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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. more...

Tensor fasciae suralis, also known as ischioaponeuroticus is a clinically relevant muscle variant located in the popliteal fossa. Though rare, when present the muscle may arise from any of the hamstrings and gets inserted to the crural fascia of leg or tendocalcaneus and is innervated by the tibial component of sciatic nerve. Here we report a variant of tensor fasciae suralis originated from the lowermost part of linea aspera along with the fibers of short head of biceps femoris in the left lower limb of a male cadaver aged approximately 58 years. The muscle was 16 cm in length and 1 cm breadth in its widest part. It was found inserted to the crural fascia over the lateral head of gastrocnemius and was found innervated by common peroneal nerve. To the best of our knowledge, the tensor fascia suralis muscle originated from linea aspera along with short head of biceps femoris and innervated by common peroneal nerve has not been reported in either cadaveric or imaging studies. more...

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. more...

It is uncommon to have additional muscles in the upper limb. Some of them may restrict the movements or compress the nerves and vessels, while others may go unnoticed. During the routine dissection for undergraduate medical students, we observed an additional muscle in the anterior compartment of the forearm in about 60-year-old male cadaver. The muscle had a prominent belly and a long tendon. Distally, it was attached to the flexor retinaculum by a short and thick tendon. Proximally, long tendon of the muscle passed between the flexor carpi ulnaris and palmaris longus and was attached to the common aponeurosis shared by the extensor carpi ulnaris and flexor digitorum profundus muscles. The additional muscle belly was supplied by a branch from the anterior interosseous nerve. The ulnar nerve and artery was passing deep to the fleshy belly of the muscle. The muscle reported here might compress the ulnar nerve and artery and may produce neurovascular symptoms. On the other hand, the tendon and fleshy belly of the muscle could be useful in muscle/tendon grafts. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for surgeons during the forearm and hand surgeries. more...

Awareness of anatomical variations in lungs is essential during segmental or lobar resections of lungs. We studied the variations of fissures, lobes and hilar structures in 65 right and 73 left isolated lungs from the dissection hall. Horizontal fissure was absent in 3.07% and incomplete in 35.38% of right lungs. Four point six one percentage of right lungs had 3 fissures and 4 lobes. Three point zero seven percentage of right lungs had 3 arteries, 67.69% had 2 arteries, and 29.23% had only one artery in the hilum. Sixty-three point zero seven percentage of right lungs had two veins in the hilum; 32.30% had 3 veins in the hilum; and 4.61% had more than 3 veins in the hilum. Ninety-eight point four six percentage of right lungs showed 2 bronchi in the hilum, and 1.53% of them showed 3 bronchi in the hilum. Two of the right lungs (3.07%) had an artery passing across the oblique fissure. Fifteen point zero six percentage of left lungs showed incomplete oblique fissure and 2.73% showed 2 fissures and 3 lobes. Five point four seven percentage of left lungs showed 2 arteries and 94.52% had only one artery in the hilum. Eighty point eight two percentage of left lungs had two veins in the hilum and 19.17% had 3 veins in the hilum. Twenty-one point nine one percent of left lungs had 2 bronchi and 78.08% had only one bronchus in the hilum. The knowledge of variations in the lobar and hilar anatomy of the lung presented in this study is clinically important while interpreting the radiological images and performing surgical procedures. more...

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: antero-posterior length, transverse width, distance (d(1)) from tubercle of root of zygoma to the centre of the foramen (CF) and distance (d(2)) 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 d(1) was 32.58±1.72mm on right side and 32.75±1.76mm on left side. Mean d(2) 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. more...