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'\l J>

REPORT ON SOME

Anatomical Variations

FOR 1882.
BY

FRANCIS J. SIIEI'IIERD, M. D.,

OF MONTREAL, CANADA.

REPRINT.

UROOKLYN, N.Y.

Annals of Anatomy and Surgeky,

No. 4 Monrne Street.

1882.

, 4

ON SOME ANATOMICAL VARIATIONS.
Bv FRANCIS J. SHEPHERD, M.D., CM., M.R.C.S., Eng.,

OF MOWTREAL, CANADA,

DEMONSTRATOR OF ANATOMY IN MC GILL UNIVERSITY ; SURGKON TO THE
OUT-DOOR DEPARTMENT OF THE MONTREAL GENERAL HOSPITAL.

'T^HE following variations were among the most im-
A portant observed in the dissecting room of McGill
University during the last Winter session (i88i-'82):

SYMMETRICAL DEPRESSIONS IN THE PARIETAL BONES.

The skull-cap of an old woman, aged about seventy (70),
presented a most remarkable appearance. In each pari'
etal bone, i cm. from the sagittal suture, was an
oblong, ovoid, smooth depression, measuring on the right
side 7 cm. in length by 5 cm. in jvidth, and on the left
8 cm. in length by 5.5 cm. in width. These depressions
were i cm. in depth, and, as they approached the coronal
suture, they increased their distance from the sagittal.
They terminated anteriorly 3 cm. from the line of the
coronal suture. The deficiency of bone was evidently at
the expense of the outer and middle tables, for the inner
surface of the skull-cap was perfectly sijiooth. The bone
at the bottom of the depressions was quite transparent, and
only of the thickness of parchment. In addition to the
above described depressions, others were seen in the course
of the lambdoidal sutures on each side of the occipital pro-
tuberance ; these were similar in character to the parietal
ones, and the bone was of the same thinness. The one on the

Oa^'^erTlVr "' ^""'''' "^ ''""'"'''^ -^ '^'^^^^O^' Vol. vi., No. 4.

2 FRANCIS J. SIIEPHEHD.

right side was more marked, and measured 5 cm. in length
by 1.5 cm. in breadth. The subject was a very old woman
whose bones exhibited very well m&rked senile osteoporosis'
The left femur was very characteristic, and there was an
intra-capsular fracture of the right. The astragalus could
easily be broken down between the finger and thumb
The bones of the skull were yellow, fatty, and porous.

Prof. Humphry, in an interesting paper on these depres-
sions,' says he is unable to tell how they are produced • he
does not believe they are caused by disease or accident, and
suggests that they may be due to absorption of the outer
tables of the skull, but remarks "that it is as difficult to
know why absorption should attack this region as why
deficiency ot formation should be manifested here." Prof
Humphry has seen similar depressions in the skull of an
ourang-outang, and also in an infant. In the case I have
described above I have no doubt the cause was senile osteo-
porosis ; this supposition is strengthened by the fact that
similar depressions existed in the course of the lambdoidal
sutures, and that all the bones were more or less in an
advanced state of osteoporosis. The lines of all the sutures
had become ossified, and there was no trace of the serrations
of the sagittal or lambdoidal. The coronal could be fairly
made out. It is strange that most, if not all, the cases
of the depressions which have been described have occur-
red in old women. I have elsewhere « reported a somewhat
similar case, also in a woman, but there was no decided
osteoporosis present.

CERVICAL RIB.

This occurred on the left side of a female subject. The
nb was freely movable, and possessed a head, neck and

^ Journal of Anatomy and Physiolo^', vol viii
•Montreal General Hospital Reports, vol. i./iSSo.

ANATOMICAL VARIATIONS. 3

body. Anteriorly it terminated by articulating with a bony
process on the upper surface of the first thoracic rib. The
upper surface of the cervical rib was grooved for the verte-
bral artery and seventh cervical nerve. As I intend, at
some future time, describing this case, with others I have
notes of, I shall not enter into further details at present.
OSSIFICATION OF THE SACRO-ILIAC ARTICULATION.
This rare condition was observed on the right side of a
female pelvis ; the bony union was only at the upper third
of the joint; the lower two-thirds were perfectly normal
and coated with healthy cartilage. It appeared as if the
transverse processes of the two upper pieces of the sacrum
were fused to the upper edge of the articular surface of the
ilium. The first right sacral foramen was considerably
larger than the left, but the right half of the first two pieces
of the sacrum appeared somewhat smaller than the left. It
looked ill-developed. The right articular facet, which artic-
ulated with the fifth lumbar vertebra, was much enlarged
and roughened, and looked as if old disease might have
existed there. The coccyx was completely ossified to the
sacrum, and consisted of five pieces. Ossification of the
sacro-iliac articulation occurs normally in some of the

sloths.^

FUSION OF TIBIA AND FIBULA.

This occurred in the left leg of a muscular male subject.
The lower two inches of the tibia and fibula were fused
together as in many of the lower animals, as, for instance,

the rabbit. This occurs also in one of the Primates the

Tarsius, as a normal condition.

THIRD TROCHANTER OF THE FEMUR.

One example of this anomaly presented. It is homologous
with the trochanter tertius of some of the lower animals

1 Prof. Flower, Lectures on (he Edentata, Brithh Medical Journal, 18S2.

Ill

* FSAKCISJ. SHEPHERD.

(a.s, for example, the horse, rhinocero,, etc.), and gives
attachment to the gh,teus maximum When it occurs i„

tTw ' / "?. '"■'' "''"" "" «"^' '"""•'"'"■ According
o Wa deyer,. ,t occurs in man quite as often as the sup"a

condyIo,c process of the humerus. Furst» found th.a" \

occurred very frequently. In ,„r,y skeletons of Swedes

examined by him in the Caroline In.stitu.e of Stockholm',

fifteen had a trochanter tertius ; and in six skeletons of Lap!

i '^'-

™^ r. AB„OR„AUT,ES OP THE D,GA,TR,c A»D 0„0 HVOTD MUSCLES

landers four possessed a trochanter tertius. I have only
seen it twrce in some two hundred subjects.

HVOGLOSSUS MUSCLE, AB.SENCE OF MIDDLE PORTION.

The portion of this muscle arising from the lesser comu
was once seen wanting. Between the portion arising from

i'.,«rfjrA,..«SJ3^ja

ANATOMICAL VARIATIONS.

the Rrcat cornu and that arising from the body was an
interval where the lingual artery was uncovered by muscle.
In some of the lower animals each portion is a separate
muscle, which might explain the deficiency.

ANTERIOR IJELLV OF THE OMO HVOID INSERTED INTO

THE LOWER JAW.

In this case the anterior belly of the omo hyoid blended
with the stcrno-hyoid, and, passing up over the hyoid bone
(to which it gave a few fibres) and the digastric muscle, was
mserted into the lower jaw a little to the left of the sym-
physis. (See Fig. I, ^). McWhinnic {London Medical
Gazette, 1846) mentions a similar case. I have once
before seen this unusual insertion of omo hyoid. It
occurred on both sides of the same subject.

TWO ANTERIOR BELLIES TO THE DIGASTRIC.
This occurred in the same subject and on the same side
as the above-mentioned omo hyoid variation. The anterior
belly divided into two, one of which was inserted into
the body of the hyoid bone, and the other was inserted, as
usual, mto the lower jaw. The posterior belly ended in a
tendinous raph^, from each side of which muscular fibres
arose, those from the upper part being inserted into the
lower jaw, and those from the lower passing down to the
hyoid bone. There was no distinct binding down to the
hyoid bone by fascia of the tendon. (See Fig. i, D\

MUSCULAR SLIP FROM THE MASTOID PROCESS TO THE
SERRATUS POSTICUS SUPERIOR.

This slip was noted as occurring on the left side of a
muscular male subject. It arose from the mastoid process
beneath the sterno-mastoid, passed over the splenius capitis
and colli, and ended by a tendinous expansion in the upper
edge of the serratus posticus superior an inch from the

FRANCIS J, SHEPHERD.

spinous processes. The slip „as or good si.e, measuring
half an mcli rn breadth. ''

MUSCULAR SUI. FROM ,,EVAr„K AN,;UL, .SCAPULA TO THE

SKRRATUS MAUNUS.
This occurred in .wo subjects. I„ one .he slip' was
double one portion going .o be inserted into the first rib
belHnd the tubercle, and the other blending with the first
serration of the serratus magnus.
On one occasion a slip was seen passing from the levator
■ 7"'-"?"'- 'o the rhomboideus minor. This occurred
on both sues of the same subject. All these different slips
have been described by Prof. Wood,, and are considered by
h.m to be varieties and modifications of the occipito-scapular
muscle, winch occurs normally in many of the lower animaK

STERNO-SCAPULAR MUSCLE.
This muscle was noticed on the right' side of a female
subject. It arose from the upper border of the scapula and
the transverse ligament in common with the omo hyoid
passed under the clavicle and over the axillao^ vessels and

o"fTV' k"T' '^' ^°""' ^"^^^" into the cartilage
o he first nb. The right subclavius muscle was of smfll
s ze. This muscle, according to Prof. Wood,» occurs norm-
ally m the msectivora, but reaches its highest development
in pachyderms or ruminants as the elephant, hippopotamus,
P.g, horse, etc., and it sometimes embodies the subclavius
and at other times is made up, by the union at the imperfect
clavicle or its tendinous representative, of a sterno-clavicular
and scapulo-clavicular element. I have notes of four cases
occurring in two hundred and twenty subjects.

PECTINEUS.
On the left side of a male subject this muscle was divided
mto two by a distinct intermuscular septum. The inner
» Transactibnofthe Philosophical Society, London, 1870

LOC. Clt,

ANATOMICAL VAIHATIONS. 9

portion was supplied by a branch from the obturator nerve,
and the outer by a branch from the anterior crural. This
is the normal arrangement in some of the lower animals.

SUPERNUMERARY HEAD TO THE QUADRICEI'.S EXTENSOR

MUSCLE.

This extra head arose on the left side of a male subject
by two tendinous slips, one of which had its origin from the
anterior portion of the capsule of the hip joint, the other
from the anterior border of the great trochanter. These
two slips soon united and formed one strong tendon, which
passed down the thigh between the iliacus and the tensor
vaginae femoris lying on the vastus extcrnus, about the
middle of the thigh it became muscular and passed under
the rectus femoris, and was inserted into the common quad-
riceps tendon. The muscular belly was three inches in
length.

PLANTARIS, TWO HEADS.
The second head arose by fleshy fiBres from the posterior
ligament of the kwee joint and the outer head of the gas-
trocnemius.

BRACHIO-RADIALIS.

This muscle was seen in the right arm of a male subject
It arose from the external condyloid ridge above the supi-
nator longus, and between it and the insertion of the del-
toid ; it passed down internal to the supinator longus and
external to the biceps, and over the supinator brevis to be
inserted by a round tendon into the oblique line of the
radms immediately above the insertion of the pronator
radu teres. This muscle was of considerable size. Prof
Wood Mooks upon this muscle as a variety of fourth head
to the biceps. In the same arm various other anomalies
existed. (2.) A tendinous slip passed from the tendon of
Steeps to the pronator radii teres. It was given olT from the
' Proceedings of Royal Society. London, 1868.

Ill

ff-i

^ FRANCIS J. SHEPHERD.

tendon of the biceps two inches from its insertion, passed
• downwards and inwards crossing the radial artery, joined the
pronator about the junction of its upper and middle third
(3.) The extensor carpi radialis longior and brevior arose
together, and after passing down the forearm for a short
distance, divided into three slips, two of which united to
form the longior tendon, and the largest formed the brevior
The,r msertion was normal. (4.) The flexor carpi radialis
had two heads : the second was tendinous, and arose from
the mner side of .he coronoid process below the pronator
teres. The median nerve passed between the two heads
<S.) There was continuity of the brachialis anticus with the
supmator longus by a muscular slip. This occurs normally
in apes and monkeys, assisting them in twisting their bodies
when hangmg by their anterior extremities. 1

THE INFERIOR THYROID ARTERY.
This artery was absent in the right side of a female sub-
ject, the superior thyroid being of large size. In the same
subject the right vertebral artery entered the transverse pro-
cess of the third cervical vertebra.

COMMON ILIAC ARTERIES.
In a negress, where the abdominal aorta divided between
the fourth and fifth lumbar vertebra, the iliacs were
unusually short, measuring only 2 cm. (^ inch) in length
guam, m. his work on the arteries, mentions one similar
case.

HIGH DIVISION OF THE POPLITEAL.
_ It divided opposite the posterior ligament of the knee
joint mto two branches-viz., the posterior tibial and a com-
mon trunk for the anterior tibial and peroneal artery The
peroneal artery was of large size. This is 'the first case of
nigh division I have met with.

> Prof. Wood, Proceedings of Royal Society. London, 1866.

ANATOMICAL VARIATIONS. q

ABNORMAL HEPATIC VEINS.
After the vena cava had pierced the liver, and had there
been joined by a few small hepatic veins, principally from
the left lobe, it passed on as usual to the diaphragm; just
as it pi'erced the diaphragm it was joined by a large vein,
the size of a finger, and with walls as thick as an artery of like'
size. This vein, when traced back, proved to be a common
trunk formed by two large hepatic veins, which came from
the right lobe. The common trunk measured an inch in
length. Hepatic veins have been seen emptying directly into

FIG. 2. ABNORMAL HEPATIC VEINS.

R, Right auricle ; D, Line of the diaphragm • Z» Liver • v v
inferior ; H, Abnormal hepatic veins. ' ^ ' ^' ^'"" "^^

the right auricle, and this is the normal arrangement in some
of the lower animals. The case I have described is apparently
an mtermediate stage of the above-mentioned variety (See
Fig. 2). ' ^

THORACIC DUCT.

In a negress the thoracic duct had the following course •

It commenced, as usual, from the receptaculum chyli then

crossed over the aorta and passed through the aortic opening

of the diaphragm to the left side of the artery, continued up

Ill

"R^^CISJ. SHEPHEND .

'•40 c. [j;: i ; zr: ~r- ■' - o„„

a. .-ts i„„..-o„ with .he ccecu^wa ' X tsL; "^ "^"■"
'ng as this of the opening between the il. f""""

«>ighteasi„gi.e„se to sl^JZ/'^lZl^.T''
not seen this pent noticed by writers on ITl '

I discovered this specimen, , h'ave ha te utX to "
am.ne some dried specimens in my possession o,,,
measurements, I find the average length o The „ '

six preparations is 3.25 cm andth. '""'"«^ '"

or the iienm c,ose\o' thTclV ^f: Thr^""
opening is 3.80 cm,, with a circmV ^'■^^"

8.^ cm. The s,.ort:stotni„r »::"">: ''""" °'
ence of ileum 6 cm. So it seems fZ T' """" "'^"■"f""

that in normaicasesthere s a prlr"^'"""'""''
circumference of the ileum and t^CTf T''" '"'
In the case with the small „ , ^^ °P'"''"g-

not exist, as the iltmr ^t^^i^ "°""°" "'^

TABLE.

Greatest circumference of ileum, I 8.70cm. \\ Length nf,. I

Smallest Circumference of ileum. 6.L. L„" h ! r^'^"''"^'' ^•5°^-
Greatest length of opening, ' II ^^"g^h of the.

Smallest length of opening,

3.80 cm. Circumference,
2. 20 cm. Circumference,

opening,! 2.20cm,

8. 60 cm.
6,00 cm.

mmmia

mrr

il verte-
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