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Anomalous palmer arch – A case report
S54
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
musculocutaneous nerve gave a large communicating branch to median nerve while passing through coracobrachialis. Awareness of variations like communicating branches is critical during surgical interventions for reconstructive and orthopedic procedures. Apart from nerve variants, third head of biceps brachii was observed on both sides. It took origin from medial border of humerus just distal to insertion of coracobrachialis. Its small tendon was flattened, mostly forming bicipital aponeurosis and a small part merging with biceps brachii tendon. On both sides, musculocutaneous nerve provided nerve supply to third head of biceps. Further clinical and surgical significance of such variations will be discussed during presentation.
63. Is the number of short gastric arteries usually 5–7 or less?
by either of superficial palmer branches of radial artery, arteria princeps policis, arteria radialis indicis or arteria nervi mediana. Our objective to report the present case is to demonstrate a bilateral variation in the pattern of superficial palmer arch. Method: The routine dissection on upper limb of a formalin preserved cadaver of an aged male revealed an anomalous pattern of superficial palmer arch. The arterial arcade was properly cleaned, branches traced as far as possible and photographs were taken. Result: The superficial branch of ulnar artery from the medial side, instead of joining with any of the usual arteries on radial side, terminated by forming interdigital artery for webspace between middle and index fingers. The arch was of incomplete variety and the anomaly was bilateral. Conclusion: The knowledge of anatomical variation has immense importance during diagnostic angiography and during various surgeries of hand.
Vijay Upadhyaya 1,∗ , Eti Sthapak 2 1
SGPGIMS, India; 2 ERAS Medical College, India
Introduction: Arteries which supply fundus of stomach arise above the level of splenic artery and to left of greater curvature of stomach. Short gastric arteries are variable in number, and usually 5–7 SGA are present in an individual according to western data. Importance of SGA is in abdominal apoplexy. Usually they arise from splenic artery or its division but may arise from left gastroepiploic artery. In this series, we studied the number of short gastric artery in select group of patients operated for splenectomy with underlying hematological disorder in Indian population and emphasized on the number of SGA needed to ligate during surgery. Material and Methods: 10 cases of moderate to massive splenomegaly with symptomatic hypersplenism with underlying haematological disease (Thalassemia, ITP and spherocytosis) were operated. The number of short gastric arteries requiring ligation was meticulously noted. The number of short gastric arteries ligated was noted and compared with the available anatomical data of cadaveric dissection. Result: The number of short gastric arteries noted during routine cadaveric dissection ranged from 3 to 5; less than 4 SGA were observed in 40% cases whereas SGA ranging between 4 and 6 in number were observed in 60%; none of our patients had more than 6 SGA. As per the available anatomical data, the number of SGA is (5–7) more than our series. Conclusion: Our preliminary result shows that the number of short gastric arteries ranges between 3 and 6 instead of 4 and 7, though a detailed cadaveric or radiological study is needed to confirm the findings.
64. Anomalous palmer arch – A case report S. Sen ∗ , S. Chakraborty, B. Sinha, S. Biswas, H. Dasgupta Nilratan Sircar Medical College & Hospital, Kolkata, West Bengal, India Objective: The superficial palmer arch is formed by superficial terminal branch of ulnar artery and completed on radial side
65. Anomalous origin of left vertebral artery from arch of aorta and associated vascular anomalies – A case report R. Roy ∗ , A. Pal, A.K. Ghosal, R. Kundu Institute of Post Graduate Medical Education & Research, Kolkata, India Objective: The vertebral artery, being a part of the subclavian arterial system, has significant contribution in cerebral vasculature. Several researchers have reported anomalous origins of the vertebral artery earlier. Reporting of this relatively rare anomalous origin of vertebral artery with associated other vascular anomalies may help to widen the medical record regarding this important arterial system and henceforth will give broader idea to the clinicians about the possible variations during surgical and interventional procedures on this arterial system. Methods: The anomalous origin of left vertebral artery from aortic arch and other associated vascular anomalies were found during the routine academic dissection in an embalmed male cadaver of 70 yrs in the said institution’s anatomy department. Results: On the left side, the vertebral artery originated from arch of aorta instead of subclavian artery between left common carotid artery and left subclavian artery. Also, there were two ascending pharyngeal arteries on the left side originating from the external carotid artery; the pharyngeal branches originated from one and the meningeal branches from the other. On the right side, the origin of the vertebral artery and the number of ascending pharyngeal artery were both normal. Conclusion: Anatomical and morphological variations of the vertebral artery are of immense importance in surgery, angiography and other non-invasive and invasive clinical procedures. So it is of great importance to know the possible rare variations of the origin of the vertebral artery along with this rare instance of double ascending pharyngeal artery on the left side.
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
musculocutaneous nerve gave a large communicating branch to median nerve while passing through coracobrachialis. Awareness of variations like communicating branches is critical during surgical interventions for reconstructive and orthopedic procedures. Apart from nerve variants, third head of biceps brachii was observed on both sides. It took origin from medial border of humerus just distal to insertion of coracobrachialis. Its small tendon was flattened, mostly forming bicipital aponeurosis and a small part merging with biceps brachii tendon. On both sides, musculocutaneous nerve provided nerve supply to third head of biceps. Further clinical and surgical significance of such variations will be discussed during presentation.
63. Is the number of short gastric arteries usually 5–7 or less?
by either of superficial palmer branches of radial artery, arteria princeps policis, arteria radialis indicis or arteria nervi mediana. Our objective to report the present case is to demonstrate a bilateral variation in the pattern of superficial palmer arch. Method: The routine dissection on upper limb of a formalin preserved cadaver of an aged male revealed an anomalous pattern of superficial palmer arch. The arterial arcade was properly cleaned, branches traced as far as possible and photographs were taken. Result: The superficial branch of ulnar artery from the medial side, instead of joining with any of the usual arteries on radial side, terminated by forming interdigital artery for webspace between middle and index fingers. The arch was of incomplete variety and the anomaly was bilateral. Conclusion: The knowledge of anatomical variation has immense importance during diagnostic angiography and during various surgeries of hand.
Vijay Upadhyaya 1,∗ , Eti Sthapak 2 1
SGPGIMS, India; 2 ERAS Medical College, India
Introduction: Arteries which supply fundus of stomach arise above the level of splenic artery and to left of greater curvature of stomach. Short gastric arteries are variable in number, and usually 5–7 SGA are present in an individual according to western data. Importance of SGA is in abdominal apoplexy. Usually they arise from splenic artery or its division but may arise from left gastroepiploic artery. In this series, we studied the number of short gastric artery in select group of patients operated for splenectomy with underlying hematological disorder in Indian population and emphasized on the number of SGA needed to ligate during surgery. Material and Methods: 10 cases of moderate to massive splenomegaly with symptomatic hypersplenism with underlying haematological disease (Thalassemia, ITP and spherocytosis) were operated. The number of short gastric arteries requiring ligation was meticulously noted. The number of short gastric arteries ligated was noted and compared with the available anatomical data of cadaveric dissection. Result: The number of short gastric arteries noted during routine cadaveric dissection ranged from 3 to 5; less than 4 SGA were observed in 40% cases whereas SGA ranging between 4 and 6 in number were observed in 60%; none of our patients had more than 6 SGA. As per the available anatomical data, the number of SGA is (5–7) more than our series. Conclusion: Our preliminary result shows that the number of short gastric arteries ranges between 3 and 6 instead of 4 and 7, though a detailed cadaveric or radiological study is needed to confirm the findings.
64. Anomalous palmer arch – A case report S. Sen ∗ , S. Chakraborty, B. Sinha, S. Biswas, H. Dasgupta Nilratan Sircar Medical College & Hospital, Kolkata, West Bengal, India Objective: The superficial palmer arch is formed by superficial terminal branch of ulnar artery and completed on radial side
65. Anomalous origin of left vertebral artery from arch of aorta and associated vascular anomalies – A case report R. Roy ∗ , A. Pal, A.K. Ghosal, R. Kundu Institute of Post Graduate Medical Education & Research, Kolkata, India Objective: The vertebral artery, being a part of the subclavian arterial system, has significant contribution in cerebral vasculature. Several researchers have reported anomalous origins of the vertebral artery earlier. Reporting of this relatively rare anomalous origin of vertebral artery with associated other vascular anomalies may help to widen the medical record regarding this important arterial system and henceforth will give broader idea to the clinicians about the possible variations during surgical and interventional procedures on this arterial system. Methods: The anomalous origin of left vertebral artery from aortic arch and other associated vascular anomalies were found during the routine academic dissection in an embalmed male cadaver of 70 yrs in the said institution’s anatomy department. Results: On the left side, the vertebral artery originated from arch of aorta instead of subclavian artery between left common carotid artery and left subclavian artery. Also, there were two ascending pharyngeal arteries on the left side originating from the external carotid artery; the pharyngeal branches originated from one and the meningeal branches from the other. On the right side, the origin of the vertebral artery and the number of ascending pharyngeal artery were both normal. Conclusion: Anatomical and morphological variations of the vertebral artery are of immense importance in surgery, angiography and other non-invasive and invasive clinical procedures. So it is of great importance to know the possible rare variations of the origin of the vertebral artery along with this rare instance of double ascending pharyngeal artery on the left side.