CONFERENCE ABSTRACTS |
https://doi.org/10.5005/jp-journals-11003-0143 |
The National Anatomy Conference—“RRR” Anatomy: The Recent, Relevant, and Research-based—26th and 27th July 2024
Absence of the Peroneus Tertius Muscle: A Case Report
Ruchita N Prajapati, Rupal S Gautam, Sucheta M Chaudhary
B J Medical College, Ahmedabad, Gujarat, India
Introduction: Peroneus Tertius muscle is a muscle of the anterior compartment of the leg.
Methodology: During routine anatomical dissection for undergraduate students at Department of Anatomy, B J Medical College, Ahmedabad, Gujarat, we observed absence of Peroneus Tertius unilaterally in formalin fixed cadaver, which is a rare finding.
Results: In present case, dissection was carried out in both left and right lower limb. Both the limbs were carefully observed and examined. It was observed that there was presence of Peroneus Tertius muscle in left lower limb and absence in right lower limb.
Conclusion: The presence of Peroneus Tertius is important for Dorsiflexion and Eversion of foot in swing phase of gait. The insertion of Peroneus Tertius might play an important role in the causation of torsional stress as observed in John’s fracture and Stress fracture. Foot surgeons might use the Peroneus Tertius muscle flap for transposition and also for correcting any laxity in ankle joint. Awareness of its absence may be important for anatomists, orthopedics, physiotherapists and anthropologists.
Exploring the Chromosomal Polymorphisms in Facial Clefts: A Case Series
Subhash B, Barun K Chakrabarty, Saugat Ray, Vipin Nair, Vikas K Dagar
All India Institute of Medical Sciences, Kalyani, Basantapur, West Bengal, India
Armed Forces Medical College, Pune, Maharashtra, India
Introduction: Facial clefts are common congenital craniofacial anomalies. The incidence ranges between 1:600 and 1:1000 live births. A cleft occurring during embryonic development consequent to arrest and failure of fusion of components taking part in the formation of face and palate. Approximately 30% of facial clefts cases are syndromic cases occurring in association with chromosomal abnormalities.
Methodology: After ethical clearance, karyotyping was done in peripheral blood as per standard procedure protocols in patients with facial clefts.
Results: Chromosomal polymorphisms were found in 3 cases. In the first case increase in length of stalk on the short arm of chromosome 13, in the second case increase in length of stalks on the short arm of all acrocentric chromosomes was identifies and they know as pstk+. In the third case there was a heterochromatin region on long arm of chromosome 9 which is known as qh+.
Conclusion: Increase in highly repetitive DNA sequences in the distal chromosome segments may cause clinical symptoms in chromosomal polymorphisms. Studies reported that female reproductive disorders are closely associated with chromosomal polymorphisms. As now a days genetic counselling is must in every genetic disorder for optimum/confident genetic counselling chromosomal analysis/molecular analysis is need of time and must be part of management services so that holistic/interdisciplinary approach can be given to those patients.
Regression Equations Derived from Analysis of Distal Fragments of Adult Femora to Estimate its Length in South Indian Population
Geethanjali HT, Tejaswi HL
Mandya Institute of Health Sciences, Mandya, Karnataka, India
Department of Anatomy, Adichunchanagiri Institute of Medical Sciences, Nagamangala, Karnataka, India
Introduction: In Physical anthropology, Osteometry i.e., measurements of long bones help us to know the racial differences and in Forensic Anthropology, help in estimation of stature as a part of identification of the deceased when skeletonized remains are only available 1. This becomes a critical step during identification of the person in mass airplane accidents, deaths in natural disasters, terrorist bomb attacks etc. or in cases where only fragments of femur are obtained 1. Among all individual long bones Femur is the longest and strongest bone and it is most frequently recovered bone in Forensic situations being a large, durable bone protected by a large amount of soft tissue 2.
Objectives: (1) To determine the length of femur using measurements of distal end fragments and to derive the regression equation for the same; (2) to compare the results with previous studies.
Materials and methods: The present study was undertaken on 194, morphologically normal adult femur bones obtained from the Department of Anatomy, MIMS, Mandya. Each bone after sexing was subjected to 5 measurements including the maximum length of femur (FML) which was taken using Osteometric board and four other fragment measurements (ECB, BCB, MCL, LCL) which were taken using Vernier callipers 3.
Results: The measurements were statistically analyzed and the regression equations used to estimate the femur length from its fragmentary measurements, were derived. Among all fragments measured, Lateral condylar length (LCL) showed maximum correlation with the femur length, while Bi Condylar breadth (BCB) showed the least.
Conclusion: This study is indispensable in cases where identification of victims becomes difficult in unnatural disasters as mentioned above and when there is paucity of available evidences, sometimes bony fragments being the only cues collected. The present study attempts to derive regression equations in both sexes even when only distal fragment pieces are available. We can estimate the length of femur which in turn can be used to estimate the appropriate height of the deceased 4. Since morphometry varies with race deriving equations for different population groups is the need of the hour 4 and this study we have made such an attempt in South Indian population
Radiological Exploration of Foramen Magnum using Computed Tomography Images: A Morphological and Morphometric Analysis
Reeha Mahajan, Gita Devi, Mahander Pall
Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Jammu, Jammu and Kashmir, India
Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Jammu, Jammu and Kashmir, India
Department of Neurosurgery, Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, Jammu, Jammu and Kashmir, India
Introduction: Foramen magnum (FM) is located in the posterior cranial fossa and allows passages of vital structures. It is an important landmark for surgeons operating near craniocervical junction (CCJ) for pathologies related to FM, like meningiomas, vertebral artery aneurysms, clival chordomas, epidermoids etc. Also, the morphometric variations found among males and females can be helpful for sex determination in medicolegal cases. The aim of the present study was to determine the shape and dimensions of Foramen Magnum in both sexes, belonging to Jammu and Kashmir region.
Methodology: A retrospective cross-sectional study was conducted on Computed Tomographic images of 100 subjects (53 males and 47 females) using RadiAnt DICOM Viewer software. The shape of FM was noted and its anteroposterior (AP) and transverse diameters along with the FM Index were calculated. Statistical analysis was done using Microsoft Excel 2020 version.
Results: The commonest shape of FM was observed to be oval, seen in 34% cases, followed by round (21%), pyriform (20%), tetrahedral (14%), hexagonal (6%), irregular (3%), and triangular in 2% cases. The mean AP diameter in males and females was measured as 3.6 ± 0.32 cm and 3.52 ± 0.42 cm respectively while the mean transverse diameter in males and females was 2.93 ± 0.22 cm and 2.81 ± 0.22 cm respectively. The FM index was calculated as 82.03 ± 7.77 and 80.68 ± 8.21 in males and females, respectively. A statistically significant difference in transverse diameters was observed between males and females (p < 0.005). The difference in AP diameters and FM index between males and females was statistically insignificant.
Conclusion: There exists a significant difference in morphological shape and morphometry of Foramen magnum in both sexes. The results obtained in the present study can guide surgeons to decide the relevant CCJ approaches (anterior, posterior and posterolateral transcondylar etc.) for accuracy of intervention during surgical procedures.
Index Finger and Ring Finger Ratio (2D:4D) and its Correlation with Hypertension and its Effects for Possibility Factors in Cardiovascular Diseases in North Indian Female Population
Kumar S, Ali S
Department of Anatomy, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India
Introduction: Hypertension, a major risk factor for cardiovascular diseases (CVDs), is a growing concern globally, especially in India. The index finger to ring finger ratio (2D:4D) is a measure influenced by prenatal sex hormone exposure and has been linked to various health outcomes, including CVDs. This study investigates the potential correlation between 2D:4D ratio and hypertension in North Indian females, exploring its implications for CVD susceptibility.
Methods: The study will recruit a sample of North Indian females, categorized into hypertensive and normotensive groups based on established blood pressure criteria. Finger lengths (index and ring) of both hands will be measured using standardized techniques. The 2D:4D ratio will be calculated for each hand (individually and averaged) and compared between the groups.
Results: We anticipate finding a significant difference in 2D:4D ratio between hypertensive and normotensive females. The results will be analyzed statistically to determine the strength and direction of the correlation. Additionally, we will explore potential associations between 2D:4D and other CVD risk factors in the female population.
Conclusion: This study aims to contribute to the understanding of 2D:4D as a potential marker for hypertension and CVD risk in North Indian females. The findings may provide valuable insights for developing preventive strategies and early identification of high-risk individuals.
A Study on Morphometry of Cranium and Its Index in Dry Human Skulls of North India
Pankaj Kumar, Sadakat Ali
Department of Anatomy, Shri Guru Ram Rai Institute of Medical and Health Sciences, Shri Guru Ram Rai University Patel Nagar, Dehradun, Uttarakhand, India
Introduction: The skull is the skeleton of the head and is composed of bones united to one another at joints called sutures. Cranial anthropometry is an increasingly important area for anatomists, anthropologists, and plastic surgeons. This study aimed to anthropometrically investigate the cranial index values and contribute to the literature data.
Objectives: To calculate various cranial parameters and cranial index. To categorize skulls into various skull types.
Methodology: The present study was conducted in the department of Anatomy, Shri Guru Ram Rai Institute of Medical and Health Sciences. A total of 100 dry skulls of unknown sex were studied. The skulls which were damaged and with abnormalities were excluded from the study. The cranial length (CL), cranial width (CW), and cranial index were measured. Skulls were also categorized into various cranial types.
Results: The average cranial length was found to be 190.9 mm. While the mean cranial width was 139.4 mm. The mean cranial index was 73.03. This study indicated that out of a total of 100 skulls, the maximum belonged to Mesocranial (48%) and Dolichocranial (42%) groups, a low percentage was noticed in Brachycranial (8%) and Hyperbrachocranial (2%) groups as per M.F Ashley Montagu classification.
Conclusion: This research can be useful for clinical and research purposes for anatomists, anthropologists, forensic medicine experts, neurosurgeons, and plastic surgeons.
A Cadaveric Study on the Variations of Branching Pattern of Arch of Aorta
Misbah Ullah, Jishnu R, Rakhee Sharma
University College of Medical Sciences, Delhi, India
Introduction: The variations in branches arising from the arch of aorta are numerous. The purpose of this study is to find the variations in the branching pattern of arch of aorta, which would be useful to anatomists, radiologists, vascular surgeons, neck and thorax surgeons.
Methodology: In this cadaveric study, branching patterns of arch of aorta was studied in 19 already dissected heart specimens. The arch of aorta was cleaned and observed for number of branches. Measurements were taken with the help of digital vernier calliper.
Results: The commonest pattern of branching from the arch of the aorta of brachiocephalic trunk, left common carotid artery, and left subclavian artery was observed in 13 specimens (68.42%). Variations from the common pattern in the branching of arch of aorta were found in 6 specimens (31.57%), in which 5 specimens had additional branch arising between left common carotid artery and left subclavian artery and 1 specimen with additional branch in between right brachiocephalic trunk and left common carotid artery.
Conclusion: The accurate knowledge of branching pattern of arch of aorta is vital for vascular surgeries in the thorax, head and neck regions. Although, the variations are usually asymptomatic, they may cause dyspnea, intermittent claudication, misinterpretation of radiological examinations and complications during neck and thorax surgeries. Knowledge of these variations is precious while invading the arch of aorta and its branches by instruments to avoid any untoward surgical complications.
Histogenesis of Developing Human Fetal Liver
Aditya N Singh
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: At one-fourth of an adult’s total weight, the liver serves as the largest gland in the body. At birth, it accounts for one-twentieth of the body’s weight and causes much of the fetal abdomen to enlarge. Intrauterine liver development begins in the third or fourth week of gestation from hepatic bud and septum transversum. We are aware that the number of instances of liver cirrhosis has grown as a result of an increase in the prevalence of alcohol use, a sedentary lifestyle, viral hepatitis and other factors. This situation has led to an increase in the demand for liver transplantation. To find an alternative source of liver transplantation, such as hepatocyte transplantation, we are forced to hunt for donors since there are not enough of them.
Method: Study conducted on 40 aborted fetal liver ranging from 12–36 weeks of gestation. We grouped them into five groups then we processed liver tissue and after section cutting stained with hematoxylin and eosin then observed under light microscope.
Results: We observed appearance and disappearance of different histological parameters. Central vein observed by 12–16 weeks, portal triad was seen by 17–20 weeks, Hepatic lobule seen by 21–24 weeks. During 25–28-week glycogen deposits were observed and hematopoietic activity started decreasing.
Conclusion: The histology of a normal liver may help pathologists identify subtle but significant morphological abnormalities, such as those seen in needle biopsy specimens. Research of this kind may help identify the cell lines that are being employed in the many regenerative treatments for liver ailments. Research into liver transplantation and the use of hepatocytes derived from the liver of aborted or stillborn fetuses at different stages of gestation may benefit from a deeper knowledge of human fetal liver histogenesis.
Omphalocele in Fetus: A Case Report
Aditya N Singh
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Omphalocele is a congenital malformation in which ventral body wall is defective. It is situated in the midline. Occurs in 2.5/10000 newborns. In this condition, midgut loop after physiological herniation fails to return to abdominal cavity, as a result bowel loop, liver and other viscera herniate through defect and covered by amnion.
Method: After spontaneous abortion of 20 weeks old fetus in department of Obstetrics and Gynecology, we collected a fetus and observed a swelling and defect in anterior abdominal wall which was covered by membrane. We cut the covering of swelling and observed the contents of swelling.
Results: In this case we observed 20 weeks old male fetus with midline abdominal swelling, which is covered by amnion and after its removal, we observed that bowel loop, heart and liver were protruded thought defective abdominal wall. Size of defect was 3 cm × 4 cm. Crown-rump length of aborted fetus was 200 mm, weight was 500 gm.
Conclusion: Omphalocele is a treatable malformation and is not an indication for termination of pregnancy. It should be differentiated from Gastroschisis, in which intestinal loop herniate through defect in abdominal wall lateral to umbilicus and is not covered by amnion.
Hepatic Morphology: A Rare Presentation of Atypical Fissures and Accessory Liver Lobes and Their Clinical Importance
Yagika Pareek, Anshu Gupta, Kamal Bhardwaj
Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
Introduction: Liver is the largest abdominal viscera divided on the basis of its external appearance into right, left, caudate and quadrate lobe. Although our understanding about liver morphology and anatomy is very extensive, variations in this established knowledge are not uncommon and could lead to diagnostic errors. The present study aims to evaluate the gross morphological variations of liver and their clinical importance.
Methodology: The Present study has been carried out in dissection hall at Sarojini Naidu Medical College, Agra on 20 formalin fixed and preserved human cadaveric livers aged between 50–70 years and these livers were examined for presence of any morphological variations.
Results: Among 20 liver specimens it was observed that 1 liver particularly had 2 prominent deep fissures and 3 sulci on anterosuperior surface of right lobe of liver, presence of Reidel’s lobe, the visceral surface of left lobe of liver had 2 horizontal fissures and one small vertical fissure, presence of a deep oblique Rouviere’s sulcus, the caudate lobe had a deep vertical fissure and a prominent papillary process, the quadrate lobe was rather narrow with an incomplete horizontal fissure, presence of widened fissure for ligamentum teres. 2 accessory liver lobes were identified: one on the anterior surface of left lobe of liver and another to the right of gall bladder fossa.
Conclusion: For an accurate imaging, diagnosis and a successful surgical procedure and its outcome a precise insight is needed on these morphological variations of liver. Documentation of these variations and anomalies of liver could help develop better interventional procedures and avoid inaccuracies in imaging and diagnosis.
Morphometric Study of Human Liver in Relation to Age, Sex and Ethnicity in North and South Indian Population by Ultrasonography Method
Utkarsh Singh, AK Singh, Krishna Pandey, Nishtha Singh, Badal Singh, Mamta Anand, Supriya Sudha, RK Pandey, Kushagra Agarwal
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Liver is the largest gland in human body, it constitutes approximately one fifth of the total body weight, measuring 1.5–2.5% of the lean body mass. The size and shape of the liver vary and match the general body shape. Liver perform numerous and vital roles in maintaining homeostasis and health. These functions include the synthesis of most essential serum proteins, the production of bile and its carriers, the regulation of nutrients and metabolism and excretion of bile. Measurement of craniocaudal length supports physicians and radiologists to diagnose and manage liver diseases, ex: fatty liver disease and its types.
Aim: Aim is to study cranio-caudal length of liver and its correlation with age, gender and ethnicity.
Materials and methods: 80 healthy humans (40 North Indian and 40 South Indian population), ranging from 17 to 86 years, were taken for study. The sonographic measurements of liver were collected from real USG images. Demographic data such as age, gender and ethnicity have been collected using questionnaires.
Results: In our study we found CCL mean value 13.77 ± 1.62 cm. The mean CCL of south and north Indian populations are similar (p = > 0.05). Mean value of Cranio-caudal length of male and female were statistically similar (p = > 0.05). We also compared CCL length of liver in different age groups also, no significant difference was found between them (p = > 0.05).
Conclusion: Evaluation of liver cranio-caudal length will help clinicians as it provides inexpensive and non invasive visualization option for exploring normal morphological development, in determining various pathologies of liver and in evaluating general clinical outcomes in diseases requiring resection of liver or liver transplant.
Variation in the Origin of Cystic Artery: A Case Report
Poushali Dey, Badal Singh, Krishna Pandey, Nishtha Singh, Mamta Anand
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: To reduce the complications like intraoperative bleeding, biliary tract injury etc. during cholecystectomy knowledge about variations in the origin and course of cystic artery is important for a surgeon. Gall bladder is supplied by cystic artery, which is in turn branch of right hepatic artery. Cystic artery usually located in Calot’s triangle. Aim of our study is to become familiar with variations of cystic artery origin and course.
Methodology: While teaching MBBS students, an observation was done during routine dissection of 50-year-old male cadaver in the dissection hall of Anatomy department, Motilal Nehru Medical College, Prayagraj. Abdominal wall was incised and hepatobiliary region was dissected to observe this variation in the origin of cystic artery.
Results: We observed that cystic artery originated from Hepatic artery proper instead of right hepatic artery, then it runs in Calot’s triangle to reach gall bladder.
Conclusion: Knowledge of anatomical variation of cystic artery is important for surgeons during surgical intervention of hepato-biliary region for better surgical outcome.
Correlates of Major Fetal Anomalies in Currently Pregnant Women Attending Antenatal OPD at RAMA Medical College Kanpur
Jyoti Pandey, Vandana Tewari, Rahul Ranjan
Department of Anatomy, RAMA Medical College, Kanpur, Uttar Pradesh, India
Department of Radiodiagnosis, RAMA Medical College, Kanpur, Uttar Pradesh, India
Introduction: Major fetal anomalies continue to pose threats to the health of both mothers and their offspring. Internationally, congenital anomalies impact two to three percent of all births. In India, one to three out of every 100 babies are born with birth defects, resulting in 27 million babies being born with anomalies annually. There is a gap in the literature in our setup; hence, this study was planned with the objective of identifying the correlates of major fetal anomalies.
Methodology: Settings and Design was a cross-sectional study in our setup. The study included 3560 pregnant women visiting antenatal OPD. Data collection is carried out through a pre-formed, structured questionnaire containing data on socio-demographic factors, obstetric background, and maternal well-being. Ultrasound scans were conducted using the GE Varsana Essential 17.3/Convex Probe, TV/TR Probe. Statistical analysis was done in IBM SPSS version 26.0.
Results: Out of a total of 3235 women, the overall prevalence of fetal anomalies came out to be 87 (2.69%). Factors that were significantly associated with fetal anomalies included age greater than 35 years with an AOR of 1.21 (1.18 to 11.0), Muslim religion showing a 1.32 times higher risk with an AOR of 1.32 (1.01 to 3.11), multiparous showed 1.21 times more risk with an AOR of 1.21 (1.03 to 3.47), and having a history of miscarriage with an AOR of 1.99 (1.10 to 4.21).
Conclusion: Measures like lifestyle modifications, serial ultrasonographic screening should be done in the vulnerable groups.
Volumetric Growth of the Developing Human Fetal Liver
Shailendra K Singh, Krishna Pandey, Mamta Anand, Nishtha Singh, Badal Singh, Supriya Sudha, Rajesh Pandey
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Liver is the largest gland in the human body, accounts for one-twentieth of an adult’s weight. Its development begins in the third or fourth week of gestation and its development is impacted by maternal diabetes, increasing by 20% per week of gestation. Understanding of fetal liver volume is important for understanding fetal physiology and status of fetal growth.
Method: Present study was conducted in department of Anatomy, Motilal Nehru Medical College. Study was done on 40 fetal livers of known age and sex. Measurement of fetal liver volume was done by hydrostatic method based on Archimedes principal. We also calculated liver volume by vertical length of liver, transverse diameter and sagittal diameter of liver using linear regression formula.
Results: Mean value of volume of fetal liver was 22.152 cm3 when we measured volume by hydrostatic method. We also derived regression equation for calculation of volume. Liver volume = 0.57 (Sagittal diameter) + 1.25 (Vertical Length) – 0.25 (Transverse diameter) –25.69 R 2 = 0.84, p = 0.001. By using regression equation volume of liver was 21.44 cm3.
Conclusion: Volume of fetus can be used to assess the normal fetal growth and provide significant insight into growth of fetus. Data provided by us can be useful for radiologist for assessing fetal growth.
Accessory Renal Artery: A Case Report
Kuldeep Kumar, Krishna Pandey, Nishtha Singh, Badal Singh, Mamta Anand, Supriya Sudha, Rajesh Pandey
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Kidney is situated in the lumbar region and its arterial supply is by renal arteries. Both the renal arteries are derived from abdominal aorta at L1-L2 vertebral level. However, lots of variations related to renal arteries and position of kidney are found due to ascent of kidney from initial sacral position in intrauterine life. Renal transplantation is on rise now a days so knowledge about variations of renal arteries and position of kidney is crucial for transplant surgeons.
Method: While dissecting abdomen of 60-year-old male cadaver in department of Anatomy, Motilal Nehru Medical College, Prayagraj we observed position and vascularity of both kidneys, after exploration the renal artery, renal vein and pelvis was observed this variation and its relation with adjacent structures.
Results: In left kidney main renal artery arises from Abdominal aorta while accessory renal artery arises from inferior mesenteric artery. Accessory renal artery enters into kidney at lower pole. Left kidney was present in left iliac fossa. Right renal artery enters in kidney through hilum and shows no variation. Position of right kidney is in lumbar region. No accessory artery was observed on right side.
Conclusion: Present observation helps in awareness of variations of renal arteries and variation in position of kidney. Knowledge of these variations is of utmost help in renal transplantation, urological procedures and angiographic interventions.
Morphometric Analysis of Shaft of Femur in North Indian Population
Rinkesh Kumar, Krishna Pandey, Nishtha Singh, Badal Singh, Mamta Anand, Supriya Sudha, Rajesh Pandey
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Femur is the longest and strongest bone of body. Femur has central role in weight bearing during bipedal locomotion and standing. Morphometric analysis of femur among different populations reveals great variability, that may be due to different dietary habits, ethnicity and environmental factors. The present study aims to find out Robusticity index, Platymeric index, Foramina index, Pilastric index. These indices help us to find out total femur length. We also observed position and number of nutrient foramina.
Method: Present study was done on 76 dry femora with unknown gender and age of north Indian population. We used osteometric board and vernier caliper for measurement of different parameters of femur.
Result: Mean value of right and left femora length was 43.09 ± 2.9 cm and left 43.6 ± 2.63 accordingly. Robusticity index of right and left femora were 11.86 and 11.79 accordingly. Platymeric index right femur was 84.7 and left was 82.07. Pilastric index right femur was 86.12 while left was 103.46. Single nutrient foramen present 69.69% and double in 27.61% femora.
Conclusion: Morphometric data is useful for anatomist, orthopedic surgeon, radiologist for planning for treatment. Our study is also useful in calculating total length of femur which can be used for medicolegal and anthropological purpose.
Variation of Median Nerve: A Case Report
Jai M Kumar, Krishna Pandey, Nishtha Singh, Badal Singh, Mamta Anand, Supriya Sudha, Rajesh Pandey
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Normally Median nerve is formed by two roots from medial to lateral cords of brachial plexus. Numerous variations are present in origin of Median nerve It may arise from more than two roots and sometimes abnormal connections are present with musculocutaneous nerve.
Method: While dissecting 65-year-old male cadaver for first year medical students, in the department of Anatomy, Motilal Nehru Medical College, Prayag raj, we explored brachial plexus and noticed the variations in the formation of Median nerve.
Observation: Macroscopic observation of brachial plexus revealed that median nerve was formed from four roots. Three roots from lateral cord and one from medial cord. Upper two root from lateral cord originate at same level and unite with medial cord with the gap of 2.5 cm. Third root from lateral cord originated 2.5 cm below upper two roots, unite with medial cord 7.5 cm below meeting point of second root of lateral cord. All the roots from medial cord meet with lateral root of lateral cord anterolateral to third part of Axillary artery.
Conclusion: Knowledge about variations in formation of median nerve is helpful for general surgeons, Orthopedicians and Anatomist, in routine surgery of upper limb, nerve block and during radical neck dissection.
Anatomical Variation of Right Testicular Vein
Guruvayya S Mathad, Ranjeeta Hansdak, Deepshikha Singh, Anjoo Yadav
Lady Hardinge Medical College and Smt. S K Hospital, Delhi, India
Introduction: The male gonads are drained by pair of testicular veins. The pampiniform plexus of veins rearrange themselves to form four veins at superficial inguinal ring which further unite to form two veins at deep inguinal ring. Finally a single gonadal vein forms at variable levels that ascend in the posterior abdominal wall. Usually the right gonadal vein drains into anterolateral aspect of inferior vena cava at an acute angle, about 2 cm below the renal vein whereas the left gonadal vein drains into left renal vein at right angle. Altered variations in the drainage pattern will affect the thermoregulation of the testis. The current study presents an unusual draining pattern of right testicular vein and its clinic-embryological basis.
Methodology: Unusual draining pattern of right testicular vein was encountered during routine dissection of the abdomen in an elderly male cadaver in the department of Anatomy, LHMC, New Delhi. The abdominal visceras were removed following standard anatomical dissection procedure using Cunningham manual of practical anatomy. The retroperitoneal structures were carefully dissected and the mode of termination of gonadal veins were observed.
Results: In the present study, the right testicular vein drained into right renal vein at an angle of 110° instead of draining directly into inferior vena cava (IVC).
Conclusion: Variations in the number and draining pattern of the gonadal veins varies widely. This attributes to various pathological conditions such as varicocele, pelvic congestion syndrome leading to infertility in patients. The tendency of developing venous incompetency also increases manifold in children. Hence, in-depth knowledge of these developmental anomalies of gonadal vein is important. Comprehensive data of these variations will help in radiological interpretations, surgical interventions like posterior abdominal surgery, laparoscopic surgery, renal transplantation, treatment of varicocele and pelvic congestion syndrome.
Bilateral Anomalous Renal Vascular Architecture
Lamhoitheng Haokip, Deepshikha Singh, Ranjeeta Hansdak, Anjoo Yadav
Lady Hardinge Medical College and Associated Hospitals, Delhi, India
Introduction: The renal artery is the principal artery supplying the kidneys. It originates as a lateral branch of the abdominal aorta at the level of the L2 vertebra, approximately 1 cm below the superior mesenteric artery. Upon reaching the renal hilum, it divides into anterior and posterior terminal branches, which further subdivide into segmental arteries. This study highlights the presence of early branching pattern of renal artery.
Methodology: Bilateral anomalies of renal arteries were found during routine abdominal dissection of an elderly male cadaver at Anatomy Department, Lady Hardinge Medical College. Measurements were taken with Vernier Calliper. The number, origin, course and division of the arteries were studied.
Results: Both the renal arteries originated from the abdominal aorta at L2 vertebral level. The left renal artery divided into anterior and posterior divisions. The anterior division bifurcated to give—a branch reaching the lower end of the hilum, and a branch entering the hilum. This division was anterior to the left renal vein. The posterior division was situated posterior to the left renal vein and extended upwards, giving off three terminal branches: one pre-hilar branch in the anterior plane and two in the posterior plane. The right renal artery gave off a narrow branch to the right suprarenal gland and then bifurcated into a thin anterior division and thick posterior division. The anterior division further produced two terminal branches: the superior branch ran towards the superior pole, while the inferior branch subdivided into an intermediate branch reaching the anterior surface, 1 cm from the hilum and a branch descending towards the inferior pole. The posterior division entered the hilum and gave off two segmental arteries.
Conclusion: Comprehensive knowledge of renal vascularity is of utmost importance for good surgical interventions and radiological interpretations.
Cadaveric Study of Variations in the Division, Course and Termination of Sciatic Nerve and Its Clinical Correlation: A Case Series
V D Ashok Patarlapalli, Ranjeeta Hansdak, Deepshikha Singh, Anjoo Yadav
Department of Anatomy, Lady Hardinge Medical College, Delhi, India
Introduction: Sciatic nerve is the thickest nerve of our body. It leaves the pelvis via greater sciatic foramen below piriformis and descends along back of thigh, dividing into two terminal branches at the superior angle of popliteal fossa. It supplies the knee flexors and all the muscles below the knee, so that a complete palsy of the sciatic nerve results in a flail foot causing severe difficulty in walking. The nerve is also vulnerable to posterior dislocation of the hip and piriformis syndrome. It may be damaged in misplaced therapeutic injections into gluteus maximus.
Methodology: Study was performed on 25 elderly cadavers in the department of Anatomy, LHMC, New Delhi. Inferior extremities were dissected according to Cunningham’s manual. Level of termination and number of divisions of the sciatic nerve were noted and classified according to Beatsons and Ansons classification.
Discussion: In our study on 50 lower limbs, we observed that in one limb sciatic nerve divided within the pelvis. Whereas in 3 limbs sciatic nerve divided at the back of thigh. Out of these, in one specimen the two components of sciatic nerve showed fusion at the middle 1/3rd of thigh and eventually re-split into its two terminal branches at popliteal fossa. Trifurcation of the sciatic nerve was observed in two specimens.
Conclusion: Thorough knowledge of variant pattern of sciatic nerve is of utmost importance to the surgeons, anesthetist, orthopedicians and neurologist. It will help them in diagnosing piriformis syndrome, lower limb nerve entrapment etc., and performing nerve block.
Anatomical Variation in the Origin of Superior Thyroid Artery: A Case Report
Rajput P Singh, Sneha V Kumar, Sucheta M Chaudhary
B J Medical College, Ahmedabad, Gujarat, India
Introduction: Superior Thyroid Artery is the main arterial supply for the thyroid gland and also the upper part of larynx. Usually Superior Thyroid Artery arises from the anterior surface of the external carotid artery but in this case, it has been observed that it originates from the Common Carotid Artery. Various anatomical studies have reported wide variation in the origin and the location of the Superior Thyroid Artery. Various surgical procedures of the thyroid gland require knowledge of normal and variant arterial anatomy.
Methodology: Routine Anatomical dissection was performed on formalin fixed cadaver for under graduate students at Department Of Anatomy B.J. Medical College, Ahmedabad, Gujarat, India.
Results: During routine dissection it was observed that Superior Thyroid Artery was a branch of Common Carotid Artery on right side of the neck. We also found that origin and course of other arterial supply was normal in pattern in opposite side at the neck region.
Conclusion: Awareness of this anatomical variation might help in the minimizing the risks and complications associated with various surgeries like Thyroidectomy and Cancer surgeries of neck region. Superior Thyroid Artery is considered as a surgical landmark to trace the other branches which is required to tie in various cancerous surgeries of the neck. This knowledge regarding anatomical variation of Superior Thyroid Artery is useful for E.N.T surgeon and general surgeon to perform various surgeries.
2D Photogrammetry: A Reliable Alternative to Direct Methods in Facial Anthropometric Research
Shehzeen, S K Jain, Sonika Sharma
Department of Anatomy, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India
Introduction: Nasal anatomy is crucial in rhinoplasty, as precise modifications can profoundly impact both function and appearance, ensuring successful surgical outcomes that align with the patient’s aesthetic goals and anatomical considerations. There are various methods to analyze the morphology of nasal anatomy such as direct, 2D indirect and 3D methods. Traditional direct anthropometric approaches for nasal analysis have been replaced by two-dimensional (2D) photogrammetry; but questions remain about its accuracy and reliability. This study aims to assess inter-rater consistency in 2D photogrammetry and evaluate its reliability and precision compared to direct measurements.
Methodology: This cross-sectional study was conducted on 640 Indian healthy volunteers. Eight nasal dimensions (Nose height, Anatomical nose width, Morphological nose width, Columella length, Nasal bridge length, Alar length, Nasal tip protrusion and Nasal Index) were measured and calculated by two different approaches: Direct and 2D Indirect. We used Intra-class correlation coefficient test, Bland Altman Analysis and regression to assess the reliability of 2D method. Statistical analysis was performed using SPSS v25, with significance set at p < 0.05.
Results: Among the eight parameters examined, five nasal metrics exhibited a high degree of accuracy and reliability, including nose height, morphological nose width, alar length, nasal tip protrusion, and nasal index. On the other hand, anatomical nose width, nasal bridge length and columella length showed a moderate level of reliability in both methods.
Conclusion: The findings of the study indicated that 2D Photogrammetry demonstrates sufficient reliability as a viable alternative to the direct method. Through rigorous analysis, it emerged as a dependable substitute, offering comparable accuracy and efficacy, thereby validating its practical application in various contexts requiring precise measurements and assessments.
Digital Palpation: A Reliable Screening Tool for Assessment of Pelvic Floor Muscle Strength in Indian Women
Alisha Rai, S K Jain, Astha Lalwani
Department of Anatomy, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India
Department of Obstetrics and Gynecology, Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India
Introduction: Muscle strength has a crucial role in different physical activities, particularly in the pelvic-floor muscles (PFMs), which are responsible for providing support to the pelvic organs and maintaining continence. Pelvic floor muscle dysfunctions (PFMDs), such as pelvic organ prolapse (POPs) and urinary incontinence (UI) has a substantial effect on the overall health and wellbeing of women. Pelvic-floor muscle training has potential in effectively addressing these dysfunctions. Nevertheless, the assessment of pelvic floor muscle strength (PFMS), which is often disregarded, is crucial for personalized therapies. Although perioneometry is considered the gold standard method, digital palpation has become a popular and convenient approach. The objective of this research is to authenticate the use of digital assessment, which is essential for conducting effective evaluations of the pelvic floor without the need for specialist equipment.
Methods: This comparative study involved 435 Indian women aged 18–55, excluding those with urogenital surgery, incontinence, or pelvic organ prolapse. PFMS was evaluated using digital palpation and perineometeric scoring. Data analysis included demographic variables, kappa coefficient, Pearson’s correlation, and regression analysis.
Results: The average age was 30 years, with an average BMI of 23.95. Most participants were nulliparous. Assessment of PFMS showed substantial agreement (κ = 0.63) between digital palpation and perineometeric scoring. Regression analysis confirmed reliability (R = 0.954, R 2 = 0.910).
Conclusion: In conclusion, this study emphasizes the importance of assessing pelvic floor muscle strength (PFMS) for personalized therapies in women with pelvic floor muscle dysfunctions (PFMDs). Digital palpation, despite being simpler and more accessible than perineometeric scoring, demonstrated substantial agreement and reliability. Integrating digital assessment into clinical practice could enhance the management of PFMDs, improving women’s overall health and well-being.
Anthropometric Analysis of Hand Parameters for Redesigning Surgical Instruments
Shikha Singh, S K Jain, Sonika Sharma
Teerthanker Mahaveer Medical College & Research Centre, Moradabad, Uttar Pradesh, India
Introduction: The ergonomic study is helpful in re-designing instruments to improve the efficiency of healthcare professionals. Ergonomic challenges in the operating theatre can lead to discomfort, fatigue, and injury to surgeons, negatively impacting their performance and patients outcomes. Instruments that are designed for large male hands cause increased difficulty for small female hands during their use, thereby decreasing their work efficiency and increasing the risk of musculoskeletal (MSD) disorder. This study aims to address these issues through an anthropometric analysis of hand parameters, guiding the redesign of surgical instruments to enhance efficiency and comfort.
Methods: The study was conducted on 335 Indian healthcare professionals, comprising 168 males and 167 females. Various anthropometric and biomechanical parameters were measured on the dominant hand of all participants, including hand length, breadth, span, and wrist circumference using a measuring tape, as well as handgrip strength and pinch strength using a Jamar dynamometer and Jamar pinch gauge.
Results: Data analysis using the t-test with SPSS version 25 revealed significant differences (p = < 0.05) in hand dimensions and strength parameters between males and females. These findings underscore the necessity for adaptable and customizable surgical instruments to accommodate the ergonomic needs of all users, particularly addressing the challenge of instruments designed primarily for larger male hands.
Conclusion: This study highlights the importance of incorporating anthropometric data into the design process of surgical tools, contributing to improved occupational health for surgeons and better surgical outcomes. Future research will focus on the long-term benefits of these redesigned instruments and their impact on surgical efficiency and safety.
A Very Low Budget Plastination Lab from The Available Resources in a Government Medical College Delhi
Jishnu R, Rakhee Sharma, Renu Chauhan, Gurmeet Kaur, Harikrishnan PR
Department of Anatomy, University College of Medical Sciences, Delhi, India
Introduction: Plastination, developed by Dr Gunther von Hagens in 1977, preserves animal and human tissues by replacing body fluids and fat with silicone resins or epoxy polymers. For whole organ or sheet plastination the process includes fixation, dehydration, forced impregnation, and curing.
Methodology: Setting up the plastination lab involved several steps, starting with selecting a formalin-fixed sample. Initially started with sheet plastination, a less-than-ideal brain stem was identified as a trial specimen and slicing it with a chef knife. For tissue dehydration in acetone, a cryostat microtome was used and later moved to a deep freezer from the multidisciplinary research unit of college. Vacuum desiccator was used as a vacuum chamber. Vacuum pump and connectors were procured under nine thousand rupees and commissioned it successfully for forced impregnation. The sheet plastinated specimens were cured using UV-curable epoxy resin under sunlight. Whole organ plastination was done using S18 silicone from Plastodur.
Results: Twelve sheet plastinated specimens (brain, brain stem, kidney, and penis) and three whole organ plastinate (brainstem with cerebellum, coeliac trunk with aorta section and thyroid). Specimens including the heart, brain with brain stem, kidney, dura mater are ready for forced impregnation.
Conclusion: Plastination, reduces the exposure to harmful chemicals and minimize damages during handling of biological tissues. Setting up a basic prototype plastination lab doesn’t require much money or complex equipment. Our experience at the Department of Anatomy, University College of Medical Sciences Delhi involved creating a low budget lab and obtaining anatomical specimens using this technique.
Variations in the Jaunsaris Medial Longitudinal Arch Based on Medial Longitudinal Arch Angle and Navicular Drop Test
Sunita, Sadakat Ali, Anju Partap
Department of Anatomy, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India
Department of Anatomy, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, Uttarakhand, India
Introduction: The human foot is an extremely robust and intricate anatomical structure that provides the useful flexible surface needed for weight transfer, ground plane adaptation, shock absorption, and movement. Three distinct foot types have been proposed as a result of the anatomy of the Medial Longitudinal Arch: normal, pas planus, and pas cavus.
Methodology: In this study, 100 men and 100 women from three distinct Jaunsar age groups—20–30, 30–40, and 40–50—are included. The 200 RF and 200 LF of each participant from the Uttarakhand region of Jaunsar are measured. A foot evaluation is finished after anthropometric measurements and ocular observations. The Navicular/Arch height is measured for both weight-bearing and non-weight-bearing individuals. A digital goniometer is used to measure MLAA.
Results: The current study deviates from the hypothesis according to NDT, which indicates that people with hills have flat feet based on NDT. Instead, we found the highest percentage of Pas cavus in both the LF and the RF of the study, which is located in the hilly Jaunsar region. It follows the hypothesis according to MLAA by having 0% of Pas cavus foot and a small percentage of Pas Planus foot.
Conclusion: There were certain limitations to the current study, which demonstrated the paucity of prior research and the small number of studies that had been done in this area. The majority of the participants, according to NDT, had high-arched feet, which is an aberrant foot typology. As a result, preventive measures such as appropriate foot care, compensatory exercises, appropriate shoe selection, physiotherapy, etc., should be promoted.
Wax Embedding Technique: An Innovative Way for Preparing Museum Specimens
Swati Bansal, Virendra Budhiraja, Shveta Swami, Rimpi Gupta, Shivi Mudgal
Department of Anatomy, Kalpana Chawla Government Medical College, Karnal, Haryana, India
Introduction: Specimens in the anatomy museum are generally mounted on the plastic sheets by stitching them by using a thread. As time passes the tissue becomes brittle, especially the brain specimen, which is very delicate and by putting sutures again and again leads to damage to the tissue. Paraffin wax, which is used in the histology laboratory for making the blocks, is tried for mounting the specimen instead of the plastic sheet.
Materials and methods: Brain specimens of different sizes and thickness were taken from the dissection hall of the Department of Anatomy, Kalpana Chawla government medical college, Karnal. Four wooden block, paraffin wax, glycerin, acrylic jar were taken. The paraffin wax was melt in an incubator just above the melting point (55°C–60°C). The wooden blocks were kept on a clean horizontal surface to form a rectangular mould of appropriate size (in relation to the specimen). Glycerin was applied on the inner surface of the wooden blocks and the horizontal surface. Molten wax was poured in that mould so that a layer of wax of about 0.5 cm thick is formed. When the wax started solidifying, the specimen was kept at the center of the mould with face up and then the wax was poured around the specimen till it anchored the specimen. It was allowed to cool gradually. Generally, it took 30–45 min to solidify at room temperature. When it had completely solidified, the blocks were removed and wax mould was slowly lifted off the surface. Then, it was kept in an appropriate sized acrylic jar, filled with the preservative solution (10% formalin)
Results and conclusion: Wax mounting of specimens resulted in better understanding of anatomical details and relations of structures. This technique is easy to use, inexpensive and reproducible.
Variations in Morphological and Morphometric Features of Pterion in Dry Human Skull and Its Correlation with Craniolateral View of CT Scan
Rinke Choudhary, Sankat Mochan, Renu Chauhan, Sangita Chauhan
Department of Anatomy, University College of Medical Sciences, Delhi, India
Department of Anatomy, National Institute of Medical Sciences, Jaipur, Rajasthan, India
Introduction: The pterion is an important H-shaped anatomical landmark and sutural confluence seen in the norma lateralis of the skull where the frontal, temporal, parietal and sphenoid bones are articulated. It is located on the temporal side of the skull above the midpoint of the upper border of the zygomatic arch and behind frontozygomatic suture.
Methodology: To find out the position and type of variation concerned in dry human skull (n = 50), sutural patterns of the pterion and its distance from selected structural landmarks were analyzed macroscopically bilaterally. Measured results with dry human skull were further correlated with craniolateral view of CT scan.
Results: In the present study, out of the total skull, Spheno-parietal type of pterion(s) was found most common type (62%), followed by epipteric (20%), stellate (11%), atypical (5%) and frontotemporal (2%).
Conclusion: Appreciable differences were observed while comparing pterion in different groups. The results of the present study could be of utility for clinicians, especially where surgical intervention is indispensable to proceed with. Other wings of scientific community (radiology anthropology and forensic science) can also use this as a cross reference. Last but not the least our findings may also useful for comparing various types of pterions in altogether a different population, race or species.
A Cadaveric Study on the Variations in Renal Artery
Rajesh Kumar, Jishnu R, Gurmeet Kour, Md Misbah Ullah, Rakhee Sharma
Department of Anatomy, University College of Medical Sciences, Delhi, India
Introduction: Each kidney is supplied by a single renal artery, presence of multiple renal arteries is of specific interest to urologists, nephrologists, surgeons and radiologists. Methodology: In this cadaveric study, variation in renal artery was studied in 12 formalin fixed cadavers (24 specimens) during routine academic dissection. The renal artery was identified, cleared and observed for number of branches and bifurcations of direct branch from abdominal aorta reaching the hilum.
Results: The commonest pattern of arterial supply to each kidney is by a single renal artery arising directly from the abdominal aorta was observed in 7 cadavers i.e., 19 specimens (79.1%). Variations from the common pattern in renal artery were found in 5 cadavers and in 5 specimens (20.8%). in which 1 specimen (4.1%) having bifurcating branch which is supplying to accessory kidney.
Conclusion: The accurate knowledge of branching pattern and of renal artery is vital for urologists, nephrologists, surgeons and radiologists. Although, the variations are usually asymptomatic, they may cause misinterpretation of radiological examinations, understanding potential kidney donors and complications during nephrological surgeries. Knowledge of these variations is helpful to avoid any unwanted surgical complications.
Morphometric Analysis and Variation in Number of Cusp of Mitral Valve in Human Cadaveric Hearts: A Research Article
Rutuja Kamble, Charushila D Shinde
Mahatma Gandhi Mission Medical College, Kamothe, Mumbai, Maharashtra, India
Introduction: To treat different valvular diseases with surgery, anatomical knowledge of the Mitral valve is important. It is helpful in various types of valve surgeries, such as in the partial transfer of leaflets of mitral valve for repairs. Thus, anatomical knowledge of the bicuspid valve has great clinical importance and can help in the improvement of cardiothoracic surgery and the development of innovative operating techniques.
Aim: To analyze the morphometric parameters of Bicuspid valve and variation in number of cusps in human cadaveric hearts.
Materials and methods: The present study was conducted at Department of anatomy, MGM Medical college. 15 heart specimens were analyzed from age of 50–60 years, irrespective of the gender and the morphometric analysis of mitral valve was done along with the variation in number of cusps. The dissection was done using the Cunningham manual.
Results: The morphometric analysis of Mitral valve was found to be as follows: Mean Length of Anterior leaflet of Mitral valve was found to be 2.008 ± 0.519 cm. Mean Breadth of Anterior leaflet of Mitral valve was recorded 2.551 ± 0.239 cm. Mean Height of the Anterior leaflet of Mitral valve was 1.617 ± 0.364 cm. One Accessory cusp was found in 6 hearts out of 15 specimens. Mean Length, breadth and height of Accessory cusp I of Mitral valve was found to be 1.774, 1.793, 1.468 cm respectively. Two accessory cusps were found in 3 cadaveric hearts with Mean Length, breadth and height of 1.423, 2.659, 1.518 cm, whereas remaining 6 hearts appeared to have number of cusps (2).
Conclusion: The present study gives a morphometric analysis of mitral valve annulus and cusp. This study will be helpful for cardiac surgeons to decide the diagnosis, management of different abnormality and prosthetics for preparation of synthetic valves.
Variation in the Colic Branches of Superior Mesenteric Arteries: A Surgical Correlation
Hira, Kaur S, Jain P, Singh U, Bathla S, Hansdak R, Yadav A
Lady Hardinge Medical College, Delhi, India
Introduction: The superior mesenteric artery is the ventral branch of the abdominal aorta originating at the level of the L1 vertebra. It supplies the structures derived from the midgut extending from the major duodenal papilla in the second part of the duodenum up to the right 2/3rd of the transverse colon via inferior pancreaticoduodenal artery, jejunal and ileal branches. The colon is mainly supplied by 3 colic branches -ileocolic, right colic and middle colic arteries.
Methodology: The study was conducted on 20 formalin-fixed adult human cadavers between the age group of 65–75 years. The dissection was carried out as per Cunningham’s manual of dissection, the SMA was dissected and its branching pattern was observed, photographs were taken and findings were recorded.
Results: A varied branching pattern was observed in the superior mesenteric artery, in one case a common stump was present between the right colic and ileocolic artery (5%), in one case the right colic artery was absent (5%) and there were two cases in which the right and middle colic were seen to share a common stump (10%).
Conclusion: The superior mesenteric artery is one of the major vascular domains during resection anastomosis surgeries of the abdomen, like right hemicolectomy, ileostomy, and duodenal rotation procedures. Superior mesenteric artery syndrome though rare (0.1%–0.3%) continues to be an area of interest for interventional radiologists and surgeons, attributing to the vast range of variations the artery offers, the knowledge of varied branching patterns is of paramount importance.
Variant Anatomy of the Scapular Region
Sandeep Saluja, Sarika R Tigga, Sushil Kumar
Amrita School of Medicine, Faridabad, Haryana, India
Introduction: The shoulder apparatus presents a unique combination of muscular strength, coordination, and freedom of mobility. The diverse range of upper limb movements, exhibited by the shoulder joint is dependent on the stability provided by the four short muscles that blend with the fibrous joint capsule to form the musculotendinous rotator cuff. These four muscles, namely–subscapularis (SC), supraspinatus (SS), infraspinatus (IS) and teres minor (TMi), originate from the scapula. Identification and treatment of shoulder related injuries, becomes crucial, especially in athletes and people involved in lifting heavy weights.
Methodology: The findings presented here were encountered and recorded during routine cadaveric dissection, done for undergraduate medical students. The same will be discussed. Results: The infraspinatus muscle was seen originating from the medial two-thirds of the infraspinous fossa to bifurcate into two bellies, each with a separate insertion on the greater tubercle of humerus. The tendon of teres major was found to join with posterior surface and superior border of the latissimus dorsi tendon. Also, a variant arterial pattern was noted, wherein the posterior circumflex humeral artery (PCHA) and the profunda brachii arose conjointly from the brachial artery. The PCHA was seen to emerge posteriorly between the long and lateral heads of triceps, as a content of the lower triangular inter-muscular space. The artery then coursed upwards to accompany the axillary nerve emerging through the quadrangular space. The PCHA finally terminated by supplying the deltoid muscle.
Conclusion: Variations of the shoulder girdle musculature when compounded by a deviant arterial pattern may complicate shoulder injuries namely, the rotator cuff repair and increase the technical difficulty of surgical procedures.
Variant Origin of Circumflex Femoral Arteries: A Case Report
Mary Lianbiakmawi, Shilpa Bathla, Lamhoitheng Haokip, Shilpi Garg, Anjoo Yadav
Department of Anatomy, Lady Hardinge Medical College, Delhi, India
Introduction: Lateral and medial circumflex femoral arteries are the branches of profunda femoris artery which is the largest branch of femoral artery. Lateral circumflex femoral artery normally arises from the lateral aspect of upper end of profunda femoris artery in the femoral triangle. It passes between the anterior and posterior divisions of femoral nerve, posterior to the sartorius and rectus femoris muscles. Further, it divides into ascending, transverse and descending branches. The medial circumflex femoral artery usually originates from the posteromedial aspect of profunda femoris artery passing between the pectineus and psoas major muscles. It gives off transverse and ascending branches. The knowledge of variations regarding the origins of circumflex femoral arteries is important for interventional radiology and reconstructive surgery.
Methodology: During routine cadaveric dissection of thigh on an elderly male cadaver in the department of Anatomy, Lady Hardinge Medical College, New Delhi; a variation was observed in the origin of lateral and medial circumflex femoral arteries. The dissection was carried out as per Cunningham’s dissector. Measurements were taken with Vernier Calliper.
Results: We observed that the lateral and medial circumflex femoral arteries originated directly from the femoral artery instead of the profunda femoris artery. The profunda femoris artery originated distal to the origin of the medial and lateral circumflex femoral arteries.
Conclusion: Knowledge of these variations is significant while undertaking clinical procedures in the femoral region like vascular reconstructive procedures, catheterization procedures, surgical interventions for embolism and raising myocutaneous grafts. It will also help in reducing the chances of intra-operative secondary hemorrhage and post-operative complications.
Morphometry of Neck-Shaft Angle and Neck Length of Femur and It’s Correlations: A Cross Sectional Study
Shivani Chawla, Prachi Saffar Aneja, Susmita Saha
Department of Anatomy, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India
Background: Total hip arthroplasty is very common study these days. The hip joint is under constant tension since it bears the weight of the upper body. Osteoarthritis can lead to irreversible damage of hip joint. Designing prostheses for a certain population requires consideration of the femur’s neck shaft angle, neck length geometry, etc.
Aim and objectives: Study was aimed to estimate parameters of neck-shaft angle of right and left femur and correlate the above parameters among them.
Materials and methods: Present study was a descriptive cross sectional study on 50 Dry femurs (25 right and 25 left) which were randomly obtained from the bone bank of Department of Anatomy, FMHS, SGT University. Study was included dried, intact and nonpathological femurs and femur with tumor, fracture, trauma and any pathological abnormality were excluded. Anthropometric instruments like Osteometric board, Digital Vernier caliper, goniometer were used for measurements.
Results: To compare the morphometric parameters in accordance of right and left femur, student ‘t’ test was performed and it was found that comparison of all parameters of both side femur bones was not statistically significant. Second objective of this study, observed that femur length is not significantly correlated with Femur Neck Length and Neck-Shaft Angle.
Conclusion: These parameters can be used in accuracy and success of the hip replacement surgery demands complete knowledge of the neck shaft angle. The values obtained were greater in western world than in present study. So, the regional variations were found among different regions of world. This study will applaud biomechanical engineers to manufacture and build the implants with accurate morphometric data to suit Indian population and for enhance surgical consequences with prevention of complications.
Effectiveness of Embalming Solutions of 2% Phenoxyethanol, Glutaraldehyde and Propylene Glycol as a Substitute for Formaldehyde in Wistar Rats
Padmini Shinde, Mini Mol
Mahatma Gandhi Mission Institute of Health Sciences, Mumbai, Maharashtra, India
Introduction: Embalming is the process of artificial preservation of the human body following death which reduces the presence and growth of micro organism and prevent putrefaction. Replacement of formaldehyde is necessary to prevent health hazard due to its known carcinogenic effect.
Methodology: A comparative study on different embalming solution with formaldehyde, 2% phenoxyethanol, Glutaraldehyde and Propylene glycol was studied in Wistar rats. Twenty-four adult Wistar rats were divided into four different groups. Each group consist 6 rats. Group A embalmed with Formaldehyde, Group B embalmed with Phenoxyethanol, Group C embalmed with Glutaraldehyde and Group D embalmed with propylene glycol. These embalmed rats were preserved for 1 week and 8 weeks of duration and observed for changes in external and internal features, range of motion, bacterial and fungal growth also the histological architecture of the tissue.
Results and conclusion: The result were statistically analyzed and the details will be discussed during presentation.
Isolated Common Iliac Artery Aneurysm: Clinical Correlation
Shariq, Singh U, Arora S, Jain P, Yadav A
Lady Hardinge Medical College, Delhi, India
Introduction: The abdominal aorta ends by dividing into two common iliac arteries at the level of L4-L5 vertebrae. These two branches further divide into external and internal iliac arteries and are the principal arteries to supply the pelvis and lower limb. Aneurysms are dilatation or ballooning in the wall of a blood vessel. Aneurysms can stay silent for a while, which may be an incidental finding during routine imaging procedures or it may rupture leading to severe bleeding and blood loss which can be life-threatening. The present study describes an incidental finding in a 72-year-old male cadaver. There was no history of cardiovascular disease as the deceased person succumbed to natural death. An isolated case of an aneurysm was seen in the right common iliac artery.
Methodology: During routine dissection meant for Undergraduate teaching and learning, an intact isolated aneurysm in the right common iliac artery was observed in the Department of Anatomy, Lady Hardinge Medical College, New Delhi.
Results: The present study is observational. Abdominal aorta bifurcated at L4-L5 level. Just below the bifurcation, an isolated aneurysm approximately 16 cm in circumference extending up to the sacroiliac joint was present (length 7 cm) Tortuosity was observed in the external and internal iliac artery.
Conclusion: Aneurysm is a life-threatening condition. It usually causes no symptoms until it ruptures. The abdominal aorta is the most common site, and an isolated common iliac artery aneurysm is a rare presentation. Precise anatomical knowledge is very crucial to the operating surgeons, obstetricians and radiologists who do interventions to treat it.
Bilateral Renal Nutcracker Phenomenon and Its Clinical Correlation
Agnihotri E, Hira, Jain P, Singh U, Yadav A
Lady Hardinge Medical College, Delhi, India
Introduction: The Nutcracker phenomenon (NCP) classically means the entrapment of left renal vein (LRV) between Abdominal aorta (AA) and Superior mesenteric artery (SMA). Depending on the site of compression, NCP can be Anterior NCP (ANCP), Posterior NCP (PNCP), Mixed NCP (MNCP) and Renal hilar NCP (RHNCP). Clinical manifestations of NCP depends upon the compression of the anatomical structures underneath leading to Nutcracker syndrome (NCS). Precise knowledge of the variations causing the above phenomenon is not much studied and needs more research.
Methodology: During routine dissection teaching meant for the undergraduate teaching and learning, the finding was appreciated on the 65-year-old male cadaver. The dissection was carried as per Cunningham’s dissector manual. The relationship between the structures was observed.
Results: Renal vein was compressed by the gonadal arteries. The present finding was observed bilaterally. The gonadal arteries on both sides were seen taking origin at L1 and L2 vertebrae. Instead of following its usual course behind the kidneys, it crossed the renal vein on the anterior aspect. On the left side of the kidney, the renal vein was not one but there were two tributaries, joining as one renal vein. One of the tributaries was being entrapped between segmental branches of Left renal artery. Further, on the left side, sharp upward turn of the Left colic artery arising from Inferior mesenteric artery was overlying the hilum causing potential compression of the left renal vein.
Conclusion: NCP is a rare clinical condition that presents as NCS. It can present as chronic fatigue, renal and pelvic congestion, hematuria, flank or abdominal pain, hypertension, proteinuria, varicocele and orthostatic intolerance. Deeper exploration about this phenomenon can be resourceful help to provide adept treatment of the condition.
Congenital Absence of Portal Vein with Coexisting Errors of Midgut Rotation
Sarika Rachel Tigga, Renu Chauhan, Sandeep Saluja
University College of Medical Sciences, Delhi, India
Introduction: Portal vein is a venous channel that receives blood from the splanchnic system, and circulates it through the liver. The formative tributaries of the portal vein are the superior mesenteric and splenic veins, with other tributaries draining into its trunk or divisions. A variation rarely encountered is the congenital absence of the portal vein (CAPV) or its major divisions. In this variant, there is a failure of development of the portal vein associated with drainage of portal blood directly into the systemic circulation. The recognition of CAPV is of clinical importance as it is associated with development of congenital cardiac and skeletal abnormalities including dysplasia’s involving the kidney, spleen, arteries and endocrine glands.
Methodology: During routine cadaveric dissection for undergraduate medical students, the findings obtained were observed in a 70-year-old female cadaver. Routine methodology of dissection was carried out for exposing the abdominal viscera and the findings recorded.
Results: On inspection of the abdominal organs, the caecum was found to be sub-hepatic in position with an absent ascending colon. An inverted ‘U’ shaped sigmoid colon was situated in mid line at the pelvic brim. The superior mesenteric vein drained directly into the porta hepatis. The splenic vein, right renal and inferior mesenteric vein joined to form a short trunk of 3.5 cm length, which then drained into the inferior vena cava. The portal vein was ascertained to be absent.
Conclusion: The clinical manifestations of CAPV are frequently associated with coexisting congenital malformations and its subsequent syndromes. These include a wide array of hepatic neoplasm’s, metabolic disorders and cardiovascular, skeletal, urogenital, or biliary malformations. Presence of intestinal malrotation in the background of CAPV might indicate an association of the two entities and warrants further review of cases of diagnosed CAPV.
A Case Report on Additional Arteries from the Coeliac Trunk and Its Branches Supplying the Stomach
Astha Mehrotra, Gurmeet Kour, Rakhee Sharma
University College of Medical Sciences, Delhi, India
Objective: This case report focuses on the blood supply to the stomach through usual and additional arteries arising from the coeliac trunk or its branches. Clinicians should be aware of these potential variations to plan surgical procedures to avoid possible complications.
Materials and methods: During routine dissection of the coeliac trunk in the Department of Anatomy, University College of Medical Sciences, Delhi, we observed normal and variant branches of the coeliac trunk supplying the stomach.
Results: To start with the coeliac trunk was 2.5 cm long, and the left inferior phrenic artery originated from the coeliac trunk. Just below it, an additional branch was originating from the coeliac trunk, supplying the fundus of the stomach, esophagus and diaphragm. Two aberrant branches also originated from the left hepatic artery, one was supplying the stomach along the lesser curvature and the other to the esophagus.
Conclusion: Although variations in the blood supply of the stomach are not uncommon findings, different and new anatomic variants being reported help clinicians to have the right approach during surgical and imaging procedures to avoid any complications.
Variation in the Number and Drainage Pattern of Testicular Veins: A Case Report
Ujwaljit Singh, Rimpi Gupta, Virendra Budhiraja, Shveta Swami, Swati Bansal, Shivi Mudgal
Department of Anatomy, Kalpana Chawla Government Medical College, Karnal, Haryana, India
Introduction: The right gonadal vein (testicular vein in males, ovarian vein in females) usually drains into the inferior vena cava while the left gonadal vein drains into the left renal vein. This anatomical difference induces relatively weak hemodynamics in the left testicular vein and is considered to be one of the causes of a left varicocele. Gonadal veins serve as an entry portal for newer techniques used for treating varicocele such as percutaneous retrograde varicocele occlusion and laparoscopic varicocelectomy in males and pelvic congestion disease in females. The testicular veins show a wide range of variations, which occurs as variation in number, course, communication and termination pattern. It is well accepted that variations of the testicular and renal vasculature are of huge practical importance and the awareness about such variations is of tremendous benefit to the surgeon and the patient.
Methodology: A 72-year-old male cadaver was dissected in the Department of Anatomy as a part of MBBS teaching curriculum. The abdominal and peritoneal cavity was opened by standard anatomical dissection steps. After the removal of gut and mesentery from the abdominal cavity, the retroperitoneum and gonadal veins were dissected and carefully cleaned. Results and Discussion: In the present cadaver, the testicular veins were two in number on both sides. On right side, one of the testicular veins was draining normally into inferior vena cava, whereas the second one was draining into right renal vein. However, on left side, both the testicular veins were draining into the left renal vein. The embryological and anatomical basis shall be discussed at the time of presentation.
Conclusion: The testicular veins present numeric variation and anomalous drainage pattern. This anatomical finding can help in understanding the origin of varicocele and its recurrence after surgical interventions. Also, duplication of terminal ends calls for caution to ensure the success of procedures, which use terminal ends of gonadal veins as entry portals by surgeons.
Variation in Relation of Ulnar Artery and Ulnar Nerve to the Flexor Retinaculum
Sooraj Bensen, Gurmeet Kour, Rakhee Sharma
University College of Medical Sciences, Delhi, India
Objective: The case report focuses on the specific variation concerning the ulnar artery and nerve to the flexor retinaculum. Vascular and plastic surgeons and orthopedics should be aware of such variations to plan surgical and other procedures to avoid possible injuries to this structure.
Materials and methods: During a routine dissection of the forearm in formalin-fixed cadaver at the Department of Anatomy, University College of Medical Sciences, Delhi, a variation was observed in the course of the ulnar artery where both ulnar artery and ulnar nerve were passing below flexor retinaculum in both hands.
Results: Usually, the ulnar nerve and vessels pass above the flexor retinaculum through Guyon’s canal. In the present case, both the ulnar nerve and ulnar artery were passing below the flexor retinaculum.
Conclusion: Knowledge of variations in the course of the ulnar artery and nerve is essential for clinicians to prevent injuries of nerve and vessels during surgeries of hand, to avoid any diagnostic confusion and unnecessary complications.
Study of Variations in Lumbricals of Hand
Bhairvi Jangid, Sharadkumar P Sawant
Department of Anatomy, K J Somaiya Medical College, Mumbai, Maharashtra, India
Aim: To study variations in lumbricals of hand.
Materials and methods: This study was performed on 50 (100 specimens of human hands) embalmed donated cadavers. the photographs of the variation of the lumbricals were taken for proper documentation.
Conclusion and results: Out of 100 specimens the variations were observed in 22 specimens. Clinicians and hand surgeons should be aware of such variations of first lumbrical while dealing with the hand during various surgical procedures.
Morphometric Analysis of Cadaveric Fetal Stomach
Kadambari, Krishna Pandey, Badal Singh, Nishtha Singh, Mamta Anand, Supriya Sudha
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: The structural pattern of gut influences the nutritional and growth outcomes in new borns and adults. The intricate development of the human gastrointestinal system during the fetal period lays the foundation for lifelong digestive function and health. Among the key structures within this system, the stomach undergoes profound morphological transformations during the fetal period. Understanding the precise morphometric growth and changes is hence essential for comprehending its embryological origin, developmental process and potential clinical implications.
Methodology: The study employed a cadaveric approach, 38 human fetal specimens obtained from ethically sourced anatomical donations. Morphometric analysis included measurements of organ dimensions, including weight, length, width, length of greater curvature and length of lesser curvature by thread and Vernier callipers.
Results: It was observed that as the fetal age advanced, various parameters such as weight, length, width along with length of lesser and greater curvatures also increased, though at differential rates.
Conclusion: Despite the wealth of research on adult gastrointestinal anatomy and function, the fetal period remains relatively underexplored, presenting a significant gap in our understanding of human embryological development. The cadaveric study proposed herein seeks to address this gap by meticulously examining the morphometry of the human fetal stomach.
A Case of Iniencephaly in a 34 Week Old Cadaveric Human Fetus
Kadambari, Krishna Tiwari, Nishtha Singh, Badal Singh, Mamta Anand, Supriya Sudha
Motilal Nehru Medical College, Prayagraj, Allahabad, Uttar Pradesh, India
Introduction: Iniencephaly is an extremely rare and lethal example of defective neural tube closure, characterized by a triad of occipital bone defect, rachischisis, severe cervicothoracic lordosis and fixed retro flexion of head. Patients are usually stillborn or die soon after birth. The condition is more prevalent in females than in males. It presents a multifactorial etiology with deficient folic acid supplementation during pregnancy, intake of drugs such as sulfonamide, clomiphene etc. and infections such as cytomegalovirus. Iniencephaly may also cause complications such as obstructed labor and high risk of recurrence in subsequent pregnancies. Other associated abnormalities include encephalocele, cyclopia, hydrocephalus, absence of mandible.
Methodology: A female cadaveric fetus of 34 weeks, procured from the department of obstetrics and gynecology at Swaroop Rani Nehru hospital, Prayagraj was fixed in formalin and morphometry carried out after close observation of its anomalies.
Results: General physical examination showed evidence of intra uterine growth retardation (IUGR) as observed via gross physical findings. The fetus was found to be dysmorphic with bilateral talipes, and meningoencephalocele in the posteroinferior occipital bone causing retro flexion of cervical spine.
Conclusion: As the demand for organ transplantation rises in pediatric population, research on congenitally malformed fetuses may give a solution for the same while also shedding some light on normal fetal intrauterine development and related pathologies.
Study on Variant Anatomy of Sciatic Nerve
M Soniya, R Chitra
Department of Anatomy, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India
Introduction: Sciatic Nerve (SN) is the nerve of the posterior compartment of thigh formed in the pelvisfrom the ventral rami of the L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into Common Peroneal Nerve (CPN) and Tibial Nerve (TN) at the level of the upper angle of the popliteal fossa. Higher division of the sciatic nerve is the most common variation where the TN and CPN may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica.
Materials and methods: Fifty lower limbs were used for the study from Department of Anatomy, Siddhartha Medical College, Vijayawada, India.
Observation and results: In our study on 12 cadavers (24 lower limbs), we have observed 5 (8%) lower limbs high division of sciatic nerve was noted. High division of sciatic nerve in the back of thigh was noted in one specimen (2%), while high division within the pelvis was noted in 1 specimens (6%), while in 18 (92%) it occurred outside the pelvis.
Conclusion: Knowledge regarding such variation and differences in the course of SN is important for the surgeons to plan for various surgical interventions pertaining to the gluteal region. The variant anatomy of SN may cause piriformis syndrome and failure of SN block. Hence present study is undertaken to know the level of division, exit, course, relationship to piriformis and variations in the branching pattern of SN.
Presence of Pyramidal Lobe along with Levator Glandulae Thyroideae in Left Lobe of Thyroid Gland: A Case Report in Adult Cadaver
M Soniya, M P Sultana, R. Chitra
Department of Anatomy, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India
Introduction: Thyroid is an Endocrine Gland which regulates basal metabolic rate. Normal Thyroid Gland weighs 20 to 25 gms. Functional as well as morphological variations of the gland are very common. Levator Glandulae Thyroideae (LGT) is an important fibromuscular band from pyramidal lobe.
Case report: During routine cadaveric dissection in a 65 years female cadaver, identified a fibromuscular band of tissue extending from the Thyroid gland to hyoid bone. On further dissection it was confirmed as a case of Levator Glandulae Thyroideae. This Levator Thyroideae extends from the apex of pyramidal lobe. We measured the dimensions of Levator Glandulae Thyroideae and isthmus with the help of verneer calipers. The isthmus of Thyroid measures 6.78 mm x 5.19 mm. Levator Glandulae Thyroideae extends 27.17 mm from pyramidal lobe.
Conclusion: Levator Glandulae Thyroideae (LGT) is a fibromuscular band from pyramidal lobe. In this case Levator Glandulae Thyroideae extends from the apex of pyramidal lobe and inserted into hyoid bone. This case warrants further detailed studies to give knowledge about the different developmental and Anatomical variations of this structure including its nerve supply. This would be useful for the safe optimal thyroid surgical outcomes.
Sperm Cryopreservation in Liquid vs Vapor Phase of Liquid Nitrogen: Search for the Better Technique
Nandana Devi, Mona Sharma
Department of Reproductive Biology, All India Institute of Medical Sciences, Delhi, India
Introduction: Sperm cryopreservation is an integral technique in the field of Assisted Reproductive Technology, with slow freezing being the traditional method for sperm preservation. The drawbacks of slow freezing however are extensive with cryoinjury compromising cellular integrity, viability and fertility rates of spermatozoa. An alternative, vitrification or ultra-rapid freezing of cells directly at -196 o C liquid nitrogen (LN 2) has been found to be less detrimental to spermatozoa, in which viable cells undergo glass-like solidification. Another modification explored in recent times is to cryopreserve cells in vapor-phase of LN 2. Studies comparing efficiency of sperm cryopreservation in liquid vs. vapor-phase are very few and therefore, the current research aimed to investigate the post-thaw cell survival, morphology and nuclear chromatin decondensation in liquid and vapor-phase of LN 2 cryo-storage.
Methodology: Ten patients were recruited for this study. Semen analysis according to WHO manual (6th edition, 2021) was performed on freshly ejaculated semen after which they were prepared for cryopreservation by density gradient centrifugation. Sperms were cryopreserved for three time-points: 1 week, 1 month and 3 months in both liquid- and vapor-phase LN 2 systems. The pre- and post-cryopreserved samples were evaluated for morphology, vitality, motility and nuclear chromatin decondensation and data was analyzed using Student T-test.
Results: Sperm motility was found to be highest (average 21.11%) at 3 month liquid-phase time-point but vitality was highest at 3 month vapor-phase (average 24.80%). Normal morphology of 3 month vapor-phase (average 2.75%) was found to be closest to pre-cryopreserved morphology (average 3.20%) with teratozoospermia index of liquid-phase (average 1.12) being higher at all time-points (vapor-phase average 1.08). Further, nuclear chromatin decondensation was found to be higher in vapor-phase (average 50.94%) at all time-points (liquid-phase average 44.50%). Overall sperm parameters were found to be better at 3 month time-point of vapor-phase cryopreservation.
Conclusion: In conclusion, the data suggests that vapor-phase cryopreservation of sperm is a superior technique as compared to liquid-phase cryopreservation. This intrigues us to explore vapor-phase cryopreservation further to achieve post-thaw sperm cells that are least damaged with the highest fertilization potential.
Aberrant Communication of Vertebral Vein with Renal Vein
Gurmeet Kour, Jishnu R, Rakhee Sharma
Department of Anatomy, University College of Medical Sciences, Delhi, India
Introduction: Each kidney is drained by renal vein; in right side it gets tributaries from right suprarenal whereas left suprarenal and left gonadal drain into left renal vein. This is of specific interest to urologists, nephrologists, surgeons and radiologists.
Methodology: In this cadaveric study, renal vein was studied in 12 formalin fixed cadavers (24 specimens). The renal vein was identified, cleared and observed for number of tributaries draining into it.
Results: The commonest pattern of venous drainage is that right renal vein is gets tributaries from right suprarenal whereas in left renal vein left suprarenal and left gonadal drain into it. Among 12 cadavers, in 3 we observed aberrant communications from vertebral vein to the left renal vein.
Conclusion: Understanding source and course of drainage of renal veins is vital for urologists, vascular surgeons, onco-surgeons and to diagnostic interventional radiologist and orthopedics surgeons for bleed management, transplantation of kidney and understanding metastatic spread of certain neoplasms. We were unable to find more literature on this sort venous aberration on lower thoracis and upper lumber level so as anatomist its our duty to do more research to rule out any genders or geographical basis, this insight will guide clinicians in various fields to exclude diagnostic misinterpretations or while performing any major surgical maneuver and circumvent any aforethought endeavor.
Evaluation of Morphological Human Spermatozoa Parameters with Different Stains
Shivani Chawla
Department of Anatomy, Faculty of Medicine and Health Sciences, SGT University, Budhera, Gurugram, Haryana, India
Background: Infertility affects 15% of couples globally. The male has been identified as a contributor to infertility in 40%–50% of infertile couples. It is attributed to male-factor associated causes have created a need for further studies and advancements in semen analysis. Sperm Morphology is an important factor to effect the fertility.
Aims and objectives: The present study was to compare efficacy of Giemsa and Papanicolaou stains to indicate better morphology of human spermatozoa.
Methods: The present study was cross-sectional observational study and conducted in Department of Anatomy, Sardar Patel Medical College, Bikaner, Rajasthan in 2020–21. It was observed and compared of human spermatozoa morphology according to WHO criteria; we studied semen samples of l00 males from the private IVF labs of Bikaner, Rajasthan, two staining techniques, the Giemsa and Papanicolaou staining technique were used.
Results: All morphological parameters investigated by comparison of Giemsa and Papanicolaou stain (percent middle piece and tail abnormalities) correlated statistically significantly positive (P = 0.0001) but percent head abnormality was insignificant (P = 0.188). Head morphology was clearly seen but middle piece and tail morphology were not clearly seen with Giemsa stain while head, middle piece and tail morphology were clearly seen by Papanicolaou stain. Papanicolaou stain excelled in both the efficacy and accuracy from the Giemsa Stain.
Conclusion: In comparison the Papanicolaou stain came out better and low time consuming as compare to Giemsa stain.
Comparison of Regular and Virtual Microscopes for Learning Outcome for Teaching Histology of UG Students
Bhavesh K Sharma
Department of Anatomy, Parul Institute of Medical Science and Research, Vadodara, Gujarat, India
Introduction: Histology subject is based on the theoretical didactical strategies as well as on practical training. Medical histology is a very discipline subject in medicine and other life science curriculum world-wide. Changes in the way we teach both microscopic and gross anatomy are being implemented throughout the medical curriculum to address the increasing trend towards problem-based or systems integrated learning and to provide students with more access to recent advances in educational technology.
Aim and objectives: To compare learning outcome of Histology practical of UG students using Virtual and Regular Microscope with helps of microscopic rating (Excellent/Good/Satisfactory/Poor/Unsatisfactory).
Materials and methods: This study was questionnaire study and conducted in the Department of Anatomy, Dr. S. N. Medical College Jodhpur, Rajasthan in 2021–22 and 150 first year undergraduate medical students having ≥ 70% of attendance including first semester and consenting to the study were selected. (1) Study group–75 students were included in this group. Teaching session given for five days with the help of slides by using virtual microscope and regular Microscope. (2) Control group–75 students were included in this group. Teaching session was given for five days with the help of slide by using regular microscope.
Results: We had asked for identification and diagram of histology slides it was found, 30(40%) students out of 75 students gave good rating about regular microscope whereas, 38(50.67%) students out of 75 students gave good rating about virtual microscope. It was observed that, the mean value for regular microscope and virtual microscope were found 3.01 ± 1.03 and 4.04 ± 0.84 and In which it was found, 33(44%) students out of 75 students gave satisfactory rating about regular microscope whereas, 36(48%) students out of 75 students gave excellent rating about virtual microscope. It was observed that, the mean value for regular microscope and virtual microscope were found 2.73 ± 0.90 and 4.14 ± 1.06 respectively.
Variation of Quadriceps (q) Angle in Females from Hilly to Plain Regions of Female Population of Uttarakhand
Chanchal Sharma, Sadakat Ali
SGRR Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
Introduction: Quadriceps angle is a measure of the pull of quadriceps muscle and patellar tendon and an increase in Q-angle is associated with instability of patella and extensor dysfunction of knee joint. Q-angle can vary with change in weight, height and physical activity. There is a lack of data regarding variation of Q-angle among females from plain to hilly region of Uttarakhand. The present study was a cross sectional study conducted to address this gap.
Methodology: The present study was a prospective, observational, cross sectional study conducted at a tertiary care center from Uttarakhand. The study was conducted on apparently healthy females from 24–60 years of age, without any history of major trauma/acute injury or chronic dysfunction etc. Q-angle was measured in standing position by drawing a line from Anterior Superior iliac spines to the center of patella, and another line was drawn from the tibial tuberosity marker to the center of patella and upwards angle between these two lines, called Q-angle, was recorded using a goniometer.
Results: A total of 370 females from the age group of 24–60 years were enrolled in the study that included 200 from the Garhwal’s hilly region and 170 from the plain region of Uttarakhand. The mean Q-angle in hill residents was 11.76° ± 1.63° while those from plains had a mean value of 12.02° ± 2.26°. The mean Q-angle on right side from hills to plains was 12.02° ± 1.64° and 12.17° ± 2.32° respectively. The mean Q-angle on left side was 11.50° ± 1.59° in hills and 11.88° ± 2.20° in plains. The Q-angle was higher in females with a BMI of more than 25 in both hills as well as plains.
Conclusion: Q-angle shows significant variation in females of hilly and plain regions of Uttarakhand. It had a positive correlation with weight and had a negative correlation with height.
A Study of Left Coronary Artery in Adult Human Cadaveric Hearts of North Indian Population
Kamaldeep, Shveta Swami, Virendra Budhiraja, Rimpi Gupta, Swati Bansal, Shivi Mudgal
Department of Anatomy, Kalpana Chawla Government Medical College, Karnal, Haryana, India
Introduction: Coronary arteries play an important role in perfusion of the heart tissues. Knowledge of normal and variant anatomy and anomalies of coronary circulation is an increasingly vital component in the management of congenital and acquired heart diseases. The left coronary artery (LCA) presents wide variability in its morphological expression. Thus, this study aimed to determine these variations in the LCA and its branches. The study of coronary arteries will be useful to the cardiologists and radiologists to predefine abnormalities by invasive and non-invasive studies.
Methodology: The study was conducted in specimens obtained from routine dissection of cadavers during the undergraduate teaching in the Department of Anatomy, KCGMC, Karnal. The cadavers were procured as a part of voluntary body donation program. The left coronary artery and its branches were dissected carefully. The variation in the origin and the course of left coronary artery and its branches were noted and photographed.
Results and discussion: The variations were noted in five specimens, and the detail will be discussed at the time of oral presentation.
Conclusion: The high degree of variability of left coronary artery and its branching patterns have anatomical, pathophysiological diagnostic and therapeutic implications. Adequate knowledge of these variations with regard to source, and incidence is important for the interpretation of coronary angiography, stenting procedures and surgical myocardial revascularization.
Voluntary Body Donation: A Boon for Medical Students
Mohit K Bhati, Virendra Budhiraja, Shveta Swami, Rimpi Gupta, Swati Bansal, Shivi Mudgal
Department of Anatomy, Kalpana Chawla Government Medical College, Karnal, Haryana, India
Introduction: The study of human anatomy is essential for the proper training of health care professionals, as it permits the acquisition of precise structural knowledge of the body’s components and promotes the capacity to observe and respect the human body. the teaching of anatomy is based on the use of cadavers. However, the short age of bodies for teaching purposes and the difficulty in obtaining them have obliged some countries to opt for artificial and three-dimensional models to fill this gap. The constant need to obtain bodies in sufficient numbers to maintain a high level of teaching and learning in anatomy has triggered the search for definitive solutions at a global level.
Methodology: In KCGMC Karnal, the body donation program is running from June 2017 to till date. The total number of bodies got donated till date in our institute are 23. Out of 15 are Male and 08 are Female.
Results and conclusion: The success rate and functioning of body donation program of our institute shall be discussed at the time of presentation.
Splitting of the Femoral Nerve with Iliac Muscle: A Case Report
Sahil, Shveta Swami, Virendra Budhiraja, Rimpi Gupta, Swati Bansal, Shivi Mudgal
Department of Anatomy, Kalpana Chawla Government Medical College, Karnal, Haryana, India
Introduction: Femoral nerve is an important nerve supplying the lower limb. Variations in the origin and course of femoral nerve are frequently encountered. Aberrant slip of iliacus or psoas major muscle sometimes splits the femoral nerve. The detailed knowledge of the possible variations of these muscles and femoral nerve may have immense importance in various pelvic and pelvi-femoral surgeries.
Methodology: A 50 years old male cadaver was dissected in the department of Anatomy as a part of MBBS teaching curriculum. The abdomen was opened and psoas major muscle on both sides (right and left) were cleaned and nerves of lumber plexus were traced. A case of splitting of the femoral nerve by the slip of iliac muscle in the left iliac fossa was encountered during the dissection.
Result and conclusion: The knowledge of anatomical variations of femoral nerve is essential for the surgeons and medical fraternity to prevent the iatrogenic injury to femoral nerve during regional nerve blocks and for the radiologists to prevent diagnostic errors.
An Observational Study on Morphometry and Vascular Pattern of Human Placentae in Spontaneous Preterm Deliveries
Abhijeet Singh, Shveta Swami, Virendra Budhiraja, Rimpi Gupta
Kalpana Chawla Government Medical College, Karnal, Haryana, India
Introduction: The placenta is a feto-maternal organ. It connects growing embryo/fetus with the wall of pregnant uterus. It facilitates nutrient and gas exchange between the maternal and fetal compartments. The placenta sub serves these purposes until sufficient maturation of the fetus which enables it to survive in the extrauterine environment. The growth of the fetus depends upon the functional capacity, location and integrity of the placental attachment.
There has been paucity of literature regarding the morphometric study of human placenta and its vascular pattern (magisterial or dispersal). Therefore, the present study was conducted on morphometry and vascular pattern on the fetal surface of the human placentae.
Methodology: The present study is a observational study of placentae of spontaneous preterm births among the pregnant women and this study has been conducted on 20 spontaneous preterm placentae and 20 term human placentae at various stages of maturation and their morphological measurements and vascular patterns were observed using simple tools such as vernier callipers, ruler, digital weighing scale and their pictures were taken. The observations were tabulated and statistically analyzed.
Results and conclusion: The results of the observations will be discussed at the time of oral presentation.
Study of Sperm Morphology based Functional Assessment in Infertile Males: Search for Potential Diagnostic Tools
Aayushi Taneja, Nandana Devi, Sajda Aara, Tanya Gupta, Anmol Garg, Mona Sharma
Department of Reproductive Biology, All India Institute of Medical Sciences
Introduction: Incidence of male infertility has surged in tandem with declining semen quality, yet traditional diagnostic methods have shown limited advancement. This limitation underscores the need for more comprehensive diagnostic tools to encompass the functional competence of spermatozoa. Assessing sperm DNA and membrane integrity, viability and chromatin packaging by sperm function tests can further aid in diagnosis of male infertility. Thus, this study aimed to explore the potential of DNA Fragmentation Index (DFI), Nuclear Chromatin Decondensation Test (NCDT) and Hypoosmotic Swelling Test (HOS) in diagnosing sperm dysfunction in infertile males.
Methodology: 36 infertile patients were recruited and divided into two groups based on their morphology-abnormal semen parameters (infertile group) and normal semen parameters (subnormal group). Routine semen analysis was performed according to WHO guidelines (2021) along with sperm function tests (DFI, NCDT and HOS). Data was analyzed using Pearson correlation.
Results: Comparison of semen parameters revealed increased morphological defects (average 98.54% vs 94.64%) in the infertile group while motility and vitality were almost similar in both groups. Further comparing sperm function test between the groups, it was evident that subnormal group (82%) had increased DFI than the infertile group (36%). NCDT results indicated that 40% of infertile group and 27% of subnormal group had poor decondensation capacity. HOS results in both groups were within normal range. Correlation analysis was performed amongst the three function tests wherein both NCDT and HOS when compared with DFI showed a negative correlation (r = –0.442, r = –0.216) while comparison between HOS and NCDT showed a positive correlation (r = 0.0056). Further correlation analysis of morphology with DFI showed a negative value (r = –0.067), while NCDT indicated a positive value (r = 0.429) Comparing vitality with HOS showed a positive correlation (r = 0.452) whereas DFI showed a negative correlation (r = –0.569).
Conclusion: In conclusion, results demonstrated the importance of sperm function tests in addressing diagnostic limitations of routine semen analysis. DFI was found to be higher in men with normal semen parameters suggesting DNA fragmentation might be an additional factor threatening fertility. Further, NCDT results demonstrated that a significant portion of population in both groups had a low decondensation capacity hinting towards its role in male infertility. Thus, sperm function test with semen analysis should be performed for routine diagnosis.
Variant Superficial Veins of Head and Neck: Clinical Correlation
Kummarikunta V, Jain P, Arora S, Yadav A
Department of Anatomy, Lady Hardinge Medical College, Delhi, India
Introduction: A complex system drains the head, neck and brain - Jugular veins i.e., external, Internal and anterior jugular veins. The variations in the formation and drainage pattern of the superficial venous system are significant because these superficial veins are utilized for central venous cannulation, oral reconstruction, parenteral nutrition and assessing cardiac pathology. The knowledge of variations and anatomy of venous drainage of the face is of utmost importance for oro-maxillofacial surgeries. EJV is an exclusive site for shunt procedures involving LV in Hydrocephalus surgery. The cephalic vein to EJV bypass is significant in preserving AV fistulae for hemodialysis after subclavian thrombosis.
Methodology: During routine cadaveric dissection for undergraduate teaching in an elderly male Cadaver in the Department of Anatomy of LHMC Delhi, a peculiar drainage pattern of the anterior division of the retro-mandibular vein and variant formation of the Common Facial Vein.
Results: The right Submental vein joins the Facial vein to form the Common Facial Vein. The anterior division of the retro-mandibular Vein does not join the facial vein and goes medially deep to the facial vein to drain into the anterior jugular vein.
Conclusion: Precise knowledge regarding these variations is clinically significant as some of these veins like the Facial vein and external Jugular vein also used as patches for Carotid Endarterectomy and oral reconstructive surgeries and the retro-mandibular vein is used as a guide to exposing the Facial nerve branches in Superficial Parotidectomy.
Morphological and Morphometric Examination of Term Placenta of Normal and Gestational Diabetic Mothers
Sharma D, Chauhan R, Sharma R
Department of Anatomy, UCMS and GTB hospital, Delhi, India
Introduction: Placenta is membranous vascular organ that develops in female mammals and connects the fetus with maternal wall that facilitates nutrient and gaseous exchange between the maternal and fetal compartments. Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. The aim of present study was to study morphological and morphometric examination of term placenta of normal and gestational diabetic mothers.
Materials and methods: A total number of 40 placenta (20 normal mothers and 20 GDM mothers) were included. Morphological and morphometric parameters obtained were analyzed statistically by Fischer’s test and t test.
Results: In this study, we found that GDM placentae significantly increased in number of cotyledons, weight, volume, area, thickness, diameter and circumference compared to normal placentae.
Conclusion: Awareness of the data obtained in the present study is of immense importance not only to the anatomists, but also to the obstetricians in modifying the course of their management for Diabetic mothers.
Complete Ossification of Superior Transverse Scapular Ligament in Dry Human Scapula: A Case Report
Mrityunjay K Jha, Rashmi Prasad
Department of Anatomy, Nalanda Medical Collage, Patna, Bihar, India
Introduction: The scapula is the flat triangular bone situated on the posterolateral aspect of thoracic wall between 2nd and 7th rib. Among the 3 borders of the scapula, the superior border has a deficient portion near the base of coracoids process which is known as superior notch. The notch is bridged by Superior Transverse Scapular Ligament, thus converting the notch into foramen. The suprascapular nerve is a branch from superior trunk of brachial plexus which passes through the foramen and the suprascapular vessels crosses above the ligament. Complete ossification of superior transverse scapular ligament coverts suprascapular foramen into bony foramen and suprascapular nerve is commonly entrapped in it. This result in Suprascapular Nerve Entrapment Syndrome (SNES).
Methodology: I found a case of completely ossified superior transverse scapular ligament in a bone specimen, during routine Osteology demonstration class of undergraduate students, in the Department of Anatomy, Nalanda Medical College, Patna.
Results: The notch is bridged by Superior Transverse Scapular Ligament, thus converting the notch into foramen.
Conclusion: The anatomical an radiological knowledge of ossification of superior transverse scapular ligament may be helpful for clinicians, radiologist and surgeons dealing with suprascapular nerve entrapment conditions.
Riedel’s Lobe of the Liver and Its Clinical Implication: A Cadaveric Case Report
Gautam B Bauddh, Shilpa Bathla, Anjoo Yadav
Department of Anatomy, Lady Hardinge Medical College, Delhi, India
Introduction: Riedel’s lobe of the liver, a downward tongue-like projection of the anterior edge of the right lobe of liver towards the right side of the gallbladder, is an important anatomical variation, though typically rare. The clinical importance of the term ‘Riedel’s lobe’ has diminished due to advancements in imaging technology, which now effectively differentiate it from abdominal masses. However, recognizing the presence of Riedel’s lobe, or the more pronounced form of a downward elongated right hepatic lobe, remains crucial.
Methodology: During routine dissection of an adult female cadaver in the department of Anatomy at Lady Hardinge Medical College, New Delhi, a variation was observed in the right lobe of cadaveric liver and the measurements were recorded using a Vernier Calliper. Results: We report the case of an adult female cadaver with Riedel’s lobe. Riedel’s lobe appeared as a tongue-like projection from the right anterior margin of the liver, measuring 104.09 mm in breadth and 50.02 mm in length from the anterior edge of the right lobe of liver.
Conclusion: Riedel’s lobe of the liver is typically discovered incidentally and presents asymptomatically. Proper recognition of Riedel’s lobe facilitates accurate diagnosis of palpable masses in the right abdomen or identification of tumors located in the lower part of the elongated liver.
Anatomical Variation of Renal Artery: A Case Report
Anirudh Yadav, Rashmi Prasad, Sanjay K Sharma
Department of Anatomy, Nalanda Medical College & Hospital, Patna, Bihar, India
Introduction: Each kidney is supplied by separate renal artery which originates from the abdominal aorta and divides into segmental arteries after entering into the hilum. Segmental arteries are 1. Apical 2. Superior 3. Middle 4. Inferior 5. Posterior. In some cases, the renal arteries divide into segmental branches before entering into hilum which is one of the variations of renal artery. Another variation of renal artery is accessory renal artery.
Methodology: In the Dept. of Anatomy, NMCH, Patna many cadavers were provided for dissection to U.G students of 2023 batch. We incidentally found variation of renal artery in 1 cadaver which was provided to group E. This variation of renal artery is being presented here.
Results: The renal arteries divided into segmental branches before entering into the hilum in this case. However, there was no accessory renal artery present in this case.
Conclusion: Variations of renal artery are very much clinical significance. As we can see, there is gradual increase in kidney/renal diseases among Indian population. Also, the cases of renal transplants have increased over the years. Another pathological condition is renal artery stenosis which requires placement of stent in the renal artery. Thus, the knowledge of variations of renal artery is very important to both physician and surgeons.
Unilateral High Division of Femoral Nerve
Bhuvnesh Bhaskar, Gurmeet Kour, Rakhee Sharma, Sarika Tigga
Department of Anatomy, University College of Medical Sciences, Delhi, India
Introduction: The femoral nerve is the largest branch of the lumber plexus and is formed by dorsal branches of the ventral rami of spinal nerves L2, L3 and L4. After its formation, the nerve emerges along the lateral border of psoas major muscle, then traverses beneath the inguinal ligament, to enter the femoral triangle. Here, it is divided by the lateral circumflex femoral artery into anterior and posterior divisions. The nerve gives motor and sensory branches to supply the muscles of anterior compartment of thigh, and the hip and knee joints. It provides cutaneous innervation to the skin over the anteromedial compartment of thigh, postero-medial aspect of leg, up to the first metatarso-phalangeal joint. Due to its extensive course and distribution, the nerve is susceptible to compression, injuries and consequent ischemia and neuropathy.
Methodology: During routine dissection of the posterior abdominal wall in formalin fixed male cadaver, the psoas major was dissected off to visualize the lumbar plexus. The femoral nerve was identified and traced till its terminal branches.
Results: On dissection of the lumbar plexus, the formation and course of the femoral nerve was noted. At the level of L5 vertebra, the right femoral nerve was seen to trifurcate into a 7 cm long ventral branch that ended in the psoas minor; the right dorsal branch terminated by supplying the muscles of the anterior compartment while the left dorsal branch supplied the psoas major muscle.
Conclusion: The variations in the femoral nerve formation, course and branches are of singular interest to neurosurgeons, anesthetists, and orthopedic surgeons as the systematized anatomical knowledge helps in planning nerve blocks, analysis of neuropathy and its related symptoms. The knowledge is also crucial in avoidance of iatrogenic injuries especially during routine surgeries or vessel catheterization.
An Anatomical Study on the Formative Patterns of the Superficial Palmar Arch
Sabita Kumari, Gurmeet Kour, Jishnu R, Sarika Rachel Tigga, Renu Chauhan
Department of Anatomy, University College of Medical Sciences, Delhi, India
Introduction: The superficial palmar arch (SPA) is formed by anastomosis of the superficial branches of ulnar (UA) and radial (RA) arteries. It lies anterior to the long flexor tendons and lumbricals. The arch thus formed, gives one proper and three common digital branches. The numerous formative patterns of the SPA pose a challenge during microsurgical reconstructive surgery of hand injuries. Currently, the RA is preferred for harvesting arterial grafts and a risk of ischemia of soft tissues of the hand is imminent where the formative anastomosis is absent. Variations in SPA will be discuss during the presentation.
Methodology: The formation of the superficial palmar arch was studied in 32 formalin fixed upper limbs. The anastomotic pattern between ulnar and radial arteries was recorded and respective branches were traced.
Results: The anastomosis between the superficial palmar branches of UA and RA was the commonest formative pattern encountered in 81.25% limbs. However, 3.125% limbs exhibited anastomosis between the superficial palmar branch of UA and the princeps pollicis branch of RA. In 3.125% limbs SPA was completed by UA alone. SPA’s were termed as incomplete in 12.50%, where the anastomosis between the UA and RA was not established, and two types of patterns were observed. In 6.25% limbs, the superficial palmar branch of UA supplied medial three and a half digits, whereas the remaining digits were supplied by superficial branch of RA. In the rest 6.25% limbs, palmar arch was not formed and digits were equally supplied by superficial branch of UA and RA.
Conclusion: In this study, five arterial anastomotic patterns of SPA were observed. Reconstructive and cardiothoracic surgeons should be aware of all kinds of variations in the formation of SPA in order to avoid inadvertent damage to SPA and it’s branches.
Unilateral Incomplete Duplication of Ureter in Cadaveric Dissection: Case Report
Samridhi Arora, Jai Prakash, Sohinder Kaur
World College of Medical Sciences and Research and Hospital
Introduction: Duplication of ureter is one of the most common anomalies of the urinary tract. Duplication may be either complete or incomplete. The incidence of duplex renal collecting system and ureter ranges from 0.5%- 3%. Clinically, it may remain asymptomatic, it may cause repeated urinary tract infection (UTIs) or calculi, also get injured during pelvic surgeries.
Methodology: The case report is of a middle-aged old adult male cadaver. The finding was discovered during a routine dissection of the abdominal region for 1st year MBBS students at the dissection hall of the World College of Medical Sciences and Research and Hospital. Results: Unilateral duplicated left ureter arising from upper to lower pole of renal pelvis that joined with each other to form a single ureter (y-shape) distally before opening into urinary bladder was found.
Conclusion: Awareness of embryological development, the types and varieties of double ureter will aid radiologists and surgeons to interpret and diagnose urological images and preventing accidental injury to ureter while performing surgeries.
Variation in the Branching Pattern of Femoral Artery in Right Femoral Triangle: A Case Report
Kumari B, Chauhan R, Jishnu R
University College of Medical Sciences and GTB Hospital, Delhi, India
Introduction: Anatomic variations of the Femoral artery constitute a matter of great interest to anatomists, surgeons, and interventional radiologists due to their significant clinical relevance. The femoral artery is continuation of the external iliac artery. It begins behind the inguinal ligament, midway between the anterior superior iliac spine and the pubic symphysis and descends along the anteromedial part of the thigh in the femoral triangle, enters and passes through the adductor canal, where it becomes the popliteal artery. In the femoral trigone, the femoral artery gives five branches: the superficial circumflex iliac, epigastric, two external pudendal arteries and the profunda femoris artery. Since femoral artery is catheterized while doing angiography and embalming therefore any variation in the branching pattern of femoral artery should be known to interventional cardiologist, anatomist and surgeons in order to avoid inadvertent damage to the branches of femoral artery while performing any surgical intervention on it. Hence the branching pattern of femoral artery will be discussed.
Methodology: During a routine dissection of right femoral triangle of a 50 years old male corpse in the dissection hall of the department of anatomy a rare anatomical variation of the femoral artery was observed.
Results: The profunda femoris artery originated from the medial aspect of the femoral artery. Two lateral circumflex femoral arteries were seen to be originating from lateral aspect of femoral artery.
Conclusion: The femoral artery is frequently catheterized while performing angiography and also during embalming of a cadaver, therefore the variations observed in the present study should be known to cardiologist, anatomist and surgeons to avoid inadvertent damage during surgical interventions.
A Study on Bone Mineral Density and Morphometry of Proximal Femur in Pre-menopausal and Post-menopausal Women and its correlation with Serum Vitamin D, Serum Calcium and BMI
Poonam Srivastava, Vandana Tewari
Department of Anatomy, Rama Medical College Hospital and Research Centre, Mandhana, Kanpur, Uttar Pradesh, India
Introduction: Femur is the strongest bone in the body. Morphometric evaluation of proximal femur have predictive role in determining fracture risk. Morphometric parameters of proximal femur are affected by several factors such as age, BMI, calcium, vitamin D and bone mineral density. Thus, the aim of this study was to evaluate femoral morphometry and its relationship with BMD and serum levels of calcium, vitamin D and BMI.
Materials and methods: This study was conducted in the Department of Anatomy and Department of Orthopedics, Rama Medical College and Research Center, Rama University, Mandhana, Kanpur, UP. Total of 200 healthy women between the age of 25–64 years were included. Details of participants like age, BMI, menstrual status were noted and femoral morphometric parameter like hip axis length (HAL), femoral neck axis length (FAL), femoral neck width and length (FNW, FNL),femoral neck shaft angle (FNSA) and bone mineral density was measured by DEXA. Serum calcium and vitamin D were measured using standard kit-based method.
Results: In this study, the level of serum calcium, vitamin D and BMD were significantly high in premenopausal women. 14.4% and 23.3% of premenopausal women and 47.3% and 60.9% of post-menopausal women were vitamin D and calcium deficient respectively. 46.6% and 33.3% of premenopausal women were osteoporotic and osteopenia respectively while the same were 55.4% and 36.4% in postmenopausal women. Proximal femoral morphometry correlated significantly and positively with BMD. The correlations of BMD with calcium and vitamin D were also significantly positive in the study participants.
Conclusion: Deficiency of vitamin D and calcium is associated with altered bone structure and mass. Hence, adequate intake of both calcium and vitamin D is needed maintain the normal bone morphometry.
Prognostic Relevance of Cyclin D1 Immunoexpression in Head and Neck Squamous Cell Carcinoma
Ruchi Dhuria, Kavita Sahai, Tribhuvan P Yadav, Gayatri Vishwakarma
Department of Anatomy, Army College of Medical Sciences, Delhi, India
Introduction: Head and neck squamous cell carcinoma (HNSCC) are derived from the mucosal lining of upper aerodigestive tract. It is the sixth most common cancer in the world and second prevalent cancer in India. Males are affected significantly higher than females. Despite all the surgical techniques and advanced treatments, mortality and morbidity of HNSCC remains substantial across the globe. Cyclin D1 is a regulator in cell cycle for G1 to S phase transition in association with cyclin dependent kinases (CDK4 and CDK6). Aberrant expression of cyclin D1 indicates the loss of regular cell cycle and linked with development and progression of malignancy. The purpose of the current study was to evaluate the cyclin D1 immunoexpression in HNSCC and its association with various clinicopathological parameters, disease recurrence, overall survival and disease-free survival for its prognostic significance.
Materials and methods: Immunoexpression of cyclin D1 was observed in hundred histopathologically proven diagnosed primary HNSCC cases. Statistical analysis was done by using Pearson chi square test/ Fisher exact test to find out the association of cyclin D1 staining with clinicopathological parameters. Survival analysis was performed by using Kaplan-Meier log rank test in HNSCC patients after one year of follow up/death from the date of surgery.
Results: 55% of HNSCC cases were observed with positive nuclear immunoexpression for cyclin D1 using a threshold of 10%. 41% HNSCC patients died and 16% had disease recurrence within one year follow up period. No significant association was noticed between cyclin D1 expression and included clinicopathological parameters, disease recurrence (0.511), overall survival (p = 0.061) and disease-free survival (p = 0.334) in HNSCC. Though, multivariate cox regression analysis showed that cyclin D1 expression was significantly associated with overall survival in HNSCC (HR: 1.96; 95% CI: 1.02–3.77; p = 0.045).
Conclusion: Considering our findings, we conclude that cyclin D1 expression serves as a marker for poor prognosis in HNSCC. However, the small sample size limits the conclusiveness of this analysis. Further studies on larger group of patients are still required to explicate the prognostic potential of cyclin D1in HNSCC.
Novel Variants in Coeliac Trunk: Embryological and Clinical Correlation
Madhu R, Hira, Jain P, Singh U, Arora S, Yadav A
Lady Hardinge Medical College, Delhi, India
Introduction: The Coeliac trunk is the 1st major ventral branch of the abdominal aorta which originates at the level of the T12-L1 vertebra and it supplies the structures derived from the foregut. The standard branches of the Coeliac Trunk are the common hepatic, splenic and left gastric arteries. Variations in the branching pattern of coeliac trunk has been reported in variable percentages.
Methodology: The study was conducted on 18 formalin fixed cadavers, with ages ranging from 50–70 years with no gender specifications. The coeliac trunk was dissected as per Cunningham’s dissection manual and the branching pattern of the coeliac trunk was observed.
Results: Out of 18 cadavers studied, 2 cases showed novel variations in the branching pattern. In one case quadrifurcation of the celiac trunk was observed where the left inferior phrenic artery too was taking origin from the trunk itself. The other case showed pentafurcation with the presence of an accessory left gastric artery and cystic artery in addition to the standard description given in textbooks. In 4 cases coeliac trunk was found to be exceptionally elongated-length varied from 2.5 cm to 3.9 cm.
Conclusion: The Coeliac trunk supplies the major organs of the upper gastrointestinal tract most of which are prone to develop pathologies like peptic ulcer disease, malignancies of the esophagus and stomach, coeliac artery compression syndrome, coeliac aneurysm though rare but require surgical intervention, due to which the gross anatomical wisdom of the branching pattern of celiac trunk holds the center stage for surgeons and interventional radiologists.
Anatomical Variations in the Origin of Hepatic Arteries: A Cadaveric Study in North Indian Population
Abhishek Sharma, Shilpa Bathla, Anjoo Yadav
Lady Hardinge Medical College, Delhi, India
Introduction: Liver holds paramount importance in gastroenterological surgeries. therefore, arteries contributing to its blood supply are of pivotal importance. Common hepatic artery which is a direct branch of celiac trunk is the primary artery supplying the liver via hepatic artery proper which runs towards the porta hepatis and divides into right and left hepatic arteries to supply the respective lobes of the liver. This pattern of arterial blood supply to the liver can vary. In these variant patterns, the liver lobes may receive blood supply from the superior mesenteric artery, left gastric artery, and other visceral branches.
Methodology: A study conducted on 32 formalin fixed adult human cadavers age ranging from 60 to 80 years of age at department of Anatomy, Lady Hardinge Medical College, New Delhi. Dissection was done as per Cunningham’s manual of dissection. The hepatic artery was dissected and its branching pattern was observed, photographs were taken and findings were recorded.
Results: Out of 32 formalin fixed cadaveric livers studied, 81.3% showed normal hepatic arterial pattern and 18.7% showed aberrant vasculature. In 2 cases, the common hepatic artery gave origin to left hepatic artery and right hepatic artery originated from superior mesenteric artery. In other 2 livers, common hepatic artery trifurcated into gastroduodenal, right hepatic and left hepatic arteries. The right hepatic artery was seen arising from celiac trunk in 1 case and an additional left hepatic artery took origin from left gastric artery in 1 case.
Conclusion: Hepatic arteries are of paramount importance in various surgical procedures like liver transplant, transarterial embolization, chemoembolization and radioembolization. Therefore, comprehensive knowledge of variations in the hepatic arteries and their branches plays a vital role in performing the procedures accurately and to reduce the risk of vascular complications.
Curcumin Supplementation Shows Modulatory Influence on Ultrastructural Features in Cerebellum of Mice Exposed to Arsenic Trioxide: Preliminary Study
Parul Kaushal, Balpreet Kaur, Pushpa Dhar, TC Nag
Department of Anatomy, All India Institute of Medical Sciences, Delhi, India
Department of Anatomy, University College of Medical Sciences, Delhi, India
Introduction: Arsenic has been identified as an environmental toxicant acting through various mechanisms, including oxidative stress. The present study focused on the role of antioxidant (Curcumin) supplementation on the ultrastructural features of cerebellum in mice exposed to arsenic.
Methodology: The study was conducted on adult male Swiss Albino mice divided in various groups: control (receiving 5% gum acacia: I) and experimental groups (receiving- II: arsenic trioxide 4 mg/kg bw alone or III: arsenic trioxide 4 mg/kg bw along with curcumin 100 mg/kg bw). The test substances were administered via oral gavage for a period of 45 days and on 46th day, the animals were sacrificed by perfusion fixation. The brains were removed and the cerebellum was processed for transmission electron microscopy.
Results: Ultrastructural features of the cerebellum of arsenic exposed animals revealed cells with different degrees of damage and cytoplasmic loss. Mitochondrial matrix appeared dense with loss of cristae, furthermore, onion cristae were also note in few mitochondria. The nuclear chromatic displayed condensation and margination. Nuclei exhibiting different degrees of damage along with apoptotic nuclei were observed. We also noted disruptions and blebbing in the myelin sheath along with vacuolization, in the cerebella of arsenic exposed groups. We noted few auto-phagosomes, with cytoplasm without any organelles. There was loss of integrity of the cell membrane. Supplementation of curcumin along with arsenic led to conservation of the ultrastructural features with preserved cyto-structure.
Conclusion: The observations of the present study provide preliminary evidence of neuroprotective role of curcumin on arsenic induced adverse effects at ultrastructural level.
Variations in the Measurements of Upper Epiphysis of Femur: A Geometrical Study
Jai Prakarsh, Samridhi Arora, Sohinder Kaur
World College of Medical Science and Research, Jhajjar, Haryana, India
Introduction: fractures of upper end of femur in Road Traffic Accidents and old age people are very common and the present study was undertaken in view to help the surgeon to size of prosthesis.
Aim and objective: (1) To Assess and record the measurements of head of femur. (2) To measure the length of head of femur.
Materials and methods: Study was performed on 30 dry bones of unknown sex and age from the department of Anatomy, Integral institute of medical sciences and research, Lucknow, UP. FHL and FNL was measured. The data obtained was tabulated and Analysis.
Results: Wide range of variation was observed in both the femoral head length as well as neck length. Average FHL on bone ranged between 37.22 to 47.48 mm. Average FNL on bone ranged between 34.12 to 50.17 mm.
Conclusion: Wide range of variation have observed which could be attributed to the variable body structure and height of the individuals.
Variations in the Branching Pattern of Aortic Arch and its Clinical Correlation: A Computed Tomographic Angiographic Study
Yashu Bhardwaj, Brijendra Singh, Rashmi Malhotra, Pankaj Sharma, Rahul Sharma
All India Institute of Medical Sciences, Rishikesh, India
Introduction: The variations in the branching pattern of aortic arch (AA) occur due to their complicated embryological formation. These variations, although common and typically asymptomatic, can sometimes cause dyspnea, dysphagia, intermittent claudication, and misunderstanding of radiological scans.
Methodology: The present study was done in the Department of Anatomy in collaboration with the Department of Radiodiagnosis at the All India Institute of Medical Sciences, Rishikesh. A total of 105 samples were taken as per inclusion and exclusion criteria. Following the approval of the Institutional Ethics Committee, computed tomography (CT) angiographic data from 64-slice CT scanner and 128-slice CT scanner were collected. Reconstruction of the three-dimensional (3D) view of images was done using RadiAnt DICOM Viewer (RadiAnt©).
Result: In the present study, 15% of the patients with variations experienced dyspnea. The left common carotid artery (CCA) arose from the brachiocephalic trunk (BT) in 40% of the subjects. The left vertebral artery (VA) emerged from AA in 25% of the subjects. TIA arising from BT was also present in 10% of the patients. The left CCA and BT arose from AA as a single trunk in 10% of the participants. The following were found in 5% of the participants: the left VA arising from AA, the right VA arising from BT, BT arising as the last left branch from AA, and the right and left CCA arising as a single trunk from AA.
Conclusion: The present study is important for providing awareness and assistance in cardiothoracic surgeries and for executing any endovascular operation with such variations in the northwest Indian population.
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