About biceps- Two heads are better than one!

Let me be frank. I am a scary dude because I have two heads. I swear it’s not my fault as I was born like this. My second name is brachii. That makes me Biceps brachii.

Each of my heads arises from the scapula and gets inserted into the humerus. To get along well with my colleagues (tendons and bones), I have several coverings-bicipital aponeuosis, bicipitoradial bursa . I am forced to get along well with them to help in smooth functioning of my host. 

I rank higher than the two muscles lying below me, coracobrachialis and brachialis. I am run by musculocutaneous nerve and cervical nerves. I am fed by the brachial artery. I flex the elbow, flex and abduct the shoulder and also help in supinating the forearm. My chief antagonist is triceps muscle.

If you have read enough, let me go on to some interesting facts.  When I flex, I look like the back of a mouse. This made the humans (living in Rome) call all the muscles as muscles  because musculus means ‘ little mouse’ in Latin. You can’t call me bicep because it is considered incorrect.

Between 1505 and 1510, there was an artist named Leonardo Da Vinci who drew my portraits and explained my functions. He was not believed because he was not an anatomist. Two hundred years later, I was rediscovered by William Cheselden and Guillaume Duchenne.

Another interesting fact is that because of me, horses can rest and sleep while standing.

Fistula - A brief history

The barber and the surgeon

During 17^th century lived King Louis XIV. In the year 1685, he developed a swelling in his bum which became an abscess and finally a fistula.

The king was rumoured to have bathed only twice in his lifetime because water was supposed to cause infections! In desperation, the services of the barber- surgeon were sought.

Barber surgeons were barbers who performed minor operations. Charles- Francois Felix, who was the barber surgeon, prepared for 6 months and developed tools for his tryst with glory or despair.

He operated on the king in November 1686 and the operation was a success. The surgeon became famous and also prosperous. The courage of both the king and the barber gave a new respectability to surgeons and eventually led to the establishment of the royal academy of surgery.  

( An anal fistula is an abnormal communication between the anal canal and the skin. It occurs due to infection of anal glands.)

Jeep bottom!

Imagine that you were a driver in the World war. You drive a jeep, fight for your country and do all that is required of you and make yourself feel proud. You are tired at the end of the day and just want to take rest. Suddenly you find that fluid is leaking from the base of your spine and it is foul smelling. You think that it is just sweat, forget all about it and take rest.

In a few days, the fluid leak increases and then suddenly it becomes an abscess (pus filled). It is throbbing, painful and unbearable. You take some antibiotics and forget all about it.  It keeps coming back again and again and then you decide to do something about it. You don’t know which doctor to consult. You search the internet and think that it is ‘piles’.

I met a patient a few days ago in my clinic who did not know which doctor to approach for a pilonidal sinus. He knew the diagnosis because he had done a little bit of research on the internet. That made me dive headlong into the topic.

Pilus means hair and nidus means nest and pilonidal sinus means nest of hair. Pilonidal sinus disease was first described in 1833 and attained fame due to its presence in soldiers during World War II. During this time, it was known as “Jeep Disease”. Hair goes through the skin, forms a track and stays until it is removed.

There are several treatments for this condition. It can be excised and left to heal by itself or it can be closed primarily. Several types of flaps can be planned for the primary closure.

Since the disease happens in young individuals, cosmesis has to be considered. Time away from work or school also plays a role.