Background. The complex architecture of the right atrium, crista terminalis (CT), and the musculi pectinati (MP) poses enormous challenges in electrophysiology and cardiac conduction. Few studies have been undertaken to substantiate the gross features of MP, in relation to the CT, but there is still scarcity of data regarding this. We tried to reinvestigate the gross arrangement of muscle bundles in the right atrium. Methods. Utilizing 151 human hearts and orientation of MP and its variations and relationship to the CT were investigated along with taenia sagittalis (TS). Patterns of MP were grouped in 6 categories and TS under three groups. Result. A plethora of variations were observed. Analysis of all the specimen revealed that 68 samples (45%) were of type 1 category and 27 (18%) fell into type 2 category. Prominent muscular columns were reported in 12 samples (8%). 83 samples (55%) presented with a single trunk of TS. Multiple trunks of TS were reported in 38 samples (25%). Conclusion. Samples with type 6 MP and type B/type C TS, which have a more complex arrangement of fibers, have a tendency to be damaged during cardiac catheterization. Nonetheless, the area as a whole is extremely significant considering the pragmatic application during various cardiac interventions.
SUMMARY:Advanced imaging techniques have resulted in increasing use of minimally invasive approaches for nephron sparing surgeries of kidney. Need for precise knowledge of normal and variant anatomy of vascular pedicle of kidney is thus justified. Ample literature is available on the variations in the intrarenal vascular pattern of the kidney, which are seen frequently. But the variation in arrangement of structures at the renal hilum has not gained much interest up till now. One hundred (51 right and 49 left) embalmed kidneys were utilized for the present study. Careful dissection of renal hilar structures was carried out to observe antero-posterior relationship of structures at the hilum of the kidney. In majority (73%), the arrangement was not according to the normal textbook description i.e. renal vein, renal artery and pelvis arranged antero-posteriorly. In 31% anterior division of renal artery was seen in front of renal vein at the hilum, whereas, in 50% cases the pelvis was not the posterior most relation. The variable patterns observed were classified into five types. In cases of renal hilar tumors laparoscopic partial nephrectomy is being done with a limited field of vision. Knowledge of these variations is useful for operating surgeons to identify and individually clamp the hilar structures, which is advantageous over en-bloc clamping.
Faulty postures due to sedentary lifestyle cause weakening of core muscles which contributes to increased incidence of musculoskeletal disorders (MSDs). Although a few research studies have quantified the core muscle activity in various yogic exercises used in rehabilitation programs, evidence correlating it to functional anatomy is scarce. Such information is important for exercise prescription when formulating treatment plans for MSDs. Therefore, the objective of this review article is to examine the literature and analyze the muscle activity produced across various yoga postures to determine which type of yoga posture elicits the highest activation for the core muscle in individuals. Literature search was performed using the following electronic databases: Cochrane Library, NCBI, PubMed, Google Scholar, EMBASE, and web of science. The search terms contained: Core muscle activation and yogic posture OR yoga and rehabilitation OR intervention AND Electromyography. Activation of specific core muscle involved asanas which depended on trunk and pelvic movements. Description of specific yogic exercise as they relate to core muscles activation is described. This information should help in planning yogic exercises that challenge the muscle groups without causing loads that may be detrimental to recovery and pain-free movement. Knowledge of activation of muscles in various yogic postures can assist health-care practitioners to make appropriate decisions for the designing of safe and effective evidence-based yoga intervention for MSDs.
Variations of upper limb muscles are quite commonly seen during dissection. Biceps Brachii take an edge on this, as it commonly has two or more than two sites of origin and insertion, where mode of insertion being both aponeurotic as well as tendinous. In present study, apart from common modes of insertion, an additional musculotendinous slip was seen running from the medial side of the muscle belly of Biceps Brachii to Pronator Teres and Flexor Carpi Radialis deep to the aponeurosis. The functional aspect of such insertion is also questionable as Biceps brachii being a supinator is gaining attachment to a Pronator Muscle. Presence of such abnormal musculotendinous tissue can pose a difficult situation during surgical procedures in and around cubital fossa and can also be a cause of nerve entrapment syndromes. Additional muscular slip can lead to compression of neurovascular structure around that area.
Human hand is involved in variety of precision work which requires a combined effort of forearm muscles as well as intrinsic muscles of hand. Lumbricals along with interossei muscles connect the tendons of flexor and extensor muscles and thus play a key role in the characteristic movements of human hands. Lumbricals originate from long flexor tendon and is inserted into dorsal digital expansion. Any variation in the attachment of these muscles can lead to deviation from the normal actions of the fingers and their proximal extension into carpal tunnel and might lead to carpal tunnel syndrome. An extremely rare case of first lumbrical taking origin solely from first tendon of Flexor Digitorum Superficialis (FDS) and having proximal attachment extending into carpal tunnel was noticed bilaterally in cadaveric dissection. These variations are always challenging for clinicians and surgeons during hand surgeries.
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