scholarly journals Anatomical study on sciatic nerve variations in Andhra Pradesh, India

2019 ◽  
Vol 7 (8) ◽  
pp. 3085
Author(s):  
K. Lakshmi Kumari ◽  
M. Sushma ◽  
A. Raja ◽  
D. Asha Latha
Keyword(s):  
Sciatic Nerve ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Ischial Tuberosity ◽  
Popliteal Fossa ◽  
The Body ◽  
Lower Limbs ◽  
Gluteal Region ◽  
Pelvic Cavity ◽  
Human Cadavers

Background: The sciatic nerve is the largest and widest nerve in the body and is derived from ventral rami of spinal nerves L2 to S3. Sciatic nerve appears in the Gluteal region below Piriformis from Pelvic cavity by passing through Greater Sciatic foramen. In between the Ischial tuberosity and greater trochanter of Femur, it reaches the back of the thigh. At the superior angle of Popliteal fossa, it divides into Tibial and common Peroneal (fibular) nerves. The division varies, and it may occur within the pelvis, Gluteal, upper, mid and lower part of thigh. The anatomical variations of the level at which the Sciatic nerve divides is considered important by Neurosurgeons, Anaesthetists, Orthopaedicians and Surgeons.Methods: This study was conducted on 52 lower limbs to determine the level of sciatic nerve bifurcation and its variations on 26 embalmed human cadavers. The data was analyzed manually using numbers, frequencies and percentages.Results: The findings of this study states that in 2 limbs (3.84%) the nerve divided in the gluteal region; in 4 limbs (7.69%) in the pelvic region; in 10 limbs (19.23%) at the junction between upper and middle thigh. The highest incidence of division occurs in 36 limbs (69.23%) at the superior angle of the popliteal fossa.Conclusions: The findings of this study revealed that the majority of sciatic nerve divisions occur   at the superior angle of popliteal fossa while some divided into other regions such as Pelvis, Gluteal and thigh regions.

scholarly journals ESTUDIO ANATÓMICO EN FETOS HUMANOS: DIVISIÓN DEL NERVIO CIÁTICO Y SU RELACIÓN CON LA TÉCNICA ANESTÉSICA DE WINNIE A NIVEL GLÚTEO. ANATOMICAL STUDY IN HUMAN FETUSES: SCIATIC NERVE DIVISION RELATED TO WINNIE´S ANAESTHETIC APPROACH AT GLUTEAL LEVEL

2016 ◽  
Vol 2 (1) ◽  
pp. 25-30
Author(s):  
Evangelina Espósito ◽  
Sebastián A, Parisi ◽  
Matías F. Sosa ◽  
Alberto I. Herrando ◽  
Susana N. Biasutto
Keyword(s):  
Sciatic Nerve ◽  
Anatomical Study ◽  
Popliteal Fossa ◽  
Lower Limbs ◽  
Posterior Region ◽  
Gluteal Region ◽  
Formaldehyde Solution ◽  
Human Fetuses ◽  
Lower Side ◽  
Sacral Plexus

Introducción: El nervio ciático nace por la unión de todas las raíces del plexo sacro, sale de la pelvis por la parte inferior de la incisura isquiática mayor, desciende siguiendo la línea media en la región posterior del muslo y se divide en nervios tibial y peroneo, generalmente, a nivel del ángulo superior de la fosa poplítea. No obstante, es posible que se divida en cualquier punto de su recorrido, por lo que los bloqueos anestésicos que se realizan en la región glútea podrían ser insuficientes. Objetivo: Investigar el origen de los nervios tibial y peroneo, sus variantes en el trayecto hacia la región poplítea y su relación con la efectividad de la anestesia mediante el abordaje de Winnie. Material y Método: Se disecaron 50 fetos humanos (88 extremidades inferiores), fijados por inmersión en solución de formol, de entre 10 y 26 semanas de gestación y ambos géneros. Resultados: El nervio ciático se divide en nervios tibial y peroneo del siguiente modo: a) dentro de la fosa poplítea, en el 73,9% de los casos, b)  en la región del muslo posterior, en el 11,4% de los casos, c) en la región glútea, en el 4,5% de los casos, y d) nunca se constituye el nervio ciático, en el 10,2%. Conclusión: El bloqueo anestésico puede ver reducida su eficacia cuando se utiliza el abordaje glúteo como ocurre en la Técnica de Winnie, dado que se podría bloquear solamente uno de los troncos del nervio ciático.Introduction: The sciatic nerve originates by the junction of the sacral plexus roots, leaves the pelvis through the lower side of the greater ischiatic foramen, continues downwards along the medial line of the posterior region of the thigh and divides into tibial and peroneal nerves usually at the upper angle of the popliteal fossa. But that division may happen in upper levels and cause an incomplete anesthetic block in gluteal region. Our objective was to determine the origin of the tibial and peroneal nerves, its variations and the relation with the effectiveness in the anesthetic block by Winnie’s approach. Material and Method: We dissected 50 human fetuses (88 lower limbs), between 10 to 26 weeks of gestation, of both genders and fixed by immersion in formaldehyde solution. Results: The sciatic nerve divides into tibial and peroneal nerves in the following way: a) inside the popliteal fossa, 73.9% of the cases, b) in the posterior region of the thigh, 11.4% of the cases, c) in the gluteal region, 4.5% of the cases, and d) those cases in which there is not a sciatic nerve, in the 10.2%. Conclusion: The anesthetic block may reduce its effectiveness in gluteal approach, as it happens in Winnie’s approach, if only one of the sciatic nerve branches is involved.

A Cadaveric Study on the Variation in the Level of Division of Sciatic Nerve in Nepalese Population

2020 ◽  
Vol 9 (1) ◽  
pp. 12-16
Author(s):  
Diwakar Kumar Shah ◽  
Sanzida Khatun
Keyword(s):  
Sciatic Nerve ◽  
Ischial Tuberosity ◽  
Lower Limbs ◽  
Pelvic Cavity ◽  
Terminal Branch ◽  
Middle Region ◽  
Common Site ◽  
Greater Trochanter ◽  
Cross Sectional ◽  
Medical College

Background: Sciatic nerve, the thickest nerve of our body (around 2cm wide at its origin), leaves the pelvic cavity from the greater sciatic foramina below the piriformis muscle and between the greater trochanter of femur and ischial tuberosity. As variations have been reported in the level of division of sciatic nerve into its terminal branches, the current study aims to determine the most common site of division of sciatic nerve in Nepalese population. Materials and Methods: The current study is a cross-sectional and descriptive study which was carried out in the Department of Anatomy, Nobel Medical College, where twenty-three cadavers were used and both the lower limbs were examined. Depending upon the level of division of the sciatic nerve into its terminal branches, it was categorized into six different groups (A-F). Results: It was seen that the sciatic nerve had already divided into its terminal branches before its exit into the gluteal regionin 23.91% extremities. The second commonestsite for the termination of sciatic nerve into its terminal branch was found to be at the middle region of the back of the thigh in 19.57% followed by its division in the popliteal fossa in 17.39%. Conclusion: From the current study we conclude that the level of division of sciatic nerve was variable and it is wise to go for other means to find out the level of termination of sciatic nerve before performing any procedure in that area.

COMPREHENSIVE ANATOMICAL STUDY OF VARIATIONS IN LINGUAL AND FACIAL ARTERIES IN ADULT CADAVERS FOR SURGICAL PRACTICE

2021 ◽  
pp. 69-70
Author(s):  
Ramitha Enakshi Kumar. S ◽  
P. Vahini
Keyword(s):  
Carotid Endarterectomy ◽  
Plastic Surgery ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Malignant Tumours ◽  
Surgical Practice ◽  
Hospital Acquired Infections ◽  
The Face ◽  
Human Cadavers ◽  
Hospital Acquired

Objective: The objective of this study is to comprehensively put forth the anatomical variations in the origin and course of lingual and facial arteries found in adult cadavers. Methods: Ten human cadavers were dissected and studied for variations from the norm regarding facial and lingual arteries . Results: 80% of the cadavers displayed classical origin and course of the arteries. There was a deviation from normal regarding origin of the arteries in 20% of the cadavers. Meanwhile, abnormality in the course amounted to 10%. Conclusion: In 20% of cadavers, there were variations in origin of facial and lingual arteries , meanwhile, changes in the course of the stated arteries is 10%. These variations prove to be of signicance to surgeons to prevent mishaps and hospital acquired infections, while performing carotid endarterectomy, intra-arterial catheterizations, plastic surgery of the face and resection of malignant tumours.

Variations in Course and Branching of Sciatic Nerve and it’s Relation to Pyriformis Syndrome

2021 ◽  
Vol 9 (4) ◽  
pp. 8156-8159
Author(s):  
Patel Dinesh K ◽  
◽  
Shinde Amol A ◽  
Keyword(s):  
Sciatic Nerve ◽  
Hip Replacement ◽  
Popliteal Fossa ◽  
Point Of View ◽  
Lower Limbs ◽  
Type B ◽  
Sacral Plexus ◽  
Type D ◽  
Variant Anatomy ◽  
Anatomy Teaching

Background: Sciatic nerve is a branch of sacral plexus. It passes below the pyriformis and divides in the popliteal fossa. Higher division and relation of sciatic nerve to pyriformis have been documented. Beaton and Anson have classified relation of sciatic nerve to pyriformis. The aim of this study is to find incidence of variant anatomy of sciatic nerve as per Beaton and Anson classification. Materials and methods: 48 formalin embalmed lower limbs used for regular anatomy teaching were used. Branching and course of sciatic nerve was observed in gluteal region,thigh and popliteal fossa. Observations: As per Beaton and Anson classification, we found 81.2% showed type A or normal arrangement. Type B variation was seen in 14.6% while 4.2% showed type D variation. Conclusion: Variations in branching of sciatic nerve and it’s relation to pyriformis muscle are important from point of view of Surgeons and Anaesthetists. Knowledge of these variations will help reducing block failures in cases of sciatica, pyriformis syndrome and hip replacement surgeries. KEY WORDS: Sciatic nerve, Sacral plexus, Pyriformis Syndrome, Hip replacement.

scholarly journals Topographic anatomical study of the sciatic nerve relationship to the posterior portal in hip arthroscopy

2014 ◽  
Vol 41 (6) ◽  
pp. 440-444 ◽  
Author(s):  
Berliet Assad Gomes ◽  
Max Rogério Freitas Ramos ◽  
Rossano Kepler Alvim Fiorelli ◽  
Camila Rodrigues de Almeida ◽  
Stênio Karlos Alvim Fiorelli
Keyword(s):  
Sciatic Nerve ◽  
Hip Arthroscopy ◽  
Average Distance ◽  
Anatomical Variation ◽  
Anatomical Study ◽  
Access Point ◽  
Type A ◽  
Anatomical Variations ◽  
Type B ◽  
Surgical Access

Objective: To evaluate the anatomic topographic relation between the sciatic nerve in relation to the piriform muscle and the posterior portal for the establishment of hip arthroscopy.Methods: We dissected 40 hips of 20 corpses of adult Brazilians, 17 male and three female, six black, six brown and eight white. We studied the anatomical relationship between the sciatic nerve and the piriform muscle with their variations and the distance between the lateral edge of the sciatic nerve and the posterior portal used in hip arthroscopy. We then classified the anatomical alterations found in the path of the sciatic nerve on the piriform muscle.Results: Seventeen corpses had bilateral relationship between the sciatic nerve and the piriform muscle, i.e., type A. We found the following anatomical variations: 12.5% of variant type B; and an average distance between the sciatic nerve and the portal for arthroscopy of 2.98cm. One body had type B anatomical variation on the left hip and type A on the right.Conclusion: the making of the posterior arthroscopic portal to the hip joint must be done with careful marking of the trochanter massive; should there be difficult to find it, a small surgical access is recommended. The access point to the portal should not exceed two centimeters towards the posterior superior aspect of the greater trochanter, and must be made with the limb in internal rotation of 15 degrees.

scholarly journals A unique quadrifurcation of the sciatic nerve in the lower leg

1970 ◽  
Vol 6 (2) ◽  
pp. 919-923
Author(s):  
Afadhali D. Russa ◽  
Flora M. Fabian
Keyword(s):  
Sciatic Nerve ◽  
Sports Medicine ◽  
Popliteal Fossa ◽  
The Body ◽  
Limb Amputation ◽  
Posterior Aspect ◽  
Clinical Procedures ◽  
Fracture Management ◽  
Branching Patterns ◽  
Lower Division

Sciatic nerve is the largest nerve of the body supplying the entire posterior aspect of the lower limb. Taking its origin from the lumbosacral plexus, the nerve divides into its terminal branches at the superior angle of the popliteal fossa. Variant division patterns of the nerve especially those occurring in the thigh and the popliteal fossa are common. Divisions of the nerve occurring in the leg are rare. Even much rarer are terminations involving multiple branching patterns. Variations in the course and distribution of the sciatic nerve are of great importance in neurology, orthopedics, rehabilitation, anesthesia and many other clinical procedures. In the present study, we report a unique quadrifurcation termination of the sciatic nerve occurring deep in the distal half of the leg as observed during routine dissection by the medical students. Due to its variant muscular innervations, quadrifurcation and low divisions of the sciatic nerve may be of great importance in procedures such fracture management of the leg and foot, physiotherapy, limb amputation and in sports medicine. Embryologically, late separation of the common nerve sheath into individual terminal branches may lead to the lower division of the nerve.KEY WORDS: Sciatic nerve, quadrifurcation, lower division, fracture

scholarly journals FETAL ANATOMY OF THE STRUCTURES OF THE BUTTLE REGION IN THE HUMAN FETUS

2020 ◽  
Vol 19 (4) ◽  
pp. 20-24
Author(s):  
T. Khmara
Keyword(s):  
Sciatic Nerve ◽  
Age Groups ◽  
Perinatal Period ◽  
Gluteal Region ◽  
Accurate Information ◽  
Pelvic Cavity ◽  
Human Fetuses ◽  
Surgical Interventions ◽  
Maternity Hospitals ◽  
Neurovascular Bundles

In the scientific literature, there are reports on the compression of the nerves of the sacral plexus of the pelvic area or above the gluteal fold in different age periods of a person's life. However, not enough attention is paid by morphologists to the options for the exit of the pudendal, superior and inferior gluteal neurovascular bundles and the sciatic nerve from the pelvic cavity in the perinatal period of human ontogenesis. To perform therapeutic and diagnostic manipulations, as well as surgical interventions in the gluteal region, accurate information is required about the projection-syntopic relationships of the pudendal, superior and lower gluteal neurovascular bundles and the sciatic nerve in human fetuses of different age groups. The study was carried out on 34 preparations of human fetuses, 186.0-310.0 mm parietococcygeal length. The material was fixed in a 7% formalin solution for two weeks, after which the topographic anatomical features of the muscles, blood vessels and nerves of the gluteal region in fetuses of 6-8 months were studied by fine dissection under the control of a binocular loupe. Human fetal preparations were received after artificial termination of pregnancy, which were carried out for social and medical reasons on the basis of district and city maternity hospitals. In 63.24% of the examined fetuses of 6-8 months, the projection of the superior gluteal vessels corresponds to the point located on the border between the upper and middle third osteocetabular line, less often (33.82% of observations) - downward (by 1.5-4, 3 mm) and medially (2.0-4.5 mm) from the specified point, and as an exception (only 3%) - 5.0-5.5 mm laterally from this point. The superior sciatic nerve is located 1.0-3.8 mm lateral to the vessels of the same name. In 75.01% of cases, the lower gluteal vessels leave the pelvis medially (by 2.0-4.7 mm) and down (by 1.5-4.2 mm) from the middle of the osteo-hump line. In 17.64% of observations, the projection of the lower gluteal vessels corresponds to the middle of the osteo-hump line, and in 7.35% of the fetuses, the projection of these vessels is determined 2.5-3.4 mm outward from the point located in the middle of the osteo-hump line. The sciatic nerve leaves the pelvis mainly (75% of observations) medially (2.0-5.4 mm) from the middle of the hump-acetabular line, and in 25% of cases the projection of the sciatic nerve corresponds to the middle of this line.

scholarly journals Repensar a Ciatalgia Perante Variação Anatómica Bilateral do Nervo Isquiático, com Origem Baixa e Divisão Alta: Importância Histórica, Anatómica e Clínica

2018 ◽  
Vol 31 (10) ◽  
pp. 568 ◽  
Author(s):  
Fernando Silva Ribeiro ◽  
Maria Alexandre Bettencourt-Pires ◽  
Edivaldo Xavier da Silva Junior ◽  
Diogo Casal ◽  
Daniel Casanova-Martinez ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Undergraduate Students ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Leonardo Da Vinci ◽  
Gluteal Region ◽  
Lower Margin ◽  
Anatomical Dissection ◽  
Hind Limbs ◽  
The Common

Introduction: The aim of the present study is to report an original, unusual, case of bilateral anatomical variation of the sciatic nerve, with low origin and high division.Material and Methods: Anatomical dissection was performed on a 66 year-old female cadaver. The corpse was embalmed and conserved through our original embalming techniques.Results: The particular anatomical variation was first detected during routine dissection classes for undergraduate students. The study was completed with contralateral dissection to unveil bilateral variation. In both hind limbs, the sciatic nerve had a low origin, deep below the mid-gluteal region, and suffered high division, near the lower margin of the gluteal region, after a short length of circa 8 cm, to divide into the common fibular and tibial nerves.Discussion: We detect several cases of sciatic nerve high division, in the reports of the earliest anatomists, such as Leonardo da Vinci, Vesalius, Da Cortona, or Eustachius. Such ancestral interest for these anatomical variations demonstrates the importance of their knowledge for health professionals of different areas.Conclusion: The accurate study of sciatic nerve anatomical variations bears evident surgical, anaesthesiology and clinical applications. As more meticulous as our anatomical studies may get, one will never reach the state of perfection to consider such studies as definitive.

scholarly journals Morphology of Piriformis- its clinical implications in Piriformis syndrome

2021 ◽  
Vol 9 (1.2) ◽  
pp. 7869-7873
Author(s):  
Harsimarjit Kaur ◽  
◽  
Rimple Bansal ◽  
Gurdeep S Kalyan ◽  
Ruchi Goyal ◽  
...  
Keyword(s):  
Anatomical Variation ◽  
Anatomical Variations ◽  
Clinical Syndrome ◽  
Gluteal Region ◽  
Common Trunk ◽  
Superior Gluteal Artery ◽  
Accessory Muscle ◽  
Superficial Branch ◽  
Male Cadaver ◽  
Human Cadavers

Background and Aim: Anatomical variations of neuromuscular structures of gluteal region are common. Each and every anatomical variation reflects a different and case specific clinical presentation. Piriformis is the key muscle to this region. This work was done to re-investigate the morphology of this muscle and structures related to it, in sufficient number of specimens to correlate with clinical syndrome. Materials and Methods: 60-lower extremities with gluteal region belonging to 30 embalmed adult human cadavers named as specimens comprised the material for this study. Gluteal region was dissected to see the variations in the origin, insertion and accessory slips of piriformis muscle. Results and Conclusion: Out of 60 specimens, piriformis consisted of one belly in 55 specimens (91.67%) and two bellies were observed in 5 specimens (8.33%). In two specimens belonging to one male cadaver, the piriformis was found being pierced by common trunk for inferior gluteal and common peroneal nerves whereas in three specimens piriformis was also being pierced by one root of posterior cutaneous nerve of thigh An accessory muscle was observed bilaterally in one cadaver. This accessory muscle was present below the piriformis on right side& it was related with the emergence of tibial nerve in between the piriformis and accessory muscle which is a rare pattern. On left side this accessory muscle was present above the piriformis & was associated with presence of superficial branch of superior gluteal artery between the upper border of piriformis and this accessory muscle. All these variations should be kept in mind during physical examination or evaluating radiological images of patients with low back pain. KEY WORDS: Anatomical variation, Piriformis, Pirifomis syndrome, extraspinal sciatic.

scholarly journals Anatomy of sciatic nerve bifurcation in popliteal fossa: a fetal study

2014 ◽  
Vol 31 (04) ◽  
pp. 199-201
Author(s):  
M. Sinha ◽  
R. Gupta ◽  
A. Aggarwal ◽  
D. Sahni ◽  
H. Sinha
Keyword(s):  
Sciatic Nerve ◽  
Quantitative Data ◽  
Tibial Nerve ◽  
Early Period ◽  
Popliteal Fossa ◽  
Gluteal Region ◽  
Lateral Condyle ◽  
Significant Implication ◽  
Fibular Nerve ◽  
Common Fibular Nerve

Abstract Background: We studied the bifurcation of sciatic nerve into two components which change their position throughout the early period of life. We proposed dimensions that would help reducing failure rates of anesthesia in popliteal fossa region and screening of malignancy related to sciatic nerve. Methods: The back of thigh and popliteal fossa of both sides of 50 fetuses (24 male and 26 female) were dissected. Skin over the gluteal region was dissected upto back of the knee. Sciatic nerve was traced from gluteal region to back of the thigh. The level where common fibular nerve and tibial nerve diverge from sciatic nerve and the diameter of sciatic nerve at various levels were evaluated. Results: In 97.7% (41/42) specimens,the bifurcation was above (5.1-20.86 mm) and in 2.3% (1/42) specimens, it was below (2.37 mm) the lateral condyle of femur. In 66% cases, sciatic nerve splits into two at or within 11 mm proximal to lateral condyle, while in 75% cases within 13mm, and in 100% cases within 21mm proximal to lateral condyle. Conclusion: This study provides quantitative data about the sciatic nerve in the gluteal region and back of the thigh. This data has a significant implication in diagnostic and anesthetic practice.

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