ISRN anatomy最新文献

Background. Topography of the appendix influences its mobility, degree of mobilization of the cecum, and need for additional muscle splitting during appendectomy. Although appendectomy is a common surgical procedure, there is a paucity of data on its topography in black Africans. Methods. The position and length of the appendix and relation of the appendicular base with spinoumbilical line were determined in 48 cadavers obtained from the Department of Human Anatomy, University of Nairobi, Kenya. Results. The commonest appendicular types in males were retrocecal 10 (27%) while in females was subileal 4 (36.4%). The average length of the appendix was 76.5 ± 23.6 mm. The base of the appendix was located along, below, and above the spinoumbilical line in 25 (52.1%), 9 (18.8%), and 14 (29.2%) cases, respectively. Conclusion. The topography of appendix in Kenyans shows variations from other populations. Knowledge of these variations is important during appendicectomy.

Aim. To investigate the existence of neural structures within the meniscofemoral ligaments (MFLs) of the human knee. Methods. The MFLs from 8 human cadaveric knees were harvested. 5 μm sections were H&E-stained and examined under light microscopy. The harvested ligaments were then stained using an S100 monoclonal antibody utilising the ABC technique to detect neural components. Further examination was performed on 60-80 nm sections under electron microscopy. Results. Of the 8 knees, 6 were suitable for examination. From these both MFLs existed in 3, only anterior MFLs were present in 2, and an isolated posterior MFL existed in 1. Out of the 9 MFLs, 4 demonstrated neural structures on light and electron microscopy and this was confirmed with S100 staining. The ultrastructure of these neural components was morphologically similar to mechanoreceptors. Conclusion. Neural structures are present in MFLs near to their meniscal attachments. It is likely that the meniscofemoral ligaments contribute not only as passive secondary restraints to posterior draw but more importantly to proprioception and may therefore play an active role in providing a neurosensory feedback loop. This may be particularly important when the primary restraint has reduced function as in the posterior cruciate ligament-deficient human knee.

The anatomy of the domestic duck lung was studied macroscopically, by casting and by light, transmission, and scanning electron microscopy. The lung had four categories of secondary bronchi (SB), namely, the medioventral (MV, 4-5), laterodorsal (LD, 6-10), lateroventral (LV, 2-4), and posterior secondary bronchi (PO, 36-44). The neopulmonic parabronchi formed an intricate feltwork on the ventral third of the lung and inosculated those from the other SB. The lung parenchyma was organized into cylindrical parabronchi separated by thin septa containing blood vessels. Atria were shallow and well-fortified by epithelial ridges reinforced by smooth muscle bundles and gave rise to 2-6 elongate infundibulae. Air capillaries arose either directly from the atria or from infundibulae and were tubular or globular in shape with thin interconnecting branches. The newly described spatial disposition of the conducting air conduits closely resembles that of the chicken. This remarkable similarity between the categories, numbers, and 3D arrangement of the SB in the duck and chicken points to a convergence in function-oriented design. To illuminate airflow dynamics in the avian lung, precise directions of airflow in the various categories of SB and parabronchi need to be characterized.

Background. Day to day advances in the fields of radiology like sonography and CT need to revive interest in the cadaveric study of morphological features of liver, as the accessory fissures are a potential source of diagnostic errors. Accessory fissures vary from single to multiple over different parts of the liver. Aim. In the present study the morphological features of human liver specimens were evaluated by macroscopic examination and morphometric analysis. Methods. The study was conducted on 58 specimens obtained from cadavers utilized for routine dissection for medical undergraduates from the year 2004 to 2012 in the Anatomy Department of MIMS Medical College. Results. In the present study the livers as described in the established anatomical literature with normal surfaces, fissures, and borders were considered normal. Out of the 58 specimens, 24 were normal without any accessory fissures or lobes and with normal contours. Two specimens were with hypoplastic left lobes. Lingular process of left lobe was observed in only one specimen. Conclusions. Knowledge of the various accessory fissures of liver prevents misdiagnosis of cystic lesions or any pathological lesions of the liver.

Aim. The sural nerve complex (SNC) consists of four named components: medial sural cutaneous nerve (MSCN), lateral sural cutaneous nerve (LSCN), peroneal communicating nerve (PCN), and sural nerve (SN). The formation and distribution of the sural nerve vary in different individuals. SN is universally recognized by surgeons as a site for harvesting an autologous nerve graft. The nerve is widely used for electrophysiological studies. Hence the study of sural nerve complex was taken up. Method. SNC was observed by dissecting 100 lower limbs in the department of anatomy at three different medical colleges, over a period of 10 years. Result. Typical SN was observed in 60% of the cases. MSCN was present in all the cases; in 15% of the cases the MSCN followed an intramural course. LSCN was present in 80% of the cases. PCN was present in 70% of the cases and in most of the cases calibre was larger than that of MSCN. Conclusion. The knowledge about the variation in the origin and course of the SN is important in evaluating sensory axonal loss in distal axonal neuropathies and should be borne in mind by clinicians and surgeons.

Background. Duodenum is the second most common site of diverticula after the colon. Diagnosis of duodenal diverticula is incidental and found during other therapeutic procedures. In 90% of cases, they are asymptomatic, and less than 10% develop clinical symptoms. The difficulty to ascertain the true incidence of duodenal diverticula demanded for the present study to elucidate the prevalence of the duodenal diverticulum in South Indians. Materials and Methods. One hundred and twenty specimens of duodenum were utilized for the study. The prevalence, anatomical location, and dimension of duodenal diverticulum were studied. Results. Among the 120 specimens of duodenum, five specimens had solitary, extraluminal, and globular-shaped diverticula in the medial wall of the duodenum. In three (60%) cases, it was found in the second part of duodenum and in two (40%) cases in the third part. The mean size of the diverticula was 1.4 cm. Conclusion. In the present study in South Indian people, the prevalence (4.2%) of duodenal diverticula is low comparable to other studies in the literature. Even though most of the duodenal diverticula are asymptomatic, the knowledge about its frequency and location is of great importance to prevent complications like diverticulitis, hemorrhage, obstructive jaundice, and perforation.

Purpose. Incidental durotomy is a relatively common complication for patients undergoing posterior spinal surgery. Delineating anatomical variants in the posterior lumbar spinal canal is crucial in reducing future rates of incidental durotomy. Materials and Methods. The ligamentous attachments between the dura mater and ligamentum flavum in the lumbar region of 17 soft-fixed cadavers were investigated. The lumbar vertebral columns were removed, and cross-sectional dissection was performed at levels L1-S1. Anterior retraction of the dorsal dura mater identified attachments between the dorsal surface of the dura mater and the ligamentum flavum. Histological staining of the ligamentous attachments was carried out with hematoxylin and eosin (H&E) and elastic van Gieson (EVG). Results. Posterior epidural ligaments were present in 9 (52.9%) cadavers. Nine (9) separate ligaments were identified in these cadavers, with 3 (33.3%) at L3/L4, 5 (55.5%) at L4/L5, and 1 (11.1%) at L5/S1. Histology confirmed the presence of poorly differentiated collagen-based connective tissue, distinct from the normal anatomy. Conclusions. This study confirms the presence of multiple dorsomedial posterior epidural ligaments at the main sites for posterior spinal surgery (L3-S1). An intraoperative awareness of the variability of such connections may be an important step in reducing static rates of incidental durotomy.

Background. Knowledge of anatomical variations of posterior cord and its branches is important not only for the administration of anaesthetic blocks but also for surgical approaches to the neck, axilla, and upper arm. The present study aimed to record the prevalence of such variations with embryological explanation and clinical implication. Material and Method. 37 formalin-preserved cadavers, that is, 74 upper extremities from the Indian population, constituted the material for the study. Cadavers were dissected during routine anatomy classes for medical undergraduate. Dissection includes surgical incision in the axilla, followed by retraction of various muscles, to observe and record the formation and branching pattern of posterior cord of brachial plexus. Results. Posterior cord was formed by union of posterior division of C5 and C6 roots with posterior division of middle and lower trunk (there was no upper trunk) in 16.2% of upper extremities. Posterior cord of brachial plexus was present lateral to the second part of axillary artery in 18.9% of upper extremities. Axillary nerve was taking origin from posterior division of upper trunk in 10.8% upper extremities and thoracodorsal nerve arising from axillary nerve in 22.9% upper extremities. Conclusion. It is important to be aware of such variations while planning a surgery in the region of axilla as these nerves are more liable to be injured during surgical procedures.

Lumbar arteries arise from the abdominal aorta. Some abdominal and spinal surgeries can damage these arteries, and that can lead to serious consequences. This study aimed at studying the types and frequencies of variations of lumbar vasculature. We dissected both sides of 109 adult human cadavers and studied the variations of lumbar vasculature. Age range was 43-90 years. Fifty-seven percent were males and 43% were females. The number of lumbar arteries arising from either side of the abdominal aorta varied between 3 and 5 pairs. The lumbar arteries arose from a common single stem in 12% of the cadavers. The third and fourth pairs of lumbar arteries arose from a common single stem in 3% and 11% of cadavers, respectively, and the first and second pairs of lumbar arteries arose from a common single stem in 1% and 2% of cadavers, respectively. The first and second lumbar arteries on the right side traveled anterior to the right crus of the diaphragm in 7% and 8% of cadavers, respectively. There were several variations with regard to the number, origin from the abdominal aorta, and pathway of lumbar arteries from what is described in the literature.

Variations of the branches of aortic arch are due to alteration in the development of certain branchial arch arteries during embryonic period. Knowledge of these variations is important during aortic instrumentation, thoracic, and neck surgeries. In the present study we observed these variations in fifty-two cadavers from Indian populations. In thirty-three (63.5%) cadavers, the aortic arch showed classical branching pattern which includes brachiocephalic trunk, left common carotid artery, and left subclavian artery. In nineteen (36.5%) cadavers it showed variations in the branching pattern, which include the two branches, namely, left subclavian artery and a common trunk in 19.2% cases, four branches, namely, brachiocephalic trunk, left common carotid artery, left vertebral artery, and left subclavian artery in 15.3% cases, and the three branches, namely, common trunk, left vertebral artery, and left subclavian artery in 1.9% cases.