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 Sciatic nerve and its variations: is it possible to associate them with piriformis syndrome?

2019 ◽  
Vol 77 (9) ◽  
pp. 646-653 ◽  
Author(s):  
Ana Beatriz Marques Barbosa ◽  
Priscele Viana dos Santos ◽  
Vanessa Apolonio Targino ◽  
Nathalie de Almeida Silva ◽  
Yanka Costa de Melo Silva ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Lower Limbs ◽  
Piriformis Syndrome ◽  
Piriformis Muscle ◽  
The Common ◽  
Method Of Evaluation ◽  
Sample Method ◽  
Fibular Nerve

ABSTRACT The sciatic nerve forms from the roots of the lumbosacral plexus and emerges from the pelvis passing inferiorly to the piriformis muscle, towards the lower limb where it divides into common tibial and fibular nerves. Anatomical variations related to the area where the nerve divides, as well as its path, seem to be factors related to piriformis syndrome. Objective: To analyze the anatomical variations of the sciatic nerve and its clinical implications. Methods: This was a systematic review of articles indexed in the PubMed, LILACS, SciELO, SpringerLink, ScienceDirect and Latindex databases from August to September 2018. Original articles covering variations of the sciatic nerve were included. The level of the sciatic nerve division and its path in relation to the piriformis muscle was considered for this study. The collection was performed by two independent reviewers. Results: At the end of the search, 12 articles were selected, characterized according to the sample, method of evaluation of the anatomical structure and the main results. The most prevalent anatomical variation was that the common fibular nerve passed through the piriformis muscle fibers (33.3%). Three studies (25%) also observed anatomical variations not classified in the literature and, in three (25%) the presence of a double piriformis muscle was found. Conclusion: The results of this review showed the most prevalent variations of the sciatic nerve and point to a possible association of this condition with piriformis syndrome. Therefore, these variations should be considered during the semiology of disorders involving parts of the lower limbs.

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 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 A Rare Anatomical Variation in the Pedicle of Anterolateral Thigh (ALT) Flap

2021 ◽  
Vol 54 (02) ◽  
pp. 229-231
Author(s):  
Jiten Kumar Mishra ◽  
Shamendra Anand Sahu
Keyword(s):  
Anatomical Variation ◽  
Donor Site ◽  
Vascular Anatomy ◽  
Anatomical Variations ◽  
Donor Site Morbidity ◽  
Anterolateral Thigh ◽  
Complex Reconstruction ◽  
The Common ◽  
Tissue Flaps ◽  
Alt Flap

AbstractFree anterolateral thigh (ALT) flap finds its place in the front row among the soft-tissue flaps used for complex reconstruction of various defects. Its versatile tissue component and ease of harvesting with minimal donor site morbidity made it a popular flap. However, its variable vascular anatomy alerts the reconstructive surgeon to remain aware of the common variation and vigilant with regard to unusual variation. Commonly described variations are about the origin and course of pedicle and perforators. There are rare reports regarding the presence of double arteries and single vein in the flap pedicle. Here, the authors describe these unusual anatomical variations in the pedicle of ALT flap, with two arteries and one vein, and discuss the surgical implication of the same.

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.

Carotid endarterectomy in patients with foetal-type posterior circle of Willis: Is there an indication for local anaesthesia?

VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 404-407
Author(s):  
Maras ◽  
Tzormpatzoglou ◽  
Papas ◽  
Papanas ◽  
Kotsikoris ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Local Anaesthesia ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Variable Degree ◽  
Operative Complications ◽  
The Right ◽  
Ica Stenosis ◽  
Symptomatic Stenosis

Foetal-type posterior circle of Willis is a common anatomical variation with a variable degree of vessel asymmetry. In patients with this abnormality, carotid endarterectomy (CEA) may create cerebral hypo-perfusion intraoperatively, and this may be underestimated under general anaesthesia. There is currently no evidence that anatomical variations in the circle of Willis represent an independent risk factor for stroke. Moreover, there is a paucity of data on treating patients with such anatomical variations and co-existing ICA stenosis. We present a case of CEA under local anaesthesia (LA) in a 52-year-old female patient with symptomatic stenosis of the right ICA and coexistent foetal-type posterior circle of Willis. There were no post-operative complications and she was discharged free from symptoms. She was seen again 3 months later and was free from complications. This case higlights that LA should be strongly considered to enable better intra-operative neurological monitoring in the event of foetal-type posterior circle of Willis.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Vasileios Kalles ◽  
Konstantinos Papatheodorou ◽  
Nikolaos Goutas ◽  
Ioannis Papapanagiotou ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Anatomical Variations ◽  
Common Hepatic Duct ◽  
Drainage Pattern ◽  
Left Hepatic Duct ◽  
Surgical Interventions ◽  
Drainage Patterns ◽  
The Common ◽  
The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

scholarly journals Termination of the facial vein into the external jugular vein: an anatomical variation

2008 ◽  
Vol 7 (2) ◽  
pp. 174-175 ◽  
Author(s):  
Suhani Sumalatha D'Silva ◽  
Thejodhar Pulakunta ◽  
Bhagath Kumar Potu
Keyword(s):  
Jugular Vein ◽  
Anatomical Variation ◽  
Venous Drainage ◽  
External Jugular Vein ◽  
Facial Artery ◽  
Drainage Pattern ◽  
Facial Vein ◽  
The Face ◽  
The Common ◽  
Anterior Division

Different patterns of variations in the venous drainage have been observed in the past. During routine dissection in our Department of Anatomy, an unusual drainage pattern of the veins of the left side of the face of a middle aged cadaver was observed. The facial vein presented a normal course from its origin up to the base of mandible, and then it crossed the base of mandible posteriorly to the facial artery. Thereafter, it joined with the anterior division of retromandibular vein to form the common facial vein, which drained into the external jugular vein directly. Sound anatomic knowledge of the above variation in facial veins is essential to the success of surgical procedures in this region.

scholarly journals Bilateral anatomical variations of the hand extensors

2016 ◽  
Vol 15 (2) ◽  
pp. 278-282
Author(s):  
Humberto Ferreira Arquez
Keyword(s):  
Anatomical Variation ◽  
Medical Science ◽  
Ring Finger ◽  
Anatomical Variations ◽  
Extensor Digitorum ◽  
Left Hand ◽  
Extensor Tendons ◽  
Right Hand ◽  
The Right ◽  
Little Finger

Background: The purpose of this paper is to describe an anatomical variation of the hand extensor on the little finger of the right hand which receives four tendons, condition unknown, as it is the first case reported so far in the literature. The human extensor tendons of hand often display an array of variations. Awareness of the anatomy and variations of the extensor tendons on the dorsum of the hand is necessary not only for the anatomist but also for surgeons when considering tendons for hand surgery, tendon rerouting or transplants. Materials and Methods: Bilateral anatomical variation in the upper limb was found during routine dissection in a 75-year-old male cadaver in the Morphology Laboratory at the University of Pamplona. The variations were recorded and photographed. Result: In the left hand the extensor digitorum there was a single tendon to the index, double tendon to the middle, triple tendon to the ring finger, a single tendon to the little finger or digiti minimi. The extensor digiti minimi has double tendon. In the right hand the extensor digitorum there was a single tendon to the index, triple tendon to the middle finger, triple tendons to the ring finger, a double tendon to the little finger. The extensor digiti minimi has double tendon. The little finger receives four tendons, 2 of extensor digitorum and 2 of extensor digiti minimi. The dorsum of the left hand and right showed juncturae tendinum type 2, between the extensors tendons in the 3rd intermetacarpal space; type 3, between the extensors tendons in the 4th inter metacarpal space. Conclusion: The presence of multiple tendons may alter the kinematics around the site of attachment to the phalanx. Knowledge of anatomical variations and normal anatomy of the extensor tendons, may be helpful while performing graft and tendon transfer operations.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.278-282

Sign in / Sign up

Export Citation Format

Share Document