Indian Journal of Anatomy

This article aims to review the work of the German anatomist Joseph Disse (1852-1912), specifically with regard to the contents of his „Ueber die Lymphbahnen der Säugethierleber”. In this he described a thin space, until that moment not referred, located between the hepatocyte and the sinusoidal membrane (sinusoids).

Lateral pterygoid muscle is one of the four classical muscles of mastication including masseter, temporalis and medial pterygoid. Main function of lateral pterygoid muscle is to open the mouth or lower the mandible at temporomandibular joint. The upper/superior head of lateral pterygoid muscle originates from the infratemporal surface and infratemporal crest of the greater wing of sphenoid bone, and lower/inferior head from outer or lateral surface of lateral pterygoid plate. Inferior head inserts into the pterygoid fovea at neck of condylar process of the mandible; upper/superior head inserts into articular disc and fibrous capsule of temporomandibular joint. The mandibular division of trigeminal nerve, specifically nerve to lateral pterygoid nerve, innervates the lateral pterygoid muscle. The primary function of the lateral pterygoid muscle is to pull the head of the condyle out of the mandibular fossa along the articular eminence to protrude the mandible. A concerted effort of the lateral pterygoid muscles helps in lowering the mandible and open the jaw whereas unilateral action of a lateral pterygoid produces contralateral excursion (a form of mastication), usually performed in concert with the medial pterygoids. Unlike the other three muscles of mastication, the lateral pterygoid is the only muscle of mastication that assists in lowering/depression of the mandible (opening the jaw). At the beginning of this action it is assisted by the digastric, mylohyoid and geniohyoid muscles.

Keywords: Lateral Pterygoid Muscle; Muscle of Mastication; Temporomandibular Joint. 

Dermatoglyphics includes the study of ridge pattern on the pulp of fingers, lips and foot prints etc. Finger prints proved their uniqueness in identification. Besides this the finger print pattern indicates future risk of certain diseases like Cancer, Diabetes and Hypertension. This paper is aimed at looking such relationship between major finger print patterns and diseases like Diabetes and Hypertension.

Keywords: Finger Prints; Diabetes; Hypertension. 

Renal arteries are paired branches of abdominal aorta; these arteries are important due to increase in interventional radiological procedures, urological and vascular operations, and renal transplantation. Kidney specimens and arteries were explored, dried with hair drier, 1:10 thin solution of quick fix and acetone applied over arteries and painted with PO red colour. Variations in morphological patterns and segmental patterns of renal arteries were noted. In present study out of 50 specimens in 7 (14%) observed superior polar artery which is the branch of abdominal aorta. A branch originating from the renal artery (superior renal polar branch) was observed on the right hand side in 10 (20%) and in 17 (34%) on the left side. The results are statistically significant. 20 kidney specimens we were found duplicated renal arteries. This multiple renal artery variations are of great clinical significance to radiologists, nephrologists and urologists in imaging, procedures and urological surgeries respectively.

Context: Anthropometric measurements are being used profusely for various medicalresearches. Studies on craniofacial anthropometry have allowed for identification andquantification of syndromic clinical features, planning for treatment, monitoring ofoperative outcomes and sometimes assessment of longitudinal change.Considering that Anthropometry can be important tool in early suggestion of diseases, anattempt was made to study facial Anthropometry in healthy individuals andhypertensive subjects. Aim: The aim of the study was to compare the Anthropometric Measurements in hypertensivepatients and healthy control subjects. Settings and Design: The study was conducted in the Anthropometry section of Department of Anatomy, Mahatma Gandhi Institute of Medical Sciences (MGIMS) incollaboration with Department of Medicine. It was a cross-sectional, Observational study design incorporating a total of 100subjects. Methods and Material: Out of hundred registered for study, fifty were healthy controls and fifty patients in theage range of 34-50 years diagnosed to have hypertension from Sevagram village (a rural area in Vidharbha region of Maharshtra). The instruments used for study are Stadiometer, Digital weighing balance, Spreading Caliper, Vernier caliper and measuring tape and sphygmomanometer for measuring Blood Pressure. Various measurements were made pertaining to facial anthropometry andon the basis of the findings as per literature available, the indices calculated are Physiognomic Facial Index, Morphological Facial Index, Mandible Width- Face Height Index, Sagittal Naso-FacialIndex, Mandible-Face Width Index, Chervinïs Transverse Cephalo- Facial Index. Results: The indices thus obtained are compared for males and female’s separately. Most of the indices are non- significant except Mandible-Face Width Index in femalesand Physiognomic Facial Index and Morphological Facial Index in males. Conclusion: Facial Anthropometry was done on healthy and hypertensivesubjects. Though the data analysis have not concluded any change in facialanthropometry in hypertensive subjects with affirmation but the data obtained forcontrol subjects in Central Indian Population can further be utilised byAnthropometrics, , Anatomists, Forensic Experts and Plastic surgeons too.

Aims: The primitive aim of the study is to determine the level of termination of the brachial artery in the South Indian population (Tamil Nadu and Puducherry). Methods and Material: The present study was carried out in 30 cadavers in the department of Anatomy, at Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry from 2014 to 2017. The dissection was done precisely according to the Cunningham’s manual of anatomy upper limband lower limb. The variations were observed and the photographs were taken for reference. Statistical Analysis Used: SPSS T- TEST. Results: In 60 upper limbs, 3 (5%) specimens possessed a higher level of bifurcation of brachial artery. Conclusions: A Higher bifurcation of brachial artery can be present in a significant number of patients; hence its presence should be evaluated during vascular mapping prior to any clinical procedures.

In the modern days there is a high prevalence of Hypertension, Non-Insulin dependent Diabetes Mellitus, cardiovascular disorders and soon. Barkers Hypothesis stated that low birth weight of fetus leads to Low nephron number is a factor that is responsible for these clinical conditions. In the work towards this I have studied the fetuses of various gestations, I have studied 50 fetuses of which 30 males and 20 females were observed various renal parameters like Length, width, thickness, number of lobulations and weight of the kidney. Morphometric parameters of kidney play a vital role in estimating the gestational age. The major problem in deciding gestational age of the fetus is bleeding during implantation is wrongly interpreted as last normal menstrual period by women results in abnormal gestational age. This problem can be solved by the ultra sound measurement of renal Parameters in addition to various regular parameters like crown rump length and crown heel length and so on. In the current study there are details obtained of various morphology and morphometric analysis of fetal kidneys of different age groups which are tabulated, described and discussed with various studies conducted at different time spans. The following research contributes in solving the problem with regarding gestational age finding.

Introduction: Tendon of Plantaris muscle is one of the most desirable tendon used for reconstructive surgery. Other tendons are Palmaris longus, flexors as well as extensors of fingers and long extensors of the toes. The surgeon must base his selection of the donor tendon for grafting on the basis of tendon length or width. The Plantaris muscle is considered to be the one of the easiest tendon to harvest and therefore it remains one of the ideal choices for flaps or tendon grafts. Aims and Objectives: 1. To study the presence or absence of Plantaris muscle. 2. To study the variations of Plantaris muscle and its tendon. 3. To compare the prevalence of absence of plantraris muscle unilaterally or bilaterally. Materials and Methods: The study was done on 30 cadavers in the department of anatomy at Dr SCGMC Nanded and SRTR GMC Ambajogai. Plantaris muscle is subject to variations in the form of its presence or absence and attachments. Parameters like length of muscle, length of tendon and length of belly were measured using measuring tape and belly width and tendon width were measured using digital vernier caliper and recorded bilaterally and statistically analyzed. Observations: It was observed that length of tendon of plantaris muscle is more than the length of belly. There is statistically significant difference in the mean value of the total length of plantaris on the right and left side. There was unilateral absence of plantaris muscle on right side in 1 male cadaver and a bilateral absence in one female cadaver. Variations in insertion of plantaris were observed, like distal part of the tendon is fused with medial margin of soleus in a female cadaver on left side. Bilateral multiple slips from the tendon, few slips inserted to deep fascia, few slips to medial margin of soleus muscle and a long slip to calcaneum in a male cadaver. Conclusion: Based on the morphology and prevalence of the Plantaris muscle, it is ideal for use as the tendon graft or flap in reconstructive surgery.

Background: Cervical cancer is a major cause of mortality and premature death among women in their most productive years in low- and medium-resourced countries in Asia. Aims: Aim of this study to find the colposcopic findings in the symptomatic patients with cervical erosion and correlate the findings with cytology and histopathology. Methods: All the patients coming to gynaecological OPD with symptoms of white discharge, pruritus vulvae, menstrual irregularities were examined by per speculum examination and all those who had cervical erosion were included in the study and Pap smear and colposcopy both were done in all subjects. The colposcopic guided biopsy was done in women with abnormal findings on colposcopy (100 women) and reports were compared. Abnormal colposcopic findings were graded according to Reid’s colposcopic index (RCI). Results: Majority of patients came with the complaint of white discharge per vaginum (55%). Out of total patients, 85 women (70.9%) had inflammatory pap smear and 35 women (29.1%) had abnormal pap smear. All patients underwent colposcopic examination and out of 100 patients, 67 (55.8%) showed normal colposcopic findings and 50 women (41.6%) had abnormal colposcopic finding and biopsy was taken. Only 3 women had unsatisfactory colposcopy. Histopathology confirmed 24 (48%) women with CIN I, 12 (24%) CIN II, 6 (12%) CIN III and only 2 (4%) women with carcinoma cervix. The colposcopy findings and histopathology correlated in 88%. Conclusions: Colposcopy should be prescribed to all symptomatic patients with cervical erosion as it is a good diagnostic tool for pre-malignant conditions of cervix and correlates well with histopathological findings.

Keywords: Cervical Erosion; Colposcopy; Cytology; Histopathology.

Background: The caroticoclinoid foramen is an inconstant structure, which is located in the middle cranial fossa composed by the ossification of a fibrous ligament that begins on the anterior clinoid process and binds to the middle clinoid process. Carotico-clinoid foramen allows the passage of one of the six segments of the internal carotid artery, the clinoidal segment [1]. The fibrous ossification of ligament is considered a normal physiological process. Materials and Methods: This study was conducted in different medical colleges in South India. 300 skulls were collected from I MBBS students and the incidence of caroticoclinoid foramen was studied. Results: Out of 300 skulls of unknown sex, 2 skulls showed bilateral caroticoclinoid foramen and 5 skulls had unilateral caroticoclinoid foramen, the total incidence was 2.33%. Conclusion: The present study concludes that the knowledge about caroticoclinoid foramen will be helpful in brain surgeries and CT scan studies of intracranial haemorrhage.

Introduction: The fibula is located lateral to the tibia in the leg. The fibula is the bone of choice for grafting and to reconstruct large defects after tumor resection, because of its length, biomechanical stability, limited donor site morbidity and predictable vascular pedicle. Objectives: The objectives of the study are: (1) to locate and describe the position, number & direction of nutrient foramina of fibula. (2) To observe any variations in location, position and number of nutrient foramina of fibula. Methods: The study sample comprised of 80 dry adult human fibulae. Present study was conducted at bone bank of Department of Anatomy, Government Medical College, Aurangabad. The data pertaining to the above parameters were noted, subjected to statistical analysis and were photographed. Results: In the present study of 80 dry adult human fibulae, noted; (1.) Absence of nutrient foramen (NF) in 2 (2.5%) fibulae. (2.) Single nutrient foramen was present in 71 (88.75%) fibulae. (3.) 5 (6.25 %) fibulae showed double nutrient foramen. (4.) 2 (2.5%) fibulae showed triple nutrient foramen. (5.) The most common location of nutrient foramen was on medial crest in 52 (58.42%) and least common on anterior border in 1 (1.25%) fibulae. (6.) Out of total 89 foramena 84 (94.67%) foramen were on the middle third of the fibula. Conclusion: The present study showed 12.7% variation in number of nutrient foramen.Accurate anatomical knowledge about the location and distribution of nutrient foramen is useful for orthopedic and plastic surgeons in planning the vascularised fibular graft at middle third of the shaft.

Background: Femoral torsion is defined as the angle formed between long axis of head and neck of femur proximally and the transverse axis of the femoralcondyles distally. When this axis passes forwards it is termed as anteversion and when it passes backwards it is termed as retroversion. It is important to know the angle of torsion, as it is varies widely from person to person. Materials and Methods: Unpaired 113 dry femurs, 58 rights sided and 55 left sidedwithout any gross morphological deformities were used to measure the femoral torsion by goniometer. Maximum femoral length was measured by using osteometric board and the data were statistically analyzed. Results: Out of total 113 femur studied, 102 femur were found to be anteverted whereas 11 were found to be retroverted. Mean angle of anteversion was 10.39° irrespective of side. In case of right femurs mean value was 10.05° and for left it was 10.82°. Though mean values were higher in left sided bone, no statistically significant difference was found (p < 0.05). Mean value of retroversion was found to be 4.60° which is much lower than the mean value of anteversion. Conclusion: Any change in the angle of femoral torsion is associated with various clinical conditions. Study data will be useful for various orthopaedic procedures and diagnosis, in the fields of General Human Osteology and Forensic anthropology.

Background & Aims: The mastoid region, a fragmentary piece of skull is ideal for sex determination as it is more robust and tough making it resistant to physical damage. The mastoid bone is most protected, due to its anatomical position at the baso-lateral region of the skull. In present study, mathematical dimensions of various parts of mastoid were used by craniometric techniques to identify the sex in fragmentary remains. Material & Method: The study was performed on 132 human skulls of known sex (80 Males & 52 Females) collected from Bone Bank of Department of Anatomy at Govt. Medical College, Aurangabad and various medical colleges of Marathwada region. The measurements were taken on mastoid region of skull by defining the three craniometrical points- Asterion, Porion and Mastoidale. Distance between these three craniometrical points were located and measured in mm to calculate the area in mm2 by Heron’s formula on both right and left side of skull. Unpaired‘t’ test were used for data analysis. Total mastoid area was calculated by adding the right and left triangular areas. The total area being used as it would avoid asymmetry between the areas, so it can be used for sex determination. Results: The means of all mastoid measurements and total mastoid triangular area in males are significantly larger than those of the females (p<0.001). Result showed significant craniometric differences between male and female mastoid triangle on both right and left side of skull. Conclusion: The mastoid measurements and total mastoid triangular area provides an accurate method for sex determination in Marathwada population. Knowledge of above dimensions of mastoid process will be helpful to physical and forensic anthropologist for sexing of human skull from fragmentary skeletal remains.

Background: Knowledge about the unusual ossification of the Carotico-Clinoid Foramen (CCF), would be essential for neurosurgeons and radiologists in day-to-day clinical practice as internal carotid artery, optic nerve may get compressed. Aim: To obtain knowledge about morphometry of Anterior Clinoid Process (ACP), Optic Strot (OS) and the type of ossification of Carotico-Clinoid Foramen which would be beneficial to guide surgeries related to the cavernous sinus and internal carotid artery. Materials and Methods: A total of 135 half skulls were studied for various parameters such as the length of ACP from its base to the tip, the width at its base and the distance between the tip of ACP to optic strut were measured and were expressed in millimeters using digital calipers. SPSS 17th version was used for the statistical analysis. Paired t-test was applied to compare between right and left sides. Presence of carotico-clinoid foramen was observed and was classified as incomplete, contact form or complete. Results: The average length of ACP in the male skulls was 8.8±1.3 (right) and 8.40 ±1.4 mm (left). Its width was 7.9±1.4 mm and 7.5±1.0 mm. On female skulls the average length of the process was 8.48 ±1.6 mm on the right and 8.0 ± 1.4 mm on left side, while the width measured 7.3±1.5 mm (right) and 7.6±1.6 mm (left), on the opposite side. In our sample, a complete caroticoclinoid foramen appeared in male and female skulls were 9 (6.0%) and 8 (6.6%), contact form in male and female skull 6 (4.0%) and 3 (2.5%). At last, an incomplete form of the foramen in male and female were 21 (14%) and 19 (15.8%). The anatomic variations of the investigated structures must be considered during the approaches to the cavernous sinus and neurovascular elements of the sellar region. Conclusion: Considering the immense anatomical surgical and radiological importance of morphology of ACP, OS and CCF, this study highlighted the detailed morphometry of these structures.

Anthropometry helps in reconstruction of biological profile of the deceased such as age, sex, ethnicity and stature. Aim: The aim of the present study is to study the correlation of foot length and breadth with stature. Material and Methods: Sample size of the present study consisted of 200 students (males = 84 and females = 116) between 17- 24 years of age from Government Medical College. Their stature and foot length and breadth were recorded. Observations: It was observed that males had higher mean, standard deviation and range for each of the parameter considered than those of females. Significant correlation was observed between height and foot length and breadth. From the regression equations derived, one can calculate height from any known parameter and vice versa. Conclusion: Foot length and foot breadth showed statistically significant correlation with height in total cases and also when male and female cases were evaluated separately. Foot length and foot breadth show significant positive correlation with each other. When one has to calculate height using one parameter, we recommend the use of foot length for the same as it showed highest correlation with height. This study will be useful for stature estimation from available skeleton material or parts of the deceased body that are available.

Introduction: Human cadaveric dissection is most routinely practiced method of learning anatomy for medical students since many years. With the use of technological advancements in teaching and learning methods, there has a high risk of reduction in human cadaveric dissection as a method of learning in this modern digital era. Aims & Objectives: The present study was done to analyse the medical student’s preferences regarding the teaching and learning methods of human anatomy and to analyze the perceptions regarding anatomy dissection. Material and Methods: The sample constituted 346 randomly selected medical students from the medical institute of Navi Mumbai, Maharashtra. The present cross sectional study was conducted using a simple random sampling. Result: Total 346 students were participated in the present study. The mean age of the participants was 19.54 (±1.24) years. Males & females constituted 45.7% & 54.3% respectively of total study population. Dissection was ranked as the most preferred method by 246 (71.1%) by the students, followed by lectures 44 (12.7%) and textbooks 30 (8.7%) over the least preferred methods such as demonstrations 20 (5.8%) and computer assisted learning 6 (1.7%). Strong positive agreement was displayed by the students for items describing that dissection still the best method of learning anatomy 334 (96.5%) and dissection helps in feeling more comfortable with patients subsequently 332 (96%). Strong negative agreement was displayed by the students for items describing that dissection is boring and less informative method 282 (81.5%) and there are other better methods as dissection is outdated 268 (77.5%). Conclusion: This study has revealed that medical students still rated anatomy dissection as a most preferred method of learning anatomy, despite technological advancements.

Aim: To study the dimension of trachea on various parameters in male and female cadavers from Karad, Maharashtra, India. Objectives: The present article is based on the study of the shape of tracheal opening, an anatomical measurement of length, diameters and the angle of bifurcation of the adult trachea in cadavers from western India and their sexual dimorphism. Materials and Method: The cadaveric specimens of adult trachea comprising of 20 males and 20 females were studied. The length of the trachea, the internal and external transverse diameter at upper and lower end and the angle of bifurcation was measured. The shapes of the tracheal opening were noted by making the cross section of trachea at the inferior border of cricoid cartilage. Mean and standard deviation were calculated for all parameters. Sexual differences between the mean of measurements were calculated by applying unpaired student‘t’ test. Results: Significant difference was seen in the length and the transverse diameter of the trachea between the male and female. There was no significant difference seen in the thickness of the posterior membrane as well as the angle of bifurcation of trachea. Conclusion: It may have their clinical implication in the maintenance of airways in anesthesiology and emergency medicine.

To have a better outcome for the surgical intervention of leg, taking consideration of the details of the nutrient foramen is of prime importance.The nutrient foramen is a canal with proximal groove which allows the nutrient artery to go through the bone and supply the medullary cavity and inner cortex of the bone, here it is the posterior tibial artery. The study was undertaken on 116 dried tibia from G.S.L Medical College Rajahamundry. The detail study of the nutrient foramen of tibia was done accounting its number, size, direction, foramina index and position of foramen with respect to soleal line. In 69 right sided tibia 84% of the cases have the nutrient foramen in the upper third and rest 16% were present in the miidle third of the bone, all directed downwards with 95% of cases directed lateral to soleal line whereas in 47 left sided tibia 85% of the cases it is placed in the upper third keeping rest 15% in the middle third of the tibia all directed downward with 93% of cases directed lateral to soleal line leaving 7% to be upon the soleal line. The present study was found to be in accordance to the previous studies done by various researches and agreed to the the same results as of this one. The knowledge of morphology of Nutrient foramen is applied by orthopaedic surgeons to perform various surgical intervention like fracture repair, bone grafting and bone transplantation.

Context: Present study is based on the available data on patients with heart defects. Aim: The presence of noncardiac malformations in patients with heart defects and normal karyotype is reported. Settings and Design: Division of Human Genetics, St John’s Medical College, Bangalore is a referral centre for genetic counseling. Methods and Material: Information was gathered from 10 male and 8 female patients. Their age ranged from neonates to 16 years. Statistical analysis: Percentage analysis is calculated. Results: A total of 26 CHDs were noted and 38 NCMs were observed in 5 systems (skeletal, central nervous, digestive, urogenital, respiratory system). Malformations noted in male were 22 (58%) and in female 16 (42%). Heart defects observed in male were 16 (61.5%) and in female 10 (38.5%). Malformations in 2 systems have occurred 9 times (50%); in which skeletal anomalies were 15 (39.5%). Single heart defects have occurred 12 times and in that ventricular septal defects were 7 times (27%). In male patients, skeletal anomalies (9), ventricular septal defects (4) and malformations in 2 systems (5) were prevalent. The association between the types of heart defects versus malformations showed that in male atrial septal defects were associated to 5 system anomalies and in female dextrocardia to 4 system anomalies. Conclusions: The study has reported the presence of 38 malformations in 18 patients with 26 heart defects and normal karyotype. Two system anomalies; defects in skeletal system and associations of malformations to ventricular septal defects were found to be frequent. Patients and families were counseled and were recommended for medical and surgical management of malformations and heart defects.