Background: Shoulder joint is a multiaxial, diarthrodial joint of ball and socket variety. The various components of shoulder joint i.e. capsule, various ligaments, joint cavity and synovial tissue start developing in early embryonic and foetal life roughly in between 6 th to 12 th week of foetal development. The present study aims to analyze the sequences of development of various structures of shoulder joint in human embryo and compare the findings with other observers to gain some insight regarding its development and an attempt is made to correlate these observations clinically to analyze cause and management of recurrent shoulder dislocations. Methods: Shoulder joints of 32 foetuses collected from areas in and around Jammu were dissected properly and decalcified in Gooding and Stewart's solution. Sections were cut after obtaining blocks by paraffin wax embedding method. Slides were stained using Haematoxylin and Eosin, Masson's trichrome and orcein staining and important findings were documented. Results: The bony structures-head of humerus and glenoid fossa and joint cavity appear by 10 weeks which prolongs into bicipital sulcus by 12-1/2 weeks. Synovial tissue appears by 10 weeks and synovial villi appear by 14 weeks. Glenoid labrum, capsular ligament, coracohumeral ligament and superior glenohumeral ligament are seen by 10 weeks. Middle glenohumeral ligament is seen at 12-1/2 weeks while inferior glenohumeral ligament is seen at 14 weeks. Tendon of biceps is seen at 10 weeks. Conclusions: By 10 weeks of gestational age various structures of shoulder joint develop in situ, resembling in form and arrangement as those of adults. From these early stages, development proceeds rapidly to achieve adult characteristics. There are no intermediate stages in between where structures similar to those of lower forms i.e. syn/amphi artroses appear temporarily.
The Sciatic Nerve after originating from sacral plexus leaves the pelvis through the lower part of greater sciatic foramen into the gluteal region and divides into two components at any level from its origin to its usual division inside the upper part of popliteal fossa. The Present study was conducted in the Department of Anatomy Government Medical College Srinagar to study the variations in the level of division of the sciatic nerve during usual dissection for academic purposes. Both lower limbs of a middle aged formalin preserved Indian male cadaver were dissected out for routine teaching and simultaneously recording observations. It was observed that the left sided sciatic nerve divided into its two components inside the pelvis. The tibial and common peroneal nerves after leaving through greater sciatic foramen sandwiched piriformis muscle in the gluteal region. The common peroneal nerve passed above the piriformis where as the tibial nerve passed inferior to this muscle. The sciatic nerve on the other side of this cadaver followed the normal anatomical course. The higher division of sciatic nerve inside the pelvis though rare is of great academic and clinical significance in Neurology, General Surgery, Orthopaedics, Anaesthesiology, Sports medicine and physiotherapy. The knowledge of this variation is also important for paramedics who frequently give intramuscular injections into the gluteal region.
Background: The spinal cord is considered as the principle content of vertebral canal. It begins as a downward extension of medulla oblongata at the level of upper border of first cervical vertebrae (C1). The terminal part of spinal cord is conical and is termed as conus medullaris. In adults the level of termination of conus medullaris varies between T12 to L3 vertebrae. The level of termination of conus medullaris is clinically important to avoid injuries during spinal anaesthesia and lumber puncture. Methods: The saggital magnetic resonance images of 168 patients were reviewed in the Department of Radiodiagnosis, Government Medical College, Srinagar from January 2022 to June 2022. The most caudal point of the cord was considered as the tip of conus medullaris. A line was drawn through the tip perpendicular to the long axis of spinal cord to determine its location with adjacent vertebra. Results: The level of conus medullaris termination was most commonly located at T12-L1 intervertebral disc level. The results revealed a significant statistical difference in levels of termination of conus medullaris with respect to age and sex. Conclusions: In literature, the highest level of conus medullaris termination is stated to be at T11-T12 Intervertebral disc and the lowest level at the body of L3 vertebra. Therefore, spinal anaesthesia and lumber puncture procedure should be done below L3 vertebral body in order to avoid iatrogenic complications.
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