Variant origin of the left vertebral artery from a vertebro-subclavian trunk associated with an unusual branch arising from the brachiocephalic trunk.

Variant origin of the left vertebral artery (LVA) from the arch of aorta is well documented in the literature. Involvement of complex sequential developmental steps in the aortic arch formation results in different patterns of origin of LVA. Morphological variations in the LVA are thought to alter the cerebral hemodynamics and can cause the cerebral dysfunction. Knowledge of the morphological variations of the LVA is useful while performing the head and neck and thoracic surgeries. We here report one of the extremely rare patterns of the LVA origin, in a male cadaver aged about 65 years. LVA and left subclavian artery (LSA) arose as a common vertebro-subclavian trunk from the convexity of the aortic arch. Further, brachiocephalic trunk (BT) gave an unusual artery from its anterior surface. This artery divided into thymic and tracheal branches. Variant origin of thymic branch may be crucial during imaging and thymectomy 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

Triple falx cerebelli associated with two aberrant venous sinuses in the floor of posterior cranial fossa

During regular dissection classes, authors came across tripled falx cerebelli in a male cadaver. The main (middle) falx cerebelli was large and was attached to the internal occipital crest. It contained the occipital sinus. There were two smaller folds (right and left), one on either side of the falx cerebelli. There were two aberrant venous sinuses; each one connecting the ipsilateral sigmoid and transverse sinuses with each other. The complex dural-venous variation reported here is seldom reported in the literature. Knowledge of such variation is important for neurosurgeons and neuroradiologists as these aberrant folds could cause haemorrhage during suboccipital approaches or may lead to erroneous interpretation during imaging of the posterior cranial fossa

Anatomical variation of the extensor tendons of the second toe in the dorsum of the foot: a case report.

Extension of the lateral four toes of the foot is caused by the extensor digitorum longus. Each tendon of the extensor digitorum longus is attached to the middle and distal phalanges of the corresponding toes. The medial three tendons receive the insertion of lateral three tendons of the extensor digitorum brevis. During regular dissection for the undergraduate medical students, we came across a rare variation of extensor tendons of the second toe. The extensor digitorum brevis gave two tendinous slips to the second toe; medial slip and lateral slip. The extensor digitorum longus tendon for the second toe received the insertion of extensor digitorum brevis medial slip for the second toe, opposite to the base of second metatarsal bone. Further, the lateral slip of the extensor digitorum brevis was inserted to the lateral side of the extensor digitorum longus tendon for the second toe, opposite to the base of the proximal phalanx. Precise knowledge about the anomalies of extensors of the toes is clinically important while harvesting the tendon grafts. The knowledge of the anomaly presented in present case report is also important during plastic and orthopaedic surgeries as preference and selection of a donor site for a tendon graft is crucial

A Rare Unilateral Variation in the Course of External and Internal Carotid Arteries.

Vascular variations in the neck region are not uncommon. Knowledge of incidence of morphological variations in the course and branching of the carotid arteries is important for radiological interpretation and surgical correction when they are symptomatic. Internal carotid artery (ICA) is known to show elongation in its extra cranial course. Previous studies have demonstrated the incidence and clinical symptoms of this morphological entity. However, the occurrence of elongation and looping of the external carotid artery (ECA) is seldom reported in the literature. During regular dissections, we came across a rare case of unilateral morphological variation of both ECA and ICA, in a male cadaver aged about 55 years. ICA presented a curved course with convexity directed posteriorly, at the level of the C2-C3 vertebrae. ECA presented a pronounced kinking or coiling, one inch below the level of the angle of the mandible. In addition, a linguo-facial trunk arising from the ECA also presented a pronounced kinking throughout its entire length

Unusual Path of Branches of Ilioinguinal Nerve: A Clinically Important Anatomic Variant.

Ilioinguinal nerve is a collateral branch of lumbar plexus. Its anatomical variations in relation to adjacent musculoaponeurotic structures play a crucial role in the development of neuropathies associated with lower abdominal surgeries. In this report, we present a rare case of unusual course and branches of the ilioinguinal nerve, in a 55-year-old male cadaver. In the lateral part of inguinal canal ilioinguinal nerve gave three branches. Two of its branches pierced the external oblique aponeurosis, about 6 cm above the pubic symphysis, to supply the skin of the lower part of the anterior abdominal wall. Another branch pierced the conjoint tendon, in the medial part of the inguinal canal about 2 cm above the superficial inguinal ring. Knowledge of unusual path of these branches may be important to avoid injuries during the surgical repair of groin hernias. Further care should be taken while dealing with the conjoint tendon in the Bassini procedure

Short Axillary Vein and an Axillary Venous Ladder Formed by Basilic and Brachial Veins – An Anatomical and Clinical Perspective

Knowledge of anatomic variants of veins in the arm and axilla play a key role in planning of successful venous access. Possible anatomic variants of axillary vein, brachial vein and basilic vein and their clinical implications have been well described in the literature. We report a rare case of formation of a short axillary vein associated with complex venous communications between the basilic and brachial veins forming a venous ladder in the axilla, in formalin embalmed male cadaver. Axillary vein was formed in the upper part of the axilla by the fusion of basilic vein and unpaired brachial vein, and it was about 3cm in length. The higher-up confluence of basilic and brachial veins was also associated with presence of three communicating veins between the basilic and brachial veins in the axilla. Knowledge of reported venous variations is very useful during preoperative venous mapping and also for planning and execution of various surgical invasive procedures involving these veins

Clinically important variations in the lower limb - A case repot.

In this paper, three variations in the lower limb are reported and their clinical importance is discussed. The variations reported include a duplication of the piriformis muscle, the tibial nerve being pierced by the tendon of the plantaris and an additional muscle in the peroneal compartment of the leg

Brief Report - Unusual position of external carotid artery: a case report

The arterial pattern of the human body is one of the systems that show a large number of variations. Many reports are available regarding variations of common carotid, external and internal carotid arteries and branches of external carotid artery. We describe a very rare case of lateral position of external carotid artery. The external carotid artery was lateral to the internal carotid artery at the bifurcation of the common carotid artery. The clinical importance of this variation is discussed