Indian Journal of Anatomy

Presented is a case of Persistent left superior vena cava draining into the right atrium through coronary sinus and finally opens into Right Atrium. Abnormalities of the vascular system are more commonly seen due to its importance in circulation. Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the in nominate vein fails to regress. The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%–0.5% of the general population. Normally the superior vena cava is a single vascular structure formed by the union of right and left brachio-cephalic veins which are in turn formed by the union of corresponding internal jugular and subclavian veins of corresponding side, draining the head and neck as well as the superior extremity. During routine dissection in the Department of Anatomy, Jaipur National University Institute for Medical Sciences and Research Centre (JNU IMSRC) Jaipur. We found persistent left superior vena cava in a 64-year-old male cadaver. Both the vena cavae were formed as continuations of brachiocephalic veins of the corresponding side. The persistent left superior vena cava opened into the enlarged coronary sinus that drained into the right atrium between the opening of inferior vena cava and right atrio-ventricular orifice it has important clinical implications in certain clinical interventions. It may complicate placement of cardiac catheters or pacemaker leads.

Schizencephaly is a congenital cleft in cerebral mantle extending from pial surface to the lateral ventricle. It is lined by heterotopic grey matter. It is rare, with a prevalence of 1.48/1,00,000 births. In this case study, adult female brain specimen showed unilateral open lipped cleft - schizencephaly, in the left hemispheric perisylvian region communicating with the left lateral ventricular cavity. Cleft was lined by heterotopic grey matter. Schizencephaly is considered as the neuronal progression or migration disorder. It is also thought to be a brain segmentation disorder. This disruptive birth defect may have ischaemic - vascular injury at its root or it could be a presence of infection like Cytomegalo virus. Mutations in Homeobox gene EMX2 have been also implicated in this congenital anomaly. Our study indirectly confirms that unilateral cases of Schizencephaly may lead long life remaining undiagnosed till death.

Determination of sex is an integral first step in the development of the biological profile in human osteology The general anatomical regions used for sex determination are the pelvic girdle, skull and long bones, although other bones have also been utilized [1]. The developmental age changes are different in male and female bones including sacrum [2]. The pelvic girdle is the most accurate area to determine sex and methods using the pelvic girdle tend to make successful predictions in 90 to 95 percent of individuals [3]. In our study 100 sacra of both sexes were compared for of Body of First Sacral Vertebra (S1), sacral index , curvature index and auricular index. The results show Index of Body of First Sacral Vertebra (S1) in male is 62.53 and in females it is 54.74. Sacral Index in male is 97.45 and in females it is 101.49. One way ANOVA shows 0.001 significance suggesting statistically highly significant difference in male and female for both sacral index and Index of Body of First Sacral Vertebra (S1). Curvature Index in male is 100.57 and in females it is 99.33. One way ANOVA shows f value as 3.650 which was statistically significant. Auricular index in male is 51.34 and in female it is 50.11.one way ANOVA shows f value as 1.037 which was not significant statistically. The results show that Index of Body of First Sacral Vertebra (S1), Sacral index and curvature Index are more reliable parameters than auricular index for sexual diamorphism assessment.

Radial architecture is unique with curvature or bowing, and is of importance in normal range of rotation of the forearm. Radial bow is two dimensional but is apparent in coronal plane. Any alteration in bowing will affect proximal and distal radio ulnar articulations and hence forearm rotations. Mild changes in bowing are difficult to recognize when compare to axial and translational changes. Changes in curvature can occur following fractures, traumatic bowing and green stick fracture in children. Maintenance of bow is of utmost importance in surgical management of fractures involving radius. In 1992 Schemitsch and Richards described a method to measure radial bowing on radiographs. A radiograph of anterior-posterior view of forearm in full supination was taken and radial bow was measured using three parameters. In the present study we tried to apply similar measurement on dry bone radius of Indian population. There are studies on measurement and quantification of radial bowing using radiographs of forearm,but no studies available on dry bones. The mean value of site of maximum bow was 46.668% (SD±3.219%) of length of entire bow. The mean value of magnitude of bow was 5.0472% (SD±0.6393%) of length of entire bow. The length of entire bow of the radius and the site of maximum bowing and magnitude of bow are strongly correlated. The magnitude of bow is within 7% of entire length of bow. This is the first study of bowing of radius on dry bones.

Context: A foreign body is any object in a region it is not meant to be, where it can cause harm by its mere presence and may require medical intervention if not spontaneously expelled from the body. Foreign bodies in the upper GI tract are usually swallowed, purposefully or accidentally which are more likely to be impacted at cricopharynx or esophagus. Present study identifies the pediatric population to be especially at a high risk of foreign body ingestion and our aim is to highlight the anatomical aspects contributing to this. Aims: To identify the commonest site of impaction of foreign body in upper digestive tract and then study the causative anatomical factors leading to this. Methods and Material: A Retrospective study conducted in the department of Otorhinolaryngology including previous records from 2014 onwards in tertiary care hospital of central India. A total of 160 patients of digestive tract foreign body were taken and categorized according to age, sex, site of impaction and type of foreign body. Results: The foremost site of foreign body impaction is at Upper esophageal sphincter followed by upper 1/3rd of esophagus and commonest age group is 1-4 years. Conclusions: Swallowing is not as coordinated and successful as in planned intake of bolus of food. This clearly affects the opening of UES leading to impaction of the foreign body at this commonest site followed by upper 1/3rd of esophagus and piriform fossa thereafter.

Introduction: The word “Dermatoglyphics” indicates the study of epidermal configuration on palms, soles and finger tips. In early foetal life the differentiation of epidermal ridges takes place. These patterns do not change in an individual throughout life and no two patterns are alike. The dermatoglyphic patterns were studied in cardiovascular disorders, but there are very few dermatoglyphic studies in congenital heart diseases (CHD). 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. Results: Among the qualitative parameters, finger print patterns were studied and analysed. The percent frequency of arches, whorls and radial loops showed statistically insignificant difference in CHD group and control group. While percent frequency of ulnar loops showed statistically significant difference in CHD group and control group. Conclusion: Ulnar loops are most frequently found in dermatoglyphic pattern of finger tips in CHD group as compared to control group.

Background and Objectives: The circle of Willis, an anastomotic polygon at the base of the brain, forms an important collateral network to maintain cerebral blood perfusion. The aim of this study was to investigate different anatomic variations of the circle of Willis and their prevalence. Methods: This cross-sectional study was conducted on 500 healthy participants including 200 men and 300 women. The mean age of the patients was 50 years. Three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) technique was used. Vascular variations in the anterior and posterior parts of the circle were evaluated. Results: The findings show that the complete circle of Willis was visible in a small number of patients. The circle of Willis had a complete vascular structure in 22% of the patients. The anterior part of the circle of Willis had a complete structure in 73% of the cases, while the posterior part had a complete structure in 18% of the cases. Conclusion: We observed wide variations in the circle of Willis configuration in our study. Similar to other studies, most variations are related to the posterior part of the circle of Willis. Absence of bilateral posterior communicating artery variation is more common than other types of variations in this population.

Introduction: Sacrum is a well known site for internal fixation of spine. In internal fixation, iliosacral screws applied on sacrum corpus passes through S1 vertebra pedicle. There lies epidural space, nerve root and dural sac medial to the pedicle. So, it is important to know detailed anatomy of S1 vertebra to avoid neurovascular injuries. The present study was done to provide morphometric data about dimensions of first sacral vertebra to facilitate spinal instrumentation procedures by spine surgeons. Aim: To study the morphometric characteristics of first sacral vertebra in dry human sacra. Methods: This study was conducted on 109 dry human sacra, obtained from the bone library, Department of Anatomy of a tertiary care teaching institutes. Results: Vertebral body height of first sacral vertebra at midline ranged from 19-37 mm with mean of 30.0 mm. Vertebral body maximum transverse width and vertebral body mid-diameter of first sacral vertebra were ranged from 5–61 mm (mean of 44.6 mm) and from 23–37 mm (mean of 30.3 mm) respectively. Mean posterior pedicle height of S1 vertebra on left and right side were 25.2 mm and 25 mm respectively. Mean pedicle width of S1 vertebra on left and right side were 11.3 mm and 11.5 mm respectively. Mean pedicle depth of S1 vertebra on left and right side were 31mm and 29.1mm respectively. Conclusion: Data regarding first sacral vertebra will be useful for pedicle screw fixation and also for formation of screws.

Q- Angle is indicator of force produced by quadriceps and is a clinical tool to measure the knee function and alignment. It is well established that normal reference value of Q-angle varies in different racial groups like Caucasians, Americans, Asians and Africans owning to different anatomical and biomechanical features of knee joint complex. However, there is dearth of literature comparing values of Q-angle between Indian and East African population. Objective: (1) establish a baseline reference value of Q-angle among asymptomatic adults belonging to eastern Africa; and (2) To compare these values with their Indian counterparts. Materials and Methods: The study was done in Anatomy department on 100 students of Sharda University, Greater Noida. Bilateral Q - angle was measured with subjects standing in an erect, weight-bearing position. The subjects were divided into two groups (n=50 each group) Group-I (Indian) and Group-II (East African). Group-II subjects belonged to Kenya (n=23) and Tanzania (n=27). Bilateral asymmetry and gender variation was determined using appropriate statistical method. Result and Conclusion: In Group-I and in Group-II, the mean Q-angles values of 100 limbs were 13.78°±2.41 and 17.06°±3.73 the values were significantly higher in latter group (p<0.001). Both the groups showed significant bilateral asymmetry (p<0.05) and gender variation with Q -angle values being greater for women than in men (p<0.001).

Keywords: Q-Angle; Bilateral Symmetry; Patellofemoral Alignment. 

Skeleton is an excellent material in living and non-living population for forensic investigation. Sacrum is an ideal bone for determination of sex because it not only reflects general difference between two sexes but shows special adaptation in females for child bearing. It is believed that reliability in identifying female bone is more using alar index and transverse diameter of S1. In our study 100 sacra of both sexes were compared for of Body of First Sacral Vertebra (S1), alar index and corporobasal index. The results show Index of Body of First Sacral Vertebra (S1) in male is 62.53 and in females it is 54.74 Corporobasal Index in male is 57.89 and in females it is 52.80. One way ANOVA shows 0.001 significance suggesting statistically highly significant difference in male and female for both Corporobasal index and Index of Body of First Sacral Vertebra (S1). Alar Index in male is 66.68 and in females it is 71.21. One way ANOVA shows f value as 2.715 which is non-significant. The results show that Index of Body of First Sacral Vertebra (S1) and Corporobasal Index are more reliable perameters than Alar index for determination of sex of Sacrum.

Vascular variations have always been a subject of controversy as well as curiosity, because of their clinical significance. Pelvic arteries are the arteries supplying the lesser pelvis i.e. walls of pelvis and pelvic organs. The major neurovascular structures of pelvis lie extraperitoneally against the posterolateral walls. The nerves lie most external or superficial (adjacent to the walls), with the vascular structures internal or deep (medial) to them. Generally, the veins are external (lateral) to the arteries. So study of pelvic artery i.e. internal iliac artery was done. Cadavers of both the sexes were dissected. Pelvic artery or internal iliac artery showed variable branching pattern like, obturator artery taking origin from posterior division of internal iliac artery or arising from external iliac artery, inferior vesical artery arising from obturator artery, middle rectal artery originating from other branches of internal iliac artery, common stem was found for internal pudendal and inferior gluteal arteries, even variable pattern of branches of posterior division of internal iliac artery were observed. All the variations were photographed, tabulated and discussed.

Anthropologists and forensic medicine personnel estimate height of an individual as one of criteria to establish identity of an individual. It is also useful for physical assessment of status of nutrition in an individual by nutritionists and physicians. Stature prediction from incomplete and decomposing skeletal remains is one of most useful criteria in establishing the identity of an unknown individual. It is a useful tool in medico legal and forensic examination. Study Design: Descriptive cross-sectional study. Place of Study: Department of Anatomy, MGM medical college, Aurangabad, India. Material: 185 young and healthy college students aged between 18 to 24 years, without any disease or deformity were examined anthropometrically in respect to their height and foot dimensions. Method: Measurement of height and foot dimensions of right and left side was taken with a standard anthropometer and a Vernier caliper respectively. Result: The present study showed significant (p<0.001) positive correlation between the stature and feet dimensions with sexual dimorphism.

Aim: The supratrochlear foramen is an aperture or hole that is created when the bony septum between the olecranon fossa and coronoid fossa becomes perforated. The STF has achieved importance in recent years as its knowledge is useful for anatomists, anthropologists, orthopedic surgeons, and radiologists. The goal of our study was to determine the morphometric measurements of STFs in the AndhraPradesh population. Materials & Methods: The study was conducted on 135 humeri of unknown sex and age. The STFs were measured using Vernier calipers and the measurements on both the sides were tabulated & statistically analyzed. A light source was used to determine the translucency of the septum. Observations & Results: The prevalence of STF in the present study is 22.96% and is more common on the left side. Majority of STFs were oval (61.29%) followed by round apertures (32.25%). In the present study, the mean transverse diameter of the STF was 6.49mm and 6.35 mm, on left and right sides respectively while the vertical diameter was 4.88mm and 4.16mm on left and right sides respectively. Conclusion: STF is associated with narrow and shorter medullary canal and anterior angulation at the distal humerus. The knowledge of STF is very important for preoperative planning of intramedullary nailing for treatment of supracondylar fractures, especially following traumatic injuries and pathologic fracture.

Background: Estimation of stature has a very significant role to play in forensic anthropometry for personal identification. Objective: To discover out the correlation among proportions of feet with stature in tribals of Udaipur district in Rajasthan (India). Material and Methods: The present study was conducted on a total number of 481 male tribals of Udaipur district by using standard anthropometric techniques. Results: There was a correlation between height and foot breadth in Tribals of Udaipur and found correlation coefficient (r) as 0.0240 for right foot and for left foot it was 0.0238. Conclusion: Linear regression equations were deduced in males out of which lowest standard error of estimate was experienced in combined foot breadth of males.

Aim: To study the variations of Foramen Transversarium in cervical vertebrae and to analyze their morphological features with emphasize on their embryological and surgical importance. Material and Methods: The study included human cervical vertebrae which were procured from the dry bone collections of Department of Anatomy, Andaman & Nicobar Islands Institute of Medical Sciences, Port Blair and Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry. The age and sex were not known. The foramina transversaria of all the vertebrae were studied for shape, size and for presence of accessory foramina. Results: Significant number of bones with shape variations, size variations and many accessory foramen transversarium were found. The incidence of accessory foramen transversarium appears to be very high. One unilateral Arcuate canal (posterior arch canal) was identified. No incidence of three foramen and absence of foramen. Conclusion: Variations in number and position of foramen transversarium is important for interpreting the CT and MRI scans and essential while performing complex surgical procedures. Their morphological knowledge is clinically important since the course of the 2nd and 3rd part of vertebral artery may be distorted. These variations may be one of the causes for complaints like headache, migraine and fainting episodes due to vertebral artery compression.

The suprascapular notch is present along the superior border of the scapula and is converted into a foramen by the ossification of the superior transverse scapular ligament which joins the two corners of the notch. This particular notch allows the passage of the suprascapular nerve to the suprascapular fossa and is responsible for the motor nerve supply to the surrounding muscles. There are variations in the shape of the notche. Just below the superior transverse scapular ligament passes the anterior coracoscapular ligament which also ossifies in some cases. The ossification of these two ligament leads to narrowing of the suprascapular notch and coverting it to a foramen. This is one of the important cause of the suprascapular nerve entrapement. The knowledge of the morphometric details of the suprascapular notch is very promising in understanding the cause of the suprascapular nerve entrapement & its subsequent treatment. The present study was conducted using 69 dried scapula in the GSL Medical College Rajahmundry. Various moprphometric parameters of the suprascapular notch were measured & grouped into 6 types based on Rengachary ‘s studies. In this study type III is the commonest (36%) followed by type II (35%), type I (10%), type IV (7%) and type V (7%). Only 5% of the scapulae presented with the complete ossification of the suprascapular ligament converting the notch into foramen. The knowledge of the variation in the occurrence of the suprascapular notch and their association with the cause of the suprascapular nerve entrapement has drawn the attention of many surgeons enabling them for the proper diagnosis and its treatment.

Introduction: Profunda femoris artery is the largest deep branch of femoral artery, provides the principal supply to the extensor, adductor and flexor muscles of the thigh. This large artery arises from the posterolateral side of the femoral artery about 3.5-5cm from the mid-inguinal point. The study of the femoral artery and its branching pattern has been a great interest among the anatomists and the surgeons because of its major implication in the clinical as well as radiological interventions. Material and Methods: In the present study, hundred formaldehyde embalmed cadavers without malformations were dissected and site and level of origin of the profunda femoris artery in relation to the midpoint of the inguinal ligament from the femoral artery studied, also the internal diameter of femoral artery measured by dissection method. Results: Profunda Femoris Artery originated on right side in 46% cases and 44% on left side from the posterolateral aspect. The average distance of origin of Profunda Femoris Artery from Midpoint of Inguinal Ligament on right side was observed to be 4.45 cm while on left side was observed to be 4.69cm. The mean value of Internal Diameter of Femoral Artery was found to be 7.46 mm in males and 6.33 mm in females on right side and 7.43 mm in males and 6.29 mm in females on left side. Conclusion: Most common site of origin of profunda femoris artery was observed to be the posterolateral aspect of the femoral artery. Variations seen in the form of posterior and lateral origins. The average distance of origin of profunda femoris artery was observed between 4-5cm. In the present study 3 cases of high origin of profunda femoris artery observed. The advantage of such a high origin of profunda femoris artery is that it can be used for catheterisation and further investigation of any arterial system of the body. Gender wise comparison of mean value of internal diameter of femoral artery on both sides showed statistically highly significant difference.

One hundred human foetuses having crown-rump length in the range of 7–36 cm and gestational age of 12–36 weeks were subjected to morphological and histological studies to understand and observe the developing medulla of foetal adrenal glands. It is observed that from week 12 to 14, medulla is not clearly demarcated and clusters of medullary cells are found in the foetal cortex. Towards week 38, we observe that the medulla is well organized and differentiated with phaechromocytes and few ganglion cells clearly visible. The observations are important for clinicians to help in diagnosis of neuroblastomas.

Introduction: Identification of skeletal remains plays a major role in forensic medicine. Sex determination is the most important and initial step in individual identification. Almost all bones of the human skeleton show some degree of sexual dimorphism. However, skull and pelvis are used to permit the diagnosis of sex with high accuracy. The skull is important in this regard as it resists adverse environmental conditions over time. The present study aims to determine sexual dimorphism in 200 skulls (100 male and 100 female). Method: Adult human dry skull of known sex (100 male and 100 female) were obtained from different medical colleges of Maharashtra. The Parameters like weight, maximum skull length, maximum skull breath, maximum bizygomatic diameter were studied. Result: Mean values of all parameters are more in males than in females. Conclusion: Amongstthe parameters, maximum bizygomatic diameteris more reliable for determination of sex with 95% accuracy by using the demarcating point.

Introduction: Palmaris longus is a small vestigial muscle with long tendon and short belly. It is phylogenetically retrogressive. It may be absent in 15 % of individuals. Palmaris longus used as a popular tendon graft. Aim: The present study is done to assess absence of palmarislongus unilaterally or bilaterally by using simple clinical tests in both sexes on both sides. Method: We examined 200 subjects for the presence or absence of palmarislongus. Standard clinical tests were used to determine the presence or absence of palmarislongus tendon. Observations were analyzed by statistical method. Result: The study showed Palmaris longus was absent in 11 (5.5%) males and 9 (4.5%) females unilaterally. It was absent in 7 (3.5%) males and 4 (2%) females on left side. Chi square test was 0.073 and P value was 0.39 (P < 0.5). Conclusion: In present study we conclude that Palmaris longus was absent 10 % unilaterally and 6% bilaterally. Absence was more on left side than right side.