Aberrant Right Subclavian Artery
|
|
- Amberlynn Anderson
- 6 years ago
- Views:
Transcription
1 A Doubtful Cause of Symptoms Thomas P. Comer, M.D., Malvin Weinberger, M.D., and Howard D. Sirak, M.D. ABSTRACT Ten patients with surgically treated aberrant right subclavian artery are reviewed. In half, the symptoms persisted postoperatively. We believe that since this anomaly occurs commonly and since respiratory and swallowing difficulties are frequent in the first few months of life, one should make an exhaustive search for other causes of these symptoms before recommending surgical intervention. A n aberrant right subclavian artery arises as the last branch of the aortic arch instead of from the innominate artery, and passes obliquely toward the right side behind the esophagus to the upper border of the first rib, where it follows its ordinary course (Fig. 1). This is a common anomaly occurring more than once in every 200 persons [l, 2, 71. In the United States there are more than one million people with the anomaly. The purpose of this paper is to dispute the commonly accepted idea that aberrant right subclavian artery frequently is a cause of symptoms. The records of patients operated upon at Columbus Children s Hospital for aberrant right subclavian artery during the past ten years form the basis of this report. Anatomy Barry [3] and Congdon [S] have reviewed the embryology of aberrant right subclavian artery extensively. It is the regression of the right fourth aortic arch rather than the right dorsal aortic segment that produces the anomaly (Fig. 2). In the literature [6, 11, 121 it is stated that the course of the anomalous right subclavian artery is behind the esophagus in 80% of patients, between the trachea and esophagus in 10 to 15%, and in front of the trachea in 5 to 10%. The source for these percentages relates back to an article by Holzapfel [lo] published in In a critical review of the references cited by Holzapfel, Beabout and associates [51 were unable to find a well-documented case in which the anomalous artery passed other than posterior to the esophagus. From the Division of Thoracic Surgery, Department of Surgery, Ohio State University College of Medicine and Children s Hospital, Columbus, Ohio. Accepted for publication Dec. 10, Address reprint requests to Dr. Comer, Kern General Hospital, 1830 Flower St., Bakersfield, Calif VOL. 13, NO. 6, JUNE,
2 COMER, WEINBERGER, AND SIRAK BERRANT RIGHT SUBCLAVIAN FIG. 1, Aberrant right subclrivim artery. In 1957 Scheldrup [ 111 reported the postmortem finding of an aberrant right subclavian artery passing between the trachea and esophagus. Other than this, there have been no reports in the recent literature of the anomalous vessel passing between the esophagus and trachea or anterior to the trachea. Material The records of infants with an aberrant right subclavian artery treated surgically during the past ten years at the Columbus Children s Hospital were reviewed (Table). In all patients the anomalous artery passed posterior to the esophagus, and all had the characteristic posterior indentation of the esophagus on barium swallow (Fig. 3). The 10 patients included 7 boys and 3 girls. Ages at the time of operation varied from 8 days to 7 months. All patients had respiratory difficulty, and 3 had associated difficulty swallowing. Of the 10, only 2 had a birth weight of less than 5 pounds, 1 being 4 pounds 14 ounces and the other, 2 pounds. All patients had division of the aberrant vessel at the aorta. The 1 postoperative death was that of a patient with Down s syndrome who could not be weaned from the respirator. Followup by interview or letter was available for 8 patients: 1 patient was lost to follow-up. At the time of follow-up, which ranged from one month to ten years with an average of two and one-half years, 3 patients were asymptomatic and 5 were still symptomatic. 560 THE ANNALS OF THORACIC SURGERY
3 FIG. 2. Embryology of development of aberrant right subclavian artery with regression of the right fourth aortic arch rather than the right dorsal aortic segment. Comment The diagnosis of aberrant right subclavian artery is frequently made by a history of respiratory or swallowing difficulties associated with the classic roentgenographic finding of posterior indentation in the barium-filled esophagus above the level of the aortic arch. The indentation angles upward from left to right and corresponds to the course of the vessel toward the superior aspect of the right first rib. The defect is smaller than the posterior compression of vascular rings, such as in a double aortic arch. It is important to note that the esophagus is never dilated above the aberrant right subclavian artery, even in adults, so that, at least roentgenographically, obstruction is doubtful. Frequently the aortic knob in older persons creates a greater defect in the esophagus. Should the anomalous vessel become aneurysmal, as recently reported by Gomes [9], then obstruction is more plausible. The frequency with which respiratory and swallowing difficulties that occur in the first few months of life resolve with conservative management, such as the use of a chalasia chair and psychological support, is well known. It is hard to know, though, which is more important in the patients who VOL. 13, NO. 6, JUNE,
4 COMER, WEINBERGER, AND SIRAK SURGICALLY TREATED PATIENTS WITH ABERRANT RIGHT SUBCLAVIAN ARTERY Patient's Birth Symptoms at Length of Sex & Age Weight Symptoms Follow-up Follow-up M, 8 days 6 lb. 5 oz. Choking spells... a... a M, 6 wk. 7 lb. 0 oz. Pneumonia... b... b M, 7 wk. 7 lb. 8 oz. Stridor, feeding Stridor persists 2 yr. problem M, 8 wk. 5 lb. 14 oz. Wheeze Pe cough Unchanged 1 yr. M, 3 mo. 6 lb. 15 oz. Pneumonia Asymptomatic 1 yr. M, 3 mo. 6 Ib. 10 oz. Cough & re- Unchanged 2 mo. gurgitation M, 6mo. 5 lb. 13 oz. Frequent Unchanged 5 yr. pneumonias, retardation, Apgar 5 F, 6mo. 5 lb. 0 oz. Bronchitis Asymptomatic 2 yr. F, 6mo. 2 lb. 0 oz. Pneumonia Asymptomatic 10 yr. F, 7mo. 4 lb. 14 oz. Bronchitis, Unchanged 4 mo. regurgitation "Lost to follow-up. bdied postoperatively (Down's syndrome). FIG. 3. Posterior indentation of the esophagus by aberrant right subclavian artery on barium swallow. 562 THE ANNALS OF THORACIC SURGERY
5 become asymptomatic postoperatively-the actual division of the aberrant artery or the time and possible psychological support it offers to the parents. The fact that 5 of our 10 surgically treated patients did not have dramatic improvement following division of the supposedly obstructing vessel should make one approach surgical treatment of this anomaly with caution. We recommend an aggressive but conservative approach to relieve symptoms in patients with respiratory and swallowing difficulties and simultaneous aberrant right subclavian artery, along with a thorough search for such problems as cystic fibrosis, chalasia, hiatus hernia, neuromuscular problems of central nervous system origin, or duplications. Our 1 postoperative death was that of a patient with Down s syndrome who could not be weaned from the respirator. Postmortem examination showed nonspecific lung changes. In the original description, in 1794, of a symptomatic aberrant right subclavian artery, Bayford [4] gives a descriptive account of a patient, Jane Fordham, with a fatal history of progressive dysphagia, a history that is not at all incompatible with scleroderma. He gave the syndrome the name dysphagia Zusoria, which means difficulty in swallowing due to a trick of nature. We agree with Bayford that nature may be playing a trick on us, but we believe the trick may well be that the vast majority of aberrant right subclavian arteries truly do not cause symptoms. References 1. Abbott, M. E. Atlas of Congenital Cardiac Disease. New York: American Heart Association, Pp. 16, 17, and Raider, L. Aberrant right subclavian artery. South. Med. J. 60:145, Barry, A. Aortic arch derivatives in human adult. Anat. Rec. 111:221, Bayford, D. Account of singular case of obstructed deglutition. Mem. Med. SOC. London 2:275, Beabout, J. W., Stewart, J. R., and Kincaid, 0. W. Aberrant right subclavian artery; dispute of commonly accepted concepts. Am. J. Roentgenol. Radium Ther. Nucl. Med. 92:855, Blake, H. A., and Manion, W. C. Thoracic arterial arch anomalies, Circulation 26:251, Carney, J. Anomalous right subclavian artery considered in light of recent findings in arterial development: With a note on two cases of an unusual relation of innominate artery to trachea. J. Anat , Congdon, E. D. Transformation of aortic arch system during development of human embryo. Contrib. Embryol. 14:47, Gomes, M. M., Bernatz, P. E., and Forth, R. J. Arteriosclerotic aneurysm of an aberrant right subclavian artery. Dis. Chest 54:63, Holzapfel, G. Ungewohnlicher Ursprung und Verlauf der Arteria Subclavian Dextra. Tiibingen and Wiesbaden: Bergmann, P Scheldrup, E. W. Vascular anomalies of retro-infrahyoid (pretracheal) space and their importance in tracheotomy. Surg. Gynecol. Obstet. 105:327, Zdondsky, E. Roentgen Dingnosis of the Heart and Great Vessels (Translated by L. J. Boyd, 1st American edition). New York: Grune & Stratton, Pp VOL. 13, NO. 6, JUNE,
Aberrant Right Subclavian Artery Aneurysm
Aberrant Right Subclavian Artery William S. Stoney, M.D., William C. Alford, Jr., M.D., George R. Burrus, M.D., and Clarence S. Thomas, Jr., M.D. ABSTRACT Ten patients with aneurysm of an aberrant right
More informationA CASE REPORT OF UNUSUAL ANATOMICAL ANOMALY CAUSING: DYSPHAGIA LUSORIA
A CASE REPORT OF UNUSUAL ANATOMICAL ANOMALY CAUSING: DYSPHAGIA LUSORIA Farhan Khan *1, Suman Mani Pokhrel 2, Rajan Vaidya 3 and Tan Xiao Ping 4 *1,2,4 Department of Gastroenterology, Yangtze Medical University
More informationANOMALOUS RIGHT SUBCLAVIAN ARTERY
ANOMALOUS RIGHT SUBCLAVIAN ARTERY BY J. N. PATTINSON From the Diagnostic X-Ray Department, Middlesex Hospital Received December 15, 1952 Abnormalities in the course of the arteries arising from the aortic
More informationPatient Presenting with Dysphagia
Patient Presenting with Dysphagia Radiology Elective Presentation Mansur Ghani 5/18/2018 S L I D E 0 Patient Presentation 86 y/o female with a past medical history of DM type II, diabetic neuropathy, and
More informationPostgraduate Student, Department of Radiodiagnosis, MVJ Medical College and Research Hospital, Hoskote, Bangalore. 2
RIGHT-SIDED AORTIC ARCH WITH ABERRANT LEFT SUBCLAVIAN ARTERY AND DUPLICATION OF SUPERIOR VENA CAVA Parikhita Hazarika 1, Tejaswani Penmetsa 2, Narendranath Kudva 3 1 Postgraduate Student, Department of
More informationLarge veins of the thorax Brachiocephalic veins
Large veins of the thorax Brachiocephalic veins Right brachiocephalic vein: formed at the root of the neck by the union of the right subclavian & the right internal jugular veins. Left brachiocephalic
More informationDOUBLE AORTIC ARCH SURGERY
DOUBLE AORTIC ARCH SURGERY *Suraj Wasudeo Nagre 1 and Dwarkanath V. Kulkarni 2 1 Department of C.V.T.S., Grant Medical College, Mumbai 2 Department of C.V.T.S., G.S. Medical College, Mumbai *Author for
More informationSurgical implications of right aortic arch with isolation of left subclavian artery'
British Heart journal, I975, 37, 93I-936. Surgical implications of right aortic arch with isolation of left subclavian artery' L. Rodriguez,2 T. Izukawa, C. A. F. MoEs, G. A. Trusler, and W. G. Williams
More informationANNALS OF INTERNAL MEDICINE
ANNALS OF INTERNAL MEDICINE VOLUME 42 JUNE, 1955 NUMBER 6 DYSPHAGIA LUSORIA: CLINICAL ASPECTS IN THE ADULT * By EDDY D. PALMER, Lt. Colonel, MC, F.A.C.P., Washington, D. C. DYSPHAGIA lusoria is the term
More informationAn Anomalous Case of A. Subclavia Dextra Rising from Arcus Aortae as the Last Branch. Hiroshi Hanai, Atsuko Ryumon, Kenji Kamakura
An Anomalous Case of A. Subclavia Dextra Rising from Arcus Aortae as the Last Branch By Hiroshi Hanai, Atsuko Ryumon, Kenji Kamakura and Seiji Kaneko Department of Anatomy, Osaka Dental College, Osaka
More informationIAEM Clinical Guideline 9 Laryngomalacia. Version 1 September, Author: Dr Farah Mustafa
IAEM Clinical Guideline 9 Laryngomalacia Version 1 September, 2016 Author: Dr Farah Mustafa Guideline lead: Dr Áine Mitchell, in collaboration with IAEM Clinical Guideline committee and Our Lady s Children
More information10/14/2018 Dr. Shatarat
2018 Objectives To discuss mediastina and its boundaries To discuss and explain the contents of the superior mediastinum To describe the great veins of the superior mediastinum To describe the Arch of
More informationTHE DESCENDING THORACIC AORTA
Intercostal Arteries and Veins Each intercostal space contains a large single posterior intercostal artery and two small anterior intercostal arteries. The anterior intercostal arteries of the lower spaces
More informationLung sequestration and Scimitar syndrome
Lung sequestration and Scimitar syndrome Imaging approaches M. Mearadji International Foundation for Pediatric Imaging Aid Rotterdam, The Netherlands Pulmonary sequestration Pulmonary sequestration (PS)
More informationThe sinus venosus represent the venous end of the heart It receives 3 veins: 1- Common cardinal vein body wall 2- Umbilical vein from placenta 3-
1 2 The sinus venosus represent the venous end of the heart It receives 3 veins: 1- Common cardinal vein body wall 2- Umbilical vein from placenta 3- Vitelline vein from yolk sac 3 However!!!!! The left
More informationSectional Anatomy Quiz - III
Sectional Anatomy - III Rashid Hashmi * Rural Clinical School, University of New South Wales (UNSW), Wagga Wagga, NSW, Australia A R T I C L E I N F O Article type: Article history: Received: 30 Jun 2018
More informationLate presentation of right aortic arch with large left sided Kommerell diverticulum
www.edoriumjournals.com Case in Images PEER REVIEWED OPEN ACCESS Late presentation of right aortic arch with large left sided Kommerell diverticulum Shalini Koppisetty, Giorgios Bis, Amr E. Abbas, Ravneet
More informationVASCULAR RING: A CAUSE OF CONGENITAL STRIDOR
VASCULAR RING: A CAUSE OF CONGENITAL STRIDOR BY RICHARD W. SMITHELLS From the Bradford Children's Hospital (RECEIVED FOR PUBLICATION FEBRUARY 17, 1953) Stridor beginning at, or soon after, birth is not
More informationThe Uncommon Vascular Ring - Not that Uncommon
Cronicon OPEN ACCESS EC PAEDIATRICS Case Report The Uncommon Vascular Ring - Not that Uncommon Roshan D Souza MD 1, Deepa Prasad MD 1, James Strainic MD 1, Anoop Mohamed Iqbal MD 2 and Ravi Ashwath MD
More informationEmergency Approach to the Subclavian and Innominate Vessels
Emergency Approach to the Subclavian and Innominate Vessels Joseph J. Amato, M.D., Robert M. Vanecko, M.D., See Tao Yao, M.D., and Milton Weinberg, Jr., M.D. T he operative approach to an acutely injured
More informationOriginal Article. Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU. Key words. Background
HK J Paediatr (new series) 2018;23:233-238 Original Article Double Aortic Arch in Infants and Children CH XIE, FQ GONG, GP JIANG, SL FU Abstract Key words Background: This study aimed to report the diagnosis,
More informationThyroid and Parathyroid Glands
Thyroid and Parathyroid Glands Please view our Editing File before studying this lecture to check for any changes. Color Code Important Doctors Notes Notes/ explanation Objectives: By the end of the lecture,
More informationPersistent right aortic arch (PRAA) is the most common
J Vet Intern Med 2004;18:510 514 Tracheal Signs and Associated Vascular Anomalies in Dogs with Persistent Right Aortic Arch James W. Buchanan Medical records of 55 dogs with 1 or more vascular rings around
More informationAortic arch pathology. Cerebral ischemia following carotid artery stenosis.
Important: -Subclavian Steal Syndrome -Cerebral ischemia Aortic arch pathology. Cerebral ischemia following carotid artery stenosis. Mina Aubeed & Alba Hernández Pinilla Aortic arch pathology Common arch
More informationOBJECTIVE: To obtain a fundamental knowledge of the root of the neck with respect to structure and function
The root of the neck Jeff Dupree, Ph.D. e mail: jldupree@vcu.edu OBJECTIVE: To obtain a fundamental knowledge of the root of the neck with respect to structure and function READING ASSIGNMENT: Moore and
More informationDEVELOPMENT & STRUCTURE OF THYROID GLAND DR TATHEER ZAHRA ASSISTANT PROFESSOR ANATOMY
DEVELOPMENT & STRUCTURE OF THYROID GLAND DR TATHEER ZAHRA ASSISTANT PROFESSOR ANATOMY DEVELOPMENT OF THYROID Concept of pharyngeal arch 3 rd week 4 th week Adults 7 th week HISTOGENESIS OF THYROID GLAND
More informationJMSCR Vol. 03 Issue 06 Page June 2015
www.jmscr.igmpublication.org Impact Factor 3.79 ISSN (e)-2347-176x Anatomical Variation in Arch of Aorta: A Case Report Authors Bandopadhyay Debasis Lt Col Dr 1, Krishnan Mythili Dr 2, Kumar Sushil 3 1
More informationDysphagia after EA repair. Disclosure. Learning objectives 9/17/2013
Dysphagia after EA repair Christophe Faure, M.D. Professor of Pediatrics, Division of Pediatric Gastroenterology, Sainte-Justine University Health Center, Université de Montréal, Montréal, QC, Canada christophe.faure@umontreal.ca
More informationTHE GOOFY ANATOMIST QUIZZES
THE GOOFY ANATOMIST QUIZZES 5. NERVES Q1. Which of the following classifications of the nervous systems is correct? A. The autonomic nervous system is composed of the brain, cranial nerves and spinal nerves.
More informationNonrecurrent laryngeal nerve during carotid artery surgery: Case report and literature review
Nonrecurrent laryngeal nerve during carotid artery surgery: Case report and literature review Michael A. Coady, MD, MPH, Felix Adler, BS, Javier J. Davila, MD, and Vivian Gahtan, MD, New Haven, Conn The
More informationVariations In Branching Pattern Of Coeliac Trunk
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 14, Issue 11 Ver. IV (Nov. 2015), PP 54-58 www.iosrjournals.org Variations In Branching Pattern Of Coeliac
More informationChapter 124: Congenital Disorders of the Trachea. Bruce Benjamin
Chapter 124: Congenital Disorders of the Trachea Bruce Benjamin Investigation of the larynx and pharynx may be incomplete in infants and children with congenital abnormalities without investigation of
More informationCoronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening
Coronary Artery Anomalies from Birth to Adulthood; the Role of CT Coronary Angiography in Sudden Cardiac Death Screening E O Dwyer 1, C O Brien 1, B Loo 1, A Snow Hogan 1, O Buckley1 2, B 1. Department
More informationWheeze. Dr Jo Harrison
Wheeze Dr Jo Harrison 9.9.14 Wheeze - Physiology a continuous musical sound that lasts longer than 250 msec. can be high-pitched or low-pitched, consist of single or multiple notes, and occur during inspiration
More informationHEAD & NECK SWELLINGS
HEAD & NECK SWELLINGS EXCLUDING GOITRE FAISAL GHANI SIDDIQUI MBBS; FCPS; MCPS-HPE; PGDIP-BIOETHICS PROFESSOR OF SURGERY J I N N A H S I N D H M E D I C A L U N I V E R S I T Y MIDLINE SWELLINGS NECK SWELLINGS
More informationChapter 3: Thorax. Thorax
Chapter 3: Thorax Thorax Thoracic Cage I. Thoracic Cage Osteology A. Thoracic Vertebrae Basic structure: vertebral body, pedicles, laminae, spinous processes and transverse processes Natural kyphotic shape,
More informationLecture 01. The Thyroid & Parathyroid Glands. By: Dr Farooq Khan PMC Date: 12 th March. 2018
Lecture 01 The Thyroid & Parathyroid Glands By: Dr Farooq Khan PMC Date: 12 th March. 2018 INTRODUCTION LAYERS OF THE NECK The neck has four major compartments or layer which are enclosed by an outer musculofascial
More informationPRACTICAL GUIDE TO FETAL ECHOCARDIOGRAPHY IC Huggon and LD Allan
PRACTICAL GUIDE TO FETAL ECHOCARDIOGRAPHY IC Huggon and LD Allan Fetal Cardiology Unit, Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK IMPORTANCE OF PRENATAL
More informationSTERNUM. Lies in the midline of the anterior chest wall It is a flat bone Divides into three parts:
STERNUM Lies in the midline of the anterior chest wall It is a flat bone Divides into three parts: 1-Manubrium sterni 2-Body of the sternum 3- Xiphoid process The body of the sternum articulates above
More informationChest and cardiovascular
Module 1 Chest and cardiovascular A. Doss and M. J. Bull 1. Regarding the imaging modalities of the chest: High resolution computed tomography (HRCT) uses a slice thickness of 4 6 mm to identify mass lesions
More information11.1 The Aortic Arch General Anatomy of the Ascending Aorta and the Aortic Arch Surgical Anatomy of the Aorta
456 11 Surgical Anatomy of the Aorta 11.1 The Aortic Arch 11.1.1 General Anatomy of the Ascending Aorta and the Aortic Arch Surgery of the is one of the most challenging areas of cardiac and vascular surgery,
More informationABERRANT RIGHT SUBCLAVIAN ARTERY AND CALCIFIED ANEURYSM OF. Jose Rubio-Alvarez, Juan Sierra-Quiroga, Belen Adrio Nazar and Javier Garcia Carro.
ABERRANT RIGHT SUBCLAVIAN ARTERY AND CALCIFIED ANEURYSM OF KOMMERELL S DIVERTICULUM : AN ALTERNATIVE APPROACH. Jose Rubio-Alvarez, Juan Sierra-Quiroga, Belen Adrio Nazar and Javier Garcia Carro. Department
More informationAneurysms & a Brief Discussion on Embolism
Aneurysms & a Brief Discussion on Embolism Aneurysms, overview = congenital or acquired dilations of blood vessels or the heart True aneurysms -involve all three layers of the artery (intima, media, and
More informationChapter 2 Cardiac Interpretation of Pediatric Chest X-Ray
Chapter 2 Cardiac Interpretation of Pediatric Chest X-Ray Ra-id Abdulla and Douglas M. Luxenberg Key Facts The cardiac silhouette occupies 50 55% of the chest width on an anterior posterior chest X-ray
More informationVASCULAR RINGS A CASE - BASED REVIEW
VASCULAR RINGS A CASE - BASED REVIEW Beverley Newman, BSc. MB.Bch. FACR Professor of Radiology Stanford University and Lucile Packard Children s Hospital Q1,2,3 Frontal chest radiographs on three different
More informationCongenital Anomalies of the Aortic Arch: Evaluation with the Use of Multidetector Computed Tomography
Congenital nomalies of the ortic rch: Evaluation with the Use of Multidetector Computed Tomography ysel Türkvatan, MD Fatma Gül üyükbayraktar, MD Tülay Ölçer, MD Turhan Cumhur, MD Index terms: ortic arch
More informationRight lung. -fissures:
-Right lung is shorter and wider because it is compressed by the right copula of the diaphragm by the live.. 2 fissure, 3 lobes.. hilum : 2 bronchi ( ep-arterial, hyp-arterial ), one artery mediastinal
More informationSheet lab 5 Anatomy: CT Scans
Sheet lab 5 Anatomy: CT Scans In the orientation we see the picture from downward to upward. The first picture is a CT scan at the level of the heart. Left border of the heart is the left ventricle and
More informationCase 47 Clinical Presentation
93 Case 47 C Clinical Presentation 45-year-old man presents with chest pain and new onset of a murmur. Echocardiography shows severe aortic insufficiency. 94 RadCases Cardiac Imaging Imaging Findings C
More informationCervical aortic arch with aortic obstruction:
Thorax, 1980, 35, 26-30 Cervical aortic arch with aortic obstruction: report of two cases ROBERTO TIRABOSCHI, GIANCARLO CRUPI, GIUSEPPE LOCATELLI, SIEW YEN HO, AND LUCIO PARENZAN From the Department of
More informationCase Report Tortuous Common Carotid Artery: A Report of Four Cases Observed in Cadaveric Dissections
Case Reports in Otolaryngology Volume 2016, Article ID 2028402, 4 pages http://dx.doi.org/10.1155/2016/2028402 Case Report Tortuous Common Carotid Artery: A Report of Four Cases Observed in Cadaveric Dissections
More informationSurface anatomy of Cardiovascular system
Surface anatomy of Cardiovascular system Prof. Abdulameer Al-Nuaimi E-mail: a.al-nuaimi@sheffield.ac.uk E. mail: abdulameerh@yahoo.com The lines cover the front, side, and back of the thorax Midsternal
More informationAnomalous muscle bundle of the right ventricle
British Heart Journal, 1978, 40, 1040-1045 Anomalous muscle bundle of the right ventricle Its recognition and surgical treatment M. D. LI, J. C. COLES, AND A. C. McDONALD From the Department of Paediatrics,
More informationThe External Anatomy of the Lungs. Prof Oluwadiya KS
The External Anatomy of the Lungs Prof Oluwadiya KS www.oluwadiya.com Introduction The lungs are the vital organs of respiration Their main function is to oxygenate the blood by bringing inspired air into
More informationOesophageal Disorders
Oesophageal Disorders Anatomy Upper sphincter Oesophageal body Diaphragm Lower sphincter Gastric Cardia Symptoms Of Oesophageal Disorders Dysphagia Odynophagia Heartburn Atypical Chest Pain Regurgitation
More informationAn Overview of Bronchopulmonary Dysplasia and Chronic Lung Disease in Infancy
An Overview of Bronchopulmonary Dysplasia and Chronic Lung Disease in Infancy Housekeeping: I have no financial disclosures Learning objectives: Develop an understanding of bronchopulmonary dysplasia (BPD)
More informationTHE SURGEON S LIBRARY
THE SURGEON S LIBRARY THE HISTORY AND SURGICAL ANATOMY OF THE VAGUS NERVE Lee J. Skandalakis, M.D., Chicago, Illinois, Stephen W. Gray, PH.D., and John E. Skandalakis, M.D., PH.D., F.A.C.S., Atlanta, Georgia
More informationMediastinum It is a thick movable partition between the two pleural sacs & lungs. It contains all the structures which lie
Dr Jamila EL medany OBJECTIVES At the end of the lecture, students should be able to: Define the Mediastinum. Differentiate between the divisions of the mediastinum. List the boundaries and contents of
More informationThoracic vascular anatomical variants
Thoracic vascular anatomical variants Poster No.: C-0944 Congress: ECR 2010 Type: Educational Exhibit Topic: Chest - Vascular Authors: R. dos Santos, Â. Marques, H. M. R. Marques, N. Costa, O. Fernandes,
More informationof the Axillary Artery
Variation in the Origins of the Branches of the Axillary Artery DONALD F. HUELKE Department of Anatomy, The University of Michigan Medical School, Ann Arbor, Michigan Variability in the origin of certain
More informationThoracoscopic division of vascular rings in infants and children
Journal of Pediatric Surgery (2007) 42, 1357 1361 www.elsevier.com/locate/jpedsurg Thoracoscopic division of vascular rings in infants and children Abdulrahman Al-Bassam a, *, Mohammad Saquib Mallick a,
More informationThyroid gland. importance. relations and connections. external laryngeal nerves. malformations.
Thyroid gland 1. Recognize and understand the coverings of the thyroid gland and their clinical importance. 2. Recognize and understand the main parts of the thyroid gland and their locations, relations
More informationDebate in Management of native COA; Balloon Versus Surgery
Debate in Management of native COA; Balloon Versus Surgery Dr. Amira Esmat, El Tantawy, MD Professor of Pediatrics Consultant Pediatric Cardiac Interventionist Faculty of Medicine Cairo University 23/2/2017
More informationTHE THORACIC WALL. Boundaries Posteriorly by the thoracic part of the vertebral column. Anteriorly by the sternum and costal cartilages
THE THORACIC WALL Boundaries Posteriorly by the thoracic part of the vertebral column Anteriorly by the sternum and costal cartilages Laterally by the ribs and intercostal spaces Superiorly by the suprapleural
More informationAnatomy notes-thorax.
Anatomy notes-thorax. Thorax: the part extending from the root of the neck to the abdomen. Parts of the thorax: - Thoracic cage (bones). - Thoracic wall. - Thoracic cavity. ** The thoracic cavity is covered
More informationAnatomy of the coronary arteries in transposition
Thorax, 1978, 33, 418-424 Anatomy of the coronary arteries in transposition of the great arteries and methods for their transfer in anatomical correction MAGDI H YACOUB AND ROSEMARY RADLEY-SMITH From Harefield
More informationCONGENITAL HEART DISEASE (CHD)
CONGENITAL HEART DISEASE (CHD) DEFINITION It is the result of a structural or functional abnormality of the cardiovascular system at birth GENERAL FEATURES OF CHD Structural defects due to specific disturbance
More informationThe Cardiovascular System (Part II)
The Cardiovascular System (Part II) 黃敏銓 mchuang@ntu.edu.tw 解剖學暨細胞生物學研究所 1 Development of veins Three paired veins drain into the tubular heart of a 4-week embryo Vitelline veins: poorly oxygenated blood
More informationCongenital Lung Malformations: Radiologic-Pathologic Correlation
Acta Radiológica Portuguesa, Vol.XVIII, nº 70, pág. 51-60, Abr.-Jun., 2006 Congenital Lung Malformations: Radiologic-Pathologic Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington
More informationRadiological Anatomy of Thorax. Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem
Radiological Anatomy of Thorax Dr. Jamila Elmedany & Prof. Saeed Abuel Makarem Indications for Chest x - A chest x-ray may be used to diagnose and plan treatment for various conditions, including: Diseases/Fractures
More informationDOUBLE AORTIC ARCH IN AN INFANT TREATED SURGICALLY
Thorax (1957), 12, 214. DOUBLE AORTC ARCH N AN NFANT TREATED SURGCALLY BY J. APLEY, F. G. M. ROSS, AND R. MLNES WALKER From the United Bristol Hospitals (RECEVED FOR PUBLCATON FEBRUARY 26, 1957) Among
More informationHeart and Soul Evaluation of the Fetal Heart
Heart and Soul Evaluation of the Fetal Heart Ivana M. Vettraino, M.D., M.B.A. Clinical Associate Professor, Michigan State University College of Human Medicine Objectives Review the embryology of the formation
More informationRespiratory Symptoms due to Vascular Ring in Children
HK J Paediatr (new series) 2016;21:14-21 Respiratory Symptoms due to Vascular Ring in Children GM ZHENG, XH WU, LF TANG Abstract Aim: To highlight the clinical features, signs and diagnosis of vascular
More informationInternational Journal of Health Sciences and Research ISSN:
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Case Report Bilateral Accessory Renal Arteries, Additional Right Renal Vein and Retroaortic Left Renal Vein- A Case Report
More information9/8/2009 < 1 1,2 3,4 5,6 7,8 9,10 11,12 13,14 15,16 17,18 > 18. Tetralogy of Fallot. Complex Congenital Heart Disease.
Current Indications for Pediatric CTA S Bruce Greenberg Professor of Radiology Arkansas Children s Hospital University of Arkansas for Medical Sciences greenbergsbruce@uams.edu 45 40 35 30 25 20 15 10
More informationDiaphragm and intercostal muscles. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology
Diaphragm and intercostal muscles Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Skeletal System Adult Human contains 206 Bones 2 parts: Axial skeleton (axis): Skull, Vertebral column,
More information(i) Family 1. The male proband (1.III-1) from European descent was referred at
1 Supplementary Note Clinical descriptions of families (i) Family 1. The male proband (1.III-1) from European descent was referred at age 14 because of scoliosis. He had normal development. Physical evaluation
More informationSurgical anatomy of thyroid and parathyroid glands
Head & Neck Surgery Course Surgical anatomy of thyroid and parathyroid glands Dr Pierfrancesco PELLICCIA Pr Benjamin LALLEMANT Service ORL et CMF CHU de Nîmes CH de Arles Thyroid glands Dr Pierfrancesco
More informationEmbryology of the Ophthalmic Artery: a Revived Concept
www.centauro.it Interventional Neuroradiology 15: 363-368, 2009 Letter to the Editor Embryology of the Ophthalmic Artery: a Revived Concept M. KOMIYAMA Department of Neurosurgery, Osaka City General Hospital;
More informationDR Turner, JA Vincent, and ML Epstein. Isolated right pulmonary artery discontinuity. Images Paediatr Cardiol Jul-Sep; 2(3):
IMAGES in PAEDIATRIC CARDIOLOGY Images PMCID: PMC3232486 Isolated right pulmonary artery discontinuity DR Turner, MD, * JA Vincent, ** and ML Epstein *** * Senior Fellow, Division of Cardiology, Children's
More informationCONGENITAL KINKING OF THE AORTIC ARCH
CONGENITAL KINKING OF THE AORTIC ARCH BY J. N. PATTINSON AND R. G. GRAINGER From the Radiodiagnostic Departments of the Middlesex, St. Thomas' and the London Chest Hospitals Received February 9, 1959 In
More informationEsophageal Intramural Diverticulosis
Esophageal Intramural Diverticulosis A Clinical and Pathological Survey John W. Hammon, Jr., M.D., Reed P. Rice, M.D., Raymond W. Postlethwait, M.D., and W. Glenn Young, Jr., M.D. ABSTRACT This paper presents
More informationLife-Threatening Respiratory Distress from Mediastinal Masses in Infants
Life-Threatening Respiratory Distress from Mediastinal Masses in Infants J. Alex Haller, Jr., M.D., Dennis W. Shermeta, M.D., James S. Donahoo, M.D., and John J. White, M.D. ABSTRACT From 1972 through
More informationUndergraduate Teaching
Prof. James F Meaney Undergraduate Teaching Chest X-Ray Understanding the normal anatomical by reference to cross sectional imaging Radiology? It s FUN! Cryptic puzzle Sudoku (Minecraft?) It s completely
More informationThe Neck the lower margin of the mandible above the suprasternal notch and the upper border of the clavicle
The Neck is the region of the body that lies between the lower margin of the mandible above and the suprasternal notch and the upper border of the clavicle below Nerves of the neck Cervical Plexus Is formed
More informationTracheal stenosis in infants and children is typically characterized
Slide Tracheoplasty for Congenital Tracheal Stenosis Peter B. Manning, MD Tracheal stenosis in infants and children is typically characterized by the presence of complete cartilaginous tracheal rings and
More informationPrimary Resection of Kommerell Diverticulum and Left Subclavian Artery Transfer
Primary Resection of Kommerell Diverticulum and Left Subclavian Artery Transfer Carl L. Backer, MD, Hyde M. Russell, MD, Katherine C. Wurlitzer, BA, Jeffrey C. Rastatter, MD, and Cynthia K. Rigsby, MD
More informationA SURGEONS' GUIDE TO CARDIAC DIAGNOSIS
A SURGEONS' GUIDE TO CARDIAC DIAGNOSIS PART II THE CLINICAL PICTURE DONALD N. ROSS B. Sc., M. B., CH. B., F. R. C. S. CONSULTANT THORACIC SURGEON GUY'S HOSPITAL, LONDON WITH 53 FIGURES Springer-Verlag
More informationLecturer: Ms DS Pillay ROOM 2P24 25 February 2013
Lecturer: Ms DS Pillay ROOM 2P24 25 February 2013 Thoracic Wall Consists of thoracic cage Muscle Fascia Thoracic Cavity 3 Compartments of the Thorax (Great Vessels) (Heart) Superior thoracic aperture
More informationCT of Acute Thoracic Aortic Syndromes Stuart S. Sagel, M.D.
CT of Acute Thoracic Aortic Syndromes Stuart S. Sagel, M.D. Thoracic Aortic Aneurysms Atherosclerotic Dissection Penetrating ulcer Mycotic Inflammatory (vasculitis) Traumatic Aortic Imaging Options Catheter
More informationLab #3. Mohammad Hisham Al-Mohtaseb. Jumana Jihad. Ammar Ramadan. 0 P a g e
Lab #3 Mohammad Hisham Al-Mohtaseb Jumana Jihad Ammar Ramadan 0 P a g e Last anatomy lab: Lungs and structure on the mediastinal surfs: 1-the right lung: How do we know it s the right lung??? -the 3 lobes
More informationHonors Biology: Rat Dissection ONLINE ASSIGNMENT
Name: Honors Biology: Rat Dissection ONLINE ASSIGNMENT You and your group members will use the Honors Biology WIKI to create an online dissection manual. The point of this assignment is to illustrate what
More informationSubject Index. Bacterial infection, see Suppurative lung disease, Tuberculosis
Subject Index Abscess, virtual 107 Adenoidal hypertrophy, features 123 Airway bleeding, technique 49, 50 Airway stenosis, see Stenosis, airway Anaesthesia biopsy 47 complications 27, 28 flexible 23 26
More informationAberrant Subclavian Arteries: Cross-Sectional Imaging Findings in Infants and Children Referred for Evaluation of Extrinsic Airway Compression
Lane F. Donnelly 1 Robert J. Fleck 1, 2 Preeyacha Pacharn 1, 3 Matthew. Ziegler 1 radley L. Fricke 1 Robin T. Cotton 4 Received September 25, 2001; accepted after revision November 16, 2001. 1 Department
More informationAnatomic variants of the normal coronary artery circulation
Diagnosis and Operation for Anomalous Circumflex Coronary Artery Keishi Ueyama, MD, PhD, Mahesh Ramchandani, MD, Arthur C. Beall, Jr, MD, and James W. Jones, MD, PhD Department of Surgery, Baylor College
More informationTracheal Compression by the
Tracheal Compression by the Innominate Artery in Children W. T. Mustard, M.D., C. E. Bayliss, M.D., Blair Fearon, M.D., D. Pelton, M.D., and G. A. Trusler, M.D. V ascular anomalies causing tracheobronchial
More informationChest X-ray Interpretation
Chest X-ray Interpretation Introduction Routinely obtained Pulmonary specialist consultation Inherent physical exam limitations Chest x-ray limitations Physical exam and chest x-ray provide compliment
More informationCase Report Recurrent Wheezing and Cough Caused by Double Aortic Arch, Not Asthma
Hindawi Case Reports in Cardiology Volume 2017, Article ID 8079851, 4 pages https://doi.org/10.1155/2017/8079851 Case Report Recurrent Wheezing and Cough Caused by Double Aortic Arch, Not Asthma Qiao Zhang,
More informationLooking Outside the Box: Incidental Extracardiac Finding in Echo
Looking Outside the Box: Incidental Extracardiac Finding in Echo Dr. Aijaz Shah Head of Division, Adult Echocardiography Laboratory Prince Sultan Cardiac Centre Riyadh Case 1 17 year old boy presented
More informationPOSTOPERATIVE CONGENITAL ESOPHAGEAL ATRESIA COMPLICATIONS: A REVIEW
CHILDREN S HOSPITAL II POSTOPERATIVE CONGENITAL ESOPHAGEAL ATRESIA COMPLICATIONS: A REVIEW Dr. Nguyen Thuy Hanh Ngan Neonatal Department CONTENTS 1. Background 2. Classification 3. Management 4. Complications
More information