A Unique Bilateral Variation of the Extensor Carpi Radialis Longus: A Case Report.

A novel combination of variations involving the extensor carpi radialis (ECR) muscle group was observed bilaterally in a 75-year-old female cadaver during routine dissection. An accessory tendon was observed arising from the extensor carpi radialis longus (ECRL) and traveling with the primary tendon through the second compartment of the extensor retinaculum. While the primary tendon inserted on the base of the second metacarpal, as is typical of ECRL, the accessory tendon inserted on the base of the third metacarpal. This insertion is typical of the extensor carpi radialis brevis (ECRB) muscle. Additionally, bilateral agenesis of the ECRB was reported. Thirty-two additional forearms were assessed for similar variations, with none being observed. This combination of variations adds to the literature regarding the ECR muscle group, while also being of interest to clinicians, specifically regarding tendon reconstructive procedures as well as accessing the distal radial artery via the anatomical snuffbox.

A Rare Case of Penoscrotal Webbing and Extensive Hernias: An Anatomical Report With Genetic Insights.

During a routine anatomical dissection of an 81-year-old male cadaver received through the Gift Body Program of Saint Louis University School of Medicine (SLU SOM), a massive bulging in the abdominal area was observed that was consistent with numerous hernia repairs noted in the donor's self-reported medical history. Gross anatomical dissection of the cadaveric body revealed extensive herniation of portions of the small intestine and peritoneal sac along the costal margin and extending to the left aspect of the abdomen. Additionally, an uncircumcised phallus was buried within the suprapubic fat pad and demonstrated simple, grade III penoscrotal webbing (PSW), creating an impression of micropenis presence. To gain additional insights into the current case, analysis of the coding regions (exomes) of DNA procured from the body for putative genetic variants was performed using next-generation sequencing (NGS) technology. This analysis revealed 110 rare (minor allele frequency (MAF) ≤ 0.01), pathologic/deleterious genetic mutations. The most relevant variants to this case were the ones associated with male sexual development, BMP1 and BMP4; connective tissue development, COL3A1 and COL5A3; cilia morphogenesis and function, DNAH5 and MAPK15; as well as hormonal homeostasis, ESR1. Direct involvement of BMP1 both in male sexual development and hernia genesis makes it a strong candidate for linking the two pathologies, PSW and multiple hernias, observed in the present case. Yet the presence of a group of mutated genes linked to myopathies (ITGA7, NRAP, POLM, SCN5A, XIRP2) and muscular dystrophy (ITGA7) raises a question about the involvement of these muscular pathologies in hernia genesis and unsuccessful hernia repairs associated with the current case.

A Unique Bilateral Anatomical Variation of the Transverse Facial Artery: A Case Report.

During routine dissection of the superficial face in an 81-year-old male cadaver, an unusually large caliber transverse facial artery (TFA) was observed bilaterally. Further dissection revealed the presence of a hypoplastic facial artery (FA) that passed deep to depressor anguli oris and gave off the inferior labial artery. Bilaterally, the TFA gave rise to the superior labial artery, lateral nasal artery, and ended as the angular artery. Anastomosis of the branches of the TFA, FA, and infraorbital artery was noticed at the buccal area. To our knowledge, there are no previous reports of this anatomical variation. Documentation of variations in the arterial supply of the face will be helpful in further minimizing complications during facial surgery and cosmetic procedures.

Variation in obstetric dimensions of the human bony pelvis in relation to age-at-death and latitude.

OBJECTIVES: Previous studies associate females who died in young adulthood with narrower obstetric pelvic dimensions, presumably in association with obstetric insufficiency (though this causal relationship is unresolved). In this study, we examine whether females within groups living at higher latitudes present this pattern, as high-latitude groups have larger pelvic dimensions than groups previously examined. These patterns are compared with males. We assess whether there is evidence for younger ages-at-death in females to have been in response to natural selection against narrower true pelvis dimensions. METHODS: We measured 14 pelvic dimensions in 327 adults (188 females, 139 males), representing archaeological sites from mid-latitude and high-latitude North America. Individuals were placed into a "young" or "not young" age-at-death category. Latitude, sex, and age-at-death groups were compared using ANOVAs and scaled variance, and evidence for selection was examined with F-tests. RESULTS: Pelvic dimensions were larger in high-latitude females and males. Females but not males who died at younger ages had smaller pelvic canals than older individuals, especially in the mediolateral inlet and anteroposterior outlet dimensions. Variance in all pelvic dimensions is equal between the two female age-at-death groups. CONCLUSIONS: We found narrower obstetrical dimensions in the female pelvis among individuals who died at younger ages. However, statistically equivalent variances in the two female age-at-death groups does not support natural selection on pelvic dimensions as leading to younger ages at death. We instead argue that this difference is result of continued growth due to remodeling in the pelvis occurring in females, but not males, after early adulthood.