Abnormal muscle in the anterior compartment of the forearm: a case report

During routine dissection for the undergraduate medical students, we encountered an unusual, additional muscle in the anterior compartment of the forearm. This muscle took origin from the anterior surface of the radius in common with the flexor digitorum superficialis muscle. It had a tendon of origin and a tendon of insertion. Its fleshy radial belly and the tendon of insertion, crossed superficial to the median nerve. The muscle was inserted partly to the flexor retinaculum and partly to the undersurface of palmar aponeurosis. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for hand surgeons as it could possibly compress the median nerve because of its close relationship to it

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

Case Report: Variant Origin of an Arterial Trunk from Axillary Artery Continuing as Profunda Brachii Artery- A Unique Arterial Variation in the Axilla and its Clinical Implications

Background: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among all the reported variations of profunda brachii, its variant origin from the 3rd part of the axillary artery with common trunk for the branches of axillary artery is unique.Case Details: We report here an anomalous origin of profunda brachii as continuation of an arterial trunk arising from 3rd part of the axillary artery. This common trunk at its commencement passed between 2 roots of median nerve and gave branches of 3rd part of axillary artery before it continued as profunda brachii artery. The further course and branching pattern of profunda brachii were normal.Conclusion: Since the axillary artery is next choice of artery for arterial canulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors.Keywords: axillary artery, common trunk, profunda brachii, vascular variatio

High Origin of Ulnar Artery with Unusual Superficial Course and Abnormal Additional Branches from the Superficial Palmar Arch.

Though ulnar arterial variations are rare, superficial ulnar artery (SUA) is one of its commonest variations. During routine dissection in our department, we observed a unilateral case of SUA in a 70-year-old male human cadaver. It originated from the left brachial artery in the middle of the arm, 13cm above the medial epicondyle of humerus (15cm below the outer margin of first rib). From its origin, it passed downwards in the medial part of arm and forearm in a superficial plane compared to normal ulnar artery. In the hand, the SUA anastomosed with the superficial palmar branch of the radial artery, creating the superficial palmar arch. The superficial palmar arch gave additional branches to the thumb and index finger. Brachial artery divided into the radial and common interosseous arteries in the cubital fossa. The normal ulnar artery was absent. The existence of a SUA is undeniably of interest to the clinicians as well as to the anatomists. We hereby present a case of unilateral SUA along with a brief review of the literature and analysis of its clinical significance

Four cases of variations in the forearm extensor musculature in a study of hundred limbs and review of literature

All surgeons must bear in mind the existence of muscular variations when performing common tendon transfers. Presence of additional bellies and tendons of existing muscles or presence of additional muscles in unusual locations might misguide a surgeon, during surgery and also during diagnosis. In the present paper we are reporting four cases of variations encountered during the study of extensor muscles of the forearm in 100 limbs. In Case 1, additional bellies of extensor carpi radialis longus and extensor carpi radialis brevis and multiple tendons of insertion of abductor pollicis longus were observed in a single limb. In Case 2, an additional belly of the abductor pollicis longus was observed. In Case 3, a short muscle on the dorsum of the hand going to the index finger [extensor indicis brevis (EIB)] was found in addition to the normal extensor indicis (EI). It was also observed that some of the most superficial fleshy fibers of EIB were getting inserted into the tendon of EI. In Case 4, a rare incidence of extensor digiti medii proprius was observed. Further, the related literature is reviewed and the clinical and surgical importance of these muscular variations in diagnosis and proper planning of treatment is discussed

Multiple vascular anomalies involving renal, testicular and suprarenal arteries

Knowledge of variations of blood vessels of the abdomen is important during operative, diagnostic and endovascular pro- cedures. During routine dissection of the abdominal cavity, we came across multiple vascular anomalies involving renal, suprarenal and testicular arteries. The left kidney was supplied by two renal arteries originating together from the abdomi- nal aorta, and the right kidney was supplied by two accessory renal arteries, one of which was arising from the right renal artery and the other one from the aorta (about 2 inches below the origin of the renal artery). Accessory renal veins were present on both sides. The right testicular artery was arising from the lower accessory renal artery. The left testicular artery was looping around the inferior tributary of the left renal vein, whereby forming a sharp kink. The left middle suprarenal artery was diving into three small branches; the upper two branches were supplying the left suprarenal gland, whereas the lower branch was supplying the left kidney. Furthermore, detailed literature and the clinical and surgical importance of the case are discussed. [Arch Clin Exp Surg 2015; 4(3.000): 168-171

Circumaortic Left Renal Vein and Double Right Renal Vein: A Case Report

Venous malformation of the kidney is not uncommon. However, bilateral variation of renal veins is of rare occurrence and is clinically significant. In the present case, left renal vein divided into left pre and retro-aortic renal veins which passed in front and behind the abdominal aorta respectively, together forming a circumaortic renal vein. The retro-aortic limb received left testicular vein at a distance of 5.8 cm from inferior vena cava and pre-aortic vein received left suprarenal vein at a distance of 4.2 cm from inferior vena cava. Pre-aortic and retro-aortic veins drained into IVC separately about 4 cm apart from each other. On the right side, two separate renal veins (superior and inferior) were present. Both of them drained into inferior vena cava separately and about 2.6 cm apart from each other. This aberrant pattern of renal vein may affect the venous drainage of kidney and testis leading to renal hypertension and varicocele. Such variations should be known to urologists and surgeons before commencing any surgical and interventional procedures

A Rare Case of Huge Unilocular Autoamputated Extra-ovarian Dermoid Cyst

Ovarian dermoid cysts are one of the commonest benign, pelvic tumours. However, presence of dermoid cysts at extra-ovarian locations is very rare. The extra-ovarian dermoid cysts can be of ovarian origin or may also originate from non-ovarian sites like omentum, retroperitoneum, mediastinum, etc. We report one such rare case of extra-ovarian dermoid cyst observed in a 70-year-old postmenopausal woman at department of Gynaecology of our hospital. Her ultrasonographic observations showed a large well defined cystic lesion predominantly in the left adnexa extending into the midline with internal echoes within, which was later confirmed with MRI. Following this, she underwent a total abdominal hysterectomy with vertical midline incision. Intraoperatively, she was found to have a large tumour of 3.25kg (28cm x 26cm x 11cm) with adhesion to the omentum on its anterior upper and posterior aspects. The surface of the oval mass was smooth with few adherent lobules of fat in some areas. Its gross cut section showed a thick walled uniloculated cyst with yellow areas and thick creamy white fluid. Cyst wall had a bony hard area and two balls of hair were also noted in side. The pedicle of the tumour seen to arise from the left side broad ligament close to left ovary. Uterus was atretic with an intramural fibroid. The dermoid appears to be derived from its autoamputation from one of the pelvic organs; probably ovary. It is unique in its size and vastness occupying the major part of the lower half of the abdominal cavity

Prenatally Diagnosed Type II Arnold Chiari Malformations-A Rare Congenital Anomaly with Some Unusual Associated Defects

Arnold Chiari malformation (ACM) is one of the common anomalies of the craniovertebral junction involving both the skeletal as well as the neural structures. Among the four types of ACM, type II ACM is considered as commonest. A case of Type II Arnold Chiari malformations; a rare congenital anomaly with some unusual associated defects has been reported here. A 29 year old lady with 21weeks gestation was diagnosed to have a male foetus with type II ACM at antenatal clinic of department of Gynaecology, Sree Mookambika Institute of Medical Sciences, Kulasekaram, Tamil Nadu, India during routine antenatal check-up. Though the commonly observed malformations of type II ACM such as herniation of cerebellar tonsil, spina bifida and hydrocephalous were observed in the present case, it differed from general pattern of type II ACM in presence of a large cyst abutting spina bifida and mild scoliosis

Unusual Termination of Facial Artery Associated with the Presence of Premasseteric Branch- A Case Report.

Face being highly vascular region essentially receives extensive blood supply from the facial artery. Facial artery frequently shows variation in its pattern of origin, course and termination. An unusual premasseteric branch is the one among its variant branches on the face. We report herewith the untimely termination of facial artery as alar artery at the nose instead of medial angle of the eye associated with an abnormally large posterior branch known as premasseteric branch. Presence of premasseteric artery may be considered as beneficial in ‘raising flap’ approaches. However, ascertaining its existence makes obligatory for the surgeons during surgical procedures of the face