The extensor digitorum brevis manus, a supernumerary muscle in the fourth extensor compartment of the dorsum of the wrist, is a relatively rare anomalous muscle. Extensor digitorum brevis should be included in the differential diagnosis of soft tissue masses on the dorsal aspect of the hand as it may mimic cystic, neoplastic, inflammatory, and infectious masses arising in the dorsum of the wrist. Seventy-two upper limbs of male and female cadavers were dissected and examined to study the pattern of extensor tendons of the index finger. In the present study, we observed three cases (4.2%) of the extensor digitorum brevis manus on the left side. In one cadaver (0.72%), there was an additional tendon arising from the extensor indices which was inserted to the radial side of the dorsal digital expansion of the index finger. The extensor digitorum brevis manus muscle (EDBM), an anatomic variant of the extensor muscle of the dorsum of the hand, is found in approximately 2% to 3% of the population. This variation is, therefore, clinically and surgically relevant because the EDBM may be the only muscle responsible for the independent extension of the second digit. The aim of the present study is to report the incidences of this muscle thereby creating awareness of its existence and of its characteristic appearance to surgeons.

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Lateral epicondylitis (LE) or tennis elbow has been the subject of concern during the last 60 years, but the pathogenesis of the LE remains unclear. The LE can be due to the tendinogenic, articular or neurogenic reasons. Numerous theories have been put fourth in the recent past, out of which one of the most popular theories is that the condition results from repeated contraction of the wrist extensor muscles, especially the extensor carpi radialis brevis (ECRB) which may compress the posterior branch of the radial nerve (PBRN) at the elbow during pronation. We studied 72 upper limbs (36 formalin-fixed cadaver) for the origin, nerve supply and the course of PBRN in relation to the ECRB as one of the goal for the present study. The possible presence of an arch of the ECRB around the PBRN was also observed and recorded. The nerve to ECRB was a branch from the radial nerve in 11 cases (15.2%); from the PBRN in 36 cases (50%) and from the superficial branch of the radial nerve in 25 cases (34.7%), respectively. The ECRB had a tendinous arch in 21 cases (29.1%); a muscular arch in 8 (11.1%) cases and the arch was absent in 43 cases (59.7%). When the ECRB had a tendinous or muscular arch around the PBRN, it may compress the same and this condition may worsen during the repeated supination and pronation as observed in tennis and cricket players. The presence of such tendinous or muscular arch should be considered by orthopedicians and neurosurgeons, while releasing the PBRN during LE surgery.

The accessory phrenic nerve (APN) is commonly a branch from the nerve to the subclavius. It lies lateral to the phrenic nerve and descends behind, or sometimes in front of, the SV. It joins the main nerve usually near the first rib or sometimes union may even below the root of the lung. The APN may occasionally arise from spinal nerves C4, or C6, or from the ansa cervicalis (10).The incidence of the APN was varies a great deal in the available literature. Felix (Cited by Kikuchi) observed the APN in 17.6 % population he studied (6), in contrast to him Kelly (Cited by Loukas et al.) mentioned the presence of APN in 80.9 % cases (7). The APN may arise as additional roots from one or more of the following nerves: nerve to subclavius; nerve to sternohyoid; second or rarely, sixth cervical spinal nerves; descendens cervicalis; ansa cervicalis; and brachial plexus. It may receive a branch from hypoglossal and may communicate with spinal accessory. The size of the nerve may vary bilaterally (2). The present study was conducted to find out the occurrence of APN in Indian population and discussed its clinical significance. Material and MethodsThe anatomy of the APN was examined in forty five adult formalin-fixed cadavers (35 male, 10 female; 90 sides) used for gross anatomy dissection at the Kasturba Medical College, Mangalore for undergraduates during 2006 to 2007. The mean age of the cadavers was 58 years (range, 49 to 83 years). The cadavers had been fixed in 10 % formalin solution. None of the specimens revealed any evidence of previous surgical procedures, traumatic lesions, or gross pathologies to the neck and thorax. Findings of the dissection were recorded at different stages of the dissection. The nerves contributing to the phrenic nerve (PN) after it had crossed the scalene anterior muscle (SAM) considered being APNs. When the APN joined the PN above the level of first rib it was considered cervical type and when below the level of first rib it was considered as a thoracic type of APN. ResultsThe PN was found bilaterally in all 45 cadavers (90 PNs) and an APN was present in 48 sides (53.3 %), 181 Summary: The description of accessory phrenic nerve (APN) in the standard textbooks and available literature is vague and sometimes limited to few lines. The incidence of APN varies a great deal from 17.6 % to 80.9 % in the available literature. The aim of the present study was to calculate the incidence and variation of APN in Indian population. Material and methods: Forty five adult formalin-fixed cadavers (35 male, 10 female; 90 sides) used for gross anatomy dissection for undergraduates; during the 2 year period 2006-2007 were considered. Findings were recorded at different stages of the dissection. Results: Out of 90 body sides studied, the APN was present in 48 sides (53.3 %). In 17 of the above sides the APN was confined to the cervical region (Cervical type) and in 31 sides the APN entered the thorax (Thoracic type), all anterior to the subclavian vein (SV). In eleven specimens the APN was found bilaterally...

When adding 22 cases of bronchial adenomata seen in the Brompton Hospital to the more than 100 cases previously documented, Foster-Carter (1941) stated that no death had ever been recorded from malignant change in a bronchial adenoma. Price-Thomas (1954), reporting a personal series of 41 bronchial adenomata treated in the Brompton and Westminster Hospitals, concluded that 'the incidence of malignancy is so low that it is possible for practical purposes to ignore it'. More recent papers have, however, questioned the use of the term bronchial adenoma, emphasizing not only the varying behaviour of the four tumour types included in the term-the bronchial carcinoid, the adenoid cystic carcinoma (cylindroma), the muco-epidermoid tumour, and the true bronchial mucous gland adenoma-but also the differing degrees of malignancy of the bronchial carcinoid itself (Donahue, Weichert, and Ochsner, 1968;Meffert and Lindskog, 1970;Tolis et al., 1972;Turnbull et al., 1972). In a Mayo Clinic series of 215 cases of bronchial carcinoid (Arrigoni, Woolner, and Bernatz, 1972), 23 (11%) were considered to have atypical histological features and, of these, 70% metastasized and 30%/O were dead after a mean survival of 27 months. This is to be contrasted with the usual bronchial carcinoid five-year survival of 80% or more (Overholt, Bougas, and Morse, 1957; Donahue et al., 1967). 245 on 7 May 2018 by guest. Protected by copyright.