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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA
BANGALORE
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.
Name of the Candidate
and Address
(in block letters)
2.
Name of the Institution
Dr. MUTYALAPATI VENKATA
RAMULU
H. NO. 43, ADARSHA NAGAR,
BEHIND JANATA QUARTERS,
NEAR K.E.B. OFFICE,
KUSUGAL ROAD,
KESHWAPUR, HUBLI - 580025
KARNATAKA.
J.J.M. MEDICAL COLLEGE,
DAVANGERE - 577 004.
3.
Course of study and subject
POST GRADUATE DEGREE
M.D. – ANATOMY
4.
Date of Admission to course
23rd MAY 2009
5.
Title of the Topic
“A STUDY ON THE INCIDENCE OF
VARIATIONS IN THE ORIGIN AND
COURSE OF RENAL AND ACCESSORY
RENAL ARTERIES BY DISSECTION
METHOD”
6.
Brief Resume of the intended work :
6.1 Need for the study :
Renal arteries are a pair of lateral branches from abdominal aorta, at the
level of L1-L2 intervertebral disc, supplying right and left kidneys situated on
either side of vertebral column.
As the variations of renal arteries is common. A sound knowledge of
these variations is of utmost importance not only to anatomists, but also to
surgeons, radiologists and nephrologists. Thorough knowledge of renal arterial
variations helps in interventional radiological techniques like renal angiography.
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In treating cases of hydronephrosis, where the cause of obstruction might
be an aberrant renal artery over the ureter.
Complications of nephrectomy like secondary haemorrhage and death,
due to unligated upper or lower pole renal artery may be avoided if variations
are well known to the operating surgeon.
In arriving at a cause for varicocele, which may be due to obstruction of
testicular venous outflow by an aberrant renal artery.
Hence there is a need for study of variations of renal arteries.
6.2 Review of literature :
The paired renal arteries, one each to right and left kidneys branch laterally
from abdominal aorta at the level of L1-L2 intervertebral disc, just below the
origin of superior mesenteric artery. The right renal artery is longer and often
higher than left, passing posterior to the inferior vena cava, right renal vein,
head of the pancreas and descending part of duodenum. Left renal artery is a
little lower and passes behind the left renal vein, body of pancreas and splenic
vein.1
A study conducted on 855 consecutive patients who underwent renal
angiography showed, a single renal artery was present in both kidneys in 76%,
and multiple arteries in 24%, bilateral multiple arteries in 5%, and early division
in 8% of the cases. Additional renal arteries on right side 16% and on left side
13% of all cases. Aberrant renal arteries were 51% and accessory renal arteries
49%.2
A case of multiple variations of right renal vessels was reported, where in
65 years old male cadaver had presence of three right renal arteries. Origin of
right inferior suprarenal artery from middle renal artery. Origin of right
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testicular artery from inferior right renal artery.3
A case of two accessory renal arteries originating from left anterolateral
aspect of the abdominal aorta and running into the left kidney, superior and
inferior accessory renal arteries run into superior and inferior pole of left kidney
respectively.4
In a study conducted on 153 living kidney donors who underwent
pre-operative computerized tomography and nephrectomy, showed, the
prevalence of multiple renal arteries as 31%.5
In a study conducted on 400 renal pedicles in 200 dissecting – room
cadavers. Aberrant inferior polar renal artery was found in 3.5% cases
(i.e., 7 cases). Six on right side and one on left side. The vessel originated from
the aorta below the level of corresponding renal vein and proceeded upward and
laterally behind the vein. At the upper border of vein the artery curved down
and descended in front of the vein to reach the kidney near its lower pole.6
6.3 Objectives of the study :
 To study the variations in the origin and course of right and left renal
arteries in human cadavers by dissection method.
 To record any accessory renal arteries if found.
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7.
Material and Methods :
7.1 Source of data :
From embalmed cadavers from the Department of Anatomy, J.J.M.
Medical College, Davangere.
7.2. Method of collection of data (including sampling procedure if any):
By dissection method
Sample size – 50
7.3 Does the study require any investigations or interventions to be
conducted on patients or other humans or animals? If so, please describe
briefly.
No
7.4. Has ethical clearance been obtained from your institution in case
of 7.3?
Obtained
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8.
References :
1. Susan Standring Ed. Gray’s anatomy.
The anatomical basis of clinical
practice. 40th Ed. London: Elsevier Churchill Livingstone; 2008 .p.1231.
2. Ugur Ozkan, Levent Oguzkurt, Fahri Tercan, Osman Kizilkilic, Zafer Koc,
Nihal Koca. Renal artery origin and variations: angiographic evaluation
of 855 consecutive patients. Diag Interv Radiology 2006; 12:183-186.
3. Nayak BS. Multiple variations of the right renal vessels. Singapore Med J
2008; 49(6):e153-e155.
4. Necdet Kocabiyik, Bulent Yalcin, Cenk Kilic, Yalcin Kirici, Hasan Ozan.
Accessory renal arteries and an anomalous testicular artery of high
origin. Gulhane Medical Journal 2005; 47:141-143.
5. Jee Won Chai, Whal Lee, Yong Hu Yin, Hwan Jun Jae, Jin Wook Chung,
Hyeon Hoe Kim, Jae Hyung Park. CT angiography for living kidney
donors: Accuracy, cause of misinterpretation and prevalence of
variation. Korean J Radiol 2008; 9:333-339.
6. Hilel Nathan. Observation on aberrant renal arteries curving around and
compressing the renal vein: Possible relationship to orthostatic
proteinuria and to orthostatic hypertension. Circulation. Journal of the
American heart association 1958; 18: 1131-1134.
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9.
Signature of the candidate
10
Remarks of the guide
11
Name & Designation of
(in block letters)
11.1 Guide
Useful for Nephrologists, can be registered.
Dr. B. NANJUNDAPPA M.S.,
PROFESSOR,
DEPARTMENT OF ANATOMY,
J.J.M. MEDICAL COLLEGE,
DAVANGERE - 577 004.
11.2 Signature
11.3 Co-Guide (if any)
--
11.4 Signature
--
11.5 Head of the
Department
Dr. C.M. RAMESH M.S.,
PROFESSOR AND H.O.D.,
DEPARTMENT OF ANATOMY,
J.J.M. MEDICAL COLLEGE,
DAVANGERE - 577 004.
11.6 Signature
12
Remarks of the
Chairman & Principal
12.2. Signature.
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