scholarly journals STUDY OF DORSAL SACRAL TRIANGLE IN HUMAN SACRA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Manoj Bhavanidatta Joshi
Keyword(s):  
Epidural Anesthesia ◽  
Preoperative Assessment ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Pelvic Bone ◽  
Sacral Vertebra ◽  
Cross Sectional ◽  
Sacral Hiatus ◽  
Sacral Canal ◽  
Caudal Epidural

Introduction: Sacrum is a triangular bone shaped by combination of five sacral vertebrae. It is embedded as a wedge between the two innominate bones at the upper and back portion of pelvic bone. The opening show at the caudal conclusion of sacral canal is known as sacral rest. It is shaped due to the disappointment of combination of laminae of the fifth (every so often 4th) sacral vertebra. It is situated inferior to the 4th (or 3rd) fused sacral spines or lower end of median sacral crest. Sacrum is a vital bone for recognizable proof of sex in human skeletal framework. Since it may be a component of hub skeleton and and pelvic support, it has an applied significance in deciding sexual orientation with the assistance of estimation carried upon it. The well- known strategy for assurance of male and female sacra has been the Sacral file (SI). The varieties within the structure of dorsal divider of sacral canal are various. It may be open all through its whole length or there may be moo lying lamina of to begin with sacral vertebra. Other varieties incorporate lacks between its predominant and second rate limits, pulverization of lumen of sacral canal and hard abundance annihilating the break. The nearness of any gaps may allow the needle to elude the canal coming about in subcutaneous statement of anesthetic operator. The sacral hiatus has been used for administration of caudal epidural anesthesia in obstetrics as well as orthopedic practice for treatment and diagnosis. The foremost visit issue experienced in caudal epidural square is needle situation as in some cases it is troublesome to decide the anatomical area of sacral rest particularly in grown-ups. Clinical assessment of needle arrangement can be done with ultrasonography or fluoroscopy. In any case, it isn't continuously doable to do so since of time and cost limitations. Varieties have been found within the shape and level of sacral break. Anatomical points of interest and the information of real shape and size of sacral rest and its varieties play a major part within the victory of needle situation.  Aim: The main of this study is to find out the anatomical variations of sacral hiatus of the cadaver in human. Material and Methods: This is a Cross-sectional study carried out on dry human sacra to study the anatomical variations of sacral hiatus. Total 80 human sacra were collected from Department of Anatomy. Only dry sacra with complete sacral hiatus were included in this study. Damaged sacra were excluded in this study. For the study various parameters and measurement were used for the study. With the help of naked eye the shape of the sacral hiatus was noted. The length of sacral hiatus was measured from apex to the midpoint of base; the antero-posterior depth of sacral hiatus at the apex was measured with the help of vernier calipers and recorded as data. With the help of vernier caliper the transverse width of sacral hiatus at the base was also measured between the inner aspects of inferior limit of the sacral cornu with the help of divider and then adjusted and calculated. Result: In this all the sacrum studied was composed of five segments in 80 cases. There were many variations in the shape of sacral hiatus. In 38 (47.5%) sacra the shape was Inverted-U whereas sacra Inverted V was seen in 21(26.3%).  Both the over sorts were considered as ordinary and the sacral break was show against 4th and 5th sacral sections. The irregular shaped of sacral hiatus was observed in 12(15%) cases. A “Dumbbell” shaped sacral hiatus was observed in 5(6.3%) cases with a nodular bony growth projecting medially from both margins. The dorsal wall of sacral canal was entirely absence in 3(3.8%) cases. a rare phenomenon, absence of sacral hiatus was observed in 1(1.3%) only. Conclusion: There was variability in the anatomical structure of the sacral hiatus. The inverted U shape of sacral hiatus was most commonly seen. Apex and base of the hiatus were most commonly seen at the level of S4 and S5 respectively. These estimations will be of colossal esteem in administration of caudal epidural anesthesia and variations in shape and estimate of sacral rest will help in preoperative assessment of patients. There are anatomical varieties within the sacral break, which may relate to the complication to caudal epidural anesthesia. Understanding of these varieties may progress the victory rate of caudal epidural anesthesia. Keywords: Sacrum, Sacral hiatus, apex, base, caudal epidural anaesthesia

scholarly journals Morphometry of sacral hiatus and its clinical relevance in caudal epidural block

2015 ◽  
Vol 23 (1) ◽  
pp. 31-36 ◽  
Author(s):  
AHM Mostafa Kamal ◽  
Shamim Ara ◽  
Md Ashrafuzzaman ◽  
Khadeza Khatun ◽  
Mohammad Shaiful Islam
Keyword(s):  
Epidural Anesthesia ◽  
Function Analysis ◽  
Epidural Block ◽  
Sacral Vertebra ◽  
Cross Sectional ◽  
Male And Female ◽  
Medical College ◽  
Sacral Hiatus ◽  
The Mean ◽  
Caudal Epidural

Context: The variation in anatomical features of sacral hiatus and the dorsal wall of sacral canal is related to its clinical application in caudal epidural anesthesia. Through the sacral hiatus, it is employed in operation in the anal region and on the external genital organs, as well as cystoscopic examination of male. Continuous caudal anesthesia is also used in obstetrics during parturition for better cervical dilatation and shortening the first stage of labor. Methods: The present study was performed on 172 (one hundred seventy two) adult human dry sacra of unknown sex. The study samples were distributed in male and female sex groups by discriminant function analysis. The study was cross sectional analytical type and was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from January 2011 to December 2011. The various landmarks of sacral hiatus were measured with the help of digital slide calipers. Results: The mean length of sacral hiatus in male and female was found 26.38±12.02 mm and 25.63±10.46 mm respectively. The mean anterior-posterior diameter of sacral hiatus at the apex was found 4.76±1.73 mm in male and 4.92±2.13 mm in female. Transverse width of the sacral hiatus at the base found 17.29±3.89 mm in male and 18.01±3.70 mm in female. Different in shape of sacral hiatus between male and female found statistically not significant. Location of apex of sacral hiatus was found highest in number at the level of 4th sacral vertebra (60.20%) and maximum location of base of the sacral hiatus was at the level of 5th sacral vertebra (91.20%). The sacral hiatus has anatomical variations and understanding of these variations may improve the success of caudal epidural anesthesia. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22690 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 31-36

scholarly journals Importance of knowing the level of sacral hiatus for caudal epidural anesthesia

2014 ◽  
Vol 31 (01) ◽  
pp. 009-013 ◽  
Author(s):  
G. Nadeem
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Epidural Anesthesia ◽  
Anatomical Variations ◽  
Bony Landmarks ◽  
Sacral Hiatus ◽  
Different Shapes ◽  
The Mean ◽  
Sacral Canal ◽  
Caudal Epidural

Abstract Introduction and Materials and Methods: The Study was carried out on 100 dry human sacra to know the Anatomical variations of sacral hiatus. Results: Different shapes of sacral hiatus were observed which included- Inverted U (56%), Inverted V (14%), Irregular (16%), Dumb-bell (10%), Bifid (2%) and Elongated (2%). The apex of the sacral hiatus was most commonly found at the level of 3rd sacral vertebrae in 62%. The mean length of sacral hiatus was 25.2mm, the mean anteroposterior diameter of sacral canal at the apex of sacral hiatus was 5.53mm. The mean distance between sacral cornu at the base of sacral hiatus was observed to be 19.5mm. Conclusion: This study was done to clarify the anatomical variations of sacral hiatus using bony landmarks of sacrum for improving the reliability of caudal epidural anesthesia and to improve its success rate and reduce the complications and failure rate.

scholarly journals Morphometric Measurement of Sacral Hiatus in Dry Human Sacrum

2020 ◽  
Vol 10 (2) ◽  
pp. 73-77
Author(s):  
Sabin Poudel ◽  
Pranoti Sinha ◽  
Karma Lakhi Bhutia
Keyword(s):  
Medical Science ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Epidural Block ◽  
Cross Sectional ◽  
Length Width ◽  
Perineal Region ◽  
Sacral Hiatus ◽  
The Difference ◽  
Sacral Canal

Introduction: Sacral hiatus is the chief location for caudal epidural anesthesia during surgery of perineal region and also for a pain free parturition. Thus, this study was conducted to examine, measure and record the morphometry of sacral hiatus and to analyze it for any anatomical variations with clinical implications. Methods: The cross-sectional study was carried in the Department of Anatomy, Sikkim Manipal Institute of Medical Science, Gangtok, Sikkim. For the study seventy dry human sacral bone with entire sacral hiatus were measured. The shape of the sacral hiatus was observed. Level of the apex, base, length, width and anterior posterior diameter of sacral hiatus was measured with Digital Vernier Caliper. The study was approved by Institutional Ethical Committee (IEC No:SMIMS/IEC/2017-01). Data were analysed by one-way analysis of variance (ANOVA) and the difference was considered significant when P<0.05. SPSS 20 was used for data analysis. Results: The study revealed inverted “U” shaped sacral hiatus as the common shape in 35(50%) followed by inverted “V” shaped sacra in 18 (25.71 %) followed by irregular shaped sacral hiatus in 8 (11.42 %) cases. A Dumbbell shaped sacral hiatus was observed in 4 (5.71%) cases with a bony protuberance protruding medially from both edges. Absence or complete agenesis of sacral hiatus, a rare phenomenon, was observed in 3 (4.28%) and bifid in 2(2.85%) specimens only. Conclusion: The prevalence of inverted “U” shaped sacral hiatus and constriction of the sacral canal at apex of sacral hiatus was found high. This knowledge of variation in shape of sacral hiatus could be clinically important while providing caudal anesthesia and doing epidural block.

scholarly journals Sacral Hiatus Study in Dry Human Sacra

2014 ◽  
Vol 2 (1) ◽  
pp. 17-22
Author(s):  
M Mishra ◽  
AK Singh ◽  
P Satyavathi ◽  
N Sah
Keyword(s):  
Epidural Anaesthesia ◽  
Andhra Pradesh ◽  
Medical Science ◽  
Anatomical Variations ◽  
South Indian Population ◽  
South Indian ◽  
Caudal Anaesthesia ◽  
Sacral Hiatus ◽  
Sacral Canal ◽  
Caudal Epidural

Background and objectives: The sacral hiatus is the site for caudal epidural anaesthesia during perineal surgery and also for a painless delivery. It is also used for three dimensional colour visualization of lumbosacral epidural space in orthopaedic practice for diagnosis and treatment. Work on the morphometrical study of the sacral hiatus is limited, especially in south indian population. So this study is carried to examine, measure and record the morphometry of sacral hiatus in order to study the anatomical variations which will be useful for caudal epidural anaesthesia. Material and Methods: The study was conducted in the Department of Anatomy, Prathima Institute of Medical Science, Naganur, Andhra Pradesh. 93 dry sacra with complete sacral hiatus were taken for the study. The shape of the sacral hiatus was noted by naked eye. Level of the apex and base of the sacral hiatus was noted with respect to the sacral vertebra. The length of sacral hiatus was measured from apex to the midpoint of base, the anteroposterior depth of sacral hiatus at the apex was measured with the help of vernier calipers. The transverse width of sacral hiatus at the base was measured between the inner aspects of inferior limit of the sacral cornu with the help of divider and then adjusted, and calculated with vernier caliper. Results: In 47 (50.53 %) sacra the shape was Inverted-U and in 25 (26.9 %) sacra Inverted-V. The irregular shaped of sacral hiatus was observed in 11 (11.8 %) cases. A “Dumbbell” shaped sacral hiatus was observed in 5 (5.4%) cases with a nodular bony growth projecting medially from both margins. The dorsal wall of sacral canal was entirely absence in 4 (4.3%) cases. Absence of sacral hiatus, a rare phenomenon, was observed in 1 (1%) specimens only. Conclusion: In the present study, elongated hiatus and narrowing of the sacral canal at apex of sacral hiatus was found in a significant percentage, which should be kept in mind while giving the caudal anaesthesia in Andhra Pradesh region. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11391 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1): 17-22

scholarly journals Clinical impacts of the Sudanese anatomical variations in a relation of the recurrent laryngeal nerve to the inferior thyroid artery

2020 ◽  
Vol 8 (2) ◽  
pp. 25
Author(s):  
Mohamed Elghazali Elhasan ◽  
Wael Mohialddin Doush
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Laryngeal Nerve ◽  
Inferior Thyroid Artery ◽  
Parathyroid Glands ◽  
Main Trunk ◽  
Cross Sectional ◽  
Relationship Of ◽  
The Relationship

Background: Until recently, the knowledge of the anatomical variations in the relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) combined with visual intraoperative RLN identification are essential for the protection of these life-important structures during surgical exposure and the mobilization of thyroid and parathyroid glands. This leads to the proper treatment of patients and improvement of the surgical techniques.Aim: To describe anatomical variations in the relationship of the recurrent laryngeal nerve to the inferior thyroid artery in the Sudanese population.Patients and methods: Following ethical committee approval, an observational descriptive prospective cross-sectional study in the period between March 2019 and February 2020, for anatomical variations in the relation of the recurrent laryngeal nerve to the inferior thyroid artery in seventy-two cervical sides of thirty-six well-dissected embalmed Sudanese cadavers. The RLN was investigated in three positions: posterior to the ITA main trunk, anterior to the ITA main trunk and between the ITA branches. Then, the results were analyzed according to the gender, age and dissection side.Results: We found that the anatomical variations were more frequent in males (97.2%) than females (2.8%). The age of these variations ranged between 31–45 years which represents (61.1%). On the right side of the neck, the commonest position of the RLN is posterior to the ITA (63.9%) followed by in decreasing order of frequency, the RLNs run between the ITA branches (30.6%) and anterior to the ITA (5.6%). On the left side of the neck, the commonest position of the RLN is posterior to the ITA (69.4%). It passed between the ITA branches in (30.6%) of specimens. There was no anterior location of the RLN to the ITA. Variations in a relationship of the RLN to the ITA on one side is significantly different from the opposite side.Conclusions: Although the risk of potential damage to the RLN during surgical neck procedures involving the thyroid gland and parathyroid glands is well recognized, pre-operative detailed surgeon’s knowledge for these frequent anatomical variations and the usage of the ITA as an anatomical landmark for intraoperative RLN recognition is important. This will lead to a reduction of iatrogenic RLN injury prevalence. Future studies are recommended to compare the findings on this cadaveric study with a larger sample size in the long-term period.  

scholarly journals Anatomical variations of the anterior communicating artery complex: a multidetector CT angiographic study

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Soe Ei Phyu ◽  
Zunariah Buyong ◽  
Radhiana Hassan ◽  
Jamalludin A. Rahman ◽  
Siti Kamariah Che Mohamed
Keyword(s):  
Multidetector Ct ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Common Trunk ◽  
Anterior Communicating Artery ◽  
Typical Pattern ◽  
Cross Sectional ◽  
High Prevalence ◽  
Different Populations ◽  
The Brain

Introduction: The anterior communicating artery (ACoA) complex of the cerebral circulation, an area with great anatomical diversity, forms part of the communicating arterial supply to the brain. As brain tissues are susceptible to ischemic death, knowledge of this variability is important in diagnosis and management of diseases affecting brain circulation. The aim of the study is to measure the prevalence and to describe these variations. Methods: All patients who underwent CT angiography (CTA) scanning in HTAA from January 2009 to August 2015 were selected. A cross-sectional study was done to study these variations in 81 reconstructed CTA images. Results: Eleven types of variations were described (typical pattern; hypoplasia, aplasia, and duplication of ACoA; hypoplasia, and aplasia of A1 segment of the anterior cerebral artery (ACA); hypoplasia, and aplasia of A2 segment of ACA; A2 segments of ACA arising from a common trunk; the third A2 segment; bihemispheric ACA). A1 segment is the part of ACA from the internal carotid artery to ACoA, and A2 segment is the part of ACA from ACoA to the junction between the rostrum and genu of the corpus callosum. The typical pattern was seen in 35.8%, and the cases with other variation types constituted 64.2%, which is higher compared to previous studies. The variations in ACoA alone were 43.2%, and the most common variation was the ACoA aplasia, accounting for 28.4%. Conclusions: This study shows the high prevalence of anatomical variations in the ACoA complex, and the probable difference of this figure in different populations.

scholarly journals Anatomical Variations of Frontal Sinuses Among The Male and Female Genders Living in Karachi

2019 ◽  
Vol 10 (1) ◽  
pp. 44-48
Author(s):  
Quratulain Javaid ◽  
Ambreen Usmani ◽  
Aisha Qamar
Keyword(s):  
Demographic Data ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
Research Subjects ◽  
Cross Sectional ◽  
Male And Female ◽  
Frontal Sinuses ◽  
The Right ◽  
Study Participants

Objective: To determine morphology and variation in dimensions of frontal air sinuses in male and female genders living in Karachi. Study Design and Setting: It was a cross sectional study and was conducted at Radiology Department, JPMC. Methodology: The total number of study participants were 216. The research subjects were divided into two equal groups of males and females each having 108 members. The mean age of the participants was calculated to be 35.14 ± 8.68 years. The study subjects were recruited from Radiology Department, JPMC, Karachi. After taking written informed consent, Water’s (occipito-mental) view radiography was done to measure the parameters of height, width and area of the frontal air sinuses. The included variables were the demographic data and the physical examination to exclude facial anomalies. All the measurements were recorded and the measurements were saved by the help of Radiant DICOM digital software. Results: The parameters of height, width and the area of frontal sinuses showed highly significant variability on both the right and the left sides. All the dimensions were highly significantly greater in the males as compared to the female study participants (p=0.000). The Independent-Samples T Test was applied to compare the two gender groups. Conclusion: The parameters of height, width and area of frontal sinuses were greater in the males as compared to the females on both the left and the right sides

scholarly journals Anatomical Variations and Clinical Correlations of Sacral Hiatus and Sacral Canal

2018 ◽  
Vol 1 (2) ◽  
pp. 75-80
Author(s):  
Ruchi Dhuria ◽  
Vandana Dave ◽  
Manish Ahuja ◽  
Shaifaly M Rustagi
Keyword(s):  
Anatomical Variations ◽  
Sacral Hiatus ◽  
Clinical Correlations ◽  
Sacral Canal
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