Indian Journal of Anatomy

Brachial plexus injury resulting in variable degrees of neurapraxia and axonotmesis may potentially recover spontaneously, whereas axonotmetic or neurotmetic injuries resulting in neuromas-in-continuity, nerve root ruptures, or nerve root avulsions will not. Along with clinical evaluation, various investigation like MRI, CT Myelography, USG and electrodiagnostic methods are there. The treatment of injury includes nerve transfers, nerve grafts and muscle transfers. This article discuss about newer developments of diagnostic evaluation and management of brachial plexus injury.

Brachial plexus injury resulting in variable degrees of neurapraxia and axonotmesis may potentially recover spontaneously, whereas axonotmetic or neurotmetic injuries resulting in neuromas-in-continuity, nerve root ruptures, or nerve root avulsions will not. Along with clinical evaluation, various investigation like MRI, CT Myelography, USG and electrodiagnostic methods are there. The treatment of injury includes nerve transfers, nerve grafts and muscle transfers. This article discuss about newer developments of diagnostic evaluation and management of brachial plexus injury.
 

The human heart valves are intricate anatomical structures made up of numerous supporting structures and leaflets. Heart valves' primary function is to ensure that blood flows in a single direction, which is crucial. Malformation and dysfunction of these perplexing designs bring about possibly fatal pathologies. The development, gross anatomy and histology of the four cardiac valves will be discussed in this chapter. These four heart valves can be additionally named two atrioventricular (AV) valves and two semilunar valves; nevertheless, every valve is unique. When subjected to mechanical loading, the leaflets of the two types of valves are supported in different ways. To avoid regurgitation, the AV valves utilize a tension apparatus, which is made out of fibrocartilage containing chordae tendineae (heart strings) and expansions of ventricular myocardium known as papillary muscles. However, the semilunar or ventriculoarterial valve leaflets are self-supporting, with three leaflets that snap shut on thickened edges. Both the AV and semilunar valve primordia appear early in heart development as acellular swellings between the primitive myocardium and the endocardium. These swellings or pads are loaded up with proteoglycans and glycosaminogly cans making them jelly like consistency. The arrangement of valves during embryogenesis (i.e., valvulogenesis) begins from endocardial cells covering the myocardium. These cells go through an endothelial mesenchymal change, multiply and relocate inside an extracellular grid. In both the atrioventricular canal and the outflow tract, this causes bilateral cardiac cushions to form. Both the cells in the prospective valve and the endocardium are thought to have originated in an embryo. This review will help to get thorough knowledge about the dimensions, morphology and development of the heart valves which is required for planning surgical procedures and manufacturing various types of prosthesis for heart valves.