RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS OF DISSERTATION

|1. |Name of the Candidate |DR. PRATHAP KUMAR.J |

| |& address |No.2, 3rd Cross, Kasturinagar, NGEF East., |

| | |Bangalore -560 043 |

|2. |Name of the institution |DR.B.R.AMBEDKAR MEDICAL COLLEGE |

|3. |Course of study & Subject |M.D ANATOMY |

| | |Anatomy |

|4. |Date of admission to course |19.06.2009 |

|5. |Title of the topic |A Study of Branching Pattern and Morphometry of Abdominal Aorta |

|6. Brief Resume of the Intended work |

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|6.1 Need of the Study |

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|The incidence of atherosclerosis in Indian adults is to the extent of 40-43%. So, this entails a necessity for detailed study of branches |

|of Aorta and their terminations along with their anastamosis. |

|The site of ligation of abdominal Aorta for the treatment of aneurysm can be determined exactly by the knowledge of its branching pattern. |

|For doing “Translumbar Aortography” to know the exact site of atherosclerosis, the knowledge of the relations of Aorta & its branching |

|pattern is Important. |

|The present study is also helpful in adopting the correct procedures for treatment of Renal Vascular occlusion and mesentric vascular |

|oclusion, both of the cases may present as an Acute Abdominal Emergency. |

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|Hence a study of variation in the branching pattern of Abdominal Aorta and its morphometry has been taken up. |

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|6.2 Review of Literature |

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|A review of the literature of the branching pattern of the Abdominal Aorta reveals that either the visceral or the parietal branches were |

|studied alone with special emphasis on hepatic, renal and suprarenal circulation. |

|The Abdominal Aorta extends between the lower part of 12th Thoracic vertebra to the body of the 4th Lumbar vertebra.1 |

|The branches of Abdominal Aorta are classified as:1&2 |

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|Abdominal Aorta |

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|Visceral branches |

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|Unpaired (Median) |

|Coeliac artery |

|Superior Mesentric Artery |

|Inferior Mesentric Artery |

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|Paired (lateral) |

|Middle Suprarenal artery |

|Renal artery |

|Gonadal artery |

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|Parietal branches |

|Unpaired |

|Median sacral artery |

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|Paired |

|Inferior Phrenic artery |

|Lumbar artery |

|Common Iliac artery |

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|The commonest variation occurs in the branching pattern with regard to the renal arteries. The level of coeliac trunk and superior |

|mesentric arteries showing a variation of not more than the height equal to that of a single vertebra.2 |

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|Abdominal Aorta is the direct continuation of the descending thoracic aorta. |

|It begins at the aortic hiatus of diaphragm at the level of intervertebral disc between twelfth thoracic vertebra and first lumbar |

|vertebrae. Ends at about the level of fourth lumbar vertebrae by dividing into two common iliac arteries.3 |

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|Abdominal Aorta is extending from the lower part of twelth Thoracic vertebra upto the lower border of fourth lumbar vertebra.4 |

|The branches are classified as 4 |

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|Abdominal aorta |

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|Ventral branches |

|Celiac artery |

|Superior mesenteric artery |

|Inferior mesenteric artery |

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|Lateral branches |

|Inferior Phrenic artery |

|Middle Suprarenal artery |

|Renal artery |

|Gonadal artery |

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|Dorsal branches |

|Lumber artery |

|Median sacral artery |

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|Terminal branches |

|Common iliac artery |

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|The branches of abdominal Aorta fall into three main groups:5 |

|Ventral Midline branches |

|Paired Lateral branches |

|Paired Visceral branches |

|The incidence of Abdominal aortic aneurysms among Rochester, Minnesota residents increased seven folds between 1951 and 1980. While |

|incidence of thoracic aorta aneurysm declined. Incidence of abdominal aortic aneurysm increases with age and were greater among men. Overall|

|incidence in 1971—1980 was 36.5per 1,00,000 person years.6 |

|A retrospective study of patients with abdominal aortic aneurysm was carried out between 1990 and 1997, that 233 patients |

|were studied in Bradford. Asian population comprises 14% of total population of Bradford and 28 cases of abdominal aortic aneurysm were |

|expected per year. All cases occurred in Caucasian population.7 |

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|6.3 Objectives of the study |

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|6.3 (i): |

|The branching pattern of the arteries from the very small area of abdominal aorta. |

|Atherosclerosis, involving this part can lead to multiple organ ischemia. |

|To determine the common origin, if any of the described branches. |

|To determine the vertebral level of the origin of the branches. |

|To determine the vertebral level of termination of the abdominal aorta. |

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|6.3 (ii) |

|The incidence and prevalence can be calculated by frequency table: |

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|7. Materials & Methods |

|The material and methods consists of male and Female human cadavers, which are of south Indian origin. Measurements will be taken using |

|Vernier calipers. |

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|7.1 Source of Data |

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|Prospective study over a period of two years: |

|The specimens are obtained from the Cadavers allotted for dissection to the I MBBS students of Dr.B.R.Ambedkar Medical College. The |

|vertebral levels of the origin of the branches of the abdominal aorta are observed and recorded. Similarly, the vertebral level of |

|termination of the aorta is also noted |

|The internal diameter of the aorta will be measured after dissection. |

|7.2 Method of collection |

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|The specimens are collected from the cadavers allotted for dissection to the first year MBBS students of Dr.B.R.Ambedkar Medical College, by|

|dissection method. |

|All cadavers available for dissection at Dr.B.R.Ambedkar Medical College, Department of Anatomy allotted for first year MBBS students. |

|Present study will be carried out for two years. |

|Specimen will be numbered serially and photographed. |

|Readings obtained will be recorded and tabulated. |

|Results obtained will be correlated statistically analyzed. |

|Inclusion criteria: |

|(i)Cadavers belonging to different age groups and both sexes have been included. |

|(ii)All cadavers available for dissection, which are allotted to undergraduate students at Dr.B.R.Ambedkar Medical College, Anatomy |

|Department. |

|Exclusion criteria: |

|The specimens which are damaged are excluded. |

|7.3 Does the study require any investigations or interventions to be conducted on patient, other human or animals, if so please describe |

|briefly. |

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|------NO----- |

|7.4 Has Ethical clearance been obtained from your institution? |

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|-------YES----- |

|8. List of References : |

|1. G.J.Romanes, Cunningham’s textbook of Anatomy,12th edition;1987,oxford publisher P:923-929 |

|2. Henry Hollinshed. W, Anatomy for surgeons, 3rd edition; 1982; Harper Row; P:590-595 |

|3. Keith.L.Moore, Clinically Oriented Anatomy,1980; Williams & Wilkins P:269-275 |

|4. Peter.L.Williams, RogerWarwick, Gray’s Anatomy, Elsiever Churchill and Livingstone, 36th edition, P:710-719 |

|5. R.M.H.McMinn, Lasts Anatomy, Regional and Applied, 8th edition,1990, Churchill Livingstone P:362-363 |

|6. Joseph Melton et al, American Journal of Epidemology,1984, Vol:120, No.3, P:379-386 |

|7. J.I.Spark, Epidemiology of abdominal aortic aneurysms in the Asian community, British Journal of Surgery, 2002, Vol: 88,(3), P:382-384. |

|9. |Signature of the candidate | |

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|10. |Remarks of the Guide | |

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|11.1 |Name & Designation of the Guide | |

| |(In Block letters) |Prof Dr.B.R.RAMESH |

|11.2 |Signature | |

|11.3 |Co-Guide if any | |

|11.4 |Head of the Department | |

| | |Prof Dr.B.R.RAMESH |

|11.5 |Signature | |

|12.1 |Remarks by the Chairman & Principal | |

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|12.2 |Signature | |

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