A case of a supernumerary third head of the biceps brachii muscle - clinical significance

A three-headed biceps brachii muscle was found in one male cadaver out of 118 (0.85%) studied, both for educational and research purposes. The supernumerary head of the biceps brachii muscle was located superficially to the normal heads. It was originated from the insertion of the pectoralis major tendon at humerus. At the lower third of the arm, it was merging with the normal biceps brachii muscle and as a conjoint tendon was inserted at the radial tuberosity. The significance of our finding lies on the fact that the location of the supernumerary head was superficial to the other two heads, in contrast to previous reports in the literature. Surgeons and especially orthopaedic surgeons should bear in mind muscular variations like the one reported in the present study

The cadaver of a Caucasian man with a supernumerary fourth dorsal interosseous muscle in the right hand: a case report

<p>Abstract</p> <p>Introduction</p> <p>The human hand is a complex anatomic entity consisting of many muscles, nerves, and vessels, thus providing a special ability to perform accurate and meticulous movements. In this group of muscles are the four dorsal interosseous muscles.</p> <p>Case presentation</p> <p>A distinct supernumerary fourth dorsal interosseous muscle was found in the right hand of the cadaver of a 76-year-old Caucasian man without any other concomitant abnormality.</p> <p>Conclusions</p> <p>The presence of such an additional muscle in the hand should be considered in the management of hand deformities, whether the treatment is conservative or surgical.</p

Normal stress pattern of the pubic symphysis

© 2014. Anatomy & Cell Biology.The pelvic ring is stressed by external forces: by partial body weight, by ligament tension, and by muscles forces stabilizing the hip joints. For the symphysis ossis pubis there exist data concerning the type and magnitude of stresses. In oneleg- standing pressure, shear forces are predominant, and in both-leg-standing tensile forces are acting on the pelvic ring. Rupture of the symphysis is problematic due to the variety of its movements. Most literature descriptions of stress in the symphysis reflect only the frontal plane. Our intention was to make morphological as well as experimental investigations on the symphysis ossis pubis to delineate how it will be stressed in the horizontal plane. Twenty pubic bones taken from embalmed adult human cadavers (12 male, 8 female) were used. Horizontal and frontal slices (3 mm thick) of the symphyseal part of the os pubis were made. X-rays and densitometric analysis were performed. The width of the symphysis cartilage in the dorsal and the ventral regions was measured on 15 whole skeleton specimens coming from adult human cadavers. For experimental study an embalmed pelvic ring which had no abnormality was used. The symphysis pubis was cut completely in the midsagittal plane and then the ring was stressed via the cranial sacrum. Our results demonstrate that the symphysis is stressed by bending in the horizontal plane in one-leg-standing. In both-leg-standing the symphysis is stressed by tensile forces

Relationships of the Lateral Femoral Cutaneous Nerve to Bony Landmarks

Background The lateral femoral cutaneous nerve (LFCN) can be at risk during, for example, the insertion of pins in the anterior superior iliac spine (ASIS) during external fixation of the pelvis, total hip arthroplasty through a direct anterior approach, open surgery for impingement in the hip through an anterior approach, and periacetabular osteotomy. During surgery, the surgeon usually assumes the location of the LFCN by using the ASIS as a landmark. Questions/purposes We investigated (1) whether there is any relationship between the LFCN and the ASIS and (2) the anatomy of the LFCN at the lateral border of the psoas major. Methods Using 25 formalin-fixed cadavers, we determined the location of the LFCN emergence point as above, same level with, or below the iliac crest (IC). We measured the distances between the LFCN emergence point and the crossing of the IC and psoas major, ASIS, and pubic tubercle. We measured the distances between the ASIS and pubic tubercle (AB) and the ASIS and the point where the LFCN crossed the inguinal ligament (AC) and then calculated AC/AB. Results The LFCN was below the IC on 19 sides, at the same level on 13 sides, and above on 12 sides. The distances were -0.98 +/- A 5.57 cm to the IC, 12.39 +/- A 2.67 cm to the ASIS, and 17.76 +/- A 3.33 cm to the pubic tubercle. AB was 13.11 +/- A 1.08 cm, AC 2.95 +/- A 2.01 cm, and AC/AB 0.22 +/- A 0.16. Conclusions/Clinical Relevance The LFCN may emerge from the lateral border of the psoas major above or below the IC. The AC/AB ratio can help surgeons to find the LFCN in patients with different body types

Anatomical examination of the great inguinal blood vessels in preterm and term neonates

It is generally accepted that vessel cannulation is technically more difficult and results in more complications in neonates. A sound anatomical knowledge of the inguinal area is therefore important in the selection of appropriately sized central line catheters as well as the approach to central vessel access. Eleven stillborns were investigated. Birth weight (mean: 2,414 g, 900-4,100 g) and gestational age (mean 34 1/7 weeks', 27 6/7-42 1/7) varied within normal range. The outer diameters of the femoral artery (FA), femoral vein (FV), and great saphenous vein (GSV) were determined. The distance between the anterior superior iliac spine and the pubic tubercle was set as 100% and the vessel intersection points were calculated as percentage values of the inguinal ligament length, starting at the iliac spine. The FA has a diameter of 1.9 +/- 0.5 mm without correlation to gestational age. The FA crosses the inguinal ligament centrally. The FV has a diameter of 3.1 +/- 1.0 mm and does have correlation to gestational age. The FV crosses the inguinal ligament at 63-64%. The GSV has a diameter of 1.4 +/- 0.7 mm. Its point of intersection at the level of the inguinal ligament is 68-70%. We conclude that cannulation of the femoral artery or vein should not be performed too far (<1 cm) from the inguinal ligament. The course of the GSV is not suitable for catheter insertion. Clin. Anat. 27:376-382, 2014. (c) 2012 Wiley Periodicals, Inc

Intermediate supraclavicular nerve perforating the clavicle: a rare anatomical finding and its clinical significance

The dissection of a male 70-year-old cadaver revealed that the left intermediate supraclavicular nerve perforated the clavicle. Knowledge of this variation is important because it may cause neuropathy, with pain in the neck and shoulder region. Furthermore, it should be differentiated from a fracture of the clavicle

Anatomical variations between the sciatic nerve and the piriformis muscle: a contribution to surgical anatomy in piriformis syndrome

To detect the variable relationship between sciatic nerve and piriformis muscle and make surgeons aware of certain anatomical features of each variation that may be useful for the surgical treatment of the piriformis syndrome. The gluteal region of 147 Caucasian cadavers (294 limbs) was dissected. The anatomical relationship between the sciatic nerve and the piriformis muscle was recorded and classified according to the Beaton and Anson classification. The literature was reviewed to summarize the incidence of each variation. The sciatic nerve and piriformis muscle relationship followed the typical anatomical pattern in 275 limbs (93.6 %). In 12 limbs (4.1 %) the common peroneal nerve passed through and the tibial nerve below a double piriformis. In one limb (0.3 %) the common peroneal nerve coursed superior and the tibial nerve below the piriformis. In one limb (0.3 %) both nerves penetrated the piriformis. In one limb (0.3 %) both nerves passed above the piriformis. Four limbs (1.4 %) presented non-classified anatomical variations. When a double piriformis muscle was present, two different arrangements of the two heads were observed. Anatomical variations of the sciatic nerve around the piriformis muscle were present in 6.4 % of the limbs examined. When dissection of the entire piriformis is necessary for adequate sciatic nerve decompression, the surgeon should explore for the possible existence of a second tendon, which may be found either inferior or deep to the first one. Some rare, unclassified variations of the sciatic nerve should be expected during surgical intervention of the region