Search

Introduction: A right-sided aortic arch is a rare congenital cardiovascular anomaly that arises from persistence of the right fourth aortic arch and regression of the left fourth aortic arch. This variation commonly gives rise to an aberrant left subclavian artery (ALSA). In this report, we present an unusual variation of a right-sided aortic arch with an isolated common subclavian trunk (CST). Methods: During a routine dissection of a female cadaver, a right-sided aortic arch variation with an aberrant left subclavian artery was observed. The thorax was further dissected to reveal the right-sided aortic arch and anomalous origin of the ALSA from a CST. Results: The ascending aorta arose from the heart to form a right-sided aortic arch which branched into 1) a CST, 2) a left common carotid artery, and 3) a right common carotid artery. The CST branched into a right subclavian artery and an ALSA which traversed posteriorly to the esophagus to its normal anatomical position. The descending thoracic aorta passed along the right lateral aspect of the vertebral column, traversed posteriorly to the esophagus, and continued descending in its anatomical position through the aortic hiatus. Conclusion: Rare aortic arch congenital anomalies such as a common subclavian trunk predispose the body to numerous clinical complications. A common subclavian trunk can cause cardiovascular complications and gastrointestinal complications due to compression of the esophagus. A deep understanding of the variations in the aortic arch and its branches is necessary for all physicians when managing patients with cardiovascular and upper gastrointestinal symptoms.

Background: Variations in the roots of the brachial plexus and their branches may cause unexpected complications during surgical procedures of the neck. In this report, we show an extremely rare variation of the long thoracic nerve. Methods: During routine dissection of the posterior triangle of the neck in a white female cadaver, a variation in a branch of the brachial plexus was observed and documented. Further dissection of the axilla and anterolateral thoracic wall were performed to follow the course of the anomalous superficial nerve. Results: The abnormal nerve was discovered to be a variation of the long thoracic nerve (LTN) formed from a supraclavicular union of only the C6 and C7 spinal nerve roots. Conclusions: Variations in the anatomy of the brachial plexus are not uncommon, but variations of the LTN are rare. Awareness of the LTN in relation to the brachial plexus is useful for the head and neck surgeon operating in less often encountered spaces to prevent injury.

Purpose: To report and describe multiple rare variations of the gluteal vasculature that were discovered during dissection. Methods: During a routine dissection of a cadaver in the gluteal region, the gluteus maximus muscle was reflected bilaterally and variations in the gluteal vasculature were discovered. In the pelvic cavity, the branches of the internal iliac arteries were exposed to reveal variations in the origins of these arteries. Results: On the left side of the gluteal region, the superficial branch of the superior gluteal artery was large and descended inferiorly across the piriformis muscle. The inferior gluteal artery was unusually small and with few branches. The internal pudendal artery gave off several branches with one of these branches contributing to the cruciate anastomosis. On the right side, an enlarged superficial branch of the superior gluteal artery descended over the piriformis muscle into the inferior half of the gluteal region and the inferior gluteal artery was completely absent. Conclusions: Gluteal flaps used in the reconstruction of trunk wounds and pressure sores utilize the knowledge that both the superior and inferior gluteal arteries supply the local musculature of this region. In cases where a gluteal artery may be absent, like in the current study, lifting a flap based on one artery may lead to necrosis of adjacent musculature due to the loss of its blood supply. Knowledge of these types of anomalies may prompt surgeons to proceed with more caution during surgical interventions in the gluteal region.