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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.

Abstract Introduction In the thorax there are normally 11 pairs of intercostal spaces: the spaces between adjacent ribs. The intercostal spaces contain intercostal muscles, intercostal nerves and vessels. Case presentation During a routine dissection for undergraduate medical students, we observed a variation involving the left 3rd rib and 3rd costal cartilage in the cadaver of a man of Indian ethnicity aged about 65 years. The left 3rd rib and its costal cartilage were bifurcated at their costochondral junction enclosing a small circular additional intercostal space. Muscle tissue covered by deep fascia was present in this circular intercostal space. The muscle in the circular intercostal space received its nerve supply from a branch of the 2nd intercostal nerve. Conclusions Knowledge of such variations is helpful to surgeons operating on the anterior thoracic wall involving ribs and intercostal spaces. Knowing the possibility of the presence of an additional space between normal intercostal spaces can guide a surgeon through to a successful surgery.

Introduction: Adequate knowledge on variant morphology of brachial plexus and its branches are important in clinical applications pertaining to trauma and surgical procedures of the upper extremity. Aim: Current study was aimed to report variations of the branches of the lateral cord of brachial plexus in the axilla and their possible clinical complications. Materials and Methods: Total number of 82 upper limbs from 41 formalin embalmed cadavers was dissected. Careful observation was made to note the formation and branching pattern of lateral cord. Meticulous inspection for absence of branches, presence of additional or variant branches and presence of abnormal communications between its branches or with branches of other cords was carried out. Results: In the present study, we noted varied branching pattern of lateral cord in 6 out of 82 limbs (7%). In one of the limb, the median nerve was formed by three roots; two from lateral cord and one from medial cord. Two limbs had absence of lateral pectoral nerve supplemented by medial pectoral nerves. One of which had an atypical ansa pectoralis. In 2 upper limbs, musculocutaneous nerve was absent and in both cases it was supplemented by median nerve. In one of the limb, coracobrachialis had dual nerve supply by musculocutaneous nerve and by an additional branch from the lateral cord. Conclusion: Variations of brachial plexus and its branches could pose both intraoperative and postoperative complications which eventually affect the normal sensory and motor functions of the upper limb. [ABSTRACT FROM AUTHOR]

Objective: The idea of humanitarianism is evolving with progressing life. Awareness about this global issue has to be emphasized particularly among the younger generation and thus be encouraged to be exposed and involved in humanitarian projects in need. Being responsible citizens of the country one should develop concern about the humanitarian issues, and this attitude needs to be developed from student life. Methods: A cross sectional survey was conducted on 200 participants of the Malaysian and Indian (100 each) health science students using faculty validated close ended questionnaire. Results of the data were analyzed statistically by testing with chi square analysis from SPSS software. Results: From the present study, it has been observed that, despite the cultural and economical diversity between the two nations, there was no observable difference in student's point of view on humanitarian issues in most of the areas concerned. Overall evaluation also reflected effect of the socio-economic status of the countries on the perception of the issue amongst the students. Conclusion: Despite of different geography, diverse culture and dissimilar socio-economic status, the need of concern towards humanitarian issues is observable. Students of both nations have positive attitude towards the humanitarian issues as well. [ABSTRACT FROM AUTHOR]

Accessory cleido-occipitalis muscle is an additional muscle fascicle derived from occipital portion of trapezius muscle inserted into the clavicle. Since its location is confined to neck region, it is also known as cleido-occipitalis cervicis. In the present case, we report a unique case of accessory cleido-occipitalis muscle derived from trapezius muscle. It was more tendinous than muscular and its tendon was extending medially, crossing the supraclavicular triangle of the neck horizontally in close approximation of clavicle. A narrow gap between them was a passage for the external jugular vein with its possible entrapment. The external jugular vein is a clinically important superficial venous channel required for many therapeutic interventions. The possible entrapment of it could hinder these approaches and also could lead to several complications. [ABSTRACT FROM AUTHOR]

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]

Vascular anomalies of the spleen are usually asymptomatic. However, variant anatomy of splenic artery becomes clinically important, when the patients undergo diagnostic angiography for gastrointestinal bleeding or during transcatheter therapy. We report here a concurrent variant arterial pattern of the spleen. The splenic artery was unusually elongated and excessively tortuous. Prior to its normal termination into segmental arteries, it gave superior and inferior polar arteries which entered the spleen distal to corresponding ends of the splenic hilum. In addition to this, the spleen also received an additional blood supply from an accessory splenic artery arising from left gastro-epiploic artery. The accessory splenic artery entered the substance of the spleen through its lateral end. Presence of such kind of concurrent variant arterial pattern of spleen makes the surgeons obligatory to have prior knowledge to prevent bleeding during any surgical or radiological interventional procedures targeting the spleen, pancreas etc. [ABSTRACT FROM AUTHOR]

The occurrence of the lesser occipital nerve (LON) at an anomalous location in the "carefree part" within the posterior triangle has been seldom reported in the literature. We are reporting a rare case of location of the LON in the "carefree part" of the posterior triangle, in a 55- year-old formalin embalmed male cadaver. LON, after emerging from the posterior margin of the sternomastoid muscle (SM), ran obliquely towards the trapezius muscle. Here, it hooked around the unusual separated muscle fasciculus of the trapezius, 7.5 cm below the superior nuchal line. Further, LON gave contributions to spinal accessory nerve (SAN); one deep into the SM and another one in the posterior triangle. The knowledge on the unusual location and course of the LON and its contribution to the SAN is significantly important while an anaesthetic blockade is being performed for the management of a cervicogenic headache and a super selective radical neck dissection. [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]

During regular dissections, we observed an unusual organization of the inferior root of Ansa Cervicalis (AC). The superior root of ansa arose normally from the hypoglossal nerve. The ventral ramus of the C2 spinal nerve divided into two branches. One of its branches joined the superior root independently to form a loop at a higher level. Another branch ran along the vagus nerve, joined with the ventral ramus of C3 spinal nerve, finally connected with the superior root and formed the second loop at a lower level. No variation was found in formation of superior root. Knowledge on the possible deviations in the formation of these roots is clinically important, to prevent iatrogenic injuries in surgical procedures such as thyroplasties, arytenoids adductions, and Teflon injections. [ABSTRACT FROM AUTHOR]

Background: We report in here a very unusual appearance of a duplicated popliteal vein found in a male cadaver. Popliteal vein is usually a single vein present deep in the popliteal fossa which is formed by the union of venae comitantes of the anterior and posterior tibial arteries. Methods: Anatomical variation in the lower extremity was identified during routine dissection of human cadaver. Result: We noted the presence of unilateral doublepopliteal veins which were formed at the lower end of popliteal fossa. Both the veins were found closely related to the popliteal artery and both of them received tributaries. In the adductor canal both the popliteal veins joined to form the femoral vein. Conclusion: It has been believed that such venous variations in lower limbs have important implications for diagnostic ultrasonography imaging in cases which are suspected with deep vein thrombosis. Thus this case reported in here is very helpful for surgeons for proper diagnosis and management of deep vein thrombosis and also to radiologists to aid in the interpretation of venograms. [ABSTRACT FROM AUTHOR]

Introduction: Tendocalcaneus or Achilles tendon is formed by the fusion of the tendons of gastrocnemius and soleus muscles. Normal morphometric measurements of tendo-calcaneus serves an important landmark in its anthropometric evaluation and biomechanical characteristics. Hence the objective of this study was to provide detailed morphometric profile of tendocalcaneus in south indian cadaveric male population. Materials and method: A total of 64 dissected adult limbs was studied. Out of the 64 limbs: 37 belonged to right side while 27 were of the left side. These limbs were dissected to expose the extent of tendocalcaneus. Total length, proximal width and proximal circumference of the tendon, distal width and distal circumference of the tendon was measured. Results were tabulated and correlated using SPSS. Results: Tendon length, width and circumference showed no statistically significant differences between the right and left side. However significant correlation was observed between proximal width and distal widths, proximal circumference and distal circumference, proximal width and proximal circumference and distal width and distal circumference of the tendon. Conclusion: This cadaveric morphometric study of tendo-calcaneus would be very helpful to sports medicine physicians for diagnosis and treatment of tendo Achilles overuse injuries and tendinopathy. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

The lumbar part of the diaphragm arises from the lumbar vertebrae by right and left crura. The duplication of crura of the diaphragm is rarely reported in the past. During regular dissection classes to the medical students, we came across a case of duplicated right crus of the diaphragm. The right crus of the diaphragm was duplicated completely and presented two separate crura; medial right crus & lateral right crus. The medial right crus was attached to the anterolateral surfaces of the superior three lumbar vertebral bodies and intervertebral discs and merged with the anterior longitudinal ligament. The lateral right crus attached only to the intervertebral disc between the third and fourth lumbar vertebrae. These two crura bordered a retrocrural space in the inferior posterior mediastinum. The greater and lesser splanchnic nerves entered the abdomen by passing through this space. No duplication was observed in the left crus. The muscle fibres of medial right crus contributed to the formation of the esophageal opening. Knowledge of variations in the diaphragmatic crural anatomy is useful in the diagnosis of disease processes in the retrocrural space and also might help while performing the surgical repair of gastroesophageal reflux disease. [ABSTRACT FROM AUTHOR]