Absence of the Musculocutaneous Nerve and Associated Compensation by the Median Nerve.

The musculocutaneous and median nerves frequently show variations from their normal course. The purpose of this paper is to report a rare variation, in which the right musculocutaneous nerve was absent. Consequently, the median nerve supplied motor innervation to the flexor compartment of the arm and sensory innervation to the lateral aspect of the forearm. The primary targets of this paper are orthopedic surgeons, anesthesiologists and radiologists. In cases of injuries to the upper limb, knowledge of these variations can assist them in avoiding misdiagnoses.

A South Indian Cadaveric Study on the Prevalence of Gallstones.

Background Gallstone disease (GSD) is one among the most prevalent diseases that affects approximately 10-15% of the population. It is associated with many other diseases like gallbladder cancer, renal stones, atherosclerosis, coronary heart disease and stroke. Objective Objective of this study is to document the prevalence of gallstones among south Indian cadavers. Method One hundred and twenty three South Indian cadaveric livers/gallbladders were observed for the presence of gallstones. The age range was 40 to 70 years. The gallbladders were palpated to know the presence of stones. They were then dissected and the stones were classified based on appearance. Gall bladder walls were also observed to know the associated fibrosis. Result Among the cadavers studied, 0.81% possessed cholesterol stones and 4.06% had pigment stones. Among the stones, 83.33% were pigment stones and 16.66% were cholesterol stones. Conclusion Compared to the western countries and north Indian studies, the prevalence of gallstone diseaseis low in the south Indian population (4.87%). The low prevalence was probably due to the low socioeconomic status and the diet and lifestyle.

Concurrent Variations of Celiac and Superior Mesenteric Arteries.

Celiac trunk is the first ventral branch of the abdominal aorta. It usually terminates by giving three branches; the common hepatic artery, the left gastric artery and the splenic artery. We report a rare variation of the branching pattern of the celiac trunk. The Celiac trunk divided into two branches; left gastric artery and splenicogastroduodenal trunk. The splenico-gastroduodenal trunk divided into splenic and gastroduodenal arteries. The superior mesenteric artery and hepatic artery took origin from a common hepato-mesenteric trunk. The hepatic artery had a winding course around the portal vein and hepatic duct. The knowledge of these variations is important while doing radiological investigations and liver transplant and pancreatic surgeries.

High incidence of persistence of sacral and coccygeal intervertebral discs in South Indians - a cadaveric study.

The sacrum, by virtue of its anatomic location plays a key role in providing stability and strength to the pelvis. Presence of intervertebral discs in sacrum and coccyx is rare. Knowledge of its variations is of utmost importance to surgeons and radiologists. The current study focused on the presence of intervertebral discs between the sacral and coccygeal vertebrae in south Indian cadaveric pelvises. We observed 56 adult pelvises of which, 34 (61%) pelvises showed the presence of intervertebral discs between the sacral vertebrae and between the coccygeal vertebrae, while 22 (39%) pelvises did not have the intervertebral discs either in the sacrum or the coccyx. We also found that most of the specimens had discs between S1 and S2 vertebrae (39%), followed by, between S4 and S5 (18%), between S2-S3 (14%) and least being between S3-S4 (13%). In the coccyx it was found that 7% of pelvises had disc between Co1-Co2, 4% of them had between Co2-Co3 and 4% had between Co3-Co4. Knowledge regarding such anatomic variations in the sacro-coccygeal region is important to note because they require alterations in various instrumentation procedures involving the sacrum.

Le sacrum, en raison de son emplacement anatomique, joue un rôle essentiel pour assurer la stabilité et la force du bassin. La présence de disques intervertébraux dans le sacrum et le coccyx est rare. La connaissance de ses variations est d'une importance capitale pour les chirurgiens et les radiologues. L'étude actuelle a porté sur la présence de disques intervertébraux entre les vertèbres sacrées et coccygiennes sur des bassins cadavériques dans le sud de l'Inde. Nous avons observé 56 bassins adultes, dont 34 (61 %) ont montré la présence de disques intervertébraux entre les vertèbres sacrées et coccygiennes, tandis que 22 (39 %) autres n'avaient pas des disques intervertébraux, dans le sacrum ou le coccyx. Nous avons également constaté que la plupart des spécimens avaient un disque entre les vertèbres S1 et S2 (39 %), 18 % avaient un disque entre les vertèbres S4 et S5, et enfin 14 % entre S3 et S4. Dans le coccyx, on a constaté que 7 % des bassins avaient un disque entre Co1 et Co2, 4 % d'entre eux l'avaient entre Co2 et Co3 et 4 % entre Co3 et Co4. Il est important de noter la connaissance de ces variations anatomiques de la région sacro-coccygienne en raison des modifications nécessaires à apporter aux diverses procédures d'instrumentation impliquant le sacrum.

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.

"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.

Short Axillary Vein and an Axillary Venous Ladder Formed by Basilic and Brachial Veins – An Anatomical and Clinical Perspective

Knowledge of anatomic variants of veins in the arm and axilla play a key role in planning of successful venous access. Possible anatomic variants of axillary vein, brachial vein and basilic vein and their clinical implications have been well described in the literature. We report a rare case of formation of a short axillary vein associated with complex venous communications between the basilic and brachial veins forming a venous ladder in the axilla, in formalin embalmed male cadaver. Axillary vein was formed in the upper part of the axilla by the fusion of basilic vein and unpaired brachial vein, and it was about 3cm in length. The higher-up confluence of basilic and brachial veins was also associated with presence of three communicating veins between the basilic and brachial veins in the axilla. Knowledge of reported venous variations is very useful during preoperative venous mapping and also for planning and execution of various surgical invasive procedures involving these veins.

An Unusual Venous Plexus on Psoas Major Muscle Connecting the Inferior Mesenteric and Testicular Veins

Knowledge of communication between parietal abdominal veins, testicular vein and mesenteric veins is important for Surgeons, Urologists and Radiologists. These communications can result in varicocele or hemorrhoids and may lead to low success rate in hemorrhoid and varicocele surgeries. During routine dissection classes, we observed an unusual large venous plexus on the left psoas major muscle. The venous plexus was unilateral and was formed by many anastomotic venous channels on the psoas fascia and communicated with the left testicular and inferior mesenteric veins. The testicular and inferior mesenteric veins were significantly enlarged below the level of communication with the venous plexus.

An Unusual Termination of Facial Vein and Anterior Division of Retromandibular Vein into External Jugular Vein: A Case Report

Facial vein, being the largest vein of the face forms the common facial vein after joining with the anterior division of retromandibular vein below the angle of the mandible. Usually, it drains into the internal jugular vein. During routine dissection of head and neck region of a male cadaver, aged approximately 50 years, an unusual pattern in the termination of veins on the left side of the neck was observed. The formation, course and termination of external jugular vein were normal. The anterior division of retromandibular vein joined with external jugular vein about 5 cm above the clavicle and the facial vein opened into the external jugular vein about 2.5 cm above the clavicle. In addition, there was a thin venous communication between anterior division of retromandibular vein and external jugular vein. The superficial veins of the neck are often used for cannulation; either for intravenous infusion or for central venous pressure monitoring. Furthermore, these venous segments are used as a patch for carotid endarterectomies. Hence, a thorough knowledge of the normal anatomy and their variations may be useful for performing these procedures.

Triple falx cerebelli associated with two aberrant venous sinuses in the floor of posterior cranial fossa.

During regular dissection classes, we came across tripled falx cerebelli in a male cadaver. The main (middle) falx cerebelli was large and was attached to the internal occipital crest. It contained the occipital sinus. There were two smaller folds (right and left), one on either side of the falx cerebelli. There were two aberrant venous sinuses; each one connecting the ipsilateral sigmoid and transverse sinuses with each other. The complex dural-venous variation reported here is seldom reported in the literature. Knowledge of such variation is important for neurosurgeons and neuroradiologists as these aberrant folds could cause haemorrhage during suboccipital approaches or may lead to erroneous interpretation during imaging of the posterior cranial fossa.

Effect of streptozotocin induced diabetes on rat hippocampus.

OBJECTIVE: The present study was designed to evaluate the diabetes induced neuronal damage in the hippocampus of the rat brain. BACKGROUND: Diabetes mellitus is an endocrine metabolic disorder of impaired carbohydrate, fat and protein metabolisms characterized by chronic hyperglycemia. The neurological consequences of diabetes mellitus in the brain have gained attention most recently. MATERIALS AND METHODS: Male albino rats of Wistar strain, aged 30 days were used. The rats were divided into (A) Normal Control (B) Vehicle Control (C) 15 days of Streptozotocin (STZ), (D) 30 days of STZ, (E) 45 days of STZ, (F) 60 days of STZ diabetic groups (n = 6 in each group). Blood glucose levels and body weight were measured before STZ injection, 2 days after STZ injection and on the day of sacrifice. At the end of the experimental period rats were scarified and brains were processed for cresyl violet staining and the number of survived neurons in the hippocampus was quantified. RESULTS: Microscopic examination of cresyl violet stained sections of diabetic rat hippocampus showed significant and reliable changes. There was a significant difference in the number of survived neurons especially in 30 days of STZ, 45 days of STZ and 60 days of STZ diabetic groups compared to normal control group. CONCLUSION: The results of our study indicated that diabetic complications can cause rapid damage to the neurons in the hippocampus (Fig. 12, Ref. 22).

Abnormal Intraparotid Termination of Facial Vein and Its Clinical Importance

Facial vein is the main vein of the face. Though its origin is constant, it frequently shows variations in its termination. We report a rare type of variation of facial vein. The right facial vein coursed transversely across the masseter, superficial to the parotid duct and entered into the substance of the parotid gland, at its anterior border. Deep dissection of the gland revealed the abnormal termination of facial vein into the superficial temporal vein. The transverse facial vein drained into the facial vein. The superficial temporal vein after receiving the facial vein continued as retromandibular vein. Knowledge of this anomalous course and termination of facial vein may be important for the surgeons doing parotid, maxillofacial and plastic surgeries.

Multiple variations in the paired arteries of the abdominal aorta.

Variations in the origin of arteries in the abdomen are very common. The arteries that show frequent variations include the celiac trunk, renal arteries, and gonadal arteries. We observed multiple variations in a 45-year-old male cadaver. The variations found on the left side were: one accessory renal artery, two testicular arteries, and middle suprarenal and inferior phrenic arteries that branched from the celiac trunk. On the right side, the inferior phrenic and middle suprarenal arteries arose from the right renal artery.

Clinically important variations in the lower limb - A case report

In this paper, three variations in the lower limbare reported and their clinical importance is discussed.The variations reported include a duplicationof the piriformis muscle, the tibial nervebeing pierced by the tendon of the plantaris andan additional muscle in the peroneal compartmentof the leg (AU)