The morphological and microscopical characteristics of posterior layer of human thoracolumbar fascia; A potential source of low back pain.

BACKGROUND: Posterior layer of thoracolumbar fascia (PTLF) is the deep fascia of back of the trunk, which connects the trunk, upper limb and lower limb muscles. Very few cadaveric studies of posterior layer of thoracolumbar fascia (PTLF) are found in the literature, which mention the presence of nerve receptors in it but, quantification of the nerve receptors where not found. Providing the morphological and morphometrical data of PTLF may help the exercise physiologists, sports physicians, occupational health assistants and, physiotherapists to modify or invent new protocol of treatment to help the society. METHODS: In this study, twenty formalin embalmed human cadavers were used and we have documented the orientation of the PTLF and quantified the number of peripheral nerve endings at the different vertebral levels. RESULTS: Mean distance of PTLF from vertebral spines to the musculofascial junction was at thoracic region 3.38cm and 3.34cm; at lumbar region, it was 7.4cm and 7.36cm and at sacral region it was 2.98cm and 2.96cm on right and left side, respectively. The angulation of PTLF varies from 18-110 degrees at different vertebral levels. The microscopic data shows the thickness of PTLF and number of nerve endings in the sacral level is increased compared to that of thoracic vertebral levels. CONCLUSIONS: We have contributed the novel morphological and microscopical details to the limited existing data on PTLF. We also have provided the quantitative data of nerve fibers, which are possible nociceptors of PTLF.

"Question of the Day": Impact on learning and retention.

Background Studying regularly has been a known method for better memory and long term retention of a subject. Getting students to study on a regular basis has been tried in many ways and its impact is increased if they understand the importance and value the efficiency of it. Objectives With large number of students, it would be a time consuming process to follow one on one interactions or study sessions. Hence, we introduced a new strategy, the "Question of the Day", which is interesting, challenging and most of all; it has produced positive influence on the examination performance of the students who performed this task. Main objective of this study was to make students answer questions related to the topics taught every day. Method Regular studying and updating the subject knowledge was provided through Question of the Day (Annexure-1). The students were given the questions on a regular basis during dissection classes and were asked to document the answers for those questions. Result The students who worked on the "Question of the Day" scored significantly higher in the exams than those who did not. The results of the opinion survey clearly indicated that this exercise was liked by most of the students. Conclusion "Question of the day" did have a positive influence on the student's performance. Most of the students felt that this exercise had a positive impact on their study methods, interaction with peers and teachers, retention and recollection of the knowledge.

Unilateral Double Great Saphenous Vein: A Clinically Significant Case Report.

Great saphenous vein (GSV) is the longest vein in the body originating from the dorsum of the foot at medial malleolus to the level of groin skin crease. It is one among the clinically significant superficial veins of the lower limb. Double or duplication of GSV is considered to be one of its rarest variant forms, which might be often mistaken with the accessory saphenous vein. The overall incidence of duplicated GSV is reported to be 1%. We report herein, a unilateral duplication of GSV with its morphological and clinical perspectives. The major clinical complication that is often encountered from its duplication is recurrent incompetence of the GSV, which predisposes varicosity. Therefore, a thorough knowledge of venous anatomy is important for clinicians and sonographers.

Variant origin of an arterial trunk from axillary artery continuing as profunda brachii artery--a unique arterial variation in the axilla and its clinical implications.

BACKGROUND: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among all the reported variations of profunda brachii, its variant origin from the 3rd part of the axillary artery with common trunk for the branches of axillary artery is unique. CASE DETAILS: We report here an anomalous origin of profunda brachii as continuation of an arterial trunk arising from 3rd part of the axillary artery. This common trunk at its commencement passed between 2 roots of median nerve and gave branches of 3rd part of axillary artery before it continued as profunda brachii artery. The further course and branching pattern of profunda brachii were normal. CONCLUSION: Since the axillary artery is next choice of artery for arterial cannulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors.

Additional muscle fibers of brachioradialis with anomalous high origin and entrapment of radial nerve in an osseomuscular canal.

Normally, brachioradialis originates from the upper part of the lateral supracondylar ridge of the humerus. Variations in its origin are very rare. We observed the presence of an additional set of fleshy muscle fibers in the lateral part of the anterior compartment of the arm in addition to the other normal muscles. This unusual case was observed at the Mookambika Institute of Medical Sciences, Kulashekara, Tamil Nadu, India, during routine dissection of the upper limb. The anomalous fleshy fibers were attached proximally to the middle part of the shaft of the humerus, close to the insertion of deltoid. Some of its fibers continued further up to the acromian process of scapula. These fibers passed downwards along with deltoid and joined the fibers from the humerus before getting merged with the brachioradialis distally. These additional muscle fibers were compared with the brachioradialis accessorius and the uniqueness, functional significance and the clinical relevance werediscussed (Fig. 2, Ref. 6). Full Text in PDF www.elis.sk.

Evaluation of amygdaloid neuronal dendritic arborization enhancing effect of Centella asiatica (Linn) fresh leaf extract in adult rats.

OBJECTIVE: Centella asiatica (CeA), a creeper, growing in moist places in India and other Asian countries. Leaves of CeA are used for memory enhancement in Ayurvedic system of medicine, an alternative system of medicine originated from India. In the present study, we have investigated the role of CeA fresh leaf extract treatment on adult rats on dendritic morphology of amygdaloid neurons, one of the regions concerned with learning and memory. METHODS: Adult rats (2.5-month old) were fed with 2, 4 and 6 mL/(day kg) of fresh leaf extract of CeA for 2, 4 and 6 weeks. After the treatment period the rats were killed, brains were removed and amygdaloid neurons were impregnated with silver nitrate (Golgi staining). Such silver impregnated amygdaloid neurons were traced using camera lucida and dendritic branching points (a measure of dendritic arborization) and intersections (a measure of dendritic length) were quantified. These data were compared with those of age matched control rats. RESULTS: The results showed a significant increase in the dendritic length (intersections) and dendritic branching points in amygdaloid neurons of the rats treated with higher dose [6 mL/(day·kg)] of CeA for longer period of time (i.e. 6 weeks). CONCLUSIONS: Constituents/active principles present CeA fresh leaf extract has neuronal dendritic growth stimulating property; hence it can be used for enhancing neuronal dendrites in stress and other neurodegenerative and memory disorders.

Variant branching pattern of axillary artery: a case report.

During routine dissection of an approximately 50-year-old male cadaver for the undergraduate medical students at Melaka Manipal Medical College, Manipal University, Manipal, we came across a variation in branching pattern of right axillary artery. The second part of axillary artery gave rise to a common trunk which divided into the subscapular and lateral thoracic arteries. The third part of right axillary artery gave rise to anterior and posterior circumflex humeral arteries. Variations in the branching pattern of axillary artery are important for the surgeons performing interventional or diagnostic procedures in cardiovascular diseases.

Persistent sacrococcygeus ventralis muscle in an adult human pelvic wall: a variation for surgeons to note.

Occurrence of abnormal muscles in the pelvic wall is very rare. During a routine dissection of the pelvic wall, an abnormal muscle referred to as sacrococcygeus ventralis was noted in a 65-year-old South Indian cadaver. The fleshy fibers of the muscle were arising from the lateral part of the ventral surface of the sacrum at the level of S3 segment. The muscle passed downwards in front of the S4 and S5 sacral segments, halfway through its course it became tendinous and finally became inserted in the ventral surface of the coccyx. Sacrococcygeus ventralis is a muscle which is well developed in animals where it acts on their tail. In human beings, sacrococcygeus ventralis is seen only during fetal life. A rare case of its persistence in an adult pelvic wall is reported and discussed here.

Enhancement of Amygdaloid Neuronal Dendritic Arborization by Fresh Leaf Juice of Centella asiatica (Linn) During Growth Spurt Period in Rats.

Centella asiatica (CeA) is a creeping herb, growing in moist places in India and other Asian Countries. Ayurvedic system of medicine, an alternate system of medicine in India, uses leaves of CeA for memory enhancement. Here, we have investigated the role of CeA fresh leaf juice treatment during growth spurt period of rats on dendritic morphology of amygdaloid neurons, one of the regions concerned with learning and memory. The present study was conducted on neonatal rat pups. The rat pups (7-days-old) were fed with 2, 4 and 6 ml/kg body of fresh leaf juice of CeA for 2, 4 and 6 weeks. After the treatment period, the rats were killed, brains removed and amygdaloid neurons impregnated with Silver nitrate (Golgi staining). Amygdaloid neurons were traced using camera lucida and dendritic branching points (a measure of dendritic arborization) and intersections (a measure dendritic length) quantified. These data were compared with those of age-matched control rats. The results showed a significant increase in dendritic length (intersections) and dendritic branching points along the length of dendrites of the amygdaloid neurons of rats treated with 4 and 6 ml/kg body weight/day of CeA for longer periods of time (i.e. 4 and 6 weeks). We conclude that constituents/active principles present in CeA fresh leaf juice has neuronal dendritic growth stimulating property; hence it can be used for enhancing neuronal dendrites in stress and other neurodegenerative and memory disorders.

Centella asiatica (L.) leaf extract treatment during the growth spurt period enhances hippocampal CA3 neuronal dendritic arborization in rats.

Centella asiatica (CeA) is a creeping plant growing in damp places in India and other Asian countries. The leaves of CeA are used for memory enhancement in the Ayurvedic system of medicine, an alternative system of medicine in India. In this study, we have investigated the effect during the rat growth spurt period of CeA fresh leaf extract treatment on the dendritic morphology of hippocampal CA3 neurons, one of the regions of the brain concerned with learning and memory. Neonatal rat pups (7 days old) were fed with 2, 4 or 6 ml kg(-1) body weight of fresh leaf extract of CeA for 2, 4 or 6 weeks. After the treatment period the rats were killed, their brains were removed and the hippocampal neurons were impregnated with silver nitrate (Golgi staining). Hippocampal CA3 neurons were traced using a camera lucida, and dendritic branching points (a measure of dendritic arborization) and intersections (a measure of dendritic length) were quantified. These data were compared with data for age-matched control rats. The results showed a significant increase in the dendritic length (intersections) and dendritic branching points along the length of both apical and basal dendrites in rats treated with 4 and 6 ml kg(-1) body weight per day of CeA for longer periods of time (i.e. 4 and 6 weeks). We conclude that the constituents/active principles present in CeA fresh leaf extract have a neuronal dendritic growth stimulating property; hence, the extract can be used for enhancing neuronal dendrites in stress and neurodegenerative and memory disorders.