Annual Meeting in Tulsa (Hosted by Elmus Beale) on June 11-15, 2019, We Were All Energized
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Intrahepatic Pancreatic Pseudocyst: Case Series
JOP. J Pancreas (Online) 2016 Jul 08; 17(4):410-413. CASE SERIES Intrahepatic Pancreatic Pseudocyst: Case Series Dhaval Gupta, Nirav Pipaliya, Nilesh Pandav, Kaivan Shah, Meghraj Ingle, Prabha Sawant Department of Gastroenterology, Lokmanya Tilak Municipal Medical College &Hospital, Sion, Mumbai, India ABSTRACT Intrahepatic pseudocyst is a very rare complication of pancreatitis. Lack of experience and literature makes diagnosis and management of intrahepatic pseudocyst very difficult. Majority of published cases were managed by either percutaneous or surgical drainage. Less than 30 cases of intrahepatic pseudocysts have been reported in the literature and there is not a single report of endoscopic ultrasound guided management of intrahepatic pseudocysts. Here we report a case series of 2 patients who presented with intrahepatic pseudocysts and out of which first case was successfully managed by EUS guided drainage. Our second case is also the youngest patient presented with intrahepatic pseudocyst till now. INTRODUCTION abdominal distention since last 1 month. However he did located in or around t not have significant weight loss, gastrointestinal bleeding, A pancreatic pseudocyst is a collection of pancreatic fluid pedal edema, jaundice, fever. His past medical history and he pancreas. Pancreatic pseudocysts family history was not significant. He was chronic alcoholic are encased by a non-epithelial lining of fibrous, necrotic since last 15 years with intake of approximately 90 gram and granulation tissue secondary to pancreatic injury. -
Normal Anatomy of Porta Hepatis—A Cadaveric Study
THIEME 22 Original Article Normal Anatomy of Porta Hepatis—A Cadaveric Study Dhanalaxmi D. Neginhal1 Umesh K. Kulkarni1 1Department of Anatomy, Belagavi Institute of Medical Sciences, Address for correspondence Umesh K. Kulkarni, MS (Anat), Belagavi, Karnataka, India Department of Anatomy, Belagavi Institute of Medical Sciences, Belagavi, Karnataka, India (e-mail: [email protected]). Natl J Clin Anat 2019;8:22–26 Abstract Background and Aim Porta hepatis (PH) of the liver acts as a gateway for exit and entry of important structures like portal vein, hepatic artery, and hepatic duct. Having knowledge of variations about the dimensions and structures at PH becomes important to avoid complications during surgical and radiological interventions. Our study aims to observe the dimensions of PH and also the number, arrangement, and variations of structures passing through PH. Materials and Methods Fifty adult cadaveric human livers which were preserved in formalin were studied. Transverse diameter, anteroposterior diameter, and circumference of PH were measured using vernier calipers, measuring scale, and thread. PH was carefully dissected to study the number, arrangement, and combination of arteries, veins, and ducts at PH. Results The mean transverse diameter, anteroposterior diameter, and total circumference of PH was 3.17 ± 0.50, 1.68 ± 0.36, and 10.46 ± 1.415 cm, respectively. Eighteen specimens showed presence of two arteries, two veins, and one duct at PH. Keywords Maximum number of arteries, veins, and ducts passing through PH were 5, 4, and 1, ► porta hepatis respectively. The ducts were anterior, arteries in the middle, and veins were posterior ► portal vein in PH of all the livers. -
A Novel Approach of Gross Structure of Human Liver
wjpmr, 2019,5(2), 181-186 SJIF Impact Factor: 4.639 WORLD JOURNAL OF PHARMACEUTICAL Research Article Manoj et al. AND MEDICAL RESEARCH World Journal of Pharmaceutical and Medical ResearchISSN 2455 -3301 www.wjpmr.com WJPMR A NOVEL APPROACH OF GROSS STRUCTURE OF HUMAN LIVER A. Manoj and Annamma Paul Department of Anatomy, School of Medical Education, M.G University (Accredited by NAAC with A-Grade), Kottayam, Kerala, India. *Corresponding Author: A. Manoj Department of Anatomy, Government Medical College, Thrissur- 680596, under Directorate of Medical Education Health and Family Welfare– Government of Kerala, India. Article Received on 05/12/2018 Article Revised on 26/12/2018 Article Accepted on 16/01/2019 ABSTRACT This current exploratory research conducted to design for comprehensive study of human liver inorder to get best knowledge of learning objectives of its Gross structure. Topography of the liver was taken to know the exact position of liver. The weight, length of surfaces and borders were measured. It had two principal anatomical lobes based on attachment of ligaments and two functional lobes due to the distribution of blood and bile. It had five surfaces with one distinct border. Owing to the dichotomous divisions of the hepatic artery, portal vein and bile ducts it has to have eight vascular segments which can be resected without damaging those remaining. Apart from peritoneal covering it had been connected with falciform ligaments, Coronary ligaments, Triangular ligaments, Ligamentum teres, Ligamentum venosum. The nonperitoneal areas were fissures of ligamentum venosum, teres hepatis, Groove of inferior venacava, Fossa for gall bladder and bare area. -
Brachial Plexus Posterior Cord Variability: a Case Report and Review
CASE REPORT Brachial plexus posterior cord variability: a case report and review Edward O, Arachchi A, Christopher B Edward O, Arachchi A, Christopher B. Brachial plexus posterior cord anatomical variability. This case report details the anatomical variants discovered variability: a case report and review. Int J Anat Var. 2017;10(3):49-50. in the posterior cord of the brachial plexus in a routine cadaveric dissection at the University of Melbourne, Australia. Similar findings in the literature are reviewed ABSTRACT and the clinical significance of these findings is discussed. The formation and distribution of the brachial plexus is a source of great Key Words: Brachial plexus; Posterior cord; Axillary nerve; Anatomical variation INTRODUCTION he brachial plexus is the neural network that supplies motor and sensory Tinnervation to the upper limb. It is typically composed of anterior rami from C5 to T1 spinal segments, which subsequently unite to form superior, middle and inferior trunks. These trunks divide and reunite to form cords 1 surrounding the axillary artery, which terminate in branches of the plexus. The posterior cord is classically described as a union of the posterior divisions from the superior, middle and inferior trunks of the brachial plexus, with fibres from all five spinal segments. The upper subscapular, thoracodorsal and lower subscapular nerves propagate from the cord prior to the axillary and radial nerves forming terminal branches. Variability in the brachial plexus is frequently reported in the literature. It is C5 nerve root Suprascapular nerve important for clinicians to be aware of possible variations when considering Posterior division of C5-C6 injuries or disease of the upper limb. -
A Very Rare Case of an Accessory Subscapularis Muscle and Its Potential Clinical Significance
Surgical and Radiologic Anatomy (2021) 43:19–25 https://doi.org/10.1007/s00276-020-02531-6 ANATOMIC VARIATIONS A very rare case of an accessory subscapularis muscle and its potential clinical signifcance Nicol Zielinska1 · Łukasz Olewnik1 · Piotr Karauda1 · R. Shane Tubbs3,4,5 · Michał Polguj2 Received: 27 May 2020 / Accepted: 7 July 2020 / Published online: 12 July 2020 © The Author(s) 2020 Abstract The subscapularis muscle is the largest muscle of the rotator cuf and its main function is internal rotation. It is morphologi- cally variable in both point of origin and insertion. The presence of an accessory subscapularis muscle can lead to brachial plexus neuropathy. This report presents a very rare accessory subscapularis muscle originating from two distinct bands on the subscapularis and teres major muscles. The insertion was divided among four tendons. The fourth tendon is bifurcated. One of these was connected to the tendon of the subscapularis muscle and the other three inserted into the base of the cora- coid process of the scapula. This anomalous muscle has the potential to entrap the nerves of the posterior cord such as the axillary, lower subscapular, and thoracodorsal nerves. Keywords Subscapularis muscle · Subscapularis tendon · Accessory subscapularis muscle · Lower subscapular nerve · Rotator cuf · Quadrangular space syndrome · Compression syndrome Introduction the subscapularis fossa. Its insertion is situated on the supe- rior part of the humerus (in most cases, the lesser tuberosity) The subscapularis muscle (SM) is the largest and the most [11, 14, 23]. The SM limits the axillary fossa from behind. It powerful muscle of the rotator cuf [10, 11]. -
Appendix-A-Osteology-V-2.0.Pdf
EXPLORATIONS: AN OPEN INVITATION TO BIOLOGICAL ANTHROPOLOGY Editors: Beth Shook, Katie Nelson, Kelsie Aguilera and Lara Braff American Anthropological Association Arlington, VA 2019 Explorations: An Open Invitation to Biological Anthropology is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. ISBN – 978-1-931303-63-7 www.explorations.americananthro.org Appendix A. Osteology Jason M. Organ, Ph.D., Indiana University School of Medicine Jessica N. Byram, Ph.D., Indiana University School of Medicine Learning Objectives • Identify anatomical position and anatomical planes, and use directional terms to describe relative positions of bones • Describe the gross structure and microstructure of bone as it relates to bone function • Describe types of bone formation and remodeling, and identify (by name) all of the bones of the human skeleton • Distinguish major bony features of the human skeleton like muscle attachment sites and passages for nerves and/or arteries and veins • Identify the bony features relevant to estimating age, sex, and ancestry in forensic and bioarchaeological contexts • Compare human and chimpanzee skeletal anatomy Anthropology is the study of people, and the skeleton is the framework of the person. So while all subdisciplines of anthropology study human behavior (culture, language, etc.) either presently or in the past, biological anthropology is the only subdiscipline that studies the human body specifically. And the fundamental core of the human (or any vertebrate) body is the skeleton. Osteology, or the study of bones, is central to biological anthropology because a solid foundation in osteology makes it possible to understand all sorts of aspects of how people have lived and evolved. -
Anatomical Terminology
Name ______________________________________ Anatomical Terminology 1 2 3 M P A 4 5 S U P E R I O R P X 6 A D S C E P H A L I C 7 G I S T E R N A L R A 8 9 10 D I S T A L E U M B I L I C A L 11 T L R C C B 12 T I E P R O X I M A L D 13 14 P A L M A R O R R O 15 16 L P T R A N S V E R S E D M 17 P I U C R A N I A L I 18 G L U T E A L C P A N 19 20 21 N A N T E C U B I T A L I A 22 D P E D A L R B N L 23 24 I C F D G L 25 C U I N F E R I O R O U U U B C M I M 26 L I F I I N B 27 28 A N T E B R A C H I A L N A A 29 30 R A O A L P A T E L L A R 31 L N L L N L 32 33 34 35 P C T L C T T A 36 37 F E M O R A L U P O L L A X E T L X L X S R R E V A T S I R I L A A O A 38 39 40 C E L I A C B U C C A L P L E U R A L Across Down 4. -
Electrodiagnosis of Brachial Plexopathies and Proximal Upper Extremity Neuropathies
Electrodiagnosis of Brachial Plexopathies and Proximal Upper Extremity Neuropathies Zachary Simmons, MD* KEYWORDS Brachial plexus Brachial plexopathy Axillary nerve Musculocutaneous nerve Suprascapular nerve Nerve conduction studies Electromyography KEY POINTS The brachial plexus provides all motor and sensory innervation of the upper extremity. The plexus is usually derived from the C5 through T1 anterior primary rami, which divide in various ways to form the upper, middle, and lower trunks; the lateral, posterior, and medial cords; and multiple terminal branches. Traction is the most common cause of brachial plexopathy, although compression, lacer- ations, ischemia, neoplasms, radiation, thoracic outlet syndrome, and neuralgic amyotro- phy may all produce brachial plexus lesions. Upper extremity mononeuropathies affecting the musculocutaneous, axillary, and supra- scapular motor nerves and the medial and lateral antebrachial cutaneous sensory nerves often occur in the context of more widespread brachial plexus damage, often from trauma or neuralgic amyotrophy but may occur in isolation. Extensive electrodiagnostic testing often is needed to properly localize lesions of the brachial plexus, frequently requiring testing of sensory nerves, which are not commonly used in the assessment of other types of lesions. INTRODUCTION Few anatomic structures are as daunting to medical students, residents, and prac- ticing physicians as the brachial plexus. Yet, detailed understanding of brachial plexus anatomy is central to electrodiagnosis because of the plexus’ role in supplying all motor and sensory innervation of the upper extremity and shoulder girdle. There also are several proximal upper extremity nerves, derived from the brachial plexus, Conflicts of Interest: None. Neuromuscular Program and ALS Center, Penn State Hershey Medical Center, Penn State College of Medicine, PA, USA * Department of Neurology, Penn State Hershey Medical Center, EC 037 30 Hope Drive, PO Box 859, Hershey, PA 17033. -
Surgical Significance of Variations in Anatomy in the Biliary Region
International Journal of Research in Medical Sciences Hassan AU et al. Int J Res Med Sci. 2013 Aug;1(3):xx-xx www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 DOI: 10.5455/2320-6012.ijrms20130812 Review Article Surgical significance of variations in anatomy in the biliary region Ashfaq Ul Hassan1*, Showqat A. Zargar2, Aijaz Malik3, Pervez Shah4 1Department of Anatomy, SKIMS Medical College, Srinagar, Kashmir, India 2Department of Gastroenterology, SKIMS, Srinagar, Kashmir, India 3Department of Surgery, SKIMS, Srinagar, Kashmir, India 4Department of Medicine, SMHS Hospital, Srinagar, Kashmir, India Received: 8 May 2013 Accepted: 21 May 2013 *Correspondence: Dr. Ashfaq Ul Hassan, E-mail: [email protected] © 2013 Hassan AU et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Variations in the anatomy of the gallbladder, the bile ducts, and the arteries that supply them and the liver are important to the surgeon, because failure to recognize them can cause iatrogenic injury to the biliary tract. A surgeon should be always be careful while operating in this area. In addition these anomalies are associated with a range of other congenital anomalies, including biliary atresia and cardiovascular or other gastrointestinal malformations, biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction etc, so a look out for other anomalies should be carried out simultaneously. Keywords: Gall bladder, Cystic fossa, Calots triangle, Monyhans hump, Extrahepatic, Atresia, Double Gall bladder, Triple Gall bladder, Agenesis, Cystic duct, Carolis disease NORMAL ANATOMY the left from the neck of the gallbladder, and joins the common hepatic duct to form the common bile duct. -
Anatomy Test 1
Anatomy Test #1 Terminology and General Stuff 2005-06 (a) Multiple Choice - Basic info 1. The study of human function is: a. Physiology b. Genealogy c. Anatomy d. None of these 2. Most terminology in this course is medical and: a. Means nothing b. is named for dead guys c. Is derived from Latin prefixes and suffixes Matching - General relative anatomical terminology A B 3. Superficial a. The main part 4. Inferior b. Secondary branches 5. Anterior c. Toward the feet 6. Peripheral d. Palm up, face up 7. Visceral e. Toward the front f. Farther from point of attachment g. Away from mid-line h. Toward an organ I. Close to point of attachment J. Toward the head k. Closer to the surface Modified True (T) and False (F) - If False, replace the highlighted word with one that that makes it a true statement. Make this correction in place of writing “F” or “False”. General anatomical terminology (anatomical directions) 8. The elbows are Proximal to the shoulders. 9. The shoulders are Superior to the shins. 10. The vertebral column (backbone) is Medial to the navel. 11. The teeth are Deep to the lips. 12. The heart is Medial to the lungs. 13. Your palms are prone when they are typing (like I am now) 14. Your feet are inferior to your ankles. Completion – Levels of Organization 15. Many cells of one type is a (an): 16. Many macromolecules make up a (an): 17. An organ system is comprised of many: Modified True (T) and False (F) - If False, replace the highlighted word with one that that makes it a true statement. -
Chapter 5 the Shoulder Joint
The Shoulder Joint • Shoulder joint is attached to axial skeleton via the clavicle at SC joint • Scapula movement usually occurs with movement of humerus Chapter 5 – Humeral flexion & abduction require scapula The Shoulder Joint elevation, rotation upward, & abduction – Humeral adduction & extension results in scapula depression, rotation downward, & adduction Manual of Structural Kinesiology – Scapula abduction occurs with humeral internal R.T. Floyd, EdD, ATC, CSCS rotation & horizontal adduction – Scapula adduction occurs with humeral external rotation & horizontal abduction © McGraw-Hill Higher Education. All rights reserved. 5-1 © McGraw-Hill Higher Education. All rights reserved. 5-2 The Shoulder Joint Bones • Wide range of motion of the shoulder joint in • Scapula, clavicle, & humerus serve as many different planes requires a significant attachments for shoulder joint muscles amount of laxity – Scapular landmarks • Common to have instability problems • supraspinatus fossa – Rotator cuff impingement • infraspinatus fossa – Subluxations & dislocations • subscapular fossa • spine of the scapula • The price of mobility is reduced stability • glenoid cavity • The more mobile a joint is, the less stable it • coracoid process is & the more stable it is, the less mobile • acromion process • inferior angle © McGraw-Hill Higher Education. All rights reserved. 5-3 © McGraw-Hill Higher Education. All rights reserved. From Seeley RR, Stephens TD, Tate P: Anatomy and physiology , ed 7, 5-4 New York, 2006, McGraw-Hill Bones Bones • Scapula, clavicle, & humerus serve as • Key bony landmarks attachments for shoulder joint muscles – Acromion process – Humeral landmarks – Glenoid fossa • Head – Lateral border • Greater tubercle – Inferior angle • Lesser tubercle – Medial border • Intertubercular groove • Deltoid tuberosity – Superior angle – Spine of the scapula © McGraw-Hill Higher Education. -
BILIARY OBSTRUCTION in the REGION of the PORTA HEPATIS Hunterian Lecture Delivered at the Royal College of Surgeons of England on 13Th February 1958* by Anthony J
BILIARY OBSTRUCTION IN THE REGION OF THE PORTA HEPATIS Hunterian Lecture delivered at the Royal College of Surgeons of England on 13th February 1958* by Anthony J. H. Rains, M.S., F.R.C.S. Senior Lecturer in Surgery, University of Birmingham, Surgeon, United Birmingham Hospitals IN CLINICAL PRACTICE, cases of obstruction of the bile ducts in this particular region of anatomy are comparatively rare, though they are of acclaimed notoriety. In a series of 2,033 cases of disease of the gall- bladder and bile ducts treated in the United Birmingham Hospitals, there were ninety-three cases of primary obstruction in the region of the porta hepatis (4.5 per cent.). When first encountering a case, one is assailed by personal lack of experience of such lesions and the knowledge which can be applied to provide a remedy or relief for the patients who are often afflicted at the dawn or in the prime of their lives, by lesions which are not always intrinsically fatal but which have fatal consequences in so far as they lead to the impairment of the drainage of bile with increasing liver damage. Unlike obstruction to blood vessels, no help is to be expected from the natural development of collaterals, and the surgeon is faced with relieving the obstruction or the eventual death of the patient. His task is made difficult, not only by the anatomical inaccessibility and the complexity and variations of bile ducts, hepatic artery and portal vein, but also by a characteristic inflammatory response to local extravasations of bile, varieties of cholangitis, and what is often misguidedly called " previous operative interference." Types of lesion Table I shows the different types of lesion that may be encountered and the incidence in this series.