International Journal of Anatomy and Physiology

International Journal of Anatomy and Physiology ISSN: 2326-7275 Vol. 2 (12), pp. 027-035, September, 2013. © International Scholars Journals

Full Length Research Paper

Asymptomatic carotid artery stenosis and correlation with coronary artery stenosis among 200 patients undergoing cabg

T. Sumalatha¹*, Sreelatha², T.K. Rajasree³ and T. Sivaprasad⁴

¹Department of Anatomy, Osmania medical college, Hyderabad, India.

²Department of Anatomy, Gandhi medical college, Hyderabad, India.

³Department of Anatomy, Mallareddy medical college, Hyderabad, India.

⁴Consultant cardiac intensivist, Hyderabad.

*Corresponding author. E-mail: [email protected].

Accepted 04 July, 2013

Abstract

The aim of this study is to find out the incidence of asymptomatic carotid artery stenosis among patients undergoing CABG. To find its correlation with age, sex and any predilection to side and site of carotid artery. Doppler ultrasound of carotid arteries was done in 200 patients undergoing Carotid Artery Bypass Grafting (CABG). Patients including both sexes were aged between 35 and 75 years. Patients without any pre existing neurological deficits in the last 6 months were included in the study. Among the study population, 34 cases (17%) of carotid artery stenosis cases were found. The highest number of patients 17 (50%) was found in the age group of 56-65 years. The prevalence of carotid artery stenosis among patients aged more than 55 years  (21.5%) is significantly high  (p<0.05), than patients  less than 55 years (10.1%) old. Out of 34 cases, 38% had bilateral carotid artery stenosis, 32% had right side and 30% had left side carotid stenosis. The commonest site involved was at carotid bulb and internal carotid artery (CB and ICA) in 61.9% of cases. The average IMT of patients who had normal carotid arteries was found to be 0.1193mm on right side and 0.1151mm on left side. Males are at more risk than females. In the age group of 56-65yrs, there is a peak incidence of asymptomatic carotid artery stenosis. The carotid stenosis is highly prevalent among patients with severe coronary artery disease. Atherosclerosis predominantly affects the carotid artery bifurcation due to its typical flow characteristics. The average IMT of carotid arteries of indian patients who had normal carotid arteries was found to be 0.1193mm on right side and 0.1151mm on left side.

Key words: Atherosclerosis, screening, intima-media thickness, Indian population.

Abstract

Calcanei with certain talar facet patterns predispose to subtalar arthritis. Knowledge about variations in the talar facets of the calcanei is essential for orthopedic surgeons while correcting foot deformities like pes planus. This study was undertaken after finding a scarcity of such data in the Gujarat population. The objective was to identify the patterns of the talar facets of calcanei and their clinical implications. Calcanei (n=205) from the Gujarat was utilized. Only four patterns were described as follows: Pattern (I): Fusion of the middle and the anterior facets, Pattern (2): The middle and the anterior facets separate, Pattern (3): Absent anterior facet, Pattern (4): Fusion of all the three facets. And surface area was also measured. Pattern (I) was predominant (65.82%), followed by Pattern (2) in (33.33%) of cases. In the Pattern (2), the subtype b with (3-5) mm separation was the commonest. Pattern (3) found in 4.39% cases. Rare cases of pattern (4) was found in (1.39%) of cases. There is a dominance of pattern (I) calcanei in Indians as compared to the Europeans whose present pattern (2) are common. This fact necessitates the orthopedic surgeons in India to modify the surgical techniques when they perform calcaneal osteotomy. Indians may be at a greater risk of developing subtalar arthritis due to the dominance of Pattern (1) calcanei according to different studies performed. In our study we measured surface area of facets which shows more available surface area for articulation in pattern (I) which provides better stability. So chances of subtalar arthritis are less. We have to correlate it with clinical data.  

Key words: Calcaneum, facets for the talus, pattern, variation, arthritis. 

International Journal of Anatomy and Physiology ISSN: 2326-7275 Vol. 2 (3), pp. 020-022, March, 2013. © International Scholars  Journals

Full length research paper

Variation of musculocutaneous nerve in arm with additional muscular slip in forearm

Shweta J.Patel¹, Rashvaita k. Patel², Chintan Bhatt³ and C.D. Mehta⁴

^1,2,3,4Department of Anatomy, government medical college, Surat, India.

Accepted 14 March, 2013

Abstract

The Musculocutaneous nerve arises from the lateral cord of the brachial plexus, passes inferolaterally and then pierces through the coracobrachialis, after supplying it descends between the biceps and the brachialis, sending branches to both and continues as the lateral cutaneous nerve of the forearm. Variations in the origin, course, branching pattern, termination and the connections of the musculocutaneous nerve are not uncommon. These variations have clinical significance during surgical procedures, in the brachial plexus block and in diagnostic clinical neurophysiology. A detailed study was carried out on 80 upper limbs by using 40 embalmed cadavers during 4 years in anatomy department during routine undergraduates’ dissection classes. Dissection of the infraclavicular part of the brachial plexus was done. The variations in the origin, number and course, and their correlations to the coracobrachialis were noted. Absence of the musculocutaneous nerve was noted in 2 upper limbs (2.5 %).The musculocuatenous nerve was found but not piercing the coracobrachialis in 1 upper limb. (1.25%) and the nerve was found to rejoin the median nerve. The observations show that the musculocutaneous nerve has significant variations and that these variations have clinical significance in post traumatic evaluations and in the exploratory innervations of the arm for peripheral nerve repair. It is important for surgeons, clinicians and anatomist to be aware of possible anatomical variations to avoid unexpected complications.

Key words: Musculocutaneous nerve, brachial plexus, median nerve, coracobrachialis, biceps brachii.

International Journal of Anatomy and Physiology ISSN: 2326-7275 Vol. 2 (3), pp. 011-013, March, 2013. © International Scholars  Journals

Full length research paper

Morphological study of cutaneous ligaments

Anjali S. Sabnis

K.J. Somaiya Medical College and Hospital, Sion, Mumbai -400022, Maharashtra, India.

*Corresponding author. Email: [email protected]

Accepted 04 February, 2013

Abtract

The cutaneous ligaments of phalanges of palm and foot are fine and sender fibrous strips running from tendon sheath to skin over phalanges. Different opinions regarding cutaneous ligaments have created interest to find out the structure of them. By keeping aim in the mind to study ligaments in relation to attachment, thickness, length and histological structure, a study was conducted on 80 digits of 8 cadavers. These ligaments are running in relation to ventral and dorsal aspect of the digital nerve from tendon sheath to the skin. Attachment of the ligaments to the skin is suggestive of stabilization of skin during movements. The morphological data of cutaneous ligaments will be helpful in surgical implication of Duputren’s Contracture, replantation and revascularization of the digit. Thus clinical significance of cutaneous ligaments has attracted vascular surgeons in microsurgery of hand.

Key words: Cutaneous ligaments, Cleland’s ligament, Grayson’s ligaments, Duputren’s contracture.

International Journal of Anatomy and Physiology Vol. 2 (1), pp. 014-019, March, 2013. © International Scholars  Journals
Full length research paper

Anatomical study of the human ansa cervicalis nerve and its variations

Ahmed M.S. Hegazy

Anatomy and Embryology, Department of Anatomy, Faculty of Medicine, Benha University, Egypt. E-Mail: [email protected]

Accepted 27 February, 2013

Abstract

With the expanding use of the ansa cervicalis nerve for laryngeal reinnervation procedures. So the aim of this work was to study the anatomical variations of ansa cervicalis in its roots, course and branching pattern. Twenty five Egyptian necks (50 sides) were dissected. The results showed that the ansa cervicalis (AC) consisted of two roots: superior and inferior roots. These two roots joined together to form a nerve loop. The superior root of AC originated from the hypoglossal nerve in 100%.The superior root of AC descended in front of the external carotid artery in 68% and in front of the internal carotid artery in 32%. The inferior root of AC was derived from the ventral rami of C2 and C3 in 84% and from C2 in 16%. There were four morphological forms of the loop of ansa cervicalis: I- U-shaped loop in 84%. II- Y-shaped loop in 8%. III- double fused Y-shaped loop in 4%.VI- double separate Y-shaped loop in 4%. The superior root of AC gave a branch to the superior belly of omohyoid in 96% and a branch to sternomastoid in 24% . The inferior root of AC gave a branch to inferior belly of omohyoid and a communicating branch to phrenic nerve in 4%. These anatomical variations of the ansa cervicalis can be used in surgical procedures such as reinnervation of the laryngeal muscles following the damage of recurrent laryngeal nerve and to avoid the iatrogenic injuries of this nerve during the surgical operations of the neck. 

Key words: Ansa cervicalis, human, anatomical variations, surgical procedures,

International Journal of Anatomy and Physiology Vol. 1 (1), pp. 006-010, December, 2012. © International Scholars Journals

Full Length Research Paper

Transmaxilar access for treatment of blow-out orbital fracture with titanium mesh 

Edson Martins de Oliveira Junior¹*, Fernando Elias Melhem^1,2, Antonio Carlos Campos^1,b, Marcia Maria de Gouveia¹, and Carlos Augusto Alves Ferreira¹

¹Department of Dentistry - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil.

²Department of Surgery - Prosthesis and Maxillofacial Trauma - Faculdade de Odontologia - Universidade de São Paulo, São Paulo/SP - Brazil.

*Corresponding author. E-mail: [email protected]

Received 04 September, 2012; Accepted 23 December, 2012 

Abstract

Orbital fractures blow-out type result from traumatic force applied directly to the eye, often associated fracture of the medial orbital wall, without involvement of adjacent bones. This type of fracture results in prolapse of the orbital contents into the maxillary and/or ethmoid sinus. Diplopia, enophthalmos, hiposfagma, periorbital edema and ecchymosis are the major clinical findings. The Computerized Tomography (CT) scan of the orbits is the gold standard in accurate diagnosis of these fractures in order to determine the degree of prolapse orbital structuresinto thesinus, oriented their treatment. About the surgical access to these fractures is classically done by extra-oral way, through subciliar and transconjunctivalaccesses, which sometimes result in undesirable local complications such as scar, ectropion or entropion. This paper aims to report a case of blow-out fracture for which we chose to access via the maxillary sinus, by Caldwell-Luc  access, with reduction of the fracture and deserniation of orbital content through titanium mesh fixed on the superior and medial walls of the maxillary sinus.

Key words: Orbital, trauma, fracture, maxillary sinus, titanium mesh.