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A case report of pyramidal lobe of thyroid gland and its clinical implications
S51
j o u r n a l o f t h e a n a t o m i c a l s o c i e t y o f i n d i a 6 4 S ( 2 0 1 5 ) S37–S62
Objectives: The diaphragm is supplied by the superior and the inferior phrenic arteries. The superior phrenic artery is a branch from thoracic aorta and the inferior phrenic artery arises from the abdominal aorta. The left inferior phrenic artery runs posterior to the esophagus and then to the left of the esophageal opening in the diaphragm. The right inferior phrenic artery runs behind the inferior vena cava and then along the right of its opening. The inferior phrenic arteries have received increased attention in recent years because of their involvement in arterial supply and growth of hepatocellular carcinoma. The knowledge of anomalous origin of inferior artery is important in the treatment of hepatocellular carcinoma by transcatheter arterial embolization. Methods: During routine dissection for MBBS students, variant origin of the left and right inferior phrenic arteries was observed in an adult female human cadaver. Result: The right inferior phrenic artery originated from the celiac trunk. On the left side, a branch arose from celiac trunk, which divided into two. One joined the splenic artery and other was a common trunk which further divided into the left inferior phrenic artery and left suprarenal artery. Conclusion: In abdominal vascular occlusions, the inferior phrenic artery can serve as an important source of collateral circulation. Therefore, all the radiologists and surgeons managing hepatocellular carcinoma or gastro-esophageal bleeding need to be aware of this variant anatomy.
52. Pterion: A site for neurosurgical approach Shaikh Shamama Farheen ∗ , C.V. Diwan Government Medical College, Aurangabad, Maharashtra, India Abstract: The pterion is a point of sutural confluence seen in the normalateralis of the skull where frontal, parietal, temporal and sphenoid bones meet. Pterion is important in surgical interventions following surgical approaches to the anterior and middle cranial fossae, following extradural haemorrhage as well as tumours involving inferior aspects of the frontal lobe, such as olfactory meningioma and in repairing aneurysms of the middle cerebral artery. Aim of the Study: To determine the position of pterion using the midpoint of the zygoma (MPZ) and the frontozygomatic suture (FZS) as palpable points. Material and Methods: 20 dry skulls were studied irrespective of sex. Measurements were taken on both sides of the skull from the pterion to the midpoint of zygoma (MPZ) and frontozygomatic suture (FZS) using sliding vernier callipers. Result: No obvious differences between the right and left sides were observed for any of the measurements. Conclusion: In the present study, the pterion is an important landmark that could reliably be located using the FZS and MPZ according to the sexual differences. This information may be useful prior to surgery and may render pterional craniotomy safer.
53. A case report of pyramidal lobe of thyroid gland and its clinical implications S. Ralte 1,2,∗ , A. Bhattacharyya 1,2 , Y. Khonglah 1,2 1
Department of Anatomy, North Eastern Indira Gandhi Institute of Health & Medical Sciences (NEIGRIHMS), Meghalaya, India; 2 Department of Pathology, North Indira Gandhi Regional Institute of Health & Medical (NEIGRIHMS), Shillong, Meghalaya, India
Regional Shillong, Eastern Sciences
Introduction: The thyroid gland, an endocrine gland, is known to present with morphological variations. During development, the thyroid is connected to the tongue by a barrow tubular canal, the thyroglossal duct, which later disappears. Sometimes, the caudal end of the duct persists in the form of the pyramidal lobe, an accessory lobe of the thyroid gland. Material and Methods: During routine dissection of thyroid region in a 50-year-old male cadaver in the Department of Anatomy, NEIGRIHMS, a slender pyramidal lobe was found to extend upward from the right side of isthmus of the thyroid gland. A short fibromuscular band called the Levator glandulae thyroidae connected the apex of pyramidal lobe of thyroid to the body of the hyoid bone. Measurements of the lobe were taken. Small pieces of tissue were cut from both ends of the lobe. Sections were stained with Hematoxylin and Eosin, and Masson’s trichrome stains and examined under light microscope.Gross Observations: The length, width, and thickness of the pyramidal lobe were 28 mm, 2.7 mm and 1.2 mm, respectively. Light Microscopy Observations: Stained sections showed the presence of thyroid follicles with colloid in the pyramidal lobe. Striated muscle was observed in the Levator glandulae thyroidae amidst fibroglandular stroma. The pyramidal lobe is a common site of benign and malignant diseases of thyroid such as nodular goitre, Hashimoto’s thyroiditis, and papillary carcinoma. If present, the pyramidal lobe should always be examined during thyroid surgical procedures and preserved or removed accordingly in subtotal and total thyroidectomies.
54. A variation of superficial palmar arch M. Paul ∗ , K.L. Talukdar, H. Bayan, J.D. Sarma, G. Rabha Department Of Anatomy, Gauhati Medical College, Guwahati, India Objective: The superficial palmar arch is an anastomosis fed mainly by the ulnar artery. The latter enters the palm with the ulnar nerve, anterior to the flexor retinaculum and lateral to the pisiform. It passes medial to the hook of the hamate, then curves laterally to form an arch that is convex distally and level with a transverse line through the distal border of the fully extended pollicial base. Methods: Routine dissection of the upper limb was performed in the Department of Anatomy, Gauhati Medical College, Guwahati. Results: The superficial palmar arch was found with a variation in the course and its branches.
j o u r n a l o f t h e a n a t o m i c a l s o c i e t y o f i n d i a 6 4 S ( 2 0 1 5 ) S37–S62
Objectives: The diaphragm is supplied by the superior and the inferior phrenic arteries. The superior phrenic artery is a branch from thoracic aorta and the inferior phrenic artery arises from the abdominal aorta. The left inferior phrenic artery runs posterior to the esophagus and then to the left of the esophageal opening in the diaphragm. The right inferior phrenic artery runs behind the inferior vena cava and then along the right of its opening. The inferior phrenic arteries have received increased attention in recent years because of their involvement in arterial supply and growth of hepatocellular carcinoma. The knowledge of anomalous origin of inferior artery is important in the treatment of hepatocellular carcinoma by transcatheter arterial embolization. Methods: During routine dissection for MBBS students, variant origin of the left and right inferior phrenic arteries was observed in an adult female human cadaver. Result: The right inferior phrenic artery originated from the celiac trunk. On the left side, a branch arose from celiac trunk, which divided into two. One joined the splenic artery and other was a common trunk which further divided into the left inferior phrenic artery and left suprarenal artery. Conclusion: In abdominal vascular occlusions, the inferior phrenic artery can serve as an important source of collateral circulation. Therefore, all the radiologists and surgeons managing hepatocellular carcinoma or gastro-esophageal bleeding need to be aware of this variant anatomy.
52. Pterion: A site for neurosurgical approach Shaikh Shamama Farheen ∗ , C.V. Diwan Government Medical College, Aurangabad, Maharashtra, India Abstract: The pterion is a point of sutural confluence seen in the normalateralis of the skull where frontal, parietal, temporal and sphenoid bones meet. Pterion is important in surgical interventions following surgical approaches to the anterior and middle cranial fossae, following extradural haemorrhage as well as tumours involving inferior aspects of the frontal lobe, such as olfactory meningioma and in repairing aneurysms of the middle cerebral artery. Aim of the Study: To determine the position of pterion using the midpoint of the zygoma (MPZ) and the frontozygomatic suture (FZS) as palpable points. Material and Methods: 20 dry skulls were studied irrespective of sex. Measurements were taken on both sides of the skull from the pterion to the midpoint of zygoma (MPZ) and frontozygomatic suture (FZS) using sliding vernier callipers. Result: No obvious differences between the right and left sides were observed for any of the measurements. Conclusion: In the present study, the pterion is an important landmark that could reliably be located using the FZS and MPZ according to the sexual differences. This information may be useful prior to surgery and may render pterional craniotomy safer.
53. A case report of pyramidal lobe of thyroid gland and its clinical implications S. Ralte 1,2,∗ , A. Bhattacharyya 1,2 , Y. Khonglah 1,2 1
Department of Anatomy, North Eastern Indira Gandhi Institute of Health & Medical Sciences (NEIGRIHMS), Meghalaya, India; 2 Department of Pathology, North Indira Gandhi Regional Institute of Health & Medical (NEIGRIHMS), Shillong, Meghalaya, India
Regional Shillong, Eastern Sciences
Introduction: The thyroid gland, an endocrine gland, is known to present with morphological variations. During development, the thyroid is connected to the tongue by a barrow tubular canal, the thyroglossal duct, which later disappears. Sometimes, the caudal end of the duct persists in the form of the pyramidal lobe, an accessory lobe of the thyroid gland. Material and Methods: During routine dissection of thyroid region in a 50-year-old male cadaver in the Department of Anatomy, NEIGRIHMS, a slender pyramidal lobe was found to extend upward from the right side of isthmus of the thyroid gland. A short fibromuscular band called the Levator glandulae thyroidae connected the apex of pyramidal lobe of thyroid to the body of the hyoid bone. Measurements of the lobe were taken. Small pieces of tissue were cut from both ends of the lobe. Sections were stained with Hematoxylin and Eosin, and Masson’s trichrome stains and examined under light microscope.Gross Observations: The length, width, and thickness of the pyramidal lobe were 28 mm, 2.7 mm and 1.2 mm, respectively. Light Microscopy Observations: Stained sections showed the presence of thyroid follicles with colloid in the pyramidal lobe. Striated muscle was observed in the Levator glandulae thyroidae amidst fibroglandular stroma. The pyramidal lobe is a common site of benign and malignant diseases of thyroid such as nodular goitre, Hashimoto’s thyroiditis, and papillary carcinoma. If present, the pyramidal lobe should always be examined during thyroid surgical procedures and preserved or removed accordingly in subtotal and total thyroidectomies.
54. A variation of superficial palmar arch M. Paul ∗ , K.L. Talukdar, H. Bayan, J.D. Sarma, G. Rabha Department Of Anatomy, Gauhati Medical College, Guwahati, India Objective: The superficial palmar arch is an anastomosis fed mainly by the ulnar artery. The latter enters the palm with the ulnar nerve, anterior to the flexor retinaculum and lateral to the pisiform. It passes medial to the hook of the hamate, then curves laterally to form an arch that is convex distally and level with a transverse line through the distal border of the fully extended pollicial base. Methods: Routine dissection of the upper limb was performed in the Department of Anatomy, Gauhati Medical College, Guwahati. Results: The superficial palmar arch was found with a variation in the course and its branches.