the renal artery. There are reports about variant origin and course of these arteries. Accessory testicular artery is also a common finding but its providing origin to inferior suprarenal artery is an important observation. During a routine dissection of abdomen of approximately 55-year-old male cadaver, unique vascular abnormality was observed. On the left side, a common arterial trunk originating from abdominal aorta immediately branched to give rise to superior testicular and inferior suprarenal arteries, the former after a short course hooked by the left suprarenal vein. In addition, the left suprarenal vein, second left lumbar vein, and left testicular vein joined to form a common trunk which drained into the left renal vein. A sound knowledge of vascular variations in relation to the kidney and suprarenal gland is important to surgeons dissecting the abdominal cavity [ABSTRACT FROM AUTHOR]

Division of nerves close to their origin and muscular entrapments by nerves in the limbs is not very common. Femoral nerve is the largest branch of the lumbar plexus and arises from dorsal divisions of ventral rami of L2 to L4 spinal nerves. During routine cadaveric dissection for first year medical students at Melaka Manipal Medical College (Manipal Campus), Karnataka, India, we observed a variation in the division and course of left femoral nerve in about 65-year-old male cadaver. The femoral nerve was split into two divisions above the inguinal ligament after its origin from the lumbar plexus. The lower division of the nerve passed deep to the iliopsoas muscle fibres and the upper division ran superficial to iliacus muscle deep to fascia iliaca. Both the divisions joined just above the inguinal ligament to form the trunk of the femoral nerve. Further course and distribution of the nerve was normal. The reports have shown that compression neuropathies of femoral nerve in the limbs are caused by neoplastic masses, vascular abnormalities and also by different anomalous muscles. Such neuropathies may also result from indirect compression of femoral nerve between the fibres of psoas major muscle and lateral pelvic wall. The potential clinical importance of above mentioned variations in the division of femoral nerve would emphasize the surgeons to diagnose the neuromuscular entrapments and consequent alterations of sensation in the anterior and medial aspects of the thigh. [ABSTRACT FROM AUTHOR]

Dorsal and ventral divisions of ventral rami of lower lumbar and sacral spinal nerve were found to pass ventral and dorsal to the piriformis muscle respectively. These divisions joined each other below the piriformis muscle to form sciatic nerve. This low formation of sciatic nerve was observed in distal part of left gluteal region of a 50-year-old male cadaver. The sciatic nerve thus formed passed caudally into back of thigh and divided into tibial and common peroneal nerves in the upper part of popliteal fossa. In addition, a communicating nerve from the sciatic nerve was found to join the common peroneal nerve in the popliteal fossa. Such variations may lead to piriformis syndrome or non-discogenic sciatica. [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: 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: 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]

Normally, the popliteal fossa contains popliteal vessels, tibial and common peroneal nerves. An occurrence of muscle in the popliteal fossa is very rare. During routine dissection classes for medical undergraduates, an anomalous muscle in the popliteal fossa was encountered. The muscle was originating from the thick fascia around the popliteal vessels. It was getting inserted to the medial head of the gastrocnemius through a narrow tendon and was supplied by a branch of tibial nerve. The muscle was observed in the right limb and was unilateral. An awareness of the possibility that such anomalous muscles can occur in the popliteal fossa is clinically essential as these may possibly entrap and compress the popliteal vessels. The muscle reported in the present case bears clinical significance since near its origin it almost completely surrounded the popliteal vessels and could pull on these vessels on contraction (Fig. 3, Ref. 14).

To evaluate the effect of phenytoin on burn wounds and to compare the effect of the combination of topical phenytoin preparation in dexamethasone treated burn wounds in rats, partial thickness thermal burn wounds were inflicted upon five groups of six rats each. Group I was assigned as control, Group II received the standard silver sulphadiazine, Group III was given topical phenytoin and Group IV received injection dexamethasone, Group V received the combination of the phenytoin and the dexamethasone. The parameters observed were epithelialization period, percentage of wound contraction and histopathological analysis as indicative of the process of healing. Phenytoin group showed significant improvement in burn wound contraction in comparison to standard silver sulphadiazine group, the combination group of topical phenytoin and dexamethasone also showed significant contraction compared to dexamethasone group. The period of epithelialization also decreased significantly in groups II, III and V. In conclusion, phenytoin promotes burn wound healing as evidenced by decrease in period of epithelialization and faster wound contraction.

Ethanolic extract of leaves of O. sanctum was investigated for normal wound healing and dexamethasone depressed healing using incision, excision and dead space wound models in albino rats. The extract of O. sanctum significantly increased the wound breaking strength in incision wound model. The extract treated wounds were found to epithelialize faster and the rate of wound contraction was significantly increased as compared to control wounds. Significant increase in wet and dry granulation tissue weight, granulation tissue breaking strength and hydroxyproline content in dead space wound model was observed. The extract significantly decreased the antihealing activities of dexamethasone in all the wound models. The results indicated that the leaf extract promotes wound healing significantly and able to overcome the wound healing suppressing action of dexamethasone. Histological examination of granulation tissue to determine the pattern of lay-down for collagen confirmed the results.

With a view to investigate the contribution and role of environment within a wooden pyramid model on the wound healing suppressant effect of dexamethasone in rats, wound breaking strength, dry weight, hydroxyproline content and histology of granulation tissue of the dead space wound were studied in rats. The results indicate that the environment within the wooden pyramid not only promotes significant wound healing but also reduces the wound healing suppressant effect of dexamethasone. Histological studies also confirmed the results.