Browsing by Author "Ilayperuma, I."

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Anatomical dimension of the Caudate lobe of the liver
(University of Kelaniya, 2011) Widanagama, M.A.; Prabodha, L.B.L.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
On the posterior surface of the liver, the Caudate lobe lies between the inferior vena cava and the fissure for the ligamentum venosum. It is connected to the right lobe of the liver by the Caudate process. However, functionally it belongs to the left lobe. In left hepatic lobectomy, the left lobe together with most of the Caudate lobe is removed. Furthermore, the diameters of right lobe and Caudate lobe have been used to distinguish between the normal and cirrhotic livers. This study was carried out to establish the anatomical dimensions of the Caudate lobe in a group of adult Sri Lankans. A total of 26 apparently healthy livers obtained from formalin fixed cadavers were studied. The Caudate lobe was measured along its maximum antero-posterior and transverse diameters using a sliding caliper capable of measuring to the nearest 0.01 mm. Maximum transverse diameter of the right lobe of the liver was taken to compare the ratio between the right lobe and the Caudate lobe. The mean maximum antero-posterior and transverse diameters of the Caudate lobe was 51.6 ± 4.6 mm and 27.6 ± 4.5 mm respectively. The transverse diameter of the right lobe was 85.05± 13.2 mm. The mean ratio of the transverse diameter of the Caudate lobe to that of the right lobe was found to be 0.32 ± .06. The results of the study demonstrate the anatomical dimensions established for the Caudate lobe for a group of adult Sri Lankan population. These data will facilitate in improving the outcome of surgical procedures of the liver.
Anatomical dimensions of the portal vein: A cadaver study
(12th Annual Research Symposium, University of Kelaniya, 2011) Pinsara, G.H.M.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
The portal vein is formed by union of the superior mesenteric and splenic veins. It lies in front of the inferior vena cava and runs vertically upwards in the free edge of the lesser omentum finally reaching the porta hepatis. In liver transplantation and pancreatectomy, a length of portal vein is removed for anastomose with the recipient vessels. A complete knowledge of the anatomic variations in portal venous anatomy is an essential prerequisite for the outcome of these procedures. Despite the significance of the portal vein little is known about its dimensions in Sri Lankans. The present study was undertaken to investigate the diameter and length of portal vein in a group of adult Sri Lankan population and to compare the results with other published data. The characteristics of cadavers including age, gender, weight and height were recorded. A total of twenty four apparently healthy livers obtained from cadavers were utilized. The diameter of the portal vein at a predetermined sites and the length up to the porta hepatis were recorded. All measurements were taken using a sliding caliper capable of measuring to the nearest 0.01 mm. Results were expressed as mean ± SD. Statistical analysis was performed using the t test. P value <0.05 was considered statistically significant. Portal vein anatomy was normal and mono-pad in all cases studied. The mean diameter of the portal vein at the porta hepatis was found to be 8.96±1.26mm and the mean length was 8.28±2.33cm. The results indicated that in our study population, the portal veins are longer but their diameters were smaller than when compared with the reported measurements in the anatomy texts. These may be attributed to racial differences. Precise knowledge of the expected normal portal vein diameter at a given anatomic location is the first step towards developing a quantitative estimate of the severity of the portal vein abnormalities. This study provides a reference data set for adult Sri Lankans against which to compare the diameters of the portal vein in various pathological conditions.
An anatomical study of the tarsal tunnel: A cadaveric study
(University of Kelaniya, 2011) Karunanayake, A.; Hasan, R.; Salgado, S.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; de Alwis, R.P.; Herath, S.; Senadipathy, C.; Mahawaththa, T.; Fernado, E.; Ilayperuma, I.
Tarsal tunnel is a passage formed between the flexor retinaculum and the underlying tarsal bones. Tendons of tibialis posterior, flexor digitorum longus, flexor hallucis longus and the neurovascular bundle of the posterior compartment of the leg pass through this tunnel in separate fascial compartments. To relieve symptoms and signs of Tarsal tunnel syndrome, orthopedic surgeries and anesthetic nerve blocks are used. Therefore, knowing the anatomy of the tarsal tunnel is important to understand and manage conditions related to this region. The aim of this study, is to describe the morphology and its possible variations in a Sri Lankan population compared to what is described in standard anatomy text books. A descriptive study was carried out by dissecting 28 human cadavers available in the Department of Anatomy, University of Kelaniya. Typical anatomy was observed in 26 cadavers (92.85%) where tibialis posterior (TP), flexor digitorum longus (FDL),neurovascular bundle and flexor hallucis longus (FHL) were in separate compartments anterior to posterior respectively. In one cadaver (3.57%) FDL and FHL were in a single compartment. In another cadaver (3.57%) bifurcation of the tendon of flexor digitorum longus was observed passing through a separate compartment posterior to neurovascular bundle. Even though the majority of the results were in agreement with the typical description of the anatomy of the tarsal tunnel, a certain degree of variability was observed in this area. This knowledge will be of use to clinicians involved in procedures related to the tarsal tunnel.
Coracobrachialis muscle: morphology, morphometry and gender differences
(Springer, 2016) Ilayperuma, I.; Nanayakkara, B.G.; Hasan, R.; Uluwitiya, S.M.; Palahepitiya, K.N.
PURPOSE:Coracobrachialis (CBM) is a complex muscle with a wide range of variations in its morphology and innervation. The goal of this study was to elucidate the morphology, morphometry, gender differences of CBM and precise anatomical position of the musculocutaneous nerve (MCN) with reference to surrounding anatomical landmarks in an adult Sri Lankan population. METHOD: Cadaveric upper limbs (n = 312) were examined for the proximal and distal attachments, length, width, thickness of CBM and its relationship with the MCN. RESULTS: The CBM originated from the tip of the coracoid process of the scapula and lateral, posterior and medial aspects of the tendon of short head of biceps brachii. Gender differences were observed in all morphometrical parameters of CBM. In 83.33 %, MCN perforated the CBM. In 50 % the MCN pierced the middle one-third of CBM while none pierced the lower one-third. The distance from the coracoid process to the point of entry of MCN into CBM (distance P) was 50.62 mm. A positive correlation was observed between the arm length and distance P indicating that arm length provides an accurate and reliable means of gauging the distance P of an individual. CONCLUSION: The present study provides new evidence pertaining to the origin of CBM. Further, it was revealed that the predicted distance P of any upper extremity can be calculated by dividing the arm length by 5. Precise anatomical location of MCN in relation to CBM using unequivocal and well-defined anatomical landmarks will be imperative in modern surgical procedures.
Incidence of pyramidalis muscle
(University of Kelaniya, 2011) Rajawasam, P.P.; Prabodha, L.B.L.; Gamage, U.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
Pyramidalis is a triangular muscle that lies in front of the lower part of rectus abdominis muscle within the rectus sheath. This muscle is known to vary considerably in size and present either unilaterally or bilaterally. A large number of studies supports the racial variation in its occurrence. This preliminary study was carried out to investigate the incidence of pyramidalis muscle and also to establish its anatomical dimensions in a sample group of Sri Lankans. A total of forty two cadavers were studied during the routine gross anatomy dissections. The presence or absence of the muscle either bilaterally or unilaterally was noted on visual inspection. The maximum length and width of the pyramidalis was measured using a sliding caliper capable of measuring to the nearest 0.01mm. Pyramidalis was present bilaterally in 85.71% and absent in 14.28% of the subjects. The maximum length of the muscle was 6.24 ± 0.12 cm on right side and 7.09 ± 0.20 cm on left side. The maximum width was 1.32 ± 0.14 cm on right side and 1.52 ± 0.18 cm on left side. Bilateral variation in the dimensions of the muscle was statiscally significant. The occurrence of pyramidalis muscle was established for a group of adult Sri Lankan population. Our results reveal there is a racial trend in the incidence of pyramidalis muscle between Sri Lankan and other races such as black and white populations.
Morphology of the Thyroid Gland and its common variations
(12th Annual Research Symposium, University of Kelaniya, 2011) Hasan; Rizvi; de Alwis, R.P.; Herath, S.; Senadipathy, C.; Mahawaththa, T.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; Fernado, E.; Ilayperuma, I.; Salgado, S.
The thyroid gland is an endocrine gland located in the anterior triangle of the neck across the midline. Many pathological conditions such as tumours and inflammatory diseases are associated with the thyroid gland. The incidence of thyroid diseases, with or without an indication for surgical intervention is a common occurrence in clinical practice. Hence an in-depth knowledge of the morphology of the thyroid gland and its variation is of paramount importance to clinicians. Literature surveys carried out do not reveal adequate studies relevant to the morphology of the thyroid gland and its variations in a Sri Lankan population. The aim of the study is to identify the morphology of the thyroid gland and its possible variations in the Sri Lankan population. A descriptive study was carried out by dissecting 31 human cadavers (12 female and 19 male) aged between 35-80 years in the Department of Anatomy, University of Kelaniya. Measurements were taken with Vernier Caliper. The results show thirty one thyroid glands (62 sides) were observed and measurements were taken. Average length, width and thickness of the right lateral lobes were 4.11cm, 1.25cm and 1.95 respectively. Average length, width and thickness of the left lateral lobes were 4.02cm, 1.13cm and 2.05cm respectively. Pyramidal lobe was found in 12 thyroid glands (38.7%), of which 4 were in females and 8 in males. Of these 12, in 9 glands pyramidal lobe was arising from the left lobe (75%) and the rest from the isthmus(25%). Only 83.33% of pyramidal lobes were associated with levator glandulae thyroidae and the rest were independent. Levator glandulae thyroidae was observed in 10 glands (32.25%). In three glands (9.67%) isthmus was found to be absent. Significant gender difference was not identified in the dimensions of the gland. No significant difference in dimensions was observed when compared to western figures. Presence of the pyramidal lobe is not an uncommon finding. Therefore, having a sound knowledge in morphology of the thyroid may reduce the unwarranted outcomes in thyroid surgeries in Sri Lanka.
Morphometrical analysis of the human palatine sutures
(University of Kelaniya, 2011) Udayanga, L.B.M.; Prabodha, L.B.L.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Ambikaipakan, S.
The hard palate is traversed by a crucial suture which consists of mid palatal, interpalatine and transverse palatine sutures. The defects of the fusion of these palatine sutures lead to cleft palate. The goal of this study is to investigate the length and the gender differences of the palatine sutures in dried Sri Lankan skulls. A total of 63 (38 male; 25 female) dried human skulls were included in the study. The combined straight lengths of the midpalatal and interpalatine sutures and transverse palatine sutures were measured following the standard procedures with a spreading caliper capable of measuring to the nearest 0.01 mm. The mean combined lengths of the midpalatal and interpalatine sutures and transverse palatine sutures were (male: 46.76 ± 3.43; female: 44.96 ± 3.12); (male: 36.12 ± 4.6; female: 34.14 ± 2.9) respectively. Gender differences in the lengths of the palatine sutures were statistically significant (p<0.05). The results of this preliminary study establish the existence of a statistically significant sexual dimorphism in the lengths of the palatine sutures. Further, it provides a reference set of data on the lengths of the palatine sutures for an adult Sri Lankan population. Such data will facilitate the understanding of the etiopathogenesis of malformations of this cranial region and artificial teeth mould industry.
Variations in the Termination of the Human Thoracic Duct
(University of Kelaniya, 2012) Hasan, R.; Salgado, S.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; Vithanage, S.; Wijesooriya, P.; Ilayperuma, I.; Fernando, E.
Introduction: The mammalian thoracic duct is the main lymphatic channel which drains lymph from the distal extremities of the trunk, lower limbs and the left half of the proximal trunk. In humans, it runs a typical course commencing over the twelfth thoracic vertebra and ascends through the aortic orifice of the diaphragm. It inclines to the left at the level of the Sternal angle and terminates by draining into the left jugulosubclavian junction. Objectives: Variations from this typical course are not uncommon and have been the subject of extensive research. Knowledge of the possible variations in the thoracic duct would enable accurate thoraco- cervical surgery, thus preventing inadvertent damage to the thoracic duct and consequent leakage of chyle.This research is carried out with the aim ofenhancing the existing knowledge of the possible variations of termination of the human thoracic duct while also documenting a relevant Sri Lankan study. Methodology: This research was carried out as a descriptive study in36 preserved human cadavers in the Departments of Anatomy, the University of Kelaniya and the University of Ruhuna. Results: In 22 (61.11%) cadavers the thoracic duct drained into the left jugulosubclavian junction whereas in 11 (30.56%) cadavers it drained into the left subclavian vein. Moreover, in 2(5.56%) cadavers it drained into the left internal jugular vein. Interestingly, in 1 (2.77%) cadaver thoracic duct drained into both left subclavian vein and jugulosubclavian junction through the presence of a bifurcation. Conclusion: It was apparent that majority of the findings are comparable to previous research, while there were variations in the percentage incidence of the findings.