scholarly journals A Study of Tibial Nerve in the Popliteal Fossa Along With Its Variations in Its Branching Pattern

2020 ◽  
Vol 6 (2) ◽  
pp. 29-34
Author(s):  
W Benjamin ◽  
Raghavendra V Pisale ◽  
SA Premchand ◽  
Edward Indla ◽  
Seema Valsalan Ennazhiyil ◽  
...  
Keyword(s):  
Soleus Muscle ◽  
Tibial Nerve ◽  
Lower Limbs ◽  
Detailed Knowledge ◽  
Branching Pattern ◽  
Human Cadavers ◽  
Selective Neurectomy ◽  
Pattern Number ◽  
Formalin Fixed ◽  
Single Branch

Background: A detailed Knowledge of these variations in motor branching patterns will help the surgeons when certain procedures are done for calf reduction and also when selective neurectomy is required. It is also required by the anesthetists to give neurolytic blocks. Subjects and Methods: 40 formalin-fixed lower limbs of adult human cadavers were selected. The origin of the tibial nerve, variations in a branching pattern, number of muscular branches given was studied by dissection. The Level of origin of these nerves was taken to the apex of the head of the fibula (AHF). Results: In 70 % of specimens the origin of the Tibial Nerve was < 12 cm and in 30 % it was between 12-24 cm above the level of AHF. In 10% of cases, the sural nerve originated from the nerve to the medial head of gastrocnemius (MHG). In 82.5% of specimens, the MHG received one branch from the tibial nerve and in 17.5% it received two branches. The lateral head of Gastrocnemius (LHG) received one branch from the tibial nerve. In 10%, there was a common branch for the LHG and the soleus muscle. 90% of specimens had one branch and 10% had two branches that supplied the soleus muscle. A single branch supplied the plantaris muscle. The popliteus muscle also received a single branch. Conclusion : The results in the study provide information that is required by the anatomists, surgeons, radiologists and anesthetists.

scholarly journals Branching Pattern of the Medial Calcaneal Neurovascular Bundle in Porta Pedis of the Human Foot

2019 ◽  
Vol 1 (4) ◽  
pp. 2-12
Author(s):  
Khalid Musa Fadlelmula Awadelseid
Keyword(s):  
Neurovascular Bundle ◽  
Lower Limbs ◽  
Tarsal Tunnel ◽  
Branching Pattern ◽  
Plantar Surface ◽  
Human Foot ◽  
Medial Side ◽  
Common Observation ◽  
The Right ◽  
Single Branch

The medial calcaneal nerve (MCN) is the first branch of the posterior tibial nerve (PTN) in the porta pedis, enervates the skin of the heel and medial side of the foot. Heel pain is a common condition encountered by physicians, and this may have a significant clinical association with the MCN’s branching pattern. This study was to identify branching pattern variations in the medial calcaneal neurovascular bundle. This study was carried out using 60lower limbs of formalin-embalmed cadavers, using the tarsal tunnel dissection method for 30right and 30 left lower limbs. The medial calcaneal neurovascular bundle course was identified by exposing the PTN and its branches from the distal end of the leg toward the plantar surface beyond its bifurcation and resecting the skin and flexor retinaculum. Many MCN branching pattern variations (specifically concerning origins, numbers, and levels of branching) were observed. In the right foot a single branch was present in 21 specimens (70%), while two branches were observed in nine specimens (30%). In the left foot, a single branch was present in 22 specimens (73.3%) and two branches were present in 8 specimens (26.7%). In this study, two branches originate from lateral planter artery is the most common observation. This study concludes that a single MCN originating from the TN is the most common variant. Two medial calcaneal arteries (MCAs) originating from the LPA is also common.

scholarly journals Anatomical Variations of the Recurrent Laryngeal Nerve and Implications for Injury Prevention during Surgical Procedures of the Neck

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 670
Author(s):  
Alison M. Thomas ◽  
Daniel K. Fahim ◽  
Jickssa M. Gemechu
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Surgical Procedures ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Branching Pattern ◽  
The Right ◽  
Relationship Of ◽  
Intrinsic Laryngeal Muscles ◽  
Formalin Fixed

Accurate knowledge of anatomical variations of the recurrent laryngeal nerve (RLN) provides information to prevent inadvertent intraoperative injury and ultimately guide best clinical and surgical practices. The present study aims to assess the potential anatomical variability of RLN pertaining to its course, branching pattern, and relationship to the inferior thyroid artery, which makes it vulnerable during surgical procedures of the neck. Fifty-five formalin-fixed cadavers were carefully dissected and examined, with the course of the RLN carefully evaluated and documented bilaterally. Our findings indicate that extra-laryngeal branches coming off the RLN on both the right and left side innervate the esophagus, trachea, and mainly intrinsic laryngeal muscles. On the right side, 89.1% of the cadavers demonstrated 2–5 extra-laryngeal branches. On the left, 74.6% of the cadavers demonstrated 2–3 extra-laryngeal branches. In relation to the inferior thyroid artery (ITA), 67.9% of right RLNs were located anteriorly, while 32.1% were located posteriorly. On the other hand, 32.1% of left RLNs were anterior to the ITA, while 67.9% were related posteriorly. On both sides, 3–5% of RLN crossed in between the branches of the ITA. Anatomical consideration of the variations in the course, branching pattern, and relationship of the RLNs is essential to minimize complications associated with surgical procedures of the neck, especially thyroidectomy and anterior cervical discectomy and fusion (ACDF) surgery. The information gained in this study emphasizes the need to preferentially utilize left-sided approaches for ACDF surgery whenever possible.

scholarly journals Anatomical Study of Variations in the Branches of Superior Mesenteric Artery – A Study from a Teaching Hospital in Chennai, India

2021 ◽  
Vol 10 (20) ◽  
pp. 1506-1510
Author(s):  
Ganga Venkatachalam ◽  
Kanagavalli Paramasivam ◽  
Lakshmi Valliyappan
Keyword(s):  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Lumbar Vertebra ◽  
Anatomical Study ◽  
Middle Colic Artery ◽  
Branching Pattern ◽  
Colic Artery ◽  
Human Cadavers ◽  
Derivatives Of

BACKGROUND Superior Mesenteric Artery (SMA) is one of the anterior branches of the abdominal aorta. It originates from abdominal aorta at the level of lower border of first lumbar vertebra, one centimeter below the coeliac trunk. It gives the first branch inferior pancreaticoduodenal artery (IPDA), The colic branches arise from concave right side of the superior mesenteric artery, these are middle colic artery (MCA), right colic artery (RCA), ileo colic artery (ICA). Jejunal and ileal branches arise from left side of the SMA. Superior mesenteric artery supplies derivatives of midgut. Knowledge of branching pattern of the SMA is clinically important to gastroenterologists operating on gut and neighboring structures like pancreas, duodenum, and liver. We wanted to study the variations in the branches of superior mesenteric artery. METHODS This is a descriptive study conducted on 50 adult embalmed human cadavers by conventional dissection method, the findings were noted and tabulated. RESULTS Present study shows that inferior pancreatic duodenal artery orginated from SMA in 47 (94 %) specimens. IPDA was absent in 3 (6 %) specimens. Middle colic artery was found to arise from SMA in 48 (94 %) and MCA was absent in 2 (4 %) specimens. Right colic artery was found to arise from SMA in 47 (94 %) specimens and it was absent in 3 (6 %) specimens. Ileo-colic artery was found to arise from SMA in all 50 (100 %) specimens. CONCLUSIONS Awareness of these complex variations may prevent devastating complications during colonic surgeries. Variations in the branching pattern of superior mesenteric artery is essential for surgeons operating on derivatives of midgut, liver, pancreas. KEY WORDS Branches, Colic, Superior Mesenteric Artery, Variations

scholarly journals Fatigue-incduced modulation of human soleus Hoffmann reflex under conditions of homosynaptic postactivation depression due to pair tibial nerve stimulation

2017 ◽  
Vol 74 (2) ◽  
pp. 55-59
Author(s):  
O. Kolosova
Keyword(s):  
Soleus Muscle ◽  
Tibial Nerve ◽  
Voluntary Contraction ◽  
H Reflex ◽  
Afferent Nerves ◽  
Tibial Nerve Stimulation ◽  
Static Contraction ◽  
Conditioned Responses ◽  
Postactivation Depression ◽  
Stimulation Of

The purpose of our work was to investigate in detail the influence of pair stimulation of tibial nerve (n.tibialis) on human soleus H-reflex amplitude at rest and after long-lasting voluntary contraction of calf muscle (m.m. gastrocnemius-soleus), which caused the fatigue of soleus muscle. The method of H-reflex of soleus muscle was used. Test and conditioned responses (by pair stimulation of n. tibialis) were registered. Homosynaptic postactivation depression led to inhibition of H-reflex at rest. After fatiguing voluntary static contraction the amplitudes of test and conditioned soleus H-reflex were significantly reduced. Then both H-reflex amplitudes subsequently recovered. Soleus H-reflex inhibition might be due to the activation of the groups III and IV afferent nerves under the influence of mechanical and metabolic changes in the muscle.

scholarly journals The relationship between the deep fibular nerve and the dorsalis pedis artery and its surgical importance

2009 ◽  
Vol 42 (01) ◽  
pp. 018-021
Author(s):  
R. Chitra
Keyword(s):  
Vascular Supply ◽  
Lower Limbs ◽  
Surgical Approaches ◽  
Tarsal Tunnel ◽  
Detailed Knowledge ◽  
Dorsalis Pedis Artery ◽  
Extensor Hallucis Longus ◽  
Relationship Of ◽  
The Relationship ◽  
Fibular Nerve

ABSTRACTThe aim of this study was to demonstrate the relationship between the deep fibular nerve and the dorsalis pedis artery to provide useful anatomical knowledge for safe surgical approaches in plastic surgery. The dissection of 30 cadaver lower limbs was undertaken to describe the relationship of the deep fibular nerve to the dorsalis pedis artery in the anterior tarsal tunnel and on the dorsum of the foot. The anterior tarsal tunnel is a flattened space between the inferior extensor retinaculum and the fascia overlying the talus and navicular. The deep fibular nerve and its branches pass longitudinally through this fibro-osseous tunnel, deep to the tendons of the extensor hallucis longus and extensor digitorum longus. Four distinct relationships of the deep fibular nerve to the dorsalis pedis artery were determined. The dorsalis pedis neurovascular island flap contains both the dorsalis pedis artery and the deep fibular nerve. Because the design of a neurovascular free flap requires detailed knowledge of the nerve and vascular supply, the data presented here are intended to help surgeons during surgical approaches to the foot and ankle.

scholarly journals Variations in branching pattern of the axillary artery: a study in 40 human cadavers

2012 ◽  
Vol 11 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Rajesh Astik ◽  
Urvi Dave
Keyword(s):  
Axillary Artery ◽  
Artery Bypass ◽  
Clinical Signs ◽  
Coronary Bypass ◽  
Signs And Symptoms ◽  
Anatomical Variations ◽  
Common Trunk ◽  
Branching Pattern ◽  
Lateral Thoracic Artery ◽  
Human Cadavers

BACKGROUND: Variations in the branching pattern of the axillary artery are a rule rather than an exception. The knowledge of these variations is of anatomical, radiological, and surgical interest to explain unexpected clinical signs and symptoms. OBJECTIVE: The large percentage of variations in branching pattern of axillary artery is making it worthwhile to take any anomaly into consideration. The type and frequency of these vascular variations should be well understood and documented, as increasing performance of coronary artery bypass surgery and other cardiovascular surgical procedures. The objective of this study is to observe variations in axillary artery branches in human cadavers. METHODS: We dissected 80 limbs of 40 human adult embalmed cadavers of Asian origin and we have studied the branching patterns of the axillary artery. RESULTS: We found variations in branching pattern of axillary artery in 62.5% of the limbs. Anatomical variations included: origin of lateral thoracic artery from the subscapular artery; absent thoracoacromial trunk and all its branches arose directly from the second part of the axillary artery; division of thoracoacromial trunk into deltoacromial and clavipectoral trunks, which were divided into all branches of thoracoacromial trunk; origin of subscapular, anterior circumflex humeral, posterior circumflex humeral and profunda brachii arteries from a common trunk from the third part of the axillary artery; and origin of posterior circumflex humeral artery from brachial artery in addition to third part of the axillary artery. CONCLUSIONS: The study was carried out to show important variations in the branching pattern of axillary artery, in order to orient the surgeons performing angiography, coronary bypass, and flaps in reconstructive surgeries.

scholarly journals A study on branching pattern of main portal vein

2017 ◽  
Vol 06 (02) ◽  
pp. 152-157
Author(s):  
Chaitra BR ◽  
Seema Deepak ◽  
Dakshayani KR
Keyword(s):  
Portal Vein ◽  
Anatomical Variations ◽  
Branching Pattern ◽  
Main Portal Vein ◽  
Human Cadavers ◽  
Portal Vein Anatomy ◽  
Left Portal Vein ◽  
Clear Identification ◽  
Intimate Knowledge ◽  
Transplantation Procedures

Abstract Background: An intimate knowledge and awareness of branching patterns of main portal vein is necessary before hepatic surgeries. The presence of portal vein variants increases the risk of bile duct hilar anatomical variations also. This information may be of help for accurate radiological interpretation, to prevent complications like hemorrhage, difficult anastomosis in the recipient, ischemia in the graft and allograft failure at the time of liver transplantation. Hence the present study was conducted with the objective of observing the branching pattern of the main portal vein, to measure length of right portal vein and angle between right and left portal vein. Material and Methods: The present study was conducted on 84 liver specimens of human cadavers fixed with 5% formalin, collected from the Department of Anatomy and Forensic Medicine, MMC&RI, Mysore. The parameters were measured using image J software. Results: Bifurcation of main portal vein was seen in 75 liver specimens [89.3%]. Trifurcation of main portal vein was seen in 9 specimens [ 10.7%]. Mean angle between Right and left portal vein was 146.7°. Mean length of right portal vein was 2.27 cm. Conclusion: Knowledge of portal vein variations is critically significant in surgical resection and transplantation procedures. Resection of any portion of liver should be well planned and clear identification of sub segments of liver is necessary before surgery. Surgeons and radiologists must have a thorough understanding of variants in portal vein anatomy in order to prevent injury to portal vein and for successful radiological interventions.

scholarly journals Surgical Anatomy of the Orbit in Human Cadavers–An Endoscopic Pictorial Documentation

2017 ◽  
Vol 79 (02) ◽  
pp. 173-176
Author(s):  
Homajoun Maslehaty ◽  
Saskia Schultheiss ◽  
Martin Scholz ◽  
Athanasios Petridis
Keyword(s):  
Rectus Muscle ◽  
Surgical Anatomy ◽  
Anatomical Landmark ◽  
Inferior Rectus ◽  
Anatomical Structures ◽  
Topographic Anatomy ◽  
Endoscopic Anatomy ◽  
Human Cadavers ◽  
Formalin Fixed ◽  
Inferior Rectus Muscle

Background The aim of our study was a pictorial documentation of the anatomical structures of the orbit. Methods We performed a transmaxillary endoscopic approach in nine formalin-fixed human heads. We identified and documented the anatomy of the inferior part of the orbit. Results The first intraorbital anatomical landmark was the inferior rectus muscle, from which important structures medially and laterally could be identified. Anatomical structures and their relation to each other were documented and presented as illustrative figures. Conclusion Knowledge of the topographic anatomy of the inferior part of the orbit could be sufficiently imparted by our illustrations. The presented transmaxillary approach allowed a wide overview of the anatomical structures located in the inferior part of the orbit. Our pictorial documentation may provide neurosurgeons more safety and the opportunity to become familiar with the endoscopic anatomy.

Lower Limbs Trauma in Pediatrics

2017 ◽  
Vol 21 (03) ◽  
pp. 175-183 ◽  
Author(s):  
Claudia Piccolo ◽  
Michele Galluzzo ◽  
Margherita Trinci ◽  
Stefania Ianniello ◽  
Michele Tonerini ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Lower Limbs ◽  
Detailed Knowledge ◽  
Kinetic Chain ◽  
Lower Extremity Injuries ◽  
Missed Diagnosis ◽  
Extremity Injuries ◽  
Mechanism Of Trauma ◽  
Adequate Management ◽  
Skeletally Immature Patient

This article reviews acute and chronic lower extremity injuries in children, focusing mainly on those traumas typical of the pediatric population. The child is not just a small version of an adult, so physicians need a very detailed knowledge of the anatomy and physiologic changes occurring during growth to understand and evaluate the mechanism of trauma, and choose the most adequate management. In adolescents the most common lesion encountered affects the physes, which are still open. They predispose to injury as the weakest point in the kinetic chain, so those mechanisms responsible for ligamentous traumas in adults can cause physeal injuries in a skeletally immature patient. In association with them, apophyseal lesions are also very common, leading to avulsion injuries at the site of tendon origin or insertion, also called locus minoris resistentiae. Understanding these types of injuries is essential, specifically for the radiologist, because a missed diagnosis can lead to later complications such as growth arrest and osteoarthritis.

scholarly journals Quantitative input-output relationships between human soleus muscle spindle afferents and motoneurons

2018 ◽  
Vol 119 (3) ◽  
pp. 887-893
Author(s):  
Alan McComas ◽  
Hubert deBruin ◽  
Winnie Fu
Keyword(s):  
Electrical Stimulation ◽  
Normal Distribution ◽  
Soleus Muscle ◽  
Tibial Nerve ◽  
Great Toe ◽  
The Mean ◽  
Reflex Discharge ◽  
First Time ◽  
The Relationship ◽  
Weak Extension

A method is described that, for the first time, allows instantaneous estimation of the Ia fiber input to human soleus motoneurons following electrical stimulation of the tibial nerve. The basis of the method is to determine the thresholds of the most and least excitable 1a fibers to electrical stimulation, and to treat the intervening thresholds as having a normal distribution about the mean; the validity of this approach is discussed. It was found that, for the same Ia fiber input, the percentage of soleus motoneurons contributing to the H (Hoffmann)-reflex differed considerably among subjects; when the results were pooled, however, there was an approximately linear relationship between Ia input and motoneuron output. Weak extension of the great toe diminished the soleus motoneuron reflex discharge in all but 2 of 16 subjects; the results for weak ankle plantarflexion were less consistent, but overall, there was a reduction in soleus motoneuron output also. The methodology should provide new insights into disorders of movement and tone, especially as it permits estimates of motoneuron depolarization to be made. NEW & NOTEWORTHY Assuming a normal distribution of Ia fiber thresholds to electrical stimulation and using the H-reflex, we determined for the first time an Ia input-α-motoneuron output relationship for the human soleus muscle. The relationship varies greatly among subjects but, overall, is approximately linear. Minimal contraction of a toe muscle alters the relationship dramatically, probably due to presynaptic inhibition of Ia fibers. Drawing on the literature, we can calculate changes in α-motoneuron membrane potential.

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