SUMMARY:During routine dissection of the upper limbs of a Caucasian male cadaver, multiple variations of the branches of the brachial plexus were observed. On the left side, the musculocutaneous nerve was absent and the muscles of the anterior compartment of the arm were innervated by the median nerve. The median nerve was also formed from three roots viz; two from the lateral and one from the medial cord of the brachial plexus. On the right side, the musculocutaneous nerve contributed a long communicating branch to the median nerve in the distal half of the arm. There were also communicating branches between the ulnar and radial nerves in both limbs at the humeral level. The co-existence of these variations appears to be unique and has not been reported in the literature reviewed. The anatomic and clinical significance of these variations is discussed.

Coronary artery anomalies are traditionally classified into anomalies of origin, course and termination. One of the anomalies of origin is absence of the left main coronary artery (LMCA), where the left anterior descending (LAD), the circumflex (Cx) and the ramus medianus (RM) (when present) arteries originate directly from the left aortic sinus. The study aimed to document the prevalence of absent LMCA, discuss its possible embryogenesis and clinical relevance. A review of 407 coronary angiograms performed by cardiologists of three private hospitals in the eThekwini Municipality area of KwaZulu-Natal, South Africa, was performed. The LMCA was absent in 9.6% (39/407) of the coronary angiograms. The LAD and Cx arteries originated directly from the left aortic sinus with a single ostium in 8.6% (35/407) and separate ostia in 1% (4/407) of the angiograms. In four of the angiograms with absent LMCA, a RM artery was recorded originating directly from the left aortic sinus in addition to the LAD and the Cx arteries. Angiographic detection of the anomalies of the coronary arteries is essential in the determination of the significance of such findings and their management.

SUMMARY: An understanding of the left coronary artery (LCA) anatomy is important for accurate diagnosis and therapeutic intervention in the management of coronary arterial diseases. This angiographic study aims to document the parameters of the LCA that may be of importance in the diagnosis and treatment of coronary artery diseases. An analysis of 151 coronary angiograms obtained from the cardiac catheterization laboratory in the eThekwini Municipality area of KwaZulu-Natal, South Africa was performed. The mean length and diameter of the LCA were 10.4±4.1 mm (range 2.8-23.9 mm) and 3.8±0.8 mm (range 2.1-6.5 mm), respectively. The mean angle of division between the two main branches was 86.2°±26.1° (range 27°-68.5°). There was a positive correlation between the length and the angle of division of the LCA, with the longest LCAs having the largest angle of division. The branching patterns of the LCA were 80.8%, 18.5% and 0.7% for bifurcation, trifurcation and quadrifurcation, respectively. Coronary arterial dominance was 81.5%, 15.2%, and 3.3% for right, left, and co-dominance, respectively. This study corroborated earlier findings that the longer the length, the wider the angle of LCA division. A wide angle of LCA division, the shape and disposition of the proximal tract of LCA branches may affect flow, interfere with proper deployment of stents or may predispose to earlier atherosclerotic lesions.

Arising from the aorta, the right (RCA) and left (LCA)

SUMMARY:The trigeminal cave (TC) is a special channel of dura mater, which extends from the posterior cranial fossa into the posteromedial portion of the middle cranial fossa at the skull base. The TC contains the motor and sensory roots of the trigeminal nerve, the trigeminal ganglion (TG) as well as the trigeminal cistern. This study aimed to review the anatomy of the TC and TG and determine some parameters of the TC. The study comprised two subsets: A) Cadaveric dissection on 30 sagitally sectioned formalin fixed heads and B) Volume injection. We found the dura associated with TC arranged in three distinct layers. TC had relations with internal carotid artery, the cavernous sinus, the superior petrosal sinus, the apex of petrous temporal bone and the endosteal dura of middle cranial fossa. The mean volume of TC was 0.14 ml. The mean length and breadth of TG were 18.3 mm and 7.9 mm, respectively, mean width and height of trigeminal porus were 7.9 mm and 4.1 mm, respectively, and mean length of terminal branches from TG to point of exit within skull was variable. An understanding of the precise formation of the TC, TG, TN and their relations is important in order to perform successful surgical procedures and localized neural block in the region of the TC.