International Journal of Research and Review Vol.7; Issue: 11; November 2020 Website: www.ijrrjournal.com Original Research Article E-ISSN: 2349-9788; P-ISSN: 2454-2237
Understanding the Concept of Sevani in Ayurveda: A Cadaveric Study
Rahul Kumar Gupta1, Rajni Dhaded2
1Assistant Prof. Department of Rachna Sharir, Jammu Institute of Ayurveda & Research, Nardani Jammu, J&K, 2Associate Prof. Department of Rachna Sharir, BVVS Ayurvedic Medical College Bagalkot, Karnataka
Corresponding Author: Rahul Kumar Gupta
ABSTRACT need to be made available. Sevani is one of the important structures emphasized by Sevani is one of the vital structures emphasized Sushrutacharya which are situated five in by all most all the Acharyas where surgical the Shiras, one each in Jihva and Medra.1 procedures should be avoided. These are Sevani is a structure which holds two parts situated five in the Shiras, one each in Jihva and together for its structural and functional Medra. The relevance of Sevani is mentioned in different operative procedures. So an attempt is integrity in the body. These Sevani should made to understand the term Sevani , also to be avoided during the surgical procedures as know the relevant structures underlying it , to there is difficulty in the reunion of the 2 explore the extent, nature and particular structure. In this study an attempt has been anatomical structure as Sevani with the help of made to define the term Sevani, its nature cadaveric dissection was taken. and extent through the conceptual study and observations drawn from the cadaveric Keywords: sevani, shira, jivha, medra, nature, dissection. cadaver, dissection. MATERIAL AND METHODS INTRODUCTION Three adult cadavers available in the Nature has bestowed many favors department of Shareera Rachana, SDMCA, which are scientific miracles working for a Hassan were dissected in the region of smooth running of the human body. Veda is Shiras, Jihva and Medra. Numbers were an ancient scientific document from which assigned to the cadavers and observations every science and technology have were recorded. Structures were identified in originated. Ayurveda the science of life, is the dissected region and a complete also an outcome of such an imperishable anatomical study was done. This was intention of man’s conscience to explicit the correlated with the data collected from nature added with the sequential classics and contemporary science and comprehension of knowledge gained critically analyzed. through self experimentation. Thus science can be considered as a gradual evolution OBSERVATION which includes addition in the basis of The dissection of the three cadavers Ayurveda, whose eternal basic principle in the region of head, tongue and penis was remains the same. Ayurveda as a medical carried out as per Cunningham’s manual of science basically demands understanding of practical anatomy. Dissection procedure the structural and functional constitution of was carried out layer by layer, observed and the human body and its application in the studied. practice of medicine and surgery. Detailed subject on basic Ayurvedic anatomical concepts in view of modern anatomy are
International Journal of Research and Review (ijrrjournal.com) 242 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study.
DISSECTION OF HEAD REGION highest nuchal lines. In front, it persists Skin: The skin was thick and provided with between the two frontal bellies and blends numerous hairs. Then a median incision was with the subcutaneous tissue at the root of taken into the skin of the scalp from the root the nose. On each side, extends as a thin of the nose to the external occipital membrane superficial to the temporal fascia protuberance. Then a coronal incision was and is attached to the zygomatic arch. taken from the middle of the first cut to the Loose Subcutaneous Tissue root of each auricle. This incision is Beneath the epicranius muscle and continued behind the auricle to the mastoid its aponeurosis, loose areolar tissue was process and in front of it to the root of the seen. In this space emissary veins were zygomatic arch. traced. Dense Subcutaneous Tissue Pericranium It was composed fibrous and fatty It is the outer periosteum of skull tissue connecting firmly the overlying skin and loosely covers the bones except at the and underlying galea aponeurotica and sutural margins where it is continuous with epicranius muscle. Large blood vessels and the endocranium through the sutural nerves of the scalp were seen. The walls of membrane. The periosteum was striped the vessels were adherent to the fibrous from the external surface of the vault of the network. skull down to a level below the upper Epicranius Muscle and Its Aponeurosis attachment of the temporalis muscle The bellies of occipitalis and detaching it from the skull. Looking at the frontalis were joined to form the epicranius skull from above four bones was seen. The muscle. The temporo parietalis muscle was bone forming the anterior part of the vault also traced. A sagital incision was taken was the frontal bone. The greater part of the through the epicranial aponeurosis from the roof and side walls of the cranial cavity root of the nose to the external occipital were formed by the right and left parietal protuberance. Each half was pulled laterally bones. Sagittal suture was found in the and detached from temporal lines. midline were the two parietal bones joined. Occipito-Frontalis The two parietal bones joined the frontal A pair of occipital bellies behind and bone at the coronal suture which crossed the a pair of frontal bellies in front were united cranial vault from side to side and runs by intervening galea aponeurotica. Each downwards and forwards. The posterior part occipital belly took origin from lateral two of the vault was formed by the occipital thirds of the superior nuchal line of occipital bone which was better seen when the skull bone and from the adjacent mastoid is viewed from behind. A suture named bone.The frontal bellies had no bony origin lambdoid, which was in inverted ‘Y’ was and they arised from the skin and found joining the occipital bone to the subcutaneous tissue of the eyebrow and the parietal bones. Lateral to the occipital bone, root of the nose. In front of coronal suture a part of the temporal bone was better seen, the frontalis joins with galea aponeurotica. when the skull was viewed from the lateral Temporo-Parietalis side. A cut was taken at the sutures of the A variable sheet of muscle took skull through the periosteum as it is origin from the galea and inserted into the continuous with endocranium. This turned root of the auricle. the scalp, periosteum and upper parts of the Galea Aponeurotica temporalis muscles down over the auricles. The occipitalis and frontalis muscles A saw cut was made parallel to the sagital were joined together by a sheet of fibrous suture on both the sides avoiding cutting tissue. This sheet extended behind between deeper than the marrow cavity. Caution was the two occipital bellies and is attached to taken in the temporal region as the skull was the external occipital protuberance and very thin. A blunt chisel was introduced into
International Journal of Research and Review (ijrrjournal.com) 243 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study. the saw cut and the inner tables were split and the bones. Torn blood vessels were by a series of sharp strokes with a mallet. most numerous close to the midline. Even when this is divided, the calavaria did Superior sagittal sinus was seen deep to the not lift free because it was attached to the endocranium. The endocranium was more endocranium and the outer covering of the firmly attached to the base of the cranial brain; both were firmly adhered to the cavity than to the vault. Branches of the interior of the skull. middle meningeal artery, with the Sutural Ligaments corresponding veins on the external The loosely attached pericranium surfaces, were found grooving the inner was found continuous with the endocranium table of the skull. The largest venous sinuses through the sutures of the skull, forming the were traced along the lines of attachment of sutural ligaments. When the part of the skull the dural folds to the endocranium. Then a cap was detached, the outer surface of the median sagittal incision was made through endocranium was exposed. It was found to the endocranium to open the superior be rough because of the fine fibrous and sagittal sinus. vascular processes which passed between it
FIGURES OF DISSECTION OF SCALP
Figure 1. layer of scalp Figure 2 : Cranial Sutures 1 Skin , 2 subcutaneous, 3 galea aponeurotica 1 coronal sutures, 2 sagittal sutures, 3 lambdoid suture, 4 loose aerolar tissue, 5 pericraium 4 squamous suture
Figure 3: Emissary veins Figure 4: Confluence of Sinuses
International Journal of Research and Review (ijrrjournal.com) 244 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study.
Figure 5 : Sutural ligament Figure 6: layers of sutural ligament
TONGUE DISSECTION After seeing the infrahyoid structures, for During the dissection in the neck the clear approach to the tongue, mandible region the following structures were found was separated from the maxilomandibular from superficial to deep. The skin was joint. Then the mandible was cut vertically incised from the chin to the sternum in the at symphysis menti and lower lip. The left midline. The flaps of the skin were reflected mylohyoid muscle and part of the right were inferolaterally where the platysma muscle reflected and the geniohyoid muscle was traced. The anterior jugular vein was extending from the mental spine of the traced near to the midline which was mandible to the body of the hyoid bone was piercing the deep fascia about two cm above observed. The hypoglossal nerve, deep part the sternum. Then a transverse incision was of the submandibular gland, and lingual made through the first layer of the deep nerve and mucous membrane of floor of the fascia just above the sternum, extending mouth with twigs of the sublingual artery upto the anterior border of the were observed. The stylohyoid muscle is sternocleidomastoid muscle. Soon after reflected superiorly; the hyoglossus muscle reflecting this fascia suprasternal space was ascending from the greater horn and body of found. The fat and the fascia in that area the hyoid bone to the side of the tongue. The were cleared. The parotid glands were styloglossus muscle was traced pushed forwards and the accessory nerve posterosuperiorly and interdigitating with was traced. After removal of deep fascia bundles of the hyoglossus muscle. The four thin straps of infrahyoid muscles were genioglossus muscle was seen anteriorly, traced. These muscles were crossed by a fanning out into the tongue. The pair of anterior jugular veins which passed hypoglossal nerve, crossed twice by the down the neck one on either side of the digastrics muscle, crossing twice the lingual midline. The whole muscle was then artery, and supplying all the muscles of the separated and reflected upwards towards the tongue both extrinsic and intrinsic except lower border of mandible. Anterior triangle palatoglossus muscle was traced. After and its subdivision of the neck were reflecting the geniohyoid muscle, the observed. The median line of the neck was genioglossus muscle was identified in the divided by hyoid bone into suprahyoid and floor of the mouth. Superiorly the frenulum infrahyoid region. The two mylohyoid was incised and the muscle fibers of the muscles and median raphe and genioglossus which are attached to the base submandibular gland were observed. In the of the tongue were identified. It arises from infra hyoid region, sternohyoid and the mental spine of the mandible and gets omohyoid muscles were observed laterally. inserted in to the hyoid bone and the floor of
International Journal of Research and Review (ijrrjournal.com) 245 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study. the tongue. Innervated by the hypoglossal artery supplying to the base of the tongue nerve, the genioglossus depresses and and sublingual gland was traced. protrudes the tongue. The branch of lingual
FIGURES OF DISSECTION OF TONGUE
Figure 7: Frenulum of tongue Figure8: Genioglossus muscle
Figure 9: Ventral aspect of tongue Figure10: Vascular supply of tongue 1 freulum of tongue, 2 lingual veins 1 Genioglossus muscle, 2 tongue, 3 lingual artey ,4lingual nerve
Figure 11: Midsagittal section of head (1) tongue attachment of Genioglossus muscle
International Journal of Research and Review (ijrrjournal.com) 246 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study.
DISSECTION OF PENIS The deep fascia formed a close Two parts of the penis were seen a constricted sheath around the corpora. The root, attached portion and a body, free suspensory ligament of the penis was traced portion. The root was situated in the in the dorsum and sides of the penis. The superficial perineal pouch. It was composed deep dorsal vein along with the dorsal of three masses of erectile tissue i.e. the two arteries and nerves were found on each side crura and one bulb. The two dorsally placed of it. corpora cavernosa were fused together in DISSECTION OF UROGENITAL the body of the penis. But these two were TRIANGLE IN FEMALE diverged in the perineum to form the crura A longitudinal incision along the of the penis which were attached to the sides medial border of the labia majora laterally of the pubic arch. The corpus spongiosum to the ischiopubic ramus and the skin of the was traced on the ventral surface which perineum was removed. The subcutaneous transmitted the urethra and was enlarged tissue of the perineum was composed of a proximally to form the bulb of the penis. superficial fatty and a deeper membranous The bulb of the penis continued forward as layer. The fat of the labia majora was the corpus spongiosum. Its terminal part cleared. The excess fat was removed and the was expanded to form a conical enlargement membranous plane laterally to the called the glans penis. Throughout its whole ischiopubic ramus was reflected. it is traversed by the urethra. The base of the After clearing the muscular fascia, glans penis has a projecting margin, the the ischiocavernosus and bulbospongiosus corona glandis, which overhangs an muscles were identified. Great care was obliquely grooved constriction known as the taken because the muscles were very thin neck of the penis. and delicate. The perineal body was cleared Skin and the bulbospongiosus muscle from the The skin was thin, dark in color, perineal body on one side was reflected loosely envelops the subjacent structures carefully lifting it from the surface of the and devoid of hairs. At the neck of the penis vestibular bulb and noting the manner in the skin was reflected forwards over the which the muscle ends at the base of the glans as a fold, the prepuce. A median raphe shaft of the clitoris. The greater vestibular was seen on the ventral surface of penis glands at the posterior margin of the which was formed by the line of fusion of vestibular bulbs, deep to the the two genital folds which formed the floor bulbospongiosus muscles were identified. of the spongy urethra. A cut was taken from The ischiocavernosus muscle on the same the symphysis pubis to the end of the side was reflected and the crus of the clitoris prepuce. Then the skin was reflected along were exposed. The corpus cavernosum the dorsum of the penis. clitoridis was traced forward until it unites Superficial Fascia with the corpus cavernosum of the opposite It was composed of loose areolar side to form the shaft of the clitoris. tissue without fat. The extension of the DISSECTION OF UROGENITAL membranous layer of the superficial fascia TRIANGLE IN MALE of the abdominal wall on to the penis was The skin from the penis, scrotum found which is called as fundiform and perineum laterally to the ischiopubic ligament. The superficial dorsal vein of ramus was removed. There was no fat in the penis was traced in the superficial fascia subcutaneous tissue of the penis and which divided proximally into right and left scrotum. In the scrotum this layer, the tunica branches, which passed to the external dartos scroti, contains smooth muscle. The pudendal veins of the corresponding thigh. half scrotum was pulled along with its Deep Fascia contained testis, towards the ventral abdominal wall, revealing the complete
International Journal of Research and Review (ijrrjournal.com) 247 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study. perineum and the ventral surface of the bulbospongiosus muscle was reflected from penis. The subcutaneous tissue of the the midline and the manner in which the perineum consists of a fatty and a muscle covered the bulb of the corpus membranous layer. Both were carefully spongiosum and encircled the root of the reflected to one side from the shaft of the penis was observed. The corpus penis. The ischiocavernosus and spongiosum, its bulb, and at the tip of the bulbospongiosus muscles were dissected penis, the glans were identified and traced. and the deep fascia of these muscles The corpora cavernosa penis was traced and completely investing the shaft of the penis observed how the right and left unite to (deep penile fascia) was observed. The form the shaft of the penis. The crus of the muscular fascia was cleared to reveal the penis from the ischiopubic ramus were cut ischiocavernosus and bulbospongiosus on one side and the bulb on this side was muscles covering the crura and bulb of the made free from its attachment to the penis. One ischiocavernosus muscle was perineal membrane. The deep artery of the reflected and the crus of the corpus penis and the artery to the bulb were cavernosum penis was exposed. The identified.
FIGURES OF DISSECTION OF PENIS
Figure 12 Ventral aspect of penis Figure 13 Bulbospongiosus muscle 1 raphe of penis ,2 Scrotal raphe
Figure 14 Figure 15
Figure 14,15 Bulbospongiosus muscle in females .
International Journal of Research and Review (ijrrjournal.com) 248 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study.
DISCUSSION Shiras. This has extended along the five Discussion on Shirogata Sevani sutures of the head. Clinical point of view During the cadaveric dissection it these sutural ligaments have their own was observed that the loosely attached significance. Infections in the scalp region pericranium was found continuous with the are very painful because of the abundant endocranium through the sutures of the fibrous tissue in the subcutaneous layer. skull, forming the sutural ligaments. This infection spreads by the emissary Beneath this endosteal layer was attached to veins, which are valveless, to the skull the sutural lines. Endosteal layer contributes bones, causing osteomyelitis. Infected blood in the formation of the important sinus in the diploic veins may travel by the system. Sutures are limited to skull and emissary veins further into the venous occur wherever margins or broader surfaces sinuses and produce venous sinus of bones are separated by the connective thrombosis. Subperiosteal blood or pus is tissue. The sutural ligaments are a surviving limited to one bone because of the unossified part of mesenchymatous sheets in attachment of the periosteum to the sutural which the dermal bones develop. Sutural ligaments. ligaments display regions of differentiation Discussion on Jihvagta Sevani concerned in growth and binding of apposed On the basis of review and practical bone surfaces. On its sutural aspect each observations following facts are revealed: bone is covered by a layer of osteogenic The superior fibers of the genioglossus cells (the cambial layer). It is overlaid by a muscle ascend forward to enter the whole capsular lamella of fibrous tissue. It is length of the ventral surface of the tongue collectively corresponding to and from the root to the apex, intermingling with continuous with the periosteum at the the intrinsic lingual muscles.The median margins of the sutural surfaces both inside lingual septum, a median fibrous partition and outside the skull. A central stratum of extending through the length of the tongue, loose fibrous connective tissue is found giving attachment to transverse lingual between these two layers of sutural muscles. Posterior it extends laterally to periosteum. This central stratum contains form the hyoglossal membrane connecting thin walled blood vessels, the veins which the lingual root to the hyoid bone and the communicate with diploic vessels, inferior fibers of the genioglossi are intracranial venous sinuses and external attached to it. It is observed that to fix the veins of the scalp. The fibrous periosteum tongue to the floor of mouth, frenulum and adherent to the bones crosses the interval genioglossus fibers lying in the median part between them as the two uniting layers just beneath the frenulum and lingual (external and internal) enclosing the sutural septum have got a very important role. ligament and to its strength. During active Genioglossi muscles are symmetrically growth the orientation of collagen fibers arranged on either side which can be within sutural membranes is adaptable to revealed through the development of the several factors particularly to the direction tongue out of two lingual swellings in first of growth of minute bone spicules. When brachial arch. By this explanation one can united by sutural ligament and periosteum include the larger midline fold of mucosa such sutures are almost completely that passes from the gingival covering the immobile. By the above description it is lingual aspect of the anterior alveolar ridge understood that sutural ligament is a fibrous to the posterioinferior surface of the tongue structure which holds the bones of the head and superficial of genioglossus muscles together and thus contributes in the present in the midline and proximal part of formation of vital sinus system of brain. median lingual septum under the This structure can be correlated to Sevani of composition of Sevani. On this basis one
International Journal of Research and Review (ijrrjournal.com) 249 Vol.7; Issue: 11; November 2020 Rahul Kumar Gupta et.al. Understanding the concept of sevani in ayurveda, a cadaveric study. can ascertain the extent of Jihvagata Sevani emptying of residual urine or semen and from the posterior end of median lingual also to compress the penile part of urethra. septum along with the muscular fibers of The fibers of bulbospongiosus contribute to genioglossus up to, behind the tip of the the formation of perineal body, which is a tongue. The description of Adhijihva disease fibro muscular node located in the midline gives a clue to reveal the location of Sevani at junction between the anal canal and (Prabandhana). In the description of Alasa urogenital canal Perineal raphe is a median disease, in which there is Paaka of the ridge in the skin and fasciae overlying the muscles of tongue. Therefore it is instructed perineal body that runs forward from the to surgeons not to take incision in the anus. In males it is continuous with the midline part of the floor of tongue. This raphe of scrotum. instruction highlights the importance of In case of females, once the Sevani in the Jihvatala Bhaga. Applied urogenital membrane ruptures it does not point of view the region besides the fuse and the genital folds persist as the labia frenulum particularly in the floor is very minora. The clefts between the labia minora, important as on either side there are the vestibule, receive the openings of the sublingual glands. The lingual nerve and urethra and vagina. The genital swellings artery have got a close relationship between form the labia majora and the phallus fibers of genioglossus and sublingual persists as the clitoris. The perineal body glands. So during operations on either side lies directly posterior and is attached to of midline of tongue one should be careful. posterior commissure of labia majora and Injury to hypoglossal nerve resulting in introitus of vagina. Perineal body is the paralysis and eventual atrophy of one side major structure incised during a median of the tongue. Tongue deviates to paralysed episiotomy. Episiotomy is a surgical side; during protrusion because of the action incision of perineum and inferoposterior of unaffected genioglossus and vaginal wall taken in order to enlarge the intermingling of fibers through the median vaginal orifice. It helps to decrease septum. excessive traumatic tearing of the perineum. Discussion on Medragata Sevani The rationale of the median incision is that On the basis of practical observation the scar produced as the wound heals will it can be understood that penile urethra not be greatly different from the fibrous underlying in the midline just beneath the tissue surrounding it because the incision skin attachment of raphe up to the extends only partially into this fibrous membranous part of urethra. Practically the tissue. The muscle which are attached to this corpora spongiosum comprising penile helps to maintain pelvic organs in position. urethra can be felt in the perineal area. On Damage to it during childbirth can weaken the basis of embryological development the perineum and may lead to prolapse of penile urethra is formed as a result of fusion pelvic organs. A study was conducted to of definitive urethral folds and it develops check the relationship of episiotomy to only up to glans penis. The distal most part perineal trauma and morbidity, sexual of urethra is of ectodermal origin and is dysfunction, and pelvic floor relaxation. It formed by canalization of solid mass of was found that perineal and pelvic floor ectodermal cells. The genital swellings fuse morbidity was greatest among women with each other in the midline to form the receiving median episiotomy versus those scrotal sac into which the testis descends remaining intact or sustaining spontaneous later. Over the bulb of penis there is perineal tears. Median episiotomy was covering of bulbospongiosus muscle causally related to third- and fourth-degree arranged in symmetrical manner. The fibers tears. By considering the above this, nature of which are arranged from central raphe of Sevani refers to be of fibro muscular. and it has got a very important action in
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Discussion on the basis of clinical aspects fibrous in nature extending along the five By the above discussion it is sutures of the vault. Jihvagata Sevani is to understood that Medragata Sevani is a very be taken as a lingual median septum, important structure which has intimate superior fibers of genioglossus muscle and relation with the structures of genitourinary frenulum extending up to the tip of tongue. system and support of pelvic floor. Keeping Therefore Jihvagata Sevani is made up of this in mind eminent scholars of Ayurveda muco-fibro muscular structure. There is one have cautioned physicians to avoid surgical Sevani present in ventral aspect of Medra. incisions in and around area of Sevani. This Study has revealed three parts of Sevani are was observed in the context of trans- made according to region as Medragata perineal extraction of Ashmari. Perineal area Sevani, Phalagata Sevani and Bhagagata is a very crucial region within which eight Sevani. Medragata Sevani has to be vital structures named as Asta Marma, correlated with frenulum, continued with the structurally and functionally interconnected line of fusion of two urethral folds which with each other are situated. Among these are forming the floor of urethra upto the Asta Marma Sevani has proved its scrotum. Phalagata Sevani to be correlated significant place. Further in the context of with scrotal fold and median raphe of Mutravruddhi also it is adviced to puncture bulbospongiosus muscle Bhagagata Sevani the scrotum by avoiding PhalaSevani. In the to be considered as continuation of same context of types of incisions the guidelines line of scrotum to anterior part of anus have been given to the surgeons to perform including part of perineal body. In case of Ardhachandrakara (semilunar) incision females Sevani is to be correlated with over Guda and Medra. Even here also raphe fusion of posterior commissure and part of is to be vomited. The prognosis of perineal body. So the nature of Sevani is Bhagandara depends on its location and fibromuscular in nature. relation with the Sevani because the sphincters are attached to the perineal body. REFERENCES In high level fistula there is possibility of 1. Acharya Y T. Sushruta Samhita with cutting this connection. So Sushruta might Nibandhasangraha commentary of have cautioned the surgeons. In hypospadias Dalhanacharya. Reprint ed. Varanasi there are different degrees in which external (India): Chaukambha Sanskrit Sansthan; 2010. p. 365. meatus of urethra is situated at some points 2. Paradakara HSS, Ashtanga Hrudayam with on undersurface of penis/perineum. To Sarvanga Sundaram commentary of understand pathology physicians should Arunadutta and Ayurveda Rasayana of know the structure and development of Hemadri. 9thed. Varanasi (India): Sevani (raphe). Chaukambha Sanskrit Sansthan; 2005. p.388. CONCLUSION Sevani is a structure which holds two How to cite this article: Gupta RK, Dhaded R. parts together for its structural and Understanding the concept of sevani in functional integrity. The structure ayurveda, a cadaveric study. International responsible to hold cranial bones together is Journal of Research and Review. 2020; 7(11): sutural ligaments which are to be considered 242-251. as Shirogata Sevani. The sutural ligament is
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