A morphological study of the medial and lateral femoral circumflex arteries: a proposed new classification

Background: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. Materials and methods: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. Results: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). Conclusions: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery

A bifurcated plantaris muscle: another confirmation of its high morphological variability? Another type of plantaris muscle

The plantaris muscle usually begins with a short, narrow belly in the popliteal fossa at the lateral supracondylar line of the femur and the knee joint capsule. Then it forms a long and slender tendon and usually inserts into the calcaneal tuberosity on the medial side of Achilles tendon. Nevertheless, many anatomical variations of distal attachment have been described. Cases of atypical proximal origin are reported less frequently. In this paper, we have presented a case of a two headed plantaris muscle. First head attached to the condyle of the femoral bone, medially and inferiorly to the lateral head of the gastrocnemius muscle. The second one originated from the popliteal surface of the femur, just above the intercondylar fossa. According to present literature, no such case with atypical proximal origin was presented. Such information has potentially clinical significance during the surgical procedures performed in the area of the popliteal fossa

A new type of the coracobrachialis muscle

The coracobrachialis muscle belongs to the anterior group of the brachial region. Its main functions are flexion and adduction at the glenohumeral joint. It is highly morphologically variable, especially in the number of bellies, place of origin or insertion, and its relationship to the musculocutaneous nerve. Accessory structures associated with the coracobrachialis muscle include the coracobrachialis brevis or coracobrachialis longus muscle. The present case describes a three-headed coracobrachialis muscle with two such additional structures. One of these has a tendinous origin connected to the periosteum and located on the surgical neck of the humerus. Its insertion is fused with the third head of the coracobrachialis muscle. The other has a proximal attachment fused with the capsule of the shoulder joint, and its distal attachment is fused with the third head of the coracobrachialis muscle in place of its connection with the short head of the biceps brachii. This could result in better stabilization of the glenohumeral joint; on the other hand, it could limit operational access during treatment of subscapularis tears

Case report of the double headed extensor hallucis longus

Background: We present a case report of double-headed extensor hallucis longus (EHL) with potential clinical significance. Materials and methods: Cadaveric dissection of the right lower limb of a 70-year-old female at death was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The limb was dissected using standard techniques according to a strictly specified protocol. Each head and tendon of the muscle was photographed and subjected to further measurements. Results: During dissection, an unusual type of EHL muscle was observed. It consisted of two muscle bellies, a main tendon and an accessory tendon. Both muscle bellies were located on anterior surface of the fibula and the interosseous membrane. The main tendon insertion was located on the dorsal aspect of the base of the distal phalanx of the big toe, while the accessory tendon insertion was located medially. Conclusions: The EHL muscle is highly morphologically variable at both the point of origin and the insertion. Knowledge of its variationsis connected to several pathologies such as foot drop, tendonitis, tendon rupture, and anterior compartment syndrome

A new type of the coracobrachialis muscle

The coracobrachialis muscle belongs to the anterior group of the brachial region. Its main functions are flexion and adduction at the glenohumeral joint. It is highly morphologically variable, especially in the number of bellies, place of origin or insertion, and its relationship to the musculocutaneous nerve. Accessory structures associated with the coracobrachialis muscle include the coracobrachialis brevis or coracobrachialis longus muscle. The present case describes a three-headed coracobrachialis muscle with two such additional structures. One of these has a tendinous origin connected to the periosteum and located on the surgical neck of the humerus. Its insertion is fused with the third head of the coracobrachialis muscle. The other has a proximal attachment fused with the capsule of the shoulder joint, and its distal attachment is fused with the third head of the coracobrachialis muscle in place of its connection with the short head of the biceps brachii. This could result in better stabilisation of the glenohumeral joint; on the other hand, it could limit operational access during treatment of subscapularis tearsNingunoDepto. de Anatomía y EmbriologíaFac. de MedicinaTRUEpu