Indian Journal of Anatomy

Anatomy of the suprascapular notch and its variations has clinical relevance in the fields of plastic and reconstructive surgery. The course followed by the suprascapular nerve predisposes it to compression in the suprascapular notch resulting in suprascapular nerve entrapment syndrome.This study is a descriptive study carried over a period of two years in the Department of Anatomy, Armed Forces Medical College Pune, Maharashtra. Ninety one dry completely ossified scapulae of undetermined age and sex available in the bone bank of the Anatomy department were studiedThe suprascapular notches were classified according to the classification given by Rengachary et al. In our study, Type III notch was the most commonly observed as per the Rengachary classification. Type IV was the least commonly observed morphological variation of the suprascapular notch. In six cases suprascapular ligament was completely ossified to convert it into a suprascapular foramen which is classified as Type VI. The measurement of the Superior transverse diameter and maximum depth was done by the Vernier’s digital Calipers. In our study, type III suprascapular notch was the most common whereas type II and type IV turned out to be the least common as only one case of each type was reported. Knowledge in the variations of the morphology of suprascapular notch helps the surgeon attain adequate access to the suprascapular
nerve. Adequate access is a prerequisite to effective decompression of this nerve in all cases of suprascapular nerve entrapment neuropathies. 

Atypical separation of long flexor tendons of the forearm is contemplated as progressive variation. Flexor digitorum superficialis annularis muscle of the ring finger was observed in the superficial strata of the forearm flexor compartment. Its origin, insertion, nerve supply, morphology and morphometry are described in this report. Awareness about the incidence of such rare variant muscle is critical for operating surgeons and anatomists.

The Subject of Kidney anomalies including their incidents has created much interest to the scientists in late 1950 and 1960 with the aim of preventing and curing them as much as possible. Knowledge about their incidents Particularly helps us to know how frequently they are seen in the population and makes us to search the possible etiological factors for such high occurrence. An attempt has been made to know the various anomalies , detailed dimensions of specimens available from the cadavers. To apply this knowledge to the incoming post graduates in their research works. Renal vascular segmentation was originally recognized by John Hunter in 1794. The term accessory vessels denote two or more arterial branches supplying the same renal segment. As each segment is supplied by a single end artery. Evans et ai in 1951 and tuli in 1968 noted multiple congenital anomalies affecting nervous system, urogenital system and cardiovascular system resulting from acute folic acid deficiency during gestation in pregnant rates. Gleen in 1959 described in 30% of cases the blood supply from one renal artery to each kidney. Boatman et al. 1971, colin et al 1972 the blood supply may be internal iliac artery or external iliac artery or sacral arteries. Malfunction of renal and testicular veins – a case report from the journal of the anatomical society of india volume 54, No.2 (2005, 2206) authors Varma R., Kalaras and Rana K.

The scapula is a flat bone, situated on the posterolateral aspect of the chest wall. Its superior border is thin and extends between superior and lateral angles. It presents suprascapular notch which is converted into a foramen called suprascapular foramen by superior transverse scapular ligament [STSL] [suprascapular ligament; a fibrous band]. The suprascapular vessels pass above STSL and suprascapular nerve passes below it, through the suprascapular foramen. Complete ossification of STSL converts suprascapular foramen into bony foramen & Suprascapular nerve is commonly entrapped in it.

Aims: Aim of this study is to calculate & compare the incidence with other studies of the ossified superior transverse scapular ligament [STSL] in dry scapulae and to discuss its clinical significance.

Materials and Methods: Ninty seven dried human scapulae of Indian population of Marathwada region of Maharashtra, 67 of male and 30 of female i.e. of known sex from the Anatomy Department of Government Medical College, Aurangabad were closely examined for the presence of ossified superior transverse scapular ligament.

Results: It was found that complete ossification of STSL was 12 out of 97 scapulae of which 11 were males and one was female. 12.37% scapulae of known sex had completely ossified STSL, including nine scapulae of right side and three scapulae of left side.

Conclusions: The present study showed 12.37% incidence of ossified STSL in Maharashtrian [Indian] population. Incidence of ossification of STSL varies in different populations. It may be influenced by mechanical stress on ligament, age, sex & genetic factors. The knowledge of STSL ossification may be helpful for anatomists, orthopedicians, radiologists, neurosurgeons & clinicians in diagnosis and treatment of suprascapular nerve entrapment syndrome.

Anatomy of the suprascapular notch and its variations has clinical relevance in the fields of plastic and reconstructive surgery. The course followed by the suprascapular nerve predisposes it to compression in the suprascapular notch resulting in suprascapular nerve entrapment syndrome.This study is a descriptive study carried over a period of two years in the Department of Anatomy, Armed Forces Medical College Pune, Maharashtra. Ninety one dry completely ossified scapulae of undetermined age and sex available in the bone bank of the Anatomy department were studiedThe suprascapular notches were classified according to the classification given by Rengachary et al. In our study, Type III notch was the most commonly observed as per the Rengachary classification. Type IV was the least commonly observed morphological variation of the suprascapular notch. In six cases suprascapular ligament was completely ossified to convert it into a suprascapular foramen which is classified as Type VI. The measurement of the Superior transverse diameter and maximum depth was done by the Vernier’s digital Calipers. In our study, type III suprascapular notch was the most common whereas type II and type IV turned out to be the least common as only one case of each type was reported. Knowledge in the variations of the morphology of suprascapular notch helps the surgeon attain adequate access to the suprascapular nerve. Adequate access is a prerequisite to effective decompression of this nerve in all cases of suprascapular nerve entrapment neuropathies.

Background: The purpose of this study is to assess the awareness and willingness regarding organ and body donation in population of Kalaburagi region followed by counseling session to encourage them towards organ and body donation.

Aim: To study the awareness and willingness towards Organ and Body donation in population of Kalaburagi.

Material and Methods: Across-sectional studyusing a specially designed, validated questionnaire containing mcq’s was done amongst Medical, Dental, Ayurveda and Nursing students, staff and patients of ESIC Institute Gulbarga after taking their informed consent. It was followed by a counseling session where queries regarding organ and body donation were solved and procedure of registration for the same was explained.

Results: Amongst the 1000 study participants surveyed, 1.) 511 participants (63.39%) amongst total 806 participants shown awareness towards organ donation. 2.) 565 participants (70.09%) amongst total 806 participants shown awareness towards body donation. 3.) 317 participants (39.33%) amongst total 806 participants shown willingness for organ donation. 4.) Only 137 participants (16.99%) amongst total 806 participants shown willingness towards body donation.

Conclusions: 1.) Highest awareness was observed amongst medical students for organ and body donation compared to other categories of study participants. 2.) Least awareness was observed amongst general public/patients for organ and body donation compared to other categories of study participants. 3.) Female respondents of all categories have shown higher degree of awareness towards organ/body donation compared to their male counterparts. 4.) Female respondents of all categories also showed more willingness for organ donation than male participants.

Horse shoe Kidney was first recognized during an autopsy De Carpi in 1521. This anomaly consisits of two distinct renal masses lying vertically on either side of midline and connected at their respective lower poles by a parenchymatous or fibrous isthmus that crosses the mid plane of the body. This isthmus lies at the level of 4th lumbar vertebra just beneath the origin of inferior mesenteric artery in about 40% of cases. Fusion of upper poles instead of the lower poles results in an inverted horse Shoe Kidney which constitute 5-10% of all Horse-Shoe kidneys, (i.e. in 95% of HSK, fusion is at lower poles). HSK is found more commonly in males by a 2:1 margin. 

Summary & Conclusion: The abnormality originates between 4th and 6th weeks of gestation, after the ureteral bud has entered the renal blastema. Boyden (1931) postulated that at the 14 mm stage (4.5 weeks) the developing metanephric masses lie close to one another, any disturbance in their relation ship may result in joining at their inferior poles. Usually the fusion of the both kidneys occurs before they have rotated on their long axis ,thus pelvis and ureters of HSK are being usually placed anteriorly. Rarerly, fusion occurs after some rotation had already taken place in which case the pelves are anterimedialy placed.

Introduction: Each kidney is supplied by a single renal artery originating from abdominal aorta at the level of L1 vertebra. Accessory renal arteries are common, they derive from the persistence of embryonic vessels formed during ascent of the kidney. We present, bilateral double renal vessels and unilateral accessory renal arteries discovered during a routine dissection of abdomen at department of Anatomy, Osmania medical college, during 2014­2018.

Materials and Methods: Case1­ We found 2 renal arteries running parallel to each other towards the hilum of the right kidney, both are derived from abdominal aorta. Case 2 ­Accessory renal artery originating from main renal artery entering the lower pole of the left kidney crossing superficial to hilar structures. Case 3­ There is a crossing of the left renal artery over the renal vein disrupting the order of hilar structures. Case 4­ Left Accessory renal artery arising from abdominal aorta below the renal artery supplying the lower pole of the kidney superficial to renal vein. Case 5­ Left accessory renal artery arising from abdominal aorta, supplying the lower pole of the kidney passing below the renal vein. Case 6­ Arterial trunk originating from right renal artery and supplying the suprarenal gland and diaphragm.

Conclusions: The study was carried out among 60 cadavers and we found the variations in 14 cadavers . The incidence of the anomalies is 23.3%. Awareness of the variations of the renal artery is necessary for surgical management during renal transplantation, repair of abdominal aorta aneurysm, urological procedures and angiographic interventions.

Introduction: The most challenging aspect in anatomy curriculum is to understand, imagine and learn the concepts in human embryology because of the complexities involved in the events and processes in the development of an embryo. It is always a challenge for the teacher to act as a facilitator and unveil the human embryology topic to the students and instigate a learning process. Materials and Methods: A questionnaire with 12 questionswas prepared for 200 students of the class of phase I MBBS and administered after their preliminary practical and viva­voce exam. It was informed that the questionnaire based study would be undertaken for analysis of students’ views and would be used in planning effective teaching learning strategies and also for research purpose in medical education. Results: The feedback questionnaires were compiled and analysed. 

Conclusion: Students prefer more of interactive and clinically relevant teaching of embryology which would make learning embryology more effective. Animations and videos should be incorporated in lectures which help in assimilating of the sequence of events in human development in 3­Dimentional form which definitely improves retention of embryological knowledge better.

Common Carotid arteries (CCA) provides major sources of blood to head and neck by giving two terminal branches, external and internal carotid arteries, at the level of superior border of thyroid cartilage in carotid triangle. During routine dissection in Department of Anatomy, Shadan institute of Medical Sciences, Dr VRK Womens Medical college and we observed variations in three specimens. In one specimen we observed a higher division of External Carotid artery (ECA), near to the angle of mandible and in two specimens, we observed linguofacial trunk bilaterally. Knowledge of such variations are important for surgeries during plastic and reconstructive surgeries of head, neck and face to avoid iatrogenic injuries and for radiologists for interruption of angiograms of face and neck regions.

Development of human adrenal medulla has always been a topic of quandary because of insufficient literature. Most of the studies on adrenal medulla pertain to various species of animals but human fetuses. This research work emphasizes on the developmental chronology of events by studying 36 human fetal adrenal medullas. This study confirms that neural crest derived sympathoblasts migrate through the cortex into the medulla at 12 weeks as opposed to the prevalent view of 8 weeks in animal studies. Cortical and medullary differentiation begins at 12 weeks of gestation and is complete by 16 weeks. Medullary sinusoids appear at 16 weeks. Adrenaline and noradrenaline secreting cells are separate entities and they differentiate from the chromaffin cells at 22 weeks. Moreover ganglionic cells are seen in the medulla for the first occasion at 22 weeks. It is imperative to understand the human medullary differentiation in order to shed light on emerging diseases due to developmental anomalies of adrenal medulla.

Background & Objectives: The Circle of Willis is a large arterial anastomosis in the base of the brain between carotid and vertebrobasilar system. There is considerable individual variation in the pattern and caliber of these vessels. Aim is to study the configuration of CW and its variations. Materials and Methods: This study was carried out in 50 brain specimens obtained from embalmed human cadavers. The CW was studied in detail in each specimen with reference to its formation and variations. Results: In this study, completeness of the CW was noted in 45 (90%) brai n specimens out of 50. The circle was found to be incomplete in 5 (10%) out of 50 specimens. Anterior part of the circle was incomplete in 4 brains (8%), whereas the posterior part of the circle was found deficient in 1 specimen (2%). Symmetry was seen in 27 (54%) of the 45 circles, the circle was found asymmetrical in 18 specimens (36%). Asymmetry was due to abnormal anterior part in 7 specimens (14%) and abnormal posterior part in 11 specimens (22%). Fetal PCA was found in 9 specimens (18%). PCoA was absent in 1 (2%), hypoplastic in 1 specimen (2%). Single median ACA was noted in 2 brains (4%). A1 was missing in 1 specimen (2%). ACoA was missing in 4 specimens (8%), double ACoA was observed in 2 circles (4%) and was plexiform in 1 brain (2%). Interpretation & Conclusion: Complete symmetrical CW was seen in 27 specimens (54%). The circle was incomplete in 5 specimens (10%), most frequently in the anterior part of the circle accounting for 8%. The circle was anomalous in 18 brains (36%), observed most frequently in the posterior part of the circle accounting for 22%. Variations noted were absence, hypoplasia and duplication of the vessels forming CW.

Introduction: The base of the human skull presents Occipital condyle which articulates with the atlas vertebra forming Atlanta­Occipital joint. Keeping the head in inclined posture to engage in actions may play major role in architecture of facet. Maintenance of a particular posture demands more activity from muscles concerned. In this context the role of muscles in terms of traction to maintain a desired posture cannot be ruled out. More anatomical facts on the condyle facets will play an additional boon for the day to day surgeries. 

Materials & Methods: One hundred adult South Indian skulls were examined using the scale, divider and the transparent centimeter reticule in the present study. The shape, size, the anterior­posterior diameter (length) and transverse diameter (width), surface area of occipital condyles on both sides were estimated. The location and number of extra facets were also noted. The surface area of suboccipital muscles were measured in search of the functional relation.

Results: Mean anteroposterior (length) and transverse diameter(width) of occipital condyles were 2.12cm & 1.1 cm on right side and 2.2 cm & 1.2 cm on left respectively. Mean Surface areas of the facet were 1.76 square centimeter (sq cm) on right and 1.9 sq cm on left which was significant. 22 extra facets were present maximally on the posteromedial aspect of the left occipital condyles. Its mean anteroposterior and transverse diameter were 0.52cm & 0.44 cm on right side and 0.45 cm &0.36 cm on left respectively. Mean surface areas (sq cm) of suboccipital muscles ­ rectus capitis minor, rectus Capitis major and Obliquus Capitis Superior were 4.9, 5.05 and 10.56 on left side and 4.96,5.37 and 10.82 on right side respectively. Statistically the valued proved to be significant.

Conclusion: The present study provides anatomical knowledge on the measurements of the occipital condyles serves as a guide in various head and neck procedures for the Neurosurgeons and the Orthopaedicians. The incidence of the facets and the measurements of impressions of the suboccipital muscles on the occipital bone mentions the tilting posture of the humans on one side.

Spleen is the organ of anatomic & functional component of reticulo­ endothelial system & functions as a complex filter interposed in blood stream. Haematopoietic function of spleen continues & regresses after birth but production of lymphocytes continues in post­natal life. This study was done to correlate the chronological pattern of spleen development in this geographical eastern region of India, Odisha & compare the results from other researchers nationwide & worldwide. Aborted human foetuses without obvious congenital anomaly of gestational age between 12 weeks and 36 weeks were collected and processed for histology by H/E stain to note the differences of fetal spleen with the adult spleen.

Purpose: This study was conducted to determine the frequency and contribution of chromosomal abnormalities in couples presenting with infertility in the state of Manipur. Materials and Methods: Study was done on 23 infertile couples (23 male and 23 female) making a total of 46 cases. Chromosomal analysis from peripheral blood lymphocytes was performed according to standard cytogenetic methods using G­banding technique.

Results: Among the males, chromosomal abnormalities were found in 3 (13%) cases i.e, 2(8.6%) cases with 47,XXY (Klinefelter syndrome) and 1 (4.3%) case with 47,XYY syndrome. All the remaining males showed normal karyotype 46,XY . Among the females, all the karyotype shows a normal female karyotype i.e, 46,XX.

Conclusions: This study may be indicative that chromosomal abnormalities are common among the males with infertility which included Klinefelter Syndrome and XYY syndrome. Cytogenetic analysis could be valuable for these couples when clinical data fail to clarify the cause.

Aims: 1. To study the morphometric dimensions of infraorbital foramen. 2. To compare the differences with other populations. 3. To study its clinical implications. Settings and Design: The data was collected from various  medical colleges in Chennai.it was an observational study. Methods and Material: Total of 257 (514 sides) dry human adult skulls of unknown age and gender were assessed. The data was collected with help of Vernier caliper, scale, needle & compass. The measurements were performed onthe right and left side of the skull. The study was conducted and the distances were analyzed of infraorbital foramen (IOF) with respect to the infraorbital margin (IOM), supraorbital foramen (SOF), nasion, the nasal rim, the superior alveolar margin (SAM) and the distance from the opposite infraorbital foramen. The height and width of the IOF was also measured. The direction of the infraorbital canal was also noted.The mean and the range was observed and compared with other populations. The data were analyzed statistically. Statistical Analysis used: SSPS. Results: Mean distances of IOF to Superior orbital foramen [SOF] are 40.2mm and 40.6mm, IOF to Nasion [N] are 42.9mm and 42.8mm, IOF to Nasal Rim [NR] are 16.3mm and 16.4mm, IOF to Infraorbital Margin [IOM] are 7.0mm and 6.9 mm, IOF to Superior Alveolar Margins [SAM] are 25.5mm and 25.4mm on the right and left side respectively. The mean distance of the IOF of one side to the opposite IOF was 50.58mm. Average height & breadth of IOF was3.85mm and 3.65mm on the right and left side respectively. These values were statistically analyzed and also compared with other populations. Conclusions: This analytical study gives detailed information of IOF which will facilitate professionals to ascertain the neurovascular bundle and in turn assist in noninvasive & invasive surgical repairs.

Introduction: The supraorbital notch/foramen (SON/F) is present in the frontal bone through which the supraorbital nerve passes. The knowledge regarding the different positions of the SON/F becomes essential while performing surgeries around the orbit and in the face. This study aims to provide a baseline metrical data regarding the supraorbital foramen (SOF) in eastern Indian population. Material and Methods: In this study 52 dry human skulls (36 male, 16 female) were taken and a detailed viewing of all 104 sides was done for its form, position and occurrence along with measuring the dimensions of SON/F and its distance from different bony landmarks. Result: Our study shows the supraorbital notch was present more commonly as in 76.92%cases than supraorbital foramen which was found only in 23.08% cases. The mean distances of SON/F from the mid facial line is 19.9±3.8 mm on left and 20.9±3.4 mm on right, from the frontozygomatic suture it is 28.1±2.5 mm in left and 27.7±1.9 mm in right. And from the temporal crest is found to be 25.5±2.5 mm in left and 25.4±2.3 mm in right.

Conclusion: Accuracy in knowing the position of SON/F will aid preventing iatrogenic damage to the supraorbital nerve in various surgeries.

Introduction: Uterine anomalies arise due to malformation in the Mullerian duct development. These anomalies were often asymptomatic and unrecognized, also increases the risk of adverse pregnancy outcome like infertility, recurrent pregnancy loss, preterm delivery, amenorrhea, pain and fetal malpresentation. Many of these malformations were detected by radiologic or sonographic studies. Materials and Methods: Observational study includes 150 women between 18­35 yrs with gynecological problem in a tertiary care hospital in Kancheepuram district over a period of 1 year from January 2017 to January 2018. Pelvic imaging of study subjects with transabdominal and transvaginal ultrasound was performed as per the standard procedure. Results: Among 150 patients 75 had the complaint of primary infertility, 71 had primary amenorrhea and 4 came with frequent miscarriage. Out of 150 study subjects who underwent 2D ultrasonography, 69 showed uterine anomalies. Overall prevalence of anomalies was 46%, of which frequency of septate form of anomalies was maximum (45%), followed by Bicornuate uterus (17%), arcuate uterus (16%), didelphic uterus (13%), unicornuate uterus (4.3%), and subseptate uterus (4.3%). Conclusion: Actual prevalence with correct assessment of anomalies using radiological anatomy will help to differentiate uterine anomalies and thereby suggest a right therapeutic option.