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   Table of Contents - Current issue
July-September 2022
Volume 11 | Issue 3
Page Nos. 123-172

Online since Friday, August 12, 2022

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Future of cadaveric dissection in anatomical science education p. 123
Apurba Patra, NB Pushpa, Kumar Satish Ravi
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Clinical relevance of the caudate linguiform process (ponticulus hepatis) in human liver p. 126
Shamir O Cawich, Michael T Gardner, Jean-Pierre Louboutin, Vijay Naraynsingh
Background: The caudate linguiform process (CLP), also known as Ponticulus Hepatis, is loosely defined as a bridge of hepatic parenchyma that overlaps the inferior vena cava (IVC) fossa, occasionally converting it into a canal. The primary objective of this study was to document anatomic variants of the CLP in the human liver. A secondary objective was to perform a systematic literature review of the CLP. Methodology: We analyzed cadaveric livers and selected those with a CLP for detailed examination. Two types of CLPs were defined: A partial CLP that leaves >9 mm of retrohepatic IVC exposed and a complete CLP that leaves <10 mm of IVC surface visible. The following data were recorded: CLP height, CLP width, CLP thickness, relationship to IVC, and width of exposed IVC. Results: A CLP was present in 36 (64%) of 56 cadaveric livers studied. There were 15 (41.7%) complete CLPs and 21 (58.3%) incomplete CLPs. Complete CLPs had a mean height of 54.22 ± 11.20 mm, width of 12.51 ± 3.56 mm, thickness of 7.39 ± 3.93 mm, and left only 6.38 ± 1.75 mm of exposed IVC. The incomplete CLPs had a mean height of 51.36 ± 11.19 mm, width of 11.44 ± 3.25 mm, thickness of 9.49 ± 4.38 mm and left 13.43 ± 3.35 mm of IVC exposed and accessible. Conclusions: We have proposed exact definitions of the CLP using specific anatomic points that are radiologically identifiable, reproducible, and clinically relevant. There is a high prevalence of CLPs in this population, with 42% being complete CLPs. By preventing access to the retrohepatic IVC, a CLP increases the technical complexity of the surgery.
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Morphometric Analysis of Lumbar Dorsal Root Ganglia: A Cadaveric Study p. 131
KR Rohini, KR Ashok, B Komala
Background: As there is an increase need for less invasive techniques, especially in the spinal interventional procedures, detailed anatomical structures need to be defined for the better surgical outcome. After an intensive search of the literature, it was found that the available information regarding human lumbar dorsal root ganglia is limited. Therefore, the current study was aimed to analyze the morphometry and location of the dorsal root ganglia in lumbar region. Materials and Methods: One hundred intervertebral foramina from 10 formalin-fixed human cadavers examined from L1 to L5 level. The morphometry of dorsal root ganglia was noted and evaluated. The position of dorsal root ganglia was classified based on its relation to pedicle. Results: The mean length of the dorsal root ganglia was L1, 6.49 mm; L2, 9.63 mm; L3, 12.18 mm; L4, 13.43 mm; L5, 14.95 mm. The mean width was L1, 5.01 mm; L2, 5.96 mm; L3, 6.71 mm; L4, 6.8 mm; L5, 6.83 mm. The mean distance between the dorsal root ganglia and the nerve root was L1, 3.51 mm; L2, 4.03 mm; L3, 5.2 mm; L4, 7.24 mm; L5, 8.46 mm. Most of dorsal root ganglia were intraspinal in L1-L2 intervertebral foramen, intraforaminal in L2-L3 to L4-L5 level and extraforaminal at L5-S1. Conclusion: In-depth knowledge of position of dorsal root ganglia will be helpful in safely performing surgery in the lumbar spinal region.
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Perforators of the arm to provide anatomical basis to skin flaps: A cadaveric study p. 136
Ritu Singh, Pooja Singh, Deepshikha Kori, Navneet Kumar, Arvind Kumar Pankaj, Nirupma Gupta
Introduction: The upper extremity is commonly involved in severe soft tissue defects that can be challenging functionally and cosmetically. Anatomical studies on skin vascularization provide developmental base for the flap nourished by perforating arteries. Perforator flaps reduce donor site morbidity and recovery time. Therefore, in case of cosmetic surgery of soft tissue defect of the arm, it is mandatory for reconstructive surgeons to have beforehand knowledge of vascular anatomy of cutaneous perforators of the arm. Hence, a study was done to evaluate the total number of perforators, distribution from bony landmarks, and pedicle length from source vessels on the medial, lateral, and posterior aspects of the arm. Methodology: The study was undertaken at the Department of Anatomy, King George's Medical University, Lucknow, on 15 upper limbs of fresh cadavers of both the sexes of adult age group. Methylene blue dye was injected into the arterial system of the arm. After one hour, perforators were visualized by incising the margins of the stained arm skin. Results: We observed that maximum numbers of perforators were contributed by direct branch of the brachial artery (49.7%), followed by superior ulnar collateral artery. Numbers of perforators on the medial aspect of the arm were maximum (52.0%), followed by lateral aspect and posterior aspect of the upper arm. Perforators supplying the posterior and lateral aspects of the arm had the maximum mean length. Conclusion: Thus, a detail understanding of position, length, and numbers of perforators of the arm helps surgeons to predefine the appropriate perforator flaps for reconstructive surgeries.
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Prediction of height using hand and foot parameters in Maharashtrian population p. 143
Supriya Sarjerao Methepatil, Vrushali Ashok Dethe
Background: Height, a reflection of skeletal growth, is important in calculating various parameters such as lung volumes, glomerular filtration, and metabolic rate. In forensic medicine, where skeletal remains are recovered, calculating the stature is necessary. Estimation of height is important in design of prosthetic body parts and reconstruction surgeries. The objective of this study was to estimate the height of a person from hand and foot parameters. Methodology: In a cross-sectional study, height, hand length (HL), hand breadth (HB), foot length (FL), and foot breadth (FB) were measured in a sample of 200 students (116 females and 84 males) aged between 18 and 24 years. Multiple regression model was used to derive equations for calculation of height from these parameters. Results: Three different multiple regression equations were derived for total cases and for male population and female population separately. The equation for estimation of height in males is 78.808 + 3.592 FL − 1.094 FB + 0.508 HL + 0.003 HB, in females is 69.042 + 3.889 FL + 0.729 FB + 0.621 HL − 1.077 HB and in general is 53.649 + 3.884 FL − 0.285 FB + 0.509 HL + 1.084 HB. The multiple correlation coefficient® is 0.844 for total population and 0.673 for male population and 0.733 for female population (P = 0.001 indicating high significance). Conclusion: Multiple regression equations using FL, FB, HL, and HB can predict height.
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Morphology and histogenesis of human fetal thyroid gland p. 148
Y Jalaja, CP Anbarasi
Introduction: About 5% of the world population is affected from various thyroid disorders. The present study is undertaken to describe the morphological and morphometric variations in the fetal thyroid glands of thyroid at different stages of development in the intrauterine life. Methodology: Forty medically terminated fetuses of both sexes ranging from 15 to 36 weeks of gestation were included. The external parameters recorded were: Fetal weight; crown-rump length; foot Length; Location; Presence/absence of isthmus; Presence of pyramidal lobe; Presence of an accessory thyroid tissue were observed in situ. The length, width, and thickness of each lobe and the isthmus were noted. Results: The specimens were categorized into three gestational groups, i.e., 10–20 weeks, 21–30 weeks, and 31–40 weeks. The statistical analysis suggests that there is significant increase in fetal thyroid weight, lengths and widths of the right and left lobes, and length of the isthmus with increase in gestational age. There was no significant increase in width of isthmus with gestational age. There was no significant difference in all thyroid parameters by gender. Conclusion: The data regarding the various parameters collected and analyzed in the present study emphasized the significance of an insight into the morphological variations, morphometric dimensions, and histological findings of foetal thyroid glands in diagnosing various diseases.
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Morphometric variations in lobes and fissures of the lung: A cadaveric study in Pune region of Maharashtra p. 154
Amol Ashok Shinde, Dinesh K Patel
Background: Fissures are formed by the pleura covering the lungs. Right lung has horizontal and oblique fissures dividing the right lung into three lobes. Left lung has only oblique fissure dividing it into two lobes. Variations such as accessory, incomplete, and absence of fissure are documented in the literature. Methodology: This is a descriptive cadaveric study undertaken to determine the incidence of variation of fissures and lobes of the lung in the Pune region of Maharashtra. Results: Variations in fissures such as accessory fissure, incomplete fissure, and horizontal fissure in the left lung are seen. A rare finding of horizontal T-shaped pattern in the middle lobe was reported in two lungs. Five-, four-, three-, two-, and single-lobed lung are found. Conclusion: Variations in the number of lobes of the lung and fissures are pivotal for pulmonologists and cardiothoracic surgeons. Clinical misinterpretation in cases of air leaks and planned lobectomy can be avoided by knowledge of these variations.
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Histological Analysis of Coronary Atherosclerosis at Division: A Cadaveric Study p. 159
Deepshikha Kori, Ritu Singh, Pooja Singh, Ganpat Prasad, Archana Rani, Rakesh Verma, Navneet Kumar
Background: Coronary artery disease is the leading cause of mortality in India and it is predominately due to atherosclerosis. The present study was conducted to determine the prevalence of atherosclerosis in coronary arteries without a history of cardiac disease and to determine plaque location in the coronary arterial system. Methodology: This study was conducted in the departments of anatomy and forensic medicine on 50 adult human hearts which had no history of cardiac disease. The coronary arteries were dissected, and 300 sections were taken from the origin, division, and from the distal end of right and left coronary arteries. These tissues underwent (histological) evaluation to note atherosclerosis. Results: In the present study, out of 50 cases, 40 (80%) had atherosclerosis. The majority of atherosclerosis was present at the division of coronary arteries (18.6%). Seventy-two percentage of atherosclerosis is present at left coronary artery (LCA) division (bifurcation) and 40% at right coronary artery (RCA) division (bifurcation). Grade I atherosclerosis was observed in 18.3% of hearts, grade II in 7%, and grade III in 2% of specimens, respectively. Both RCA and LCA had a higher proportion and grade of atherosclerosis at bifurcation points than proximal and distal segments. Conclusion: The proportion and grade of atherosclerosis are significantly higher at the division of coronary arteries without a history of cardiac disease. The identification of high-risk areas for atherosclerosis will lead to future advances in locally oriented preventive strategies.
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Aural and nasal anthropometry: An observational study p. 164
Pratima Jaiswal, Aastha Sharma, Aarushi Jain
Background: Neoclassical analysis of the human face is based on assumptions that certain fixed ratios exist between parameters of a harmonious face, these relationships of the human face have been called canons. One of the facial canons is nasoaural proportion canon most commonly followed for facial reconstructive surgeries. This study aimed to determine the applicability of nasoaural proportion and inclination canon in the participants and to explore the sexual dimorphism of nasoaural parameters among them. Methodology: This observational study was performed in the department of anatomy from May 2018 to May 2019. The study participants aged from 18 to 25 years of which 50 were male and 50 were female. Nose height and ear height were measured by a digital vernier caliper. Nasofacial angle and ear angle were measured using a goniometer. All the parametric data were analyzed by t-test using MedCalc software. Results: Classical nasoaural facial canon was followed by only one (male) participant while none of the males and females followed the classical nasoaural canon. The average ratio of nose height to ear height was 0.7 in both genders. Nasoaural canon showed that nasal height and ear height were fairly correlated. The inclination canon was followed by 18% males and 8% females only. Conclusion: The ideal neoclassical canons did not seem to apply to our sample when measurements were implemented. Therefore, these cannot prove a useful basis of modus operandi in achieving esthetic goals in the Indian population.
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A clinically relevant classification of rouvière's sulcus used in the West Indies p. 169
Shamir O Cawich, Michael T Gardner, Jean-Pierre Louboutin, Vijay Naraynsingh
Rouvière's sulcus is an important intra-operative landmark for laparoscopic surgeons. However, there are numerous definitions and classification systems for Rouvière's sulcus in medical literature. We propose a uniform definition and classification system to be used by researchers so that we can make meaningful comparisons of data.
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