Structural Anatomy
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30827
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Browsing Structural Anatomy by Author "Fajkus, Austin"
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Item Bilaterally Absent Cephalic Veins: A Case Study(2022) Cronk, Jacob; Fajkus, Austin; Do, Tina; Fisher, Cara L.Background: The cephalic vein (CV) is one of the primary veins of the upper limb. It is a superficial vein located on the anterolateral surface of the arm and is a common site for venous access. The typical course begins along the radial aspect of the wrist and forearm where it joins with the median cubital vein (MCV) at the antecubital fossa and continues proximally through the superficial fascia, lateral to the biceps brachii muscle, and into the deltopectoral groove of the shoulder. It terminates by draining into the axillary vein in the deltopectoral triangle. The absence of the CV or variations in its location could have important implications for vascular procedures, such as Arteriovenous (AV) fistulas, which utilize the CV as the primary vein for preparing patients for long-term hemodialysis access. Case Information: An elderly Caucasian male cadaver presented with complete bilateral absence of the CV proximal to the antecubital fossa. Dissection revealed enlarged basilic veins (BV) and MCVs that crossed superficially to the bicipital aponeurosis and continued distally along the anterolateral side of the forearms towards the hands. Both limbs also showed a small anastomosis between the large MCV and the deep brachial vein (DBV) just distal to the bicipital aponeurosis. The BV on the right limb gives off one branch as the MCV that continues along the radial aspect of the forearm. Additionally, two smaller branches emerge and circumvent the medial epicondyle of the humerus and rejoin to form one vein that continues along the medial aspect of the forearm. The left limb showed an interesting anastomotic ring within the portion of the vein that would normally represent the MCV just distal to the bicipital aponeurosis. In contrast to the right limb, there was only one smaller branch from the BV that coursed around the medial epicondyle and travelled along the dorsal aspect of the forearm. The absence of the CV in the deltopectoral groove of both shoulders was also noted. Conclusions: This cadaveric case study illustrates a unique presentation of the upper limb venous architecture. With a significant portion of the U.S population requiring hemodialysis and/or developing end-stage renal disease, there has been an increase in the number of AV fistula procedures performed each year. Therefore, having a greater awareness of the variations of the CV may help to prevent complications in vascular procedures that require its use.Item Study of Cadaveric Posterior Circumflex Humeral Artery Variations(2022) Fajkus, Austin; Do, Tien; Cronk, Jacob; Fisher, Cara L.Purpose: There are concerns regarding the sequelae of blood clots post-vaccination due to suboptimal administration techniques with the ongoing incentive for vaccination against the Coronavirus Disease 2019 (COVID-19). Specifically, the risk of administering the intramuscular (IM) vaccine into an artery in the deltoid region. The posterior circumflex humeral artery (PCHA) is a small branch originating from the third part of the axillary artery, classically traveling with the axillary nerve, through the quadrangular space, to run along the inferior aspect of the deltoid muscle. This study investigates the presence and prevalence of variations of the PCHA not traversing in its classical path. Methods: Detailed dissection was performed on bilateral shoulders of 10 (n=20) human cadavers. The PCHA was identified in all 20 shoulders and their anatomic locations were assessed and categorized. Results: Of the 20 shoulders studied, 15% had anatomical variations of the posterior circumflex humeral artery traveling superiorly into the upper deltoid. Conclusions: Recent studies have highlighted the possibility of erroneous injection of the COVID-19 vaccine into the bloodstream as a risk of post-vaccination blood clots. The high prevalence of arterial variations revealed in this study provides an impetus for further research investigating the relationship between the variation in arterial anatomy and injection site "safe zones."