Indian Journal of Anatomy

The gastro esophageal junction is the point at which the distal end of the esophagus meets the cardiac part of the stomach. The anatomy of the gastro esophageal junction is important as it lies in the proximity of the diaphragm and is present at the junction of the thorax and abdomen. Hiatal hernia is a clinical condition in which there is protrusion of the gastro esophageal junction into the thorax through the diaphragm. Obesity, coughing, straining during bowel movements, smoking are the risk factors, which may lead to hiatal hernia. The study and diagnosis of hiatal hernia is important as most of these hernias are asymptomatic and in severe conditions it can be life threatening.

Anatomical act means act for supply of unclaimed dead body to authorized medical teaching institute for purpose of dissection and to knowing internal structure of human body because anatomy teaching become perfect by the dissection of the dead body. Anatomical act also related with body donation (donated body itself in living state) body donation is defined as act of giving body after death for medical education and research

purpose. Cadavers/donated bodies form a principle teaching tools for anatomist and to teach gross anatomy. Practicing of surgical step over cadaver prior to operating a living patient is a good mode in surgical operation. In this article source of unclaimed body, anatomy act rules and regulation regarding handling of unclaimed body are discussed

Introduction: Hypertensive disorders are the causes of maternal and fetal mortality and morbidity. Ten percent of pregnancies are affected by hypertensive disorders.This study is aimed at studying the morphological and morphometrical changes of the placenta in hypertensive disorder and their effects on fetal growth and to compare them with the normal pregnancy. Methodology: Live birth placentae were collected from hypertensive

and normal pregnancy (30 in each group). Morphometric measurements of placentae along with morphological changes were recorded. Fetal parameters and maternal history were recorded after the delivery. Results: Morphometric parameters of the placentae were reduced in hypertensive disorder which was statistically significant (p<0.05) and also morphological changes were observed. Fetal weight and length were also reduced.

In hypertensive group, the majority of women had a Caesarean section (C/S) which was statistically significant. Conclusion: In this study, we observed that hypertensive disorders will affect the placental morphology and its function thereby affecting the fetal growth. Knowledge of placental and fetal insufficiencies in hypertensive disorder can help to manage and improve the antenatal care of future pregnancy, and management of fetus and mother after delivery.

 Background and Aim: The Suprascapular notch is present at the anterolateral end of the superior border of scapula medial to the root of the coracoid process. The notch is bridged by the superior transverse scapular ligament which is attached laterally to the root of the coracoid process and converts the notch into the foramen. This

foramen transmits the suprascapular nerve (SSNr) to the fossa. This study was focused on different types of the suprascapular notch (SSN) and its combination of the anomalous superior transverse scapular ligament (STSL) was considered as a risk factor for Suprascapular nerve entrapment. Materials and Methods: This study was done

in 100 human dry scapulae. The shapes of the SSN, partially or completely ossified STSL were noted and the maximum depth, superior and middle transverse diameters of suprascapular notches was measured. The data analysis of the notches was recorded and correlated with previous studies. Results: The shape of the SSN was observed and classified into six types. The most common type of notches ”U” shaped and less common type was small “V” shaped. The partially or completely ossified STSL was also observed in this study. Conclusion: The anatomical knowledge of various types of SSN and the prevalence of ossified STSL is important for clinicians for giving suprascapular nerve block. The Knowledge of anatomical variations of SSN helps the orthopedic surgeon to diagnose the cause for painful syndromes of shoulder and the early management which helpsforgood functional recovery.

Background: Axillary artery is a continuation of the Subclavian artery, extending from outer border of first rib to the lower border of Teres Major muscle. The variations in the branching pattern of Axillary artery is not uncommon. Any deviation in the development of the vascular plexus of the limb bud may be responsible for the variations in the branching pattern. The knowledge about such variations in the branching pattern of Axillary artery is important in relation to Coronary bypass and flaps in reconstructive surgeries, treating Axillary artery thrombosis, creating the Axillary-Coronary bypass shunt in high risk patients. Recent progress in vascular surgery has emphasized a need for precise knowledge of frequency of anatomical variations in the branching pattern of Axillary artery. Aims: The aim of the present study was to Analyse the variations in the branching pattern of Axillary artery and it’s embryological significance. Materials and Methods: Forty upperlimb specimens from embalmed cadavers allotted for dissection in the department of Anatomy at ESIC Medical college and PGIMSR, Rajajinagar, Bangalore over a period of five years was used for the study. Results: We came across the presence of variation in the branching pattern in one male cadaver bilaterally. On the right side, all the branches of third part of Axillary artery emerged from commom trunk, whereas on the left side, all three branches of third part and lateral thoracic artery arised from the common trunk. Conclusion: The knowledge of branching pattern of Axillary artery is useful in treating Axillary artery thrombosis, reconstructing Axillary artery post-trauma, microvascular graft for replacing damaged arteries.

Introduction: Dermatoglyphics refers to the branch of science which studies the patterns of skin ridges present on fingers, toes and soles of human being. Since ancient times these ridge patterns and lines were used by palmists and future tellers for predicting the future. Recently the scope of dermatoglyphics has been amply recognized with expanding horizons of medical science in explaining certain diagnostic and aetiopathological riddle in various diseases, especially with heridofamilial background. The present study is undertaken to study the dermatoglyphic pattern in congenital heart diseases (CHD) and to compare it with previous studies. Materials & Methods: The cross sectional study with comparison group was designed. Hundred patients of congenital heart diseases (CHD) i.e. CHD group and hundred patients without CHD i.e. control group were examined during study period. Dermatoglyphic prints were obtained by using standard protocol method and finger tip patterns i.e. Arches, whorls, radial loops and ulnar loops were studied. The quantitative parameters like whorl loop index, triradial count, pattern intensity index and ‘atd’ angle were studied and analysed. Results: Among the quantitative parameters, whorl loop index, triradial count and pattern intensity index showed statistically insignificant difference in CHD group and control group. But ‘atd’ angle was increased significantly in CHD group as compared to control group. Conclusion: There was statistically significant increase in the values of ‘atd’ angle in CHD group as compared to control group. 

Background: Conventional Viva, so far is the commonest assessment tool used in practical examinations in Anatomy in India since long times. However, elaborate studies looking for how the students and faculty perceive it are lacking. The present study was undertaken to determine the perception of first year undergraduate medical students and Anatomy faculty about various aspects of the Conventional Viva. Methods: The feedback was collected from 586 Ist MBBS students, immediately after they finished their preliminary practical examination, during the academic years 2013-14, 2015-16, 2016-17, using pre-validated, pre-tested structured questionnaire. Responses were sought on 5-point Likert scale. Views of 40 Anatomy faculty were also invited and data was analysed statistically. Results: We observed that students were satisfied with regards to the coverage of syllabus. Both, the students and faculty, were satisfied with regards to time given to answer the questions. Students reported cognizable fear for the examiners, stress, anxiety and reduced comfort during viva. Mood of examiners and personal bias by them were important drawbacks perceived by students. Significant proportion of students and faculty felt that lack of equal opportunity to all the students, ‘carry over effect’ and the extraneous help to students in the form of

hints prevailed in the viva. Less satisfaction was reported by faculty while assessing with conventional viva.

Conclusion: Our findings indicate that there is an urgent need to appraise the current pattern of Viva-Voce. Best feasible option in a set up like ours can be ‘Monitored Viva By Sensitized And Trained Examiners’.

The objective of the study is to assess the variation in splenic measurement like length, width and thickness in normal persons and categorise them according to different age group and sex using ultrasonography. This study was done on 500 individuals aged between 21-60 years. Ultrasonographic measurement of spleen was done by ESAOTE MYLAB 40 Machine. Measurement of spleen was taken by using convex 2.5-6.6 MHz probe. It was observed that the length decreased slowly with increase in age in both sexes. The width in male first it decrease then slightly increase and after that it again decreases. In female width slightly increases up to the age of 40 years, after 40 years of age it decreases slowly up to the age of 60. The thickness in male first decrease then slightly increases and after again decreases. In female first the thickness increases slowly after that it remains relatively constant, then decreases. All dimensions of spleen were greater in males that in females. 

 Introduction: Dermatoglyphics is the study of the epidermal ridges of the skin covering the digits, palms of the hands, and soles of the feet. Dermatoglyphic patterns may be viewed as “fossils” of late first and second trimester fetal development. Any disturbances in hereditary or environmental factors at the time of ridge formation may alter the dermatoglyphic pattern. It is well known that bipolal’ mood disorder have some genetic predisposition. Material & Methods: The material for the study was clinically diagnosed cases of manic depressive psychosis (100) as per DSM-IV criteria in the age group of 15 – 70 years. Patients were those attending out patient and in patient department of psychiatry at B.M. Patil Medical College, Hospital and Research Centre, Bijapur. Finger and palm prints of 100 normal people for control of same age group were obtained from Medical students. Results: Increased incidence of whorls, decreased incidence of arches, ulnar loops and radial loops in MDP patients as compared with controls. Mean AFRC in MDP was lower & difference was statistically not significant. Mean TFRC in MDP was lower, difference was statistically significant (p=0.04). Mean ab-RC on right hand in MDP was lower & difference was statistically highly significant. (p=0.000). The Mean ab-RC on left hand in MDP was lower & difference was statistically highly significant (p=0.000). Mean atd angle on right hand in MDP was higher, difference was statistically highly significant (p=0.00). Mean atd angle on left hand in MDP was higher & difference was statistically highly significant (p=0.000). Conclusions: In the present study the observed changes suggest significant difference in dermatoglyphic patterns in bipolar mood disorder and control. Our findings match with most of the previous studies in bipolar mood disorder. Dermatoglyphics, a non-invasive method, could serve as a screening indicator for the follow up of individuals in threatened families. 

Introduction: Placenta makes connection between mother and foetus through umbilical cord. A healthy placenta is single most important factor producing healthy baby. Main mass of placenta is formed by villous and intervillous spaces. Volume of villi gradually increases with advancement of pregnancy. Aim and objective: The purpose of study was to correlate fetal birth weight with villous volume. Material and Methods: Twenty two placentae were obtained. Volume of placentae was obtained by fluid displacement method. Histological examination was done after staining with haemotoxylin & eosin, Van Gieson and Masson’s trichrome method. Size of villi was obtained by Micrometry technique and percentage of villous volume was obtained by Point Counting technique. Result and Conclusion: Volume of villi in second trimester and third trimester placentae was 70ml and 317ml respectively. The present study provided data of placental villous volume/fetal weight is better indicator of fetal well being than conventionally used placental/fetal weight ratio. Pathologist can use provided data for comparison of villous volume with diabetic and hypertensive mother.

Background: The lecture is the most commonly used teaching learning method in medical education but the effectiveness of this traditional approach is being questioned. New educational teaching techniques are rapidly appearing in literature. It is been stated that to facilitate student learning interactive teaching learning methods should dominate the curriculum. This study is undertaken to ascertain the impact and study the preference of large group and small group teaching methods on learners. Aim and Objective: The aim and objective of this study is to understand the best way to achieve transfer of knowledge and skills between teacher and students that could contribute towards meaningful teaching and learning experiences for medical anatomy. Materials & Methods: This is a prospective, mixed (qualitative and quantitative) study seeking preference for teaching method among undergraduate first year MBBS students in subject of Anatomy. Data collection was done with a structured questionnaire containing questions pertaining to their attitude, perception as well as their preference for teaching method, after taking an informed consent. Results: In this study, majority of the students preferred small group teaching over large group teaching, for being interactive way of teaching. Conclusion: Small group teachings should be incorporated in the subject of Anatomy, along with didactic lectures to enhance active learning among students.

Variation in the branching pattern of axillary artery is commonly seen. Knowledge of these variations is of anatomical, surgical and radiological importance. In present study 50 upper limb of 25 cadavers were dissected to see branching of axillary artery andits course. We found variations as posterior circumflex humeral artery coming from subscapular instead of third part of axillary artery; unilateral superficial brachial artery; bend and tortuous axillary artery. Thus variation pattern of axillary artery is important as it is used in different vascular surgeries. Also it helps to determine the brachial plexus relation as cords of brachial plexus are labelled after their relation to second part of axillary artery. 

Sylvian fissure is one of the most important landmarks of human cerebral hemisphere, with necessary surgical landmarks situated around its vicinity. Therefore, a research was designed to study the morphology of this anatomically and surgically significant fissure. The natural upward retraction of the apex of the pars triangularis commonly creates the largest opening in the superficial compartment of the sylvian fissure and provides an area on the convexity where the sylvian fissure is widest, and where it is often safest to begin opening the fissure. 58 formalin fixed cerebral hemispheres were taken and studied. 29/58 (50%) specimens exhibited U pattern while V and Y pattern was exhibited by 19/58 (32.76%) and 10/58 (17.24%) specimens respectively. most common pattern observed is U, followed by V & then Y. This study was then performed and carried further with comparing the difference in morphology of both sides.

Background: Accessory renal arteries are one of the most commonly seen variation of renal arteries. Hilar, upper polar and lower polar are the types of accessory renal arteries seen. Aim: To find the incidence of various types of accessory renal arteries in maharashtrian population. Methods: 144 kidneys are studied for variations in renal arteries like source of origin and number. Results: 17 kidneys (11.8%) show presence of accessory renal arteries. Maximum 10 (6.94%) kidneys show lower polar accessory renl arteries. 100% aortic origin for renal arteries is noted. Conclusion: Knowledge of variations like accessory renal arteries are very important for surgeons and radiologists during radiological examination before ureteropelvic procedures and renal transplants.

Content: Foramen magnum is a big foramen found at the base of skull in posterior cranial fossa, it transmits vital structures like spinal cord, vertebral artery. This foramen belongs to occipital bone. The basal region of occipital bone is covered by a large volume of soft tissue and is, therefore, in a relatively well protected anatomical position and as such, classification of sex using occipital bone may prove useful in cases of significantly disrupted remains of skeleton. Aim: To study the dimensions of foramen magnum and determine the sex of skulls. Materials and Methods: A sample of 100 dry adult human skulls (50 known male and 50 known female) available from the department of Anatomy in RIMS, Raichur and GIMS, Gulbaraga were taken TD, LD of foramen magnum of this skulls were measured with help of vernier’s calipers, area of foramen was calculated with the help of formula. Results: The longitudinal diameter, transverse diameter and area of Foramen magnum were significantly higher in male skulls than in female skull. Conclusion: The observation and results of present study demonstrate significant sexual dimorphism in the dimensions of foramen Magnum of the Karnataka population. Hence, dimensions of foramen magnum help forensic investigator and an anthropologist to determine the sex of disrupted remains of skeleton.

Aim: The variations of superior articular facets of the Atlas vertebra has been less described in most of the anatomy textbooks though it is significant clinically. Different authors have described the superior articular facets based on constrictions, grooves and shapes. Present study deals with the division of the facet, constrictions , grooves, division, shapes and depth, its frequency and possible explanation. Materials and Methods: 100 superior articular facets of 50 dried, adult atlas vertebrae were collected from the bone library, Department of Anatomy, Subbaiah Institute of Medical Sciences, Shimoga. Results: Constrictions on medial margin were more frequent, 54% bilaterally followed by constrictions on both the margins about 46% on right side and 44% on left side. Grooves were observed about 46% on right and 44% on left side on the superior articular facets. According to constriction and groove, the facets were divided into complete, incomplete and non division. Non divisions were frequently seen, 54% on right and 56% on left side and complete divisions were less frequent, 8% on right and 2% on left side. Shapes of the facets were also defined according to its division. Kidney- shaped facets (54% bilaterally) were commonly observed followed by dumb-bell shape with left side predominance (36%). Depth of the facets was studied where concave was more common. Conclusion: The knowledge of variations of superior articular facets of Atlas is of importance to anatomists, anthropologists and clinicians since asymmetry may lead to restricted movements of  atlanto-occipital joint and incomplete decompression of neuro-vascular structures.

Introduction: Laparoscopy has been a choice of preference for various surgical procedures for more than two decades. Trocar and cannula are used to make required portals in the anterior abdominal wall for inserting laparoscope. Penetrating a pointed trocar is a blind method. Using the standard confirmed points for making portals, though secure, at times can lead to injury of blood vessels of anterior abdominal wall, mainly Inferior Epigastric Artery (IEA). Anatomical variations of IEA in origin, course, branching pattern and termination are well reported. Hence there is a necessityfor mapping of IEA to avoid vessel injury. Aim: The aim of present study is to map IEA in terms of its length from its origin, distances from midline extending from pubic symphysis to umbilicus and level of termination with relation to umbilicus. Materials and Method: Study was conductedon 50 formalin embalmed adult cadavers by direct dissection methodused for routineundergraduate teaching. IEA on both sides was dissected. Length, distance from midline with five reference points and termination with reference to umbilicus was recorded. Results: Length of IEA - On right side it ranged from 7.2 – 25cms with mean 14.68±4.78, on left side from 8- 24.3cms with mean 14.91±3.55. Our study concluded safety zone 5.3cm±1.92 on either side of midline. In our study 22% right IEA and 22% left IEA ended below the umbilicus. Conclusion: The trocars can be safely inserted at 5.3cms±1.92 away from the midline on both the sides. However, preoperative mapping of IEA will help in minimizing vessel injury during laparoscopic procedures. 

Introduction: The suprascapular notch is the major site for suprascapular nerve compression. Objective: To study morphological variations of suprascapular notch in South Karnataka population and to determine posteriosuperior and posterior limits of safe zones for shoulder arthroscopic procedures from posterior approach. Materials and Methods: 100 dried adult human scapulae of unknown sex, obtained from Department of Anatomy, Kodagu Institute of Medical Sciences, Madikeri, Karnataka, India. Information regarding various forms of the suprascapular notch was noted. Results: Suprascapular notch was present in all Scapula. Based on Rengachary classification, most prevalent was Type III (33%) and least was type VI (1%). Superior Transverse Diameter (STD) =12.19±4.83, Mid Transverse Diameter (STD) =8.22±2.98 , Maximum Depth (MD) =8.46±3.35. The mean distance from SSN to Supraglenoid tubercle was 29.82±4.06 and the distance between the medial wall of the spinoglenoid notch and the posterior margin of the glenoid cavity was 15.19±2.64 respectively. Conclusions: Knowing about the morphological variations of suprascapular notch will assist the clinicians in order to understand the concepts of suprascapular nerve entrapment which will help the outcome of the treatment.