Background:A sound knowledge of normal human anatomy and common variations in it is very important for a surgeon operating on the neck because it is one of the most difficult areas to operate upon, there being very little space in this region. The recurrent laryngeal nerve (RLN) and inferior thyroid artery(ITA) are in close proximity to each other, and are greatly liable to be included in a ligature, crushed by an instrument or stretched during mobilization of the thyroid gland. Hence this study was carried out to observe the variations in the relationship of the recurrent laryngeal nerve to the vascular pedicle of the thyroid gland. Materials and Methods: The recurrent laryngeal nerve was dissected in 20 embalmed cadavers from the department of Anatomy, Government Stanley Medical college and 15 post-mortem en-bloc specimens, from the Institute of Forensic medicine, Government Stanley medical college. The origin of 70 recurrent laryngeal nerves and their relation with inferior thyroid artery and its branches were dissected and noted. The results were tabulated and analyzed by tests for the significance of the difference in the proportions. Results: On the right side, the recurrent laryngeal nerve was found in between the branches of the inferior thyroid artery in 51%, posterior to the inferior thyroid artery in 37% and anterior to the inferior thyroid artery in 11% of specimens. And on the left side, the recurrent laryngeal nerve was found 51.4% posterior to the inferior thyroid artery, 28.6% in between the branches of the inferior thyroid artery and 20% anterior to the Inferior thyroid artery. The Chi -Square test, showed statistically significant difference in the relationship of the recurrent laryngeal nerve to the Inferior thyroid artery in the right and left side. (P < 0.003) Conclusion: The significant variations observed in the relationship of the recurrent laryngeal nerve to the Inferior thyroid artery on the right and left side would be important for surgeons who are doing thyroidectomy and any vascular surgery in the neck. A thorough knowledge of the laryngeal nerves and anatomical variations is necessary for safe thyroid surgery.

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Background: Normally, the median nerve is formed by the union of two roots; medial root and lateral root of median nerve arising from the medial cord and lateral cord of brachial plexus respectively. The knowledge about the formation of median nerve from a single cord, by more than two roots, and their relationship with the axillary artery has profound importance during upper limb surgeries and during axillary block procedures. Materials and Method: The median nerve formation was studied during routine dissection for undergraduate students in 36 cadavers i.e. 72 upper limbs of formalin preserved cadavers, over a period of 6 years. Results: In this study four anomalies were found in the formation of the median nerve in 5 upper limbs. In one limb the median nerve arose from the single fused medial and lateral cords of brachial plexus (1.38%). In both upper limbs of a cadaver, three roots were taking part in the formation of median nerve (2.7%); two roots from lateral cord and one from medial cord. In one upper limb the median nerve was formed by three roots and the third root was from musculocutaneous nerve (1.38%). The median nerve was formed by four roots in an upper limb; three of them were from lateral cord and one from medial cord of brachial plexus (1.38%). Conclusion: From the study we find that the median nerve can be formed by two, three or four roots. It can also arise from a fused cord or get an additional contribution from the musculocutaneous nerve. Awareness of these different modes of formation would be an asset to the operating surgeons and anaesthetists to avoid catastrophes during their procedures.

Background: Cardiovascular disease is one of the leading causes of morbidity and mortality in the world. The aim of this study is to observe the branching pattern of left coronary artery with special attention to the origin and termination of the posterior interventricular artery(PIVA), to determine the coronary dominance and the occurrence of myocardial bridges over the anterior interventricular artery(AIVA). Myocardial bridging is a congenital anomalous condition in which a coronary artery takes a "tunneled" course under a "bridge" of overlying myocardium. The vessel is compressed in systole, resulting in angina, myocardial ischemia, acute coronary syndrome, left ventricular dysfunction, sudden cardiac death and arrhythmias.Materials and Methods: This study was taken up at the Institute of Anatomy, Madurai Medical College with 60 heart specimens collected from the cadavers of the same Institute and from the Department of Forensic Medicine. The heart specimens of different age groups, sex and socioeconomic status were preserved in 10% formalin and studied by the conventional dissection method.Results: Among the 60 heart specimens studied, left coronary artery was seen bifurcating in 62%, trifurcating in 32% and quadfurcating in 6%. Regarding dominance, right dominance with PIVA arising from right coronary artery was seen in 53 specimens (88.3%), left dominance with PIVA being the continuation of left circumflex artery(LCX) was seen in 5 specimens(8.3%) and PIVA was arising from both coronaries in 2 specimens(3.4%). Among the 5 left dominant specimens, PIVA was seen as a continuation of LCX artery in 4 and single whereas in 1 specimen the PIVA was seen to be double. With regard to termination of PIVA, it terminated in the middle of posterior interventricular sulcus(PIVS) in 2 specimens and at the junction of anterior 1/3 and posterior 2/3 of PIVS in the rest. Myocardial bridges were seen over anterior interventricular artery in 15 specimens (25%). Conclusion:Right dominance is seen in majority of hearts followed by left dominance and the balanced pattern being the least. Presence of myocardial bridges was predominantly seen over AIVA.