Objectives: To determine the percentage and type of aortic arch variations in Indian subjects and their clinical and surgical importance and embryological basis.Patients and methods: In our investigation, branching patterns of the aortic arch were studied in 62 formalin-fixed cadavers of both sexes of Indian origin, aged 45-79. The dissections were carried out in formalin-preserved cadavers and the aortic arch variations were observed after exposing the thoracic and cervical region during routine dissection of undergraduate students of Indian origin in Kasturba Medical College, Mangalore.Results: The usual three-branched aortic arch was found in 56 cadavers (91.4%); variations were found in six cadavers (9.6%); 4.8% presented common origin of the carotid arteries; 1.6% had biinnominate sequence, and the same specimen had left coronary artery arising from arch of aorta directly; 1.6% presented right subclavian artery arising directly from the aorta; 1.6% had left vertebral artery a branch of aortic arch. Five out of six cadavers with anomalous aortic arch branching pattern were females. One male cadaver presented anomalous origin of left vertebral artery directly from the arch.Conclusion: The wide spectrum of variations in the anatomical arrangements of the aortic arch branches in the Indian population was at par with other populations of the world. Although anomalous origins of the aortic arch branches are merely anatomic variants, accurate information about them is vital for vascular surgery in the thorax, head and neck region.Key words: Aortic arch, vertebral artery, brachiocephalic trunk, variations. ResumoObjetivos: Determinar a porcentagem e o tipo de variações do arco aórtico em indivíduos indianos, bem como sua importância clí-nica e cirúrgica e base embriológica.Pacientes e métodos: Em nossa investigação, os padrões de ramificação do arco aórtico foram estudados em 62 cadáveres fixados em formalina de ambos os sexos, de origem indiana e com idade entre 45 e 79 anos. As dissecações foram realizadas em cadáveres preservados em formalina, e as variações do arco aórtico foram observadas após a exposição das regiões torácica e cervical durante a dissecação de rotina de alunos da graduação do Kasturba Medical College, Mangalore, Índia.Resultados: O arco aórtico normal de três ramificações foi encontrado em 56 cadáveres (91,4%); as variações foram encontradas em seis cadáveres (9,6%); 4,8% apresentavam origem comum das artérias carótidas; 1,6% tinham seqüência binominada, e o mesmo espécime tinha a origem da artéria coronária esquerda diretamente no arco aórtico; 1,6% apresentavam a origem da artéria subclávia direita diretamente na aorta; 1,6% tinham como ramificação do arco aórtico uma artéria vertebral esquerda. Cinco de seis cadáveres com padrão de ramificação anômalo do arco aórtico eram do sexo feminino. Um cadáver do sexo masculino apresentou origem anômala da artéria vertebral esquerda diretamente no arco.Conclusão: O amplo espectro de variações nos padrões anatômi-cos das ramificações do arco a...

INTRODUCTIONGeneral surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper’s ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported.MATERIALS AND METHODSThe present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted.RESULTSIn 79% of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19% of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2% of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity.CONCLUSIONThe data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.

Kiloh-Nevin syndrome caused by compressive neuropathy of the anterior interosseous nerve in the forearm is believed to occur because of its compression by the accessory head of flexor pollicis longus (FPLah). Gantzer described two accessory muscles, the more frequent is the FPLah and the less frequently observed is the flexor digitorum profundus accessory head (FDPah). Many studies have reported the prevalence, origin, insertion, nerve supply, and relations of these accessory muscles, most of them focusing on the FPLah. This study was designed to investigate the prevalence, morphology, relation to median and anterior interosseous nerve, and also the coexistence of both the accessory heads. A total of 126 upper limbs of the embalmed cadavers were examined in this study. Fifty-eight limbs (46.03%) showed the presence of the FPLah and 18 limbs (14.28%) had the FDPah. The most common origin of both the accessory muscle bellies was from the under surface of the flexor digitorum superficialis. The FPLah inserted into the FPL muscle at varying levels with 80% inserting into the proximal third of FPL, whereas the FDPah in all cases ended near the level of the wrist joining with one or more tendons of the FDP. Clinical implication of the variation is discussed.

The objective of this study was to study the morphometry of the styloid process of temporal bone and prevalence of elongated styloid process. The morphology of elongated styloid process along with its embryological and clinical importance are discussed. The present study included 110 human dry skulls which were procured from the bone collections of the department of anatomy. The styloid process was observed macroscopically on both sides of all the skulls, the elongations if any were noted. All the styloids were measured for their length, thickness at different levels and interstyloid distance at various levels. Out of 110 specimens, only 5 skulls (4.5%) exhibited the elongated styloid process. Among them, 3 skulls (2.7%) had unilateral elongation and 2 skulls (1.8%) had bilateral elongation of the styloid process. The mean length of the styloid process was 17.8±9.3 mm and 18.2±5.6 mm for the right and left sides, respectively. The prevalence of elongated styloid process in the present study was 4.5%. The clinical anatomy of this congenital variant is important to the neurosurgeon and radiologist, while interpreting the computed tomogram and magnetic resonance image scans. The morphological knowledge of elongated styloid process is clinically important since the course of the vertebral artery may be distorted in such situations.

SUMMARY:The aim of the present study was to obtain the measurements of the different humerus segments and to estimate the length of humeri from them. For this purpose 100 (51 left and 49 right) sex-aggregated, adult dry humerus from Indian population, were taken to analyze the morphometric details of the humerus segments. The distance between five different segments viz: most proximal point of the humeral head and greater tuberosity (HA), head of the humerus and surgical neck of humerus (HB), proximal and distal point of olecranon fossa (HC), the distal point of olecranon fossa and trochlea of humerus (HD), proximal point of olecranon fossa and distal point of trochlea of humerus (HE) and finally the maximum length of humerus (HL) were obtained by means of an osteometrical board and an analogical caliper. Simples linear regressions (p < 0.01) were made to correlate each segment with the total length of the humerus. Positive results were obtained in segments HB and HE of right humerus. Regressions formulae were obtained to define these estimative.In conclusion, our study demonstrated that length of the humerus can be estimated from measures of different segments of humerus and this study helps in forensic, anatomic and archeological cases in order to identify unknown bodies and to determine stature of the individual and as well as for the orthopedic surgeons for the treatment of proximal and distal humerus fractures and for their reconstruction.

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Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.

SUMMARY:The morphometrical data related to the menisci of the adults have been reported by few authors and that of the fetuses have not been reported. The aims of the present study were to analyse the external circumference thickness, the width, peripheral and inner border lengths, and the distance between anterior and posterior horns of the fetal menisci and to compare the meniscal dimensions with that of the adult meniscal parameters which are available in the literature. The menisci from 106 knee joints of the formalin fixed South Indian fetuses which were obtained from the anatomy department were analysed. The fetuses which had musculoskeletal anomalies were excluded from the study. A vernier caliper of 0.02 mm accuracy and a non elastic cotton thread were used for the morphometry. After comparing the meniscal dimensions of the present study with the adult meniscus parameters, we established that the fetal parameters of the meniscus are entirely different from the adults. These differences are may be due to the mesenchymal differentiation or variability of the vasculature early in embryonic life. We believe that our study will provide support to the fetal anatomy, concerning surgical procedures and arthroscopy of the knee joint. Since the morphometric studies of the fetal menisci are not reported, this study may be considered new and needs to be studied further with different groups of fetuses from various stages of intrauterine development. This study is important not only for orthopedic surgeons, but also for morphologists and embryologists.