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The ability to navigate the complex and often deceptive branching patterns of the internal iliac artery can be decisive in planning and performing surgeries within the lesser pelvis. The following case report presents a peculiar quadruple division of the internal iliac artery, accompanied by a venous anastomotic structure. Apart from the posterior and anterior trunks, the superior vesicle and iliolumbar arteries arose independently from the internal iliac artery. The division was surrounded by a venous oval, compressing certain branches and potentially complicating surgical access. Due to the uncommon course of the internal iliac artery and the presence of the anastomosis, a possible nerve root compression has been identified. Both clinical significance and classification method of the case are discussed. Knowledge of this anatomical variation is valuable for both diagnosis and surgery, especially within the specialties of urology, gynaecology and general surgery. [ABSTRACT FROM AUTHOR]

Background: We present a case report of double-headed extensor hallucis longus (EHL) with potential clinical significance. Materials and methods: Cadaveric dissection of the right lower limb of a 70-year- -old at death female was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The limb was dissected using standard techniques according to a strictly specified protocol. Each head and tendon of the muscle was photographed and subjected to further measurements. Results: During dissection, an unusual type of EHL muscle was observed. It consisted of two muscle bellies, a main tendon and an accessory tendon. Both muscle bellies were located on anterior surface of the fibula and the interosseous membrane. The main tendon insertion was located on the dorsal aspect of the base of the distal phalanx of the big toe, while the accessory tendon insertion was located medially. Conclusions: The EHL muscle is highly morphologically variable at both the point of origin and the insertion. Knowledge of its variations is connected to several pathologies such as foot drop, tendonitis, tendon rupture, and anterior compartment syndrome. [ABSTRACT FROM AUTHOR]

The biceps brachii is located in the anterior compartment of the arm, which can show numerous morphological variations. During anatomical dissection, an interesting additional muscle was found: the third head of the biceps brachii originated from the short head of the same muscle. The 97.77 mm long muscle belly was directed medially over the arm and then passed into the common tendon (15.97 mm), which thereafter split into aponeurosis and tendon. The 26.33 mm aponeurosis passed and joined the fascia of the forearm. The tendon of the third head of the biceps brachii then gave rise to the ulnar head of the pronator teres muscle. Such an accessory structure could cause neurovascular compression involving the brachial artery and median nerve. Knowledge of the morphological variability of this region is essential not only for anatomists but also for clinicians. [ABSTRACT FROM AUTHOR]

Although uncommon, variant muscular variations can occur related to the quadriceps femoris. Such variations might be encountered in the clinical setting so these should be documented. Here, we report three additional heads related to the rectus femoris muscle identified during routine dissection of the right thigh. To our knowledge, such a variation has not been previously reported. [ABSTRACT FROM AUTHOR]

Background: The inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The aim of this study was to characterise the course and morphology of the terminal branches of the IMA, and also creating a new IMA classification, which seems to be necessary for clinicians performing surgery in this area.Materials and Methods: The anatomical variations in the branching patterns of the IMA were examined in 40 cadavers fixed in a 10% formalin solution. Morphometric measurements were then obtained twice by two researchers.Results: Due to the proposed classification system, type I characterised by a common trunk preceding bifurcation into sigmoidal branches and the superior rectal artery after giving left colic artery (LCA) occurred in 57.5% of cases, type II, trifurcation type, in 25%, type III with the superior rectal arteries originating firstly from the IMA in 5%, type IV with the ascending lumbar artery in 10% of cases and type V, a novelty, in 2.5%. The origin of IMA was observed at the level of L2/L3 in 22.5% of cases, at L3 in 25% of cases, at L3/L4 in 15% of cases, at L4 in 35% of cases and at the level of L5 in 2.5% of cases. More than one third (38.1%) of total cases with additional arteries and rapidly bifurcating branches occurred in types III, IV, and V. In women, only the IMA and LCA were significantly narrower than in men. Only the diameter of the IMA correlated with the diameter of the superior rectal artery.Conclusions: The IMA is characterised by high morphological variability. The introduction of a new, structured, anatomical classification seems necessary for all clinicians. [ABSTRACT FROM AUTHOR]

The plantaris muscle usually begins with a short, narrow belly in the popliteal fossa at the lateral supracondylar line of the femur and the knee joint capsule. Then it forms a long and slender tendon and usually inserts into the calcaneal tuberosity on the medial side of Achilles tendon. Nevertheless, many anatomical variations of distal attachment have been described. Cases of atypical proximal origin are reported less frequently. In this paper, we have presented a case of a two headed plantaris muscle. First head attached to the condyle of the femoral bone, medially and inferiorly to the lateral head of the gastrocnemius muscle. The second one originated from the popliteal surface of the femur, just above the intercondylar fossa. According to present literature, no such case with atypical proximal origin was presented. Such information has potentially clinical significance during the surgical procedures performed in the area of the popliteal fossa. [ABSTRACT FROM AUTHOR]

The coracobrachialis longus muscle (CBL) is an extremely rare variant of the coracobrachialis muscle (CRM). The CBL originates from the apex of the coracoid process together with the short head of the biceps brachii and inserts on the olecranon of the ulna. The CBL consists of three parts: a superior part (classical CRM - length 137.88 mm), a middle fibrous layer (23.41 mm), and an inferior part (185.37 mm). A rare relationship between the CBL and median, musculocutaneous and ulnar nerves was observed with potential compression at these three parts. In addition, this case report describes a connection between CBL and the medial head of the triceps brachii, as well as a third head of the biceps brachii, which originate from the fibrous layer. This case report highlights the relationships between the CBL and the median, ulnar and musculocutaneous nerves. [ABSTRACT FROM AUTHOR]

Background: The abductor pollicis longus (APL) originates from the lateral part of the dorsal surface of the body of the ulna below the insertion of the anconeus muscle, from the interosseous membrane, and from the middle third of the dorsal surface of the body of the radius. However, the number of its accessory bands and their insertion vary considerably.Materials and Methods: Fifty upper limbs (2 paired, 31 male, 19 female) were obtained from adult Caucasian cadavers, and fixed in 10% formalin solution before examination.Results: The APL muscle was present in all specimens. The muscles were divided into three main categories, with type II and III being dived into subtypes. Type I was characterised by a single distal attachment, with the tendon inserting to the base of the I metacarpal bone. Type II was characterised by a bifurcated distal attachment, with the main tendon inserting to the base of the first metacarpal bone; this type was divided into three subtypes (a-c). Type III was characterised by the main tendons inserting to the base of the first metacarpal bone, while the accessory band was characterised by mergers (fusion) with other tendons. This type was divided into two subtypes (a, b).Conclusions: The abductor pollicis longus is characterised by high morphological variability. [ABSTRACT FROM AUTHOR]

Background: The coeliac trunk (CT) is major visceral branch of the abdominal aorta. Familiarity with anatomic variations of the CT is relevant for planning radiological and surgical procedures. The aim of our research was determining variations of the CT, including the occurrence of accessory hepatic arteries (AHA).Materials and Methods: Forty cadavers were studied. Six patterns of CT branching were observed in this study. AHA were observed in 7 (17.5%) specimens. The most prevalent variation was normal trifurcation, accounting for 62.5% of cases. The rarest variation was absence of the CT, with an incidence of 2.5%. In this variant the left gastric artery, the common hepatic artery, and the splenic artery branched directly off the abdominal aorta.Results: The study material allowed to distinguish two CT branching patterns which, to the best of our knowledge, have not been reported before. It was a type with four branches originating from the CT: the left gastric artery, the common hepatic artery, the splenic artery, and right AHA. The other previously unreported pattern variant was the CT which gave off three branches: the common hepatic artery, the splenic artery and right AHA.Conclusions: The average distance between the aortic hiatus and the coeliac trunk calculated for all the cadavers amounted to 54 ± 11.85 mm. The average distance between the CT and the superior mesenteric artery was 11.1 ± 7.7 mm. [ABSTRACT FROM AUTHOR]

The ligamentum mucosum is a ligamentous structure within the synovial layer of the knee joint capsule. It usually arises from the infrapatellar fat pad and is inserted into the intercondylar notch of the femur. In recent years, more attention has been paid to this structure because of its clinical significance. Despite the growing attention, the complex morphology of the ligamentum mucosum has led to many misunderstandings among the scientists and clinicians. Therefore, the main objective of this study was to characterize the morphology of the ligamentum mucosum and its attachment points, classify it, and evaluate its prevalence. Classical anatomical dissection was performed on 70 lower limbs of human fetuses fixed in 10% formalin solution. Morphology was carefully assessed, and morphometric measurements were performed. The types revealed were classified. The ligamentum mucosum was present in 100% of all 70 specimens examined. Two types were detected. Type I (65.71%) - "cord-like". This type was the most common and is characterized by a single longitudinal ligament. The proximal attachment of the ligamentum mucosum was located in the middle of the infrapatellar fat, and the distal attachment was at the tip of the intercondylar notch. Type II (34.29%) - "vertical septum". This type is less common, but its morphology is much more complex compared to type I. It is wider and thicker than type I. Proximally, it is attached to the infrapatellar fat pad and distally through the entire intercondylar notch down to the anterior surface of the anterior cruciate ligament. It divides the joint cavity into medial and lateral sides. The ligamentum mucosum exhibits high morphologic variability, and the view that it is a vestigial remnant of the embryologic development of the knee should be reconsidered. We have proposed an anatomical classification of its types in human fetuses, which is a valuable addition to existing knowledge and will hopefully change the approach of clinicians and scientists. [ABSTRACT FROM AUTHOR]

The purpose of this study was to characterize the morphology of the fibularis tertius (FT) in human fetuses, and to provide a classification based on its modes of origin in human fetuses. The material comprised 100extremities from 50 spontaneously aborted human fetuses (19 male, 31 female, 100 lowerlimbs in total), aged 18–38 weeks of gestation. These were dissected and the presence or absence of the FT muscle as well as the type of its proximal attachment were determined, and the FT was measured morphometrically. The FT was present in 50% of fetuses. Four types of FT muscle origin were identified. The most common was Type 2, characterized by an origin on the middle third of the fibula and the intermuscular septum. Three other types were observed: Type 1 with an origin located on proximal third of the fibula and to the intermuscular septum, Type 3 characterized by an absent muscle belly, and an independent tendon originating from the that of the extensor digitorum longus, and Type 4 with an origin located on the distal third of the fibula and the intermuscular septum. The fibularis tertius demonstrates high morphological variability, with the most common origin located on third of the fibula and to the intermuscular septum. [ABSTRACT FROM AUTHOR]

The plantaris muscle (PM) is typically characterized by a short, slim and spindle-shaped muscle belly and long, thin tendon. It is situated posterior to the popliteal muscle, and anterior to the lateral head of the gastrocnemius muscle (GM). Little information exists regarding the high variability of origin of the PM. The main aim of the study was hence to characterize the morphology of the PM and its place of origin, classify it and evaluate its prevalence. Classical anatomical dissection was performed on 142 lower limbs (77 left, and 65 right) fixed in 10% formalin solution. The morphology of the origin of the PM and its prevalence was evaluated. The PM was present in 128 lower limbs (90.1%). Six types of origin were observed, the most common being Type I (48.4%). This type was divided into two subtypes (A–B): subtype A attaching to the lateral head of the GM, lateral femoral condyle and to the capsule of the knee joint, and subtype B, attaching to the lateral head of the GM, the lateral femoral condyle, knee joint capsule and the popliteal surface of the femur. The second most common type was Type II (25%), attaching to the capsule of the knee joint and, indirectly, to the lateral head of the GM through the lateral femoral condyle. The third most common type was Type III (10.15%), attaching to the lateral femoral condyle and the knee joint capsule. Type IV (6.25%), the rarest type, attached to the lateral femoral condyle, knee joint capsule and to the iliotibial band. Type V (8.6%) originated only from the lateral condyle of the femur. Type VI (1.6%) contains only "rare cases". The PM presents high morphological variability, and its status as a residual muscle should be reconsidered. Our presented classification of its types of origin is a valuable addition for both clinicians and anatomists. Level of Evidence – II Basic Science Research [ABSTRACT FROM AUTHOR]