Anatomy 2020 Flashcards
Arterial supply of foot
Double plantar arch Absent plantar arch Hypoplastic posterior tibial artery Hypoplastic anterior tibial artery Absent dorsalis pedis artery Origin of dorsalis pedis artery from fibular artery
Axillary artery
Common trunk for:
– subscapular, profunda brachii and posterior circumflex humeral artery
– lateral thoracic and subscapular
High origin of subscapular artery from second part.
Proximal origin for profunda brachii
Anomalous high division into radial and ulnar arteries”
Bronchial arteries
Right arising from aorta, internal thoracic, subclavian or thyrocervical trunk (usually from 1st right intercostal)
Right arising from left bronchial
May be two on the right
May be one on the left (usually two)
Coeliac axis
Right hepatic from SMA or aorta Total hepatic replacement (SMA or aorta) Accessory right or left hepatic arteries Coeliacomesenteric trunk Left gastric from SMA or aorta Splenic artery from SMA or aorta Arc of Buhler - anastomosis between coeliac and SMA
Common iliac artery
Variable level of origin
Variable level of division
Absent
No bifurcation
Transverse common iliac anastomotic vessel
Origin to iliolumbar, accessory renal, middle colic, obturator, circumflex iliac
Coronary arteries
Dominance
- Right, left or co-dominant
- Trifurcation of left main coronary artery
- Ramus intermedius
- Nodal branch off LCA
- Conus artery off right coronary sinus - supplies conus of main pulmonary artery
- LCx from non-coronary or from RCA
- RCA from non-coronary - pulmonary trunk
- RCA from left coronary sinus - malignant
- LCA from right coronary sinus
- LCA from pulmonary artery
Descending aorta
Right sided (with right sided arch) Duplicated Variable number and origin of bronchial arches Variable number of oesophageal arteries Aberrant right subclavian artery Variable number of pericardiac arteries
External carotid artery
Absent Level of origin Asymmetry of origin Type 2 proatlantal artery Common trunk of; lingual and facial arteries Occipital and posterior auricular trunk Thyrolingual trunk Thyrolinguofacial trunk
Ophthalmic artery
Middle meningeal artery arise from ophthalmic artery Ophthalmic artery origin - middle meningeal artery -- MCA - PComA - cavernous portion of ICA
Obturator artery
Accessory obturator artery (origin from inferior epigastric artery)
Origin from:
- inferior epigastric artery
- Posterior trunk of internal iliac artery
- Superior gluteal artery
- Inferior gluteal artery
- Internal pudendal artery
Posterior cerebral artery (PCA)
Foetal origin PCA Hypoplastic Pcom Fenestrated PCA Artery of Percheron Persistent carotid-basilar anastamoses
Renal arteries
1-6 arteries per kidney
Origin from aorta, adrenal, gonadal, common iliac, internal/external iliac
Penetration point at superior/inferior pole
Early branching / pre-hilar (important in transplant planning)
Common renal trunk
Posterior division may supply apical segment
Superior capsule branches off inferior phrenic
Left gonadal artery branch
Suprarenal arteries
Origin from aorta or coeliac trunk
Duplication of superior, middle or inferior suprarenal arteries
Absences of middle suprarenal artery
Spermatic artery branch from middle suprarenal artery
Variation in total number of suprarenal arteries (3-30 arteries total)
Abdominal aorta
Variable level of origin and termination Deviation to left and right Coeliacomesenteric trunk Double or triple renal artery Other possible direct branches - Accessory inferior phrenic - Accessory hepatic - Accessory superior mesenteric - Accessory suprarenal - Accessory gonadal - Internal iliac - Accessory median sacral
Anterior Cerebral artery
Absent / hypoplastic A1 segment - contralateral dominance
Azygos ACA
Fenestrated ACA
Trifurcation of A2 segments
Aortic arch
Bovine origin
Right sided arch +/- aberrant left subclavian
Double arch (co-dominant or have dominant arch)(circumtracheal)
Aortic ductus diverticulum
Aortic diverticulum of Kommerell (right sided arch/aberrrant subclavian)
Aortic nipple / left superior intercostal vein
Coarctation
Left or right vertebral arteries off arch
Thyroid ima artery off arch
Right subclavian and common carotid may arise independently
Infundibulum at site of ligamentum arteriosus attachment
Cervical arch
Hand arterial supply
Double superficial palmar arch
Absence of superficial palmar arch
Incomplete superficial palmar arch
Origin of princeps pollicis artery from superficial palmar arch
Origin of radialis indicis from superficial palmar arch
persistent median artery
Spinal cord arterial supply
“Artery of Adamkiewicz (AoA) variants
- Right sided AoA
- AoA origin extension with lumbar (L1-2) or higher thoracic (T5-8) arteries
Spinal artery variants
- Origin of posterior spinal artery from vertebral artery or PICA
- Duplication of anterior spinal artery
- Single root of anterior spinal artery (from VA or BA)
- Both anterior spinal roots from single VA
Basilar artery
Carotid / basilar communications (Trigeminal, hypoglossal and proatlantal artery)
Fenestrated
Absent (vertebrals terminate as PICAs)
Hypoplastic
Duplication - non-unification of vertebral arteries
Hypoplastic P1 with large PCom (foetal type), unilateral and bilateral
Single or dominant vertebral artery
PICA arising from basilar
Hypoplastic Pcom unilateral / bilateral
Brachial artery
Duplication
Superficial brachial artery (anterior to median nerve)
Accessory brachial artery (duplication that unites before cubital fossa)
Interosseous artery arising from brachial artery
Varied level of radial and ulnar bifurcation.
Profunda off axillary artery
Absent or duplicated profunda
Circle of Willis (CoW)
Hypoplastic PCom unilateral / bilateral Hypoplastic / absent A1 PCA origin from ICA with absent / hypoplastic P1 segment (fetal PCom) Infundibulum dilatations of PCom origin Absent / fenestrated ACom Absence of one or both ICAs
Common carotid artery
Bovine origin
Right common carotid arises from arch independently
Level of bifurcation
Rare: proatlantal artery
Vagus may run in front (instead of behind)
Absent ICA or ECA
Branches that arise from the ECA may arise from the CCA eg superior thyroid
External iliac artery
Variable level of origin and division
Terminate as profunda femoris
High origin circumflex iliac or inferior epigastric
- Hypoplastic if femoral artery from inferior gluteal or internal iliac artery
- Give rise to femoral branches (eg superficial external pudendal)”
Femoral artery
Origin from: - inferior gluteal artery - internal iliac artery Duplication of femoral artery (distal to profunda femoris origin) Level of profunda origin Gives off - inferior epigastric artery branch - 4th perforating artery (which splits distally into anterior and posterior tibial arteries) - medial or lateral femoral circumflex
Hepatic arteries
Common hepatic artery - from Aorta - from SMA - Trifurcation into left hepatic, right hepatic and gastroduodenal arteries Right hepatic artery - from coeliac artery - from SMA - accessory RHA from SMA Left hepatic artery - from left gastric artery - accessory LHA from LGA
Inferior mesenteric artery
- Arc of Riolan - anastomosis of SMA and IMA
- Absent
- Duplicated
- Left colic and rectosigmoid trunk
- Superior rectal and colosigmoid trunk
- Colorectosigmoid trunk
- Absent left colic branch
Internal carotid artery
Arises medial to external carotid artery Level of bifurcation (From C2 to C6) Retropharyngeal carotid artery Ophthalmic artery from cavernous portion of internal carotid artery Persistent foetal communicating artery Persistent hypoglossal artery Aplasia of a segment Persistent trigeminal artery Type 1 proatlantal artery
Internal iliac artery
Variable level of origin and division
Absence of anterior and posterior division
Branches before commencement of anterior and posterior division
SMA branch
Persistent sciatic artery
Hypogastric trunk branch
Middle rectal artery absent
<p>Middle cerebral artery</p>
<p>"- Duplicated
- Accessory MCA (often from ACA)
- Fenestrated
- Trifurcation
- Ophthalmic artery off M1
- Length
- Number of lenticulostriate arteries"</p>
<p>Persistent carotid- vertebrobasilar communications</p>
<p>"HOT PePper (persistent)
- hypoglossal artery - hypoglossal canal
- otic artery
- trigeminal artery (Saltzman I - no Pcom)
- proatlantal artery (Type I - ICA, Type II - ECA)
- persistent stapedial artery"</p>
<p>Popliteal artery branching</p>
<p>"- High origin posterior tibial artery
- High origin anterior tibial artery
- Trifurcation
- Hypoplastic infrapopliteal vessels
- Ascending branch to hamstring muscles
- Peroneal (fibular) magnus artery
- -- anterior and posterior tibial arteries are hypoplastic
- -- fibular artery supplies leg and foot
- Duplicated popliteal vein deep to popliteal artery"</p>
<p>Profunda femoris</p>
<p>"- Lateral or medial circumflex off femoral
- High division off femoral
- Posterior or medial origin
- Number of perforators"</p>
<p>Pulmonary artery</p>
<p>"- One side may be absent
- Three lobar branches on left
- Segmental branches change with lung segments ie may be separate apical and posterior segments on left"</p>
<p>Radial / Ulnar artery</p>
<p>"- Level of bifurcation of brachial artery
- Sole supply of deep or superficial palmar arch
- Split supply of palmar arches between radial &amp; ulnar arteries
- Persistent median artery contributes to palmar arches
- Persistent median artery but no arch with radial or ulnar artery
- No contribution of ulnar/radial artery to palmar arches"</p>
<p>Subclavian artery</p>
<p>"- Bovine origin
- Right sided arch with aberrant subclavian artery
- Aberrant right subclavian artery - 4th aortic branch +/- diverticulum of Kommerall
- Separate origin of right subclavian and right common carotid artery (ie no brachiocephalic)
- Pierce scalenous anterior
- Cervical rib compression
- Common trunks
- - Thyrocervical trunk and internal thoracic arteries (1st part)
- - Thyrocervical and vertebral trunk (1st part)
- - Transverse cervical and suprascapular artery
- Variable branches
- - transverse cervical off dorsal scapula
- - vertebral artery off arch
- - hypoplastic vertebral artery"</p>
<p>Superior mesenteric artery (SMA)</p>
<p>"- Doubled
- Arch of Buhler - anastomosis of coeliac and SMA
- Arch of Riolan - anastomoisis of SMA and IMA
- Coeliacomesenteric trunk
- Give origin to IMA
- Replace IMA
- Right or total hepatic replacement
- Variable number of branches to jejunum and ileum
- Common trunks for colic arteries
- - right and middle
- - right and ileocolic
- Origin to left gastric, splenic, common hepatic, right hepatic, accessory right hepatic"</p>
<p>Vertebral artery</p>
<p>"- Absent / hypoplasia
- Dominant VA - usually the left
- Duplicated
- Fenestrated
Variable origin
- Off arch (usually left)
- Not always 1st branch of subclavian artery
- Both roots off one vertebral artery
- Left or right common carotid origin
Variable branching
- posterior spinal artery branch, normally PICA
- PICA off basilar
- terminates as PICA (absent basilar)
- failed union with contralateral VA into basilar
- Single anterior spinal artery root
- Proatlantal artery"</p>
<p>Conus medullaris</p>
<p>"- fetus
- -- early embryonic life - entire length of spinal canal
- -- 25th week - L3
- neonate - L2 - L3
- child and adult - L1/2
Variants
- ventriculus terminalis
- filar cyst"</p>
<p>Hand innervation</p>
<p>"Thenar branch of median nerve
- Thenar branch origin variations
- Accessory thenar branch
- High division of median nerve
Ring finger
- connecting branches of median and ulnar nerves to contralateral side of finger
Ulnar nerve supplying:
- opponens pollicis
- superficial head of flexor pollicis brevis"</p>
<p>Axillary nerve (C5-6)</p>
<p>"- Sole C5 origin with minimal or absent C6 contribution
- Pierce and supply subscapularis muscle
- Innervate long head of triceps
- Innervate infraspinatus
- Give rise to nerve to teres major"</p>
<p>Brain</p>
<p>"- Perivascular spaces (pial lined)
- Asymmetry of ventricles and hemispheres
- Basal ganglia calcification
- Variable appearance with age
- Empty sella
- Choroid plexus pseudotumour (lateral, third or fourth ventricles)
- Choroid plexus calcification
- Large high convexity cisterns
- Pineal cysts
- Basal cistern
- -- hexagonal configuration of suprasellar cistern
- -- mega cisterna magna
- -- empty sella
- -- arachnoid cyst"</p>
<p>Median nerve (C5-T1)</p>
<p>"- High division
- Bifid
- Palmar cutaneous branch through retinaculum or through carpal tunnel
- Accompanied by persistent median artery
- Variant course of thenar branch
- Accessory branches
- Variable anastamoses between median and ulnar nerves"</p>
<p>Posterior cranial fossa</p>
<p>"Venous
- Duplicated occipital sinus
- Split superior sagittal sinus
- Paramidline SSS into single transverse sinus
CSF
- Mega cisterna magna
Brain
- Chiari 1 malformation
- Tonsilar ectopia
- Cerebellar agenesis
- Vermian fossa
- Dentate nucleus calcification"</p>
<p>Radial nerve (C5-T1)</p>
<p>"- Pass through quadrangular space (normally triangular space)
- Communicate with ulnar nerve
- ECRB supplied by radial or superficial branch (normally deep branch)
- Replace dorsal branch of ulnar nerve
- Be replaced by dorsal branch of ulnar nerve"</p>
<p>Ulnar nerve (C7-T1)</p>
<p>"- Pass in front of medial epicondyle
- Branch to medial head of triceps (normally radial)
- Absent dorsal branch (supplied by radial nerve)
- Dorsal branch supply dorsoradial skin with deficient radial nerve
- Level of distribution"</p>
<p>Vagus nerve</p>
<p>"- Asymmetry between left and right vagus nerves
- Vagus nerve anterior to carotid sheath vessels
- Variable distribution around oesophageal hiatus
- Contain accessory parathyroid tissue
- No ""recurrent"" path for recurrent laryngeal nerve in arteria lusoria or retro-oesophageal subclavian artery"</p>
<p>Sympathetic chain / sympathetic trunk</p>
<p>"- unfused T1 and inferior cervical ganglia (absent stellate ganglion)
- doubled superior cervical ganglion
- absent superior cardiac branch (usually on the right)
- accessory L3 white ramus communicans"</p>
<p>Brachial plexus</p>
<p>"- Prefixed plexus
- Postfixed plexus
- Presence of 2 cords (the large contains the medial cord)
- Middle trunk divides to supply all 3 cords
- Additional contributions from C4 or T2 (6 or 7 roots)
- Accessory phrenic nerve"</p>
<p>Ventricular System</p>
<p>"- thalamic adhesion in third ventricle
- absence/asymmetry of lateral ventricle posterior horn
- cavum septi pallucidi
- cavum vergae
- choroid plexus calcifications
- cavum veli interpositi"</p>
<p>Corpus callosum</p>
<p>"- Complete agenesis
- Partial agenesis (usually anterior aspect)
- Hypoplasia with dysplasia
- Apple core corpus callosum
- Kinked corpus callosum
- Dysplasia"</p>
<p>Sciatic nerve</p>
<p>"Normal division with different path
- Sciatic nerve coursing above piriformis
- Sciatic nerve piercing piriformis
Early division
- Common peroneal nerve travelling above piriformis and tibial nerve below
- Common peroneal nerve travelling above piriformis and tibial nerve piercing piriformis
- Common peroneal nerve piercing piriformis and tibial nerve exiting below piriformis
- Both common peroneal and tibial nerve travelling below piriformis separately
Persistent sciatic artery"</p>
<p>Septum pellucidum</p>
<p>"Cavum septum pellucidum
- split septum pellucidum between anterior horns of lateral ventricles
Caveum vergae
- posterior extension of cavum septum pellucidum posterior to the column of the fornix
Cavum velum interpositum
- below splenius of corpus callosum and fornix, above internal cerebral veins
- not sure if this counts as septum pallucidum"</p>
<p>Skull / Calvarium</p>
<p>"- Metopic suture (median frontal suture)
- Exostosis
- Hyperostosis frontalis interna
- Arachnoid granulation (Pacchionian impressions)
- Internal frontal protuberance
- Bilateral thinning of pariental bones"</p>
<p>Temporal bone</p>
<p>"- Dehiscent ICA - lateralised horizontal portion through the middle ear
- Dehiscent IJV
- High jugular bulb - absent sigmoid plate, thin bone which normally separates the two
- Pneumatisation petrous temporal bone apex"</p>
<p>Neck</p>
<p>"- Asymmetry of internal jugular veins
- Persistent adenoids
- Calcified stylohyoid ligament"</p>
<p>Paranasal sinuses</p>
<p>"- Haller cells (infraorbital ethmoidal air cells)
- Onodi air cell (sphenoethmoidal air cell)
- Concha bullosa (pneumatisation of middle turbinate)
- Extension of sphenoid sinus into posterior nasal septum
- Torus ethmoidalis
- Absence of Agar nasi cells
- Hypoplasia/aplasia of frontal sinuses
- Pneumatisation petrous temporal bone apex
- Low cribriform plate"</p>
<p>Parathyroid glands (excluding vascular variants)</p>
<p>"- 2-6 glands
- Ectopic parathyroid gland (most commonly inferior to inferior pole of thyroid)
Location
- Medial to recurrent laryngeal nerves
- anywhere from pericardium to above carotid bifurcation
- Intracapsular glands (within thyroid)"</p>
<p>Thyroid gland (excluding vascular variants)</p>
<p>"- Pyramidal lobe
- Ectopic thyroid
- Absence of isthmus
- Lobar hemiagenesis
- Zuckerkandl tubercle
- Thyroglossal duct cyst"</p>
<p>Nasolacrimal apparatus</p>
<p>"- up to 4 puncta
- imperforate punctum
- diverticulum of lacrimal sac
- doubled nasolacrimal duct
- supernumeral canaliculi"</p>
<p>Acetabular labrum</p>
<p>"- Round
- Flat
- Absent (rare)
- Notched
- Normally triangular in cross-section"</p>
<p>Fibularis longus and brevis</p>
<p>"Fibularis longus and brevis fusion
Fibularis longus
- insertion by three tendons
- sesamoid bone
Fibularis brevis
- give a slip to abductor digiti minimi
- give a slip to fibularis longus"</p>
<p>Hamstrings</p>
<p>"Biceps femoris
- Absence of short head
- Exclusive tibial insertion
- three heads
Semimembranosus
- absent muscle
- accessory semimembranosus muscle
Partial fusion of semimembranosus and semitendinosus"</p>
<p>Lower limb skeletal muscles</p>
<p>"- Absent plantaris
- Accessory soleus
- Third gastrocnemius head
- Asymmetry of psoas major
- Separate psoas major and iliacus
- Abberrant psoas major fascicle"</p>
<p>Menisci of knee</p>
<p>"- Discoid meniscus
- Hypoplasia or abscence
- Aberrant insertion of anterior horn of medial meniscus
- Speckled anterior horn of lateral meniscus
- Meniscal flounce
- Meniscal ossicles"</p>
<p>Popliteal fossa</p>
<p>"- Absent plantaris
- Popliteal artery superficial to vein
- Popliteal artery or vein medial to medial head of gastrocnemius
- Popliteal artery under popliteus muscle
- Third gastrocnemius head"</p>
<p>Sartorius</p>
<p>"- Absent
- Doubled
- Accessory heads
- Insert into fascia lata
- Insert into capsule of knee joint"</p>
<p>Anterior cruciate ligament (ACL)</p>
<p>"- Absent ACL
- Accessory cruciate ligament slips
- Attachment to medial meniscus"</p>
<p>Femur</p>
<p>"- Angle of neck (usually ~120 degrees)
- -- coxa valga
- -- coxa vara
- Growth arrest lines
- Size
- Cam shaped head of femur
- Variations in supply (see femoral artery section)"</p>
<p>Patella</p>
<p>"- Bipartite patella
- Multipartite patella
- Absent patella
- Variable shape
- Dorsal defect of patella"</p>
<p>Tarsal bones</p>
<p>"- Talocalcaneal coalition
- Calcaneonavicular coalition
- Os subfibulare
- Os trigonum
- Os tibiale externum (accessory navicular)
- Os supranaviculare
- Os peroneum
- Os vesalianum"</p>
<p>Femoral nerve</p>
<p>"- split into 2-3 slips within psoas, then unite as single bundle
- accessory femoral nerve
- -- from separate fibres in lumbar plexus -> pass anterior to femoral nerve
- -> saphenous nerve
- femoral branch replacing lateral femoral cutaneous nerve
- saphenous nerve terminating at knee with distribution replaced by branch of tibial nerve"</p>
<p>Sacrum</p>
<p>"- Lumbarisation of S1
- Sacralisation of L5
- Absent/incomplete median crest with non-fusion of lamina
- High sacral hiatus
- Dorsal wall agenesis"</p>
<p>Vertebrae</p>
<p>"Vertebral body
- hemivertebra
- block vertebra (partial or complete)
- butterfly vertebra
- coronal vertebral cleft (esp thoracic / lumbar)
- hypoplastic vertebra
Transitional vertebra
- occipital condyle
- atlanto-occipital assimilation
- cervical rib
- lumbar rib
- lumbarisation of S1
- sacralisation of L5
Spinous process
- unfused spinous process
- deviated spinous process
- bifid spinous process (atypical for level e.g. C7)
- variable bifid spinous process C1-C6
Cervical
- accessory ossicle of anterior arch of atlas
- os odontoideum
- persistent ossiculum terminale
- Sesamoid ossicles of nuchal ligament
- arcuate foramen
- non-fusion of C1 anterior or posterior arch
- fusion of C1 with occipital condyles
- fusion of C1 with C2
- ossification of posterior atlanto-occipital membrane
Lumbar
- Oppenheimer ossicle"</p>
<p>Trachea / Bronchial tree</p>
<p>"Trachea
- number of tracheal rings
- tracheal diverticulum
- cartilage calcification
- lunate trachea - coronal > sagittal
- tracheal buckling
Bronchi
- Right upper lobe bronchus origin from trachea (tracheal / pig bronchus)
- Cardiac bronchus
- Oesophageal bronchus
- Trifurcation of right main bronchus
- Bridging bronchus
- left middle bronchus"</p>
<p>Phrenic nerve</p>
<p>"- accessory phrenic nerve (may arise from nerve to subclavius)
- may supply subclavius
- course
- -- posterior to subclavian artery
- -- pierce anterior scalene muscle"</p>
<p>Thymus</p>
<p>"- location
- ectopic/accesory thymic tissue
- shape/size"</p>
<p>Breast</p>
<p>"- Asymmetry
- Variation with age
- Supernumerary nipple
- Accessory breast tissue
- Breast hypoplasia
- Amastia
- Amazia"</p>
<p>Diaphragm</p>
<p>"- Hernia of Bochdalek - BBBBB
- Hernia of Morgagni - anterior sternocostal triangle
- Eventration - abnormal contour
- Double IVC
- Right phrenic nerve through the diaphragm separately
- Hiatus hernia"</p>
<p>Lung fissures</p>
<p>"- Azygos fissure
- Left horizontal fissure
- Incomplete oblique fissure
- Fissure between medial basal and anterior basal segments of right lower lobe
- Absent or incomplete horizontal fissure"</p>
<p>Lung segments</p>
<p>"- Middle lobe on left
- Accessory fissures
- Azygos fissure from azygos lobe
- Superior accessory fissure - separates RLL into superior and basal segments
- Inferior accessory fissure - separates right medial basal segment
- Left horizontal fissure - separates lingula lobe
- Segmental variants
- Left apical and posterior segments
- Left anterior and medial basal segments"</p>
<p>Superior ribs</p>
<p>"- Unilateral / bilateral cervical rib
- Complete cervical rib (articulates with manubrium)
- Partial (articulates with first rib)
- Partial (attaches to manubrium or first rib via ligament)
- Enlarged C7 transverse process"</p>
<p>Thoracic wall</p>
<p>"- Pectus excavatum
- Pectus carinatum
- Poland's syndrome
- Rhomboid fossa of clavicle
- Cervical rib
- Bifid rib"</p>
<p>Thoracic duct</p>
<p>"- Variations in ~40% of the population
- double thoracic ducts
- aberrant termination - left IJV, left EJV, azygos, brachiocephalic or left subclavian veins
- multiple terminal channels from single duct
- continues on right to terminate in right IJV"</p>
<p>Carpal bones</p>
<p>"- lunotriquetral coalition
- capito-hamate coalition
- Lunula
- Os styloideum
- Os triangulare
- Trapezium secondarium
- Os epilunate
- Os hamuli proprium
- Os hypotriquetrum
- Os hypolunatum"</p>
<p>Clavicle</p>
<p>"- Rhomboid fossa - for costoclavicular (rhomboid) ligament
- Coracoclavicular joint
- Hypertrophied conoid tubercles
- Forked clavicle
- Supraclavicular foramen for suprascapular nerve"</p>
<p>Glenoid labrum</p>
<p>"- Buford complex
- Sublabral foramen
- Superior sublabral sulcus
- Pseudo-SLAP lesion
- Meniscoid labrum
- Absent middle glenohumeral ligament"</p>
<p>Humerus</p>
<p>"- Supracondylar process above medial condyle
- Enlarged deltoid tubercle
- Intertubercular groove depth and shape
- Absent humeral head"</p>
<p>Scapula</p>
<p>"- Acromion shape
- -- flattened, curved, convex or hooked
- Glenoid fossa
- -- variable shape
- Scapula facets on costal surface
- Suprascapular notch morphology variation
- os acromion"</p>
<p>Upper limb skeletal muscles</p>
<p>"- Absent palmaris longus
- Accessory belly of flexor pollicis brevis
- Absent FDS bellies (eg to little finger)
- Anconeus epitrochlearis (forms roof of cubital tunnel)"</p>
<p>Coronary sinus</p>
<p>"- Absent / atresia
- Absent Thebesian valve (valve of CS)
- Left SVC may drain into CS
- Pulmonary vein may drain into CS
- Drain into left atrium (L-R shunt)
- Duplication"</p>
<p>Coronary veins</p>
<p>"- Great cardiac vein into right atrium
- Middle cardiac vein into right atrium
- Small cardiac vein into right atrium
- Anterior veins to small cardiac vein or right marginal vein
- Accessory posterior vein (to great cardiac vein or CS)
- Accessory anterolateral vein (to great cardiac vein)
- Great cardiac vein into azygos vein
- Variable amount of venae minimae (thebesian vein) drainage"</p>
<p>Inferior vena cava (IVC)</p>
<p>"Similar to SVC
- Azygos continuation - absent hepatic segment
- Double IVC
- Left sided IVC
- Aberrant drainage of pulmonary vein into IVC
IVC specific
- 2-4 hepatic veins
- Circumaortic left renal veins
- Retroaortic left renal vein
- Retrocaval ureter"</p>
<p>Internal jugular vein (IJV)</p>
<p>"- Variable relation to common carotid, in front or behind
- Jugular bulb exposed in the middle ear
- Rudimentary with dominant EJV
- Asymmetry in size and course
- Common tributary trunks
- Accessory nerve may be anterior, posterior or pierce IJV
- Thoracic duct may drain into inferior IJV
- Receive EJV (normally EJV into subclavian)"</p>
<p>Portal vein</p>
<p>"- Portal vein trifurcation (most common)
- -- right anterior, right posterior and left PV
- Triple confluence of IMV, SMV and splenic vein
- IMV to SMV (usually to splenic)
- Left, right or both gastric veins to splenic / SMV
- Superior pancreaticoduodenal vein to SMV
- Cystic vein if present to right, left or portal vein
- Portal vein duplication (rare)
- Situs inversus
- Anterior to duodenum/pancreas"</p>
<p>Pulmonary veins</p>
<p>"- Common trunk draining left superior and inferior pulmonary veins
- Single accessory right middle pulmonary vein
- Double accessory right middle pulmomary veins
- Right top pulmonary vein
- Accessory right middle and right upper pulmonary vein
- Alternative drainage into:
- -- SVC, IVC, coronary sinus, right atrium or azygos"</p>
<p>Axillary veins</p>
<p>"- Duplication
- Variations in tributaries
- Variable distance from axillary artery"</p>
<p>Basilic vein</p>
<p>"- Variable dominance vs cephalic vein
- Median cubital vein vs median basilic and median cephalic vein
- Variable reception of median antebrachial
- Oblique vein connection to cephalic
- Accessory cephalic vein connection to cephalic
- Absent cubital fossa connection with cephalic"</p>
<p>Cephalic vein</p>
<p>"- Absent
- Duplicated
- Accessory
- Small
- Double median cubital
- Median antebrachial
- Double median antebrachial"</p>
<p>Dural venous sinuses</p>
<p>"- Hypoplastic or absent areas of SSS or TS (two most affected)
- Split SSS, draining into both TS
- ""Off midline"" SSS draining into right or left TS
- Bifid occipital sinus
- Dominant right or left transverse or sigmoid sinuses
- Accessory meningeal vein to cavernous sinus"</p>
<p>External jugular vein (EJV)</p>
<p>"- Asymmetry
- Rudimentary
- Absent unilateral or bilateral
- Drain into cephalic or IJV (normally into subclavian)
- Clavicular annulus
- Accessory tributaries (facial, lingual, cephalic)
- Duplicated"</p>
<p>Hepatic vein</p>
<p>"- 2-4 segments
- Hepatic vein into right atrium
- Common hepatic vein
- Persistent umbilical vein"</p>
<p>Renal vein</p>
<p>"- Retroaortic left renal vein
- Circumaortic left renal vein
- Duplicated
- Left inferior adrenal may drain separately or with inferior phrenic vein instead of left renal"</p>
<p>Subclavian vein</p>
<p>"- High position
- Behind anterior scalene
- Clavicular loop
- Anterior scalene loop
- Phrenic loop
- Receive AJV
- EJV into IJV instead
- Receive transeverse scapular or transverse cervical veins
- Cervical rib"</p>
<p>"Lower limb
| - superficial venous drainage"</p>
<p>"- Absent great / small saphenous
- Duplication
- Variable deep perforating tributaries to great saphenous
- Variable insertion of short saphenous – above/below popliteal fossa
- Variable insertion of great saphenous; low/high sapheno-femoral junction
- Thigh extension of small saphenous vein (Vein of Giacomini)"</p>
<p>"Lower limb
| - deep venous drainage"</p>
<p>"- Duplicated superficial femoral vein
- Duplicated popliteal veins
- Location of saphenofemoral junction
- Location of saphenopopliteal junction
- Tributaries of anterior and posterior tibial veins and fibular vein"</p>
<p>Superior vena cava (SVC) &amp; brachiocephalic trunk</p>
<p>"- Left sided vena cava
- Drainage of hemiazygos vein into left sided SVC
- Superior vena caval duplication - left SVC drains:
- -- with/without/with small brachiocephalic anastamoses
- -- to right atrium: via oblique vein of Marshall
- -- to coronary sinus
- -- to left atrium
- Left SVC drainage into IVC by persistent sinus venosus
- Azygos continuation (absence of hepatic IVC)"</p>
