Case report of a bifurcated fibular (lateral) collateral ligament: which band is the dominant one?

Background: The fibular collateral ligament is a permanent and extracapsular ligament of the knee joint. It is located on the lateral aspect of the knee and extends from the lateral epicondyle of the femur to the lateral surface of the head of the fibula. As one of the main knee joint ligaments it is a stabilizer of the posterolateral corner of the knee and resists varus stress. The case report displays the bifurcated variant of the fibular collateral ligament. The aim of this study is to determine which of those bands should be considered dominant.Materials and methods: Classical anatomical dissection was performed on the left knee joint. The fibular collateral ligament was thoroughly cleansed around its origin, distal attachments, and course. Appropriate morphometric measurements were collected.Results: A bifurcated variant of the fibular collateral ligament with inverted proportions of its two bands (main and accessory one) constitutes our findings. It originated on the lateral epicondyle of the femur. Then it divided into two bands (A1 and A2). Band A1 inserted to the head of the fibula. A bony attachment of band A2 was located on the lateral aspect of the lateral condyle of the tibia.Conclusions: Although the fibular collateral ligament is a permanent structure it presents morphological variations. It is important to constantly extend morphological knowledge for all scientists concerned in anatomy

Anatomical variations of the abductor pollicis longus: a pilot study

Background: The abductor pollicis longus (APL) originates from the lateral part of the dorsal surface of the body of the ulna below the insertion of the anconeus muscle, from the interosseous membrane, and from the middle third of the dorsal surface of the body of the radius. However, the number of its accessory bands and their insertion vary considerably.Materials and methods: Fifty upper limbs (2 paired, 31 male, 19 female) were obtained from adult Caucasian cadavers, and fixed in 10% formalin solution before examination.Results: The APL muscle was present in all specimens. The muscles were divided into three main categories, with type II and III being dived into subtypes. Type I was characterised by a single distal attachment, with the tendon inserting to the base of the I metacarpal bone. Type II was characterised by a bifurcated distal attachment, with the main tendon inserting to the base of the first metacarpal bone; this type was divided into three subtypes (a–c). Type III was characterised by the main tendons inserting to the base of the first metacarpal bone, while the accessory band was characterised by mergers (fusion) with other tendons. This type was divided into two subtypes (a, b).Conclusions: The abductor pollicis longus is characterised by high morphological variability

Types of inferior phrenic arteries: a new point of view based on a cadaveric study

Background: The diaphragm is supplied by the superior and inferior phrenic arteries. This present study focusses on the latter. The inferior phrenic arteries (IPA) usually originate from the abdominal aorta. The two arteries have different origins, and knowledge of these is important when performing related surgical interventions and interventional radiological procedures. The aim of this study was to identify variations in the origin of the IPA and conduct relevant morphometric analyses.Materials and methods: The anatomical variations in the origins of the left inferior phrenic artery (LIPA) and the right inferior phrenic artery (RIPA) were examined in 48 cadavers fixed in 10% formalin solution. A dissection of the abdominal region of the cadavers was performed according to a pre-established protocol using traditional techniques. Morphometric measurements were then taken twice by two of the researchers.Results: In the cadavers, six types of origin were observed. In type 1, the most common type, the RIPA and LIPA originate from the abdominal aorta (AA) (14 = 29.12%). In type 2, the RIPA and the LIPA originate from the coeliac trunk (CT) (12 = 24.96%). In type 3, the RIPA and the LIPA originate from the left gastric artery, with no CT observed (3 = 6.24%). Type 4 has two subtypes: 4A, in which the LIPA originates from the AA and the RIPA originates from the CT (9 = 18.72%) and 4B, in which the RIPA originates from the AA and the LIPA originates from the CT (6 = 12.48%). In type 5, the LIPA originates from the AA and the RIPA originates from the AA (1 = 2.08%). Type 6 is characterised by the RIPA and LIPA forming a common trunk originating from the CT (3 = 6.24%). Conclusions: Our findings suggest the presence of six different types of LIPA and RIPA origin. The most common form is type 1, characterised by an IPA originating from the abdominal aorta, while the second most common is type 2, in which the IPA originates from the AA by a common trunk. The diversity of other types of origin is associated with the occurrence of coeliac trunk variation (type 3). No significant differences in RIPA diameter could be found, whereas LIPA diameter could vary significantly. No significant differences in RIPA and the LIPA diameter could be found according to sex

Morphological variability of the fibularis tertius tendon in human fetuses

Background: In adults, the fibularis tertius (FT) demonstrates great morphological variation. The present study classifies the types of FT insertion in human fetuses and compares their prevalence to the prevailing classification among adults. Materials and methods: Fifty spontaneously-aborted human fetuses (19 male, 31 female, 100 upper limbs in total) aged 18-38 weeks of gestation at death were examined. The fetuses were obtained from spontaneous abortion after parental consent. The study was performed in accordance with the legal procedures in force in Poland and with the Donation Corpse program for both adults and fetuses. Results: The most common type of FT found was Type VI (32%), characterized by a bifurcated distal attachment: a main tendon inserting onto the base of the fourth metatarsal bone, and accessory bands inserting onto the fourth interosseous space. Five other types were observed: Type IV (20%), with a single tendon inserting distally to the fascia covering the fourth interosseous space; Type I (18%), with a single tendon inserting distally onto the shaft of the fifth metatarsal bone; Type V (14%), with a bifurcated arrangement comprising a main tendon characterized by a very wide insertion onto the base of the fifth metatarsal bone and an accessory band inserting onto the base of the fourth metatarsal bone; and Type III (12%) with a single tendon inserting distally onto the shaft of the fourth metatarsal bone and fascia covering the fourth interosseous space. Finally, Type II (4%) was characterized by a single tendon inserting onto the base of the fifth metatarsal bone via a very wide distal insertion. Conclusions: The fibularis tertius demonstrates high morphological variability, with the most common configuration found in adults — a single insertion onto metatarsal 5 — being actually uncommonly found in fetuses

Clinical significance of morphological variations of the inferior phrenic arteries

The rapid development of sciences such as genetics and molecular biology offers hope that better therapeutic methods can be developed and diagnosis and treatment made more effective. However, we must not forget that the basis for understanding the complex mechanisms of diseases and associated symptoms is knowledge of the relevant location and correlation among organs. In the present study, we focus on the clinical significance of the inferior phrenic artery. The diaphragm is a muscular structure that separatesthe abdominal and chest cavities. Thanks to this position, the inferior phrenic artery is much more significant than formerly assumed. A rich network of collaterals makes this vessel important in the development of neoplasms and metastases. Knowledge of anatomical variants of the inferior phrenic artery is also crucial for radiological procedures such as embolization. The main aim of this study is to review the involvement of the inferior phrenic artery in physiological and pathophysiological processes. This work has value for all practicing doctors, especially radiologists and surgeons

Potential compression of the musculocutaneous, median and ulnar nerves by a very rare variant of the coracobrachialis longus muscle

The coracobrachialis longus muscle (CBL) is an extremely rare variant of the coracobrachialis muscle (CRM). The CBL originates from the apex of the coracoid process together with the short head of the biceps brachii and inserts on the olecranon of the ulna. The CBL consists of three parts: a superior part (classical CRM — length 137.88 mm), a middle fibrous layer (23.41 mm), and an inferior part (185.37 mm). A rare relationship between the CBL and median, musculocutaneous and ulnar nerves was observed with potential compression at these three parts. In addition, this case report describes a connection between CBL and the medial head of the triceps brachii, as well as a third head of the biceps brachii, which originate from the fibrous layer. This case report highlights the relationships between the CBL and the median, ulnar and musculocutaneous nerves