BACKGROUND High origin and superficially placed ulnar artery is a rare anatomical variant that usually arises either in the axilla or arm and runs a superficial course in the forearm, enters the hand and participates in the formation of superficial palmar arch. During routine dissection of cadavers in our department, we observed a unilateral case of high origin and superficial ulnar artery in a human male cadaver. It originated from the brachial artery in the lower third of arm 4 cm above its bifurcation. From its origin, it passed downwards along the medial aspect of forearm, superficial to the flexors, entered hand superficial to the flexor retinaculum and formed superficial palmar arch. The knowledge of existence of a superficial ulnar artery is important during vascular and reconstructive surgery and also in evaluation of angiographic images. Superficial position makes it more vulnerable to trauma and more accessible to cannulation.

BACKGROUNDThe rectus abdominis is a long, flat strap muscle which extends vertically upward along the linea alba from the pubic symphysis below to the costal margin above. It is a flexor of the vertebral column and thereby plays an important role in maintaining the normal body posture. As it is a part of the anterior abdominal wall, the strength of the muscle plays a very important role in maintaining the integrity of the anterior abdominal wall. Weakness of the rectus abdominis is seen mainly in multiparous women resulting in the divarication of the recti. The lateral border of the rectus abdominis forms the medial boundary of the Hesselbach's triangle, which is the commonest site of direct inguinal hernia. It arises by two tendinous heads: Medial head arises from the anterior surface of the pubic symphysis and the lateral head arises from the lateral part of the pubic crest and the pubic tubercle. The muscle is inserted on the anterior thoracic wall by four fleshy slips along a horizontal line passing laterally from the xiphoid process and cutting in that order, the 7 th , 6 th and 5 th costal cartilages. The paired recti muscles are separated in the median plane by the linea alba. The muscle is three times as wide superiorly as inferiorly. It is broad and thin superiorly and narrow and thick inferiorly. It has a tendinous origin and a muscular insertion that is in the form of four fleshy slips that are attached in a horizontal manner to the lower part of the anterior thoracic wall. The rectus abdominis is enclosed in the rectus sheath, which is formed by the aponeuroses of the anterolateral muscles of the anterior abdominal wall. The muscle usually presents tendinous intersections along its length. MATERIALS AND METHODSThe study was carried out in the Department of Anatomy, Government Medical College, Kottayam by the dissection of 20 adult cadavers and 5 foetal cadavers during the routine dissection time of the undergraduates and postgraduates. The cadavers were obtained after ethical clearance and were embalmed prior to the study. The rectus sheath was cut by a midline incision to expose the muscle. Measurements were taken, intersections noted and photographed. RESULTSMajority of the cadavers studied (88%) had four tendinous intersections that were adherent to the anterior wall of the rectus sheath, but loosely attached to its posterior wall. This was against the description of three intersections seen in most of the anatomy books. The tendinous intersections above the level of umbilicus were complete in all the cadavers studied. There was also a marginal left-sided preponderance in the length of the rectus abdominis in both male and female cadavers. The pyramidalis muscle was seen to be absent in 25% of the cadavers. None of the foetal cadavers showed tendinous intersections. CONCLUSIONThe tendinous intersections help to increase the power of the muscle by dividing it into columns partially or completely. The presence of four tendinous intersections in most of the cadavers studied was a surprising finding. T...

BACKGROUNDThe study of course and branching pattern of median nerve was done earlier by many researchers. The knowledge of median nerve in the hand got prime importance as it supplies motor and sensory branches to the thenar muscle and volar aspect of the hand. It passes through a restricted space under flexor retinaculum and is liable to get compressed. The nerve undergoes morphological changes under the retinaculum. It also shows variations in the course and distribution in the hand. This study is aimed at avoiding damage to the nerve and its main branches in hand surgeries like traumatic tendon surgeries, reconstructive hand surgeries and decompression procedures for carpal tunnel syndrome. MATERIALS AND METHODSFifty cadaveric human hands were dissected and median nerve were traced after cutting the flexor retinaculum. Branches were identified and photographed and the findings tabulated. RESULTSThe study of median nerve in fifty cadaveric hands show remarkable variation in the branching pattern. Median nerve shows flattening when it passes under flexor retinaculum. In 88% of hands, median nerve divides into medial and lateral branches distal to the flexor retinaculum, whereas 12% hands show early bifurcation proximal to flexor retinaculum. Thenar branches are given off from the lateral division and have an extraligamentous course in 80% of hands. Subligamentous course of thenar branch was seen in 12% of hands transligamentous course in 8%.Multiple accessory thenar branches were also observed arising from the base of proper digital branch to the thumb. Communicating branches were also observed with ulnar nerve seen in all cases at different sites. The first and second lumbrical muscles were supplied by median nerve, and in 10% hands, third lumbrical was also supplied by median nerve. Multiple thin vascular branches to superficial palmar arch were also observed. CONCLUSIONThis study throws light upon anatomical variations of median nerve while it passes under the flexor retinaculum, proximal to the retinaculum and distal to the retinaculum. Anticipation of such variations were helpful during hand surgeries to avoid iatrogenic damage of the nerve and its branches.