Background: The sternocleidomastoideus muscle is the most prominent landmarks of the surface anatomy of the neck, separates the anterior part of the neck (anterior triangle) from the posterior part of the neck (posterior triangle). An accessory head of sternocleidomastoideus muscle may cause complications while trying to access vital neurovascular structures that are located in the minor and major supraclavicular fossa. The purpose of this study is to describe an anatomical variation of the sternocleidomastoideus muscle and clinical impact. Methods and Findings: The anatomical variations described were found during routine dissection conducted in the laboratory of Morphology of the University of Pamplona in two male cadavers of 47 and 75 years respectively. Measurements were taken using a Vernier caliper. Topographic details of the variations were examined, recorded and photographed. The morphological variations in the number of heads (three and four) of origin of sternocleidomastoideus muscle was found in two male subjects in right and left neck, bilaterally. The posterior cervical triangle was diminished. The bilateral narrowing of the minor and major supraclavicular fossa minimizing space needed for potential surgical access. The branching patterns of the spinal accessory nerve and arterial patterns were normal. Conclusions: The Knowledge of the presence of additional heads of sternocleidomastoideus muscle it might cause difficulties in subclavian or external jugular vein catheterization, and in surgical interventions involving structures lying under the sternocleidomastoideus muscle. These variations must be kept in mind while approaching the region to avoid complications as the classical anatomical landmarks might be misinterpreted and confuse.
Background: Brachial plexus variations are not rare. Variations in its terminal branches in the arm or forearm are frequently reported. Communications between branches of the brachial plexus are also not uncommon findings; however there is very little mention of communication between the radial and ulnar nerves in the literature. In view of this significance is performed this study with the purpose to determine any communications of radial nerve with neighboring peripheral nerves at level of axilla, arm, forearm. Methods and Findings: A total of 17 cadavers with different age groups were used for this study. The upper limbs region (34 sides) were dissected carefully and photographed in the Morphology Laboratory at the University of Pamplona. Of the 34 upper limbs studied 33 showed normal morphology, the course and branching patterns of the nerves was normal (97.06%). In 1 specimen in the left forearm (2.94%), the radial and ulnar nerves were dissected and communicating branches were observed originating near the upper third in the posterior aspect of the forearm traveling from the ulnar to the radial nerve. The communicating branch was approximately 5.84 cm long and 1.73 mm in diameter. This anastomotic branch is an unusual anastomosis, no described in the literature between radial and ulnar nerve in forearm. Knowledge on the variant pattern of peripheral nerves is imperative not only for the surgeons, but also for the radiologists during image technology and MRI interpretations and for the anesthesiologists before administering anesthetic agents thus in diagnostic approaches. Conclusions: Lack of understanding of these variations can also confound the assessment of the severity of nerve injury as well as recovery. Awareness of such anatomical variations is very important in order to proper diagnosis of sensorimotor symptoms.
Background: The veins of the head and neck have a complex developmental pattern which predisposes them to variations in formation and drainage. Superficial veins of the head and neck are utilized for central venous cannulation, oral reconstruction and parenteral nutrition in debilitated patients. Clinical and sonological examinations of these veins may provide clues toward underlying cardiac pathology. Aims:The aim of the present study was to describe anatomical variation and determined the position of the facial vein in relation to neighboring structures. Methods and Findings:Head and neck region were carefully dissected as per standard dissection procedure, studied serially during the years 2013-2017 in 16 males and 2 females, i.e. 36 sides, embalmed adults cadavers with different age group, in the laboratory of Morphology of the University of Pamplona. In 34 sides (94.5%) of the cases the facial vein (FV) terminated into the internal jugular vein via the common facial vein (CFV) as per standard anatomic description. The facial vein on two sides (5.5%) was found to drain into the external jugular vein with different degree of angulations and variable distance from the angle of the mandible. On the right side, the facial vein was draining into external jugular vein (EJV), 63.6 mm below the angle of the mandible. On the left side, the facial vein was draining into EJV, 42.4 mm below the angle of the mandible. The length of the neck was 137.8 mm. The mean distance of the superior and inferior labial veins, deep facial vein, and angular vein from the inferior orbital margin was 41.89±3.01, 52.31±3.72, 26.85±3.55 and 6.25±0.65 mm, respectively. Conclusion:A sound knowledge on variation of the course and termination of facial vein is very useful for oral and maxillofacial sur-
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