International Journal of Cadaveric Studies and Anatomical Variations

A Split Above: Case Report on High Bifurcation of the Tibial Nerve

2026-06-29T23:48:04-05:00

The tibial nerve, one of the terminal branches of the sciatic nerve, is a mixed nerve that provides motor innervation to the posterior leg and most intrinsic foot muscles, and cutaneous innervation to the plantar surface of the foot. Here we report a case of an 84 year-old female donor with a tibial nerve bifurcation more proximal to the medial malleolar-calcaneal axis that, to our knowledge, has ever been reported before in the literature. Routine donor dissection conducted at the University of Maryland Eastern Shore Department of Physical Therapy found that the tibial nerve divided into medial and lateral plantar nerves deep to the soleus muscle in the posterior compartment of the leg. The medial malleolar-calcaneal axis was used as a reference line for measurements, spanning from the medial malleolus to the medial calcaneal tubercle. Measurements were taken with a Kynup digital caliper and the split was found to occur 158.06 mm proximal to the medial malleolar-calcaneal axis. Understanding the extent of neurovascular variation in the medial ankle is critical as this region is commonly targeted in medical interventions such as a nerve block or pin and plate placement for fracture fixation. Here we expand the current knowledge of anatomical variation possible in the human body highlighting the need for imaging during patient specific medical interventions.

Anatomical Variation of Dens Ankylosis in a 91-Year-Old Donor: A Case Report and Literature Review

2026-06-30T01:40:23-05:00

This case highlights a previously undescribed lesion at the craniovertebral junction characterized by ankylosis of the dens to the anterior arch of the atlas (C1) and the anterior rim of the foramen magnum. This fusion was identified during donor dissection as part of a medical school neuroanatomy curriculum. Results of a thorough literature review are reported, confirming the novelty of the lesion described herein. Although a limited clinical history from our donor was available, the lesion may have influenced neurologic symptomatology. This case underscores the ongoing significance of human donor dissection in both the evolving field of anatomy and biomedical education.

Brain Protection

2026-09-27T15:51:07-05:00

The brain is a vital organ, but it is also a very fragile tissue. In this article, we try to focus on its protective mechanisms. The brain is supported by external and internal means of protection. The brain's external protection consists of more than one layer, including the strong bones of the skull, followed by the three meningeal membranes: the dura mater, the arachnoid mater and the pia mater. This is in addition to the cerebrospinal fluid tube located in the subarachnoid space and extending within the brain cavities. These cavities are the two lateral ventricles, one within each cerebral hemisphere; the third ventricle, which is the diencephalon cavity separating the thalami; the fourth ventricle, which represents the rhombencephalon located between the pons and medulla oblongata in front and the cerebellum in back; and the aqueduct of Sylvius located within the short midbrain. On the other hand, internal protection includes the Blood-Brain Barrier (BBB), which acts as a barrier against harmful substances that may be present in the blood, but unfortunately this is not a perfect barrier as some ingested substances can pass through it to reach the brain. This necessitates special care, including avoiding head injuries whenever possible, and refraining from taking medications or any harmful substances such as narcotics that may cross the BBB and negatively affect the brain.

Bilateral Reversed Palmaris Longus Muscle and the Connection to Down syndrome: A Case Report

2026-09-27T15:51:05-05:00

Objective: The palmaris longus muscle is located in the forearm's anterior or flexor compartment and exhibits a wide range of anatomical variations. Reversed palmaris longus muscle, with the muscle belly at the distal attachment, is rare, and the bilateral reversed variant is even more uncommon. Here, we present a case of bilateral reversed palmaris longus muscle in a donor with Down syndrome and explore its genetic, morphological, clinical, and surgical implications.

Methods: This case details the discovery of a bilateral reversed palmaris longus muscle in a donor with a history of Down syndrome. Images of the variation were obtained and measurements were recorded.

Results: A reversed palmaris longus muscle was observed in the anterior or flexor compartment of both forearms. On the right forearm, a proximal tendon was followed by a distal muscle belly in the wrist, with two distal tendon attachments. The left reversed palmaris longus muscle had a proximal tendon followed by a distal muscle belly and a single distal tendon attachment. No other anatomical abnormalities were observed in the anterior forearm bilaterally.

Conclusion: This case, to the knowledge of the authors, details the first documented instance of bilateral reversed palmaris longus muscle in an individual with Down syndrome. Although the relationship between Down syndrome and palmaris longus muscle variants has rarely been explored, abnormal gene expression may contribute to this association. This case aims to increase awareness and offer insight into an underrecognized variant of the palmaris longus muscle, highlighting the importance of identifying such variants in clinical evaluation and surgical planning.

A Rare Bilateral Variation of the Median Cubital Vein Traversing Deep to the Bicipital Aponeurosis

2026-09-27T15:51:03-05:00

Objective: To describe a rare anatomical variation of the median cubital vein (MCV) identified during human donor dissection and discuss its potential clinical implications for venipuncture and vascular access procedures.

Methods: Routine anatomical dissection of the upper limbs of a 78-year-old female donor was performed at a medical school anatomy laboratory. The superficial venous anatomy of the cubital fossa was examined, with particular attention to the course and relationships of the MCV relative to the bicipital aponeurosis and surrounding neurovascular structures.

Results: Dissection revealed a bilateral variation in which the MCV coursed deep to the bicipital aponeurosis rather than superficial to it, as is typically observed. The vein maintained its usual connections with the cephalic and basilic veins but passed beneath the aponeurotic layer on both sides. Previously documented cases of this variation have been limited to unilateral findings in male donors, making the present case the first reported bilateral occurrence in a female donor. The deeper location of the MCV may reduce venous visibility and palpability, potentially increasing the difficulty of venipuncture and placing the vein in closer proximity to the brachial artery and median nerve.

Conclusion: A median cubital vein located deep to the bicipital aponeurosis represents a rare anatomical variation with important clinical implications. Awareness of this configuration may help clinicians anticipate difficult venous access and reduce the risk of neurovascular injury. In such cases, ultrasound-guided vascular access may improve procedural success and patient safety, particularly in emergency or high-risk clinical settings.

The Global Impact of the International Journal of Cadaveric Studies and Anatomical Variations on the Advancement of Medicine

2026-09-27T15:51:00-05:00

Anatomical precision is a prerequisite for patient safety. As such, knowledge in anatomical variations is essential for practicing clinicians and surgeons. The International Journal of Cadaveric Studies and Anatomical Variations (IJCSAV) is a frontrunner in providing this essential resource to the medical community at large.

Human Anatomy is the Gateway to the Study of Medicine and Sound Medical Practice

2026-09-27T15:50:58-05:00

Medical sciences are classified into two main categories: basic medical sciences, such as anatomy, and clinical or specialized sciences, which include practical medical and surgical disciplines that deal with health disorders, and their sub-specialties. Anatomy represents the backbone of basic medical science and the gateway to its study and subsequently clinical science.