scholarly journals Perioperative Identification of an Accessory Fissure of the Right Lung

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Yannick Taverne ◽  
Gert-Jan Kleinrensink ◽  
Peter de Rooij
Keyword(s):  
Surgical Intervention ◽  
Functional Anatomy ◽  
Lower Lobe ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
Surgical Anatomy ◽  
X Rays ◽  
Profound Knowledge ◽  
The Right ◽  
Accessory Fissure

Anatomical variations of lungs are common in clinical practice; however, they are sometimes overlooked in routine imaging. Surgical anatomy of the lung is complex and many variations are known to occur. A defective pulmonary development gives rise to variations in lobes and fissures. Morphological presentation is of clinical importance and profound knowledge of the organogenesis and functional anatomy is imperative for the interpretation and evaluation of lung pathophysiology and subsequent surgical intervention. However, appreciating them on radiographs and CT scans is difficult and they are therefore often either not identified or completely misinterpreted. As presented in this case report, an accessory fissure separating the superior segment of the right lower lobe from its native lobe was seen perioperatively and could only retrospectively be defined on X-rays and CT scan. It is imperative to keep in mind that accessory fissures can be missed on imaging studies and thus can make the surgical procedure more challenging.

scholarly journals Unusual variation in musculocutaneous nerves

1970 ◽  
Vol 7 (4) ◽  
pp. 408-410 ◽  
Author(s):  
C Bhattarai ◽  
PP Poudel
Keyword(s):  
Peripheral Nerve ◽  
Clinical Investigation ◽  
Nerve Repair ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
Musculocutaneous Nerve ◽  
Branching Pattern ◽  
Variational Study ◽  
The Right ◽  
Nerve System

Background: Variations in origin, course, branching pattern, termination and connections of the musculocutaneous nerve in the arm are not as uncommon as was once thought. Variational study of nerve in Nepalese is very less and can be of surigical-clinical importance. This opinion led us to performing this study. Objectives: The aim of this study was to a study in Nepalese which could be important for clinical investigation and the surgical treatment of peripheral nerve injury. Materials and methods: This study was carried out in Manipal College of medical sciences (MCOMS). Dissection of formalised 16 cadavers (n=32 upper limbs) were carried out using normal dissection kit with the help of standard dissection manual in two and half years. Results: The study revealed the variation in course, branching pattern and termination of musculocutaneous nerve in 6.25% of cases unilaterally on the right side. No statistically significant differences by gender and side were observed. Conclusion: This present study provides the evidence of variation of musculocutaneous nerve in Nepalese. The knowledge of the anatomical variations of the peripheral nerve system can help explain an incomprehensible clinical sign. Key words: Musculocutaneous nerve; Median nerve; Brachial plexus; Peripheral nerve repair. DOI: 10.3126/kumj.v7i4.2763 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 408-410

scholarly journals Study on Curvatures of Clavicle With Its Clinical Importance

2012 ◽  
Vol 9 (4) ◽  
pp. 279-282 ◽  
Author(s):  
M K Haque ◽  
D I Mansur ◽  
K Sharma
Keyword(s):  
Intramedullary Nailing ◽  
Total Curvature ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
First Year ◽  
Medical Sciences ◽  
Human Skeleton ◽  
Left Clavicle ◽  
Lateral Curvature ◽  
The Right

Background The clavicle is the most frequently fractured bone of the human skeleton. 70–80% of fractures occur at the middle third of the shaft of the bone. Anatomical variations in the clavicle of relevance to form intramedullary fixation. Objectives The purpose of this study was attempted to know about comparative differences between curvatures of the right and left clavicles, from certain metrical parameters. Methods The materials for the present study consisted of 257 (135 right and 122 left) adult clavicles, which were collected from the Department of Anatomy and from the students of the first year M.B.B.S during the period 2010 - 2011, Department of Anatomy, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal. The deepest points of the curvatures of the clavicle, where the convexities were the maximum. These angles were measured with the help of a protractor. The sum of the two angles constituted the total curvature of the bone. Results The average medial angle, lateral angle and sum of the two angles of right side were 150.97º ±6.16 SD, 139.76º ±7.55 SD and 290.73º ±11.14 respectively and that of the left side were 151.50º ±5.67SD, 141.73º ±8.44 SD and 293.23º ±11.69SD respectively. The present study revealed that the medial and lateral angles of the left clavicle were greater than that of the right clavicle and medial curvature was more than the lateral curvature of the same clavicle. Conclusions It is important to recognize anatomical variations in the curvatures of clavicle when considering intramedullary nailing techniques. It also helps Anthropologists in their study of evolution.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6344 Kathmandu Univ Med J 2011;9(4):279-82

scholarly journals A cadaveric study of anatomical variations of fissures and lobes of lung

2014 ◽  
Vol 03 (02) ◽  
pp. 076-080
Author(s):  
A K Singh ◽  
Richa Niranjan
Keyword(s):  
Comparative Analysis ◽  
Anatomical Variations ◽  
Cadaveric Study ◽  
Ct Scans ◽  
X Rays ◽  
Academic Interest ◽  
Transverse Fissure ◽  
Radiological Images ◽  
Oblique Fissure ◽  
Accessory Fissure

Abstract Background and aim: The anatomical variations of fissures and lobes of lungs have been described by many research workers on CT scans, whereas, there were fewer studies done on gross anatomical specimens. Materials and methods: In the present study, 30 embalmed cadavers have been dissected and lungs were examined for fissures and lobes. Results: Nine out of 30 left lungs showed incomplete oblique fissures. Eight out of 30 right lungs showed incomplete transverse fissure but oblique fissure was complete, and in two right lungs, incomplete oblique and transverse fissures were found. In one cadaver one accessory lobe and one accessory fissure was present, on right side. Comparative analysis of present work with data in literature suggest that different studies performed on radiological images reported greater prevalence of incomplete or absence of pulmonary fissures as compared to present cadaveric study. Therefore our findings with regard to fissures and lobes are different from many studies but are approximately similar to two. Conclusion: Variation of lung anatomy is important for cardio-thoracic surgeons, radiologists for interpreting x-rays, CT scans and MRI and also it is of academic interest to all medical persons.

scholarly journals Study on Anatomical Variations in Fissures of Lung by CT Scan

2022 ◽  
Author(s):  
M. Manjunath ◽  
M. Vishnu Sharma ◽  
Kollanur Janso ◽  
Praveen Kumar John ◽  
N. Anupama ◽  
...  
Keyword(s):  
Ct Scan ◽  
Imaging Techniques ◽  
Lung Resection ◽  
Left Lung ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Ct Images ◽  
Cross Sectional ◽  
The Right ◽  
Accessory Fissure

Abstract Introduction Refinements in the modern computed tomography (CT) imaging techniques have led to anatomical variations in the fissures of lung being diagnosed more frequently. So far, majority of the studies conducted are cadaveric. There is paucity of studies in this aspect based on chest CT images. Hence, we undertook this study to find the anatomical variations in the fissures. Prior detection of anatomical abnormalities is important to reduce postoperative complications in lung resection surgeries. Materials and Methods This was a cross-sectional study conducted over a period of 2 years. Data were collected from the patients who underwent CT scan thorax. Patients in whom normal anatomy of lung was distorted and cases where both lungs were not visualized completely were excluded from the study. All the CT images were reviewed by a single radiologist. The presence or absence of the normal and accessory pulmonary fissures, as well as the continuity of each fissure, was recorded by the radiologist. Data were compiled and analyzed. Results The study population consisted of 394 (70.4%) males and 166 (29.6%) females, totaling 560 cases. Fissural variations were detected in 22.9% (n = 128). Also, 17.5% (n = 98) fissural variations were seen in males and 5.4% (n = 30) fissural variations were seen in females. Further, 54.7% (n = 70) of variations were detected in the right lung and 45.3% (n = 58) in the left lung. The most common fissural variation noted was right incomplete oblique fissure with a frequency of 8.4% cases (n = 47). The most common accessory fissure detected was inferior accessory fissure. Total 22 cases were detected in both the lungs, 17 cases in male and 5 in female. Conclusion Anatomical variations in fissures were found to be more in the right lung than the left lung. Accessory fissures were detected in higher incidence on the right side.

scholarly journals A Study on Morphological Variations of Fissures and Lobes of Human Lungs with its Clinical Significance

2019 ◽  
Vol 8 (2) ◽  
pp. 21-25
Author(s):  
Dil Islam Mansur ◽  
Nabin Bista ◽  
Pragya Shrestha ◽  
Sunima Maskey
Keyword(s):  
Clinical Significance ◽  
Clinical Diagnosis ◽  
Surgical Procedures ◽  
Lower Lobe ◽  
Morphological Variations ◽  
Human Lungs ◽  
Wide Range ◽  
The Right ◽  
Oblique Fissure ◽  
Accessory Fissure

Background: Fissures of lungs facilitate the movement of lobes which helps in expansion of lungs during breathing.  The fissures may be complete, incomplete or absence. Sometime the accessory fissures may also present. Awareness of variations is essential during segmental resections as well as during radiological interpretation of lungs. Hence, the present study was aimed to study the morphological variations in fissures and lobes. Material and Methods: This study was consisted of sixty nine human lungs with irrespective of sex which were available in the department of anatomy of various medical colleges. All lung specimens were carefully observed and recorded for the presence of any variations in fissures and lobes. Results: The present study revealed that the absence of horizontal fissure was observed in 7.89%, while no specimen showed absence of oblique fissure on both sides. 35.48% of left lungs had incomplete oblique fissure compared to 28.95% of the right lungs. In addition, 22.58% of right lungs and 23.68% of left lungs showed presence of accessory fissure and lobes. From above, the incomplete and absent horizontal fissure was the most common abnormalities observed in this study. The accessory fissures were more common in lower lobe of right lung whereas in left lungs it was more common in upper lobe. Conclusion: The present study showed the wide range of variations in fissures and lobes of lungs. The knowledge of variations in morphology of lungs would be helpful for clinical diagnosis and pulmonary surgical procedures.

scholarly journals Failed knee replacement: incorrect indication?

2019 ◽  
Vol 12 (9) ◽  
pp. e230829
Author(s):  
George Ampat ◽  
Emma Tixerant
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Surgical Intervention ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
X Rays ◽  
Surgical Interventions ◽  
Mri Scans ◽  
Total Knee ◽  
The Right

A 52-year-old woman sustained a direct soft tissue injury to the right knee following a fall onto the right knee. X-rays did not identify any bony injury. Physiotherapy decreased pain but instability persisted. MRI scans identified early degeneration. An orthopaedic opinion recommended total knee replacement. Following a total knee replacement, the pain has worsened and she remains functionally impaired 2 years following the surgical intervention. Knee replacements are commonly performed successful surgical interventions. The increased numbers of replacements might be due to the lowered threshold in recommending surgical intervention by health professionals. This may increase the failure rate. It also raises the question whether adequate non-operative measures were attempted?

scholarly journals Hordeum murinum aspiration revealed by a pneumopleurocutaneous fistula in a 15-month-old infant

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicolas Richard ◽  
Audrey Paygambar ◽  
Hubert Ducou Le Pointe ◽  
Sarah Biaz ◽  
Harriet Corvol
Keyword(s):  
Foreign Body ◽  
Lower Lobe ◽  
Invasive Procedure ◽  
Pleural Empyema ◽  
Complete Regression ◽  
X Rays ◽  
Rare Type ◽  
Paravertebral Muscles ◽  
Hordeum Murinum ◽  
The Right

Abstract Background Hordeum murinum is a specie of grass rarely reported among the aspirated foreign body. It has high tissue penetration power and may cause lung damages. Case presentation We report the case of a 15-month-old girl who choke while playing in the grass without any evident cause. This episode was immediately followed by vomiting and coughing with traces of blood. While she was fine during the following week, she relapsed at day (D) 7 with fever. At D10, she was finally hospitalized for signs of respiratory distress. The chest CT-scan revealed a voluminous right sub pleural empyema with an aerial component, responsible for the collapse of the right lower lobe, and complicated by a pneumopleurocutaneous fistula to the right paravertebral muscles. Intravenous antibiotics were prescribed, but no invasive procedure was performed. At D18, the spikelet of a false barley spontaneously externalized through the fistula. Evolution was favorable thereafter with disappearance of the fever and progressive decrease of the biological inflammatory syndrome. The follow-up at 4 months was reassuring, with normal clinical evaluation, and complete regression of the empyema on the chest X-rays. Conclusions Hordeum murinum is a rare type of foreign body, and the aspiration often goes unnoticed. In these peculiar cases, CT-scans can be as informative as bronchoscopies, and the evolution is usually favorable after fistulization.

scholarly journals Non-Azygos Accessory Fissure in Right Upper Lobe Associated with Superior and Inferior Accessory Fissures in Right Lower Lobe

2012 ◽  
Vol 2 ◽  
pp. 79 ◽  
Author(s):  
Thomas Jose Eluvathingal Muttikkal ◽  
Chunli Deng
Keyword(s):  
Incidental Findings ◽  
Surgical Planning ◽  
Lower Lobe ◽  
Azygos Vein ◽  
Neoplastic Disease ◽  
Pulmonary Lobectomy ◽  
Anterior Segments ◽  
The Right ◽  
Variant Anatomy ◽  
Accessory Fissure

Accessory fissures in the lungs are common congenital variations, usually detected as incidental findings in radiographs or CT scan. Accessory fissures can act as an anatomic barrier to the spread of inflammatory or neoplastic disease, as well as due to the variant anatomy, mimic lesions. It is important to recognize the presence of accessory fissures, as they affect surgical planning of pulmonary lobectomy and segmentectomy. Accessory fissure in the right upper lobe other than due to the anomalous course of azygos vein is very rare. We report a case of non-azygos accessory fissure, between the apical and the anterior segments of right upper lobe, along with superior and inferior accessory fissures in the right lower lobe.

Carotid endarterectomy in patients with foetal-type posterior circle of Willis: Is there an indication for local anaesthesia?

VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 404-407
Author(s):  
Maras ◽  
Tzormpatzoglou ◽  
Papas ◽  
Papanas ◽  
Kotsikoris ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Local Anaesthesia ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Variable Degree ◽  
Operative Complications ◽  
The Right ◽  
Ica Stenosis ◽  
Symptomatic Stenosis

Foetal-type posterior circle of Willis is a common anatomical variation with a variable degree of vessel asymmetry. In patients with this abnormality, carotid endarterectomy (CEA) may create cerebral hypo-perfusion intraoperatively, and this may be underestimated under general anaesthesia. There is currently no evidence that anatomical variations in the circle of Willis represent an independent risk factor for stroke. Moreover, there is a paucity of data on treating patients with such anatomical variations and co-existing ICA stenosis. We present a case of CEA under local anaesthesia (LA) in a 52-year-old female patient with symptomatic stenosis of the right ICA and coexistent foetal-type posterior circle of Willis. There were no post-operative complications and she was discharged free from symptoms. She was seen again 3 months later and was free from complications. This case higlights that LA should be strongly considered to enable better intra-operative neurological monitoring in the event of foetal-type posterior circle of Willis.

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