scholarly journals Unilateral Four-Headed Pectoralis Muscle Major

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Rasheed Bani Hammad ◽  
Adel Mohamed

A unilateral four-headed pectoralis major muscle was observed on the left side of an 83 year-old Caucasian male cadaver. The accessory tendon arises from the lateral aspect of the pectoralis major muscle, travels along with the tendon of the long head of the biceps brachii and blends into the capsule of the shoulder joint. This anomaly is rare. A complete or partial absence of pectoralis major muscle is normally reported. Additionally, supernumerary heads of muscles other than pectoralis major have been documented. However, the existence of an accessory tendon to the pectoralis major muscle is unique. The implications of such a finding are discussed.

2014 ◽  
Vol 31 (04) ◽  
pp. 241-243
Author(s):  
M. Bala ◽  
D. Passi ◽  
S. Kaushal

AbstractA unilateral absence of sternocostal fibers of pectoralis major muscle with unilateral presence of sternalis muscle has been noticed in right side of an adult male cadaver during routine dissection. All slips of pectoralis major muscle as well sternalis muscle innervated by medial and lateral pectoral nerves. Absence of pectoralis major has been described extensively, both as an isolated anomaly, with varying levels of hypoplasia, and in association with congenital syndromes. But the partial hypoplasia of pectoralis muscle with compensatory presence of one of the rare muscle of anterior thoracic wall the sternalis muscle make this case as unique and rare. This finding adds to our existing knowledge for the origin of sternalis, an identity not explored fully yet. Awareness of anomalous pectoralis major musculature as well presence of sternalis muscle is important for reconstructive surgeons who perform mastectomy and for radiologists during interpretation of skiagrams.


1996 ◽  
Vol 37 (3P2) ◽  
pp. 759-762 ◽  
Author(s):  
J. M. Perez Aznar ◽  
J. Urbano ◽  
E. Garcia Laborda ◽  
P. Quevedo Moreno ◽  
L. Ferrer Vergara

Purpose: Poland's syndrome is a congenital and unilateral aplasia of the pectoralis major muscle (PMM), with other anomalies of the ipsilateral upper extremity. We present 6 cases in which the only clinical expression was asymmetry of the breasts associated with partial absence of the PMM. Material and Methods: We reviewed 95000 mammograms (obtained 1985–1995) to find patients with asymmetrical breast size. Where the asymmetry could not be ascribed to any other cause, the patients were recalled for an examination of the PMM which was conducted at rest and with active contraction of the muscle. Results: Unilateral volume reduction of the PMM was found in 5 women of whom 2 were studied with MR. A 6th case was a fortuitous finding in a male patient. Conclusion: Mild forms of Poland's syndrome are more frequent than severe forms, and may go undiagnosed. Hypoplasia of one breast or a horizontal anterior axillary fold may be the sole clinical manifestation of this syndrome.


2021 ◽  
Vol 9 (4) ◽  
pp. 407-416
Author(s):  
Olga E. Agranovich ◽  
Ekaterina V. Petrova ◽  
Sergey F. Batkin ◽  
Evgeniya I. Ermolovich ◽  
Igor A. Komolkin ◽  
...  

BACKGROUND: One of the main problems that limited or made the self-ability of patients with arthrogryposis impossible is the lack of active elbow flexion due to hypoplasia (or aplasia) of the forearm flexors and, especially the m. biceps brachii. AIM: To evaluate the possibility of active forearm flexion restoration in children with arthrogryposis by partial monopolar transposition of the pectoralis major muscle. MATERIALS AND METHODS: Elbow active flexion restoration by partial monopolar transposition of the pectoralis major muscle to biceps brachii was conducted in 34 children with arthrogryposis (39 upper limbs) from 2011 to 2020. The muscle autograft included a fragment of the fascia of the m. rectus abdominis. Clinical examinations of patients were performed before and after the operation. Statistical data processing was performed using the software packages Statistica 10 and SAS JMP 11. RESULTS: The follow-up results were estimated from 6 to 99 months (44.53 31.72) postoperative. The mean age of patients was 6.24 4.24 years. The active postoperative elbow motion was 0120 (71.94 33.40). The passive postoperative elbow motion did not change and was 90130 (104.12 12.40). Muscles strength after the operation was grade 25. Elbow extension was limited in 30 cases (76.9%) from 0 to 40 (21.70 12.27) without problem in the activities of daily living. Good results were determined in 15 cases (38.5%), satisfactory in 8 (20.5%), and poor in 16 (41%). CONCLUSIONS: This study revealed that our partial monopolar transfer of pectoralis major to biceps brachii technic restored sufficient forearm flexion and improved self-ability without forming severe elbow flexor contractures of more than half of the patients with arthrogryposis.


There is a remarkable fold in the tendon of the pectoralis major muscle, described by all anatomists, but the purpose of which has never yet, as the author believes, been explained. The muscle itself consists of two portions, one smaller and upper, arising from the cla­vicle, and passing downwards and outwards to an insertion in the humerus at a greater distance from the shoulder-joint than the place where the tendon of the larger and lower portion of the muscle, which arises from the sternum and ribs, and has a general direction upwards and outwards, terminates. Thus the respective portions of tendon belonging to the two divisions of the muscle are found to cross each other ; the margin of that proceeding from the lower division passing behind, and appearing above that which proceeds from the upper fibres of the muscle. The forces exerted by each portion of the muscle being thus applied to parts of the bone at different distances from the fulcrum, act with different mechanical powers ; which the author finds in every case to correspond exactly with the variations in the effects required to be produced, under different circumstances, by these mus­cular actions. Those muscular fibres, the tendon of which is inserted nearest to the centre of motion, and which consequently act by a shorter lever, are adapted to motions requiring a less force, but a greater velocity : and such is precisely the mechanical condition of the lower portion of the pectoralis major, which is employed more especially in bringing down the arm, when previously raised, as in striking with the hammer, pickaxe, &c., where velocity is chiefly re­quired, the weight of the instrument held in the hand sufficiently sup­plying the diminution of force. On the contrary, the lever by which the upper portion of the same muscle is enabled to act being, from the more distant insertion of its tendon, of greater length, is calcu­lated to procure force at the expense of velocity, and is therefore pe­culiarly fitted for the performance of those actions by which the arm is elevated and weights raised; these being precisely the actions in which such muscles are employed. Adverting, also, to the respective obliquities in the direction of their action, the author traces the same express correspondence between the mechanism employed and the purpose contemplated. He pursues the same line of argument and obtains the same results in extending the inquiry to the structure and uses of those muscles, such as the coraco-brachialis, and the anterior fibres of the deltoid, which cooperate with the upper division of the pectoralis major; and the teres major and latissimus dorsi, which combine their actions with that of the lower division of the pectoral muscle. This diversified adaptation of parts, he observes, forms the chief characteristic of the mechanism of Nature. Operating with unlimited means, she yet works with scrupulous economy; in all her structures no power is redundant, nor a single advantage lost: so that, how­ever completely an arrangement may be subservient to one primary purpose, we find, on renewed examination, an equally accurate ad­justment to various secondary and no less important ends.


2021 ◽  
pp. 20201202
Author(s):  
Kelly S Myers ◽  
Erica Stern ◽  
Emily B Ambinder ◽  
Eniola T Oluyemi

Objectives: Defining the posterior extent of breast cancer prior to surgery has clinical implications. However, there are limited data available to guide the interpretation of breast cancers seen on MRI that abut the pectoralis muscle but lack associated muscle enhancement. Methods: In this retrospective study of breast MRIs performed between May 2008 and July 2019, 43 female patients demonstrated breast cancers abutting the pectoralis muscle without enhancement of the muscle itself. Imaging features of the cancers as well as pathologic and clinical outcomes were recorded. Statistical analyses of associations between imaging findings and clinical outcomes were performed using Fisher’s exact test, logistic regression, a Mann–Whitney U test and/or Student’s t-test. Results: The pectoralis major muscle was pathologically invaded by carcinoma in 4/43 (9.3%). There was no significant association between pectoralis muscle invasion and any MR imaging feature of the breast cancer. Tumors causing deformation of the muscle contour by MRI, tumors larger in size, tumors with a larger extent abutting the muscle and tumors in which the imaging feature abutting the muscle was a mass or non-mass enhancement (rather than a spicule) were more commonly seen in patients with muscle invasion, although these did not reach statistical significance (p > 0.05). Conclusion: In this study, a lack of pectoralis muscle enhancement by MRI did not exclude pathologic muscle invasion by breast cancers abutting the muscle. Advances in knowledge: Knowledge of the likelihood of pectoralis muscle involvement for breast cancers abutting the pectoralis muscle on MRI may guide accurate interpretation and definition of the posterior extent of disease.


2013 ◽  
Vol 5 (1) ◽  
pp. 81-85
Author(s):  
C Swathi Poornima ◽  
B Bhagyalakshmi

During routine undergraduate dissection in the upper extremities of a 65 years old male cadaver in the department of Anatomy at Dr. PSIMS & RF, coexistence of muscular and neurovascular variants were identified .Muscular variations included presence of additional head(third) of biceps brachii in the left arm, accompanied with medially positioned median nerve in relation to brachial artery bilaterally . Teres minor muscle was not identified and the origin of long head of triceps brachii extended upto the lateral border of scapula on the left side. Both the medial cutaneous nerves of arm and forearm arouse from a single trunk bilaterally. In the right limb the axillary artery showed only four branches instead of six branches, with common trunk for thoraco-acromial and lateral thoracic artery and common trunk for subscapular and posterior circumflex humeral artery. Knowledge of coexistence of these variations would of profound importance surgically and clinically, especially in limb injuries and surgical repairs. DOI: http://dx.doi.org/10.3126/ajms.v5i1.7391   Asian Journal of Medical Science Vol.5(1) 2014 pp.81-85


2016 ◽  
Vol 5 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Sushma R Kotian ◽  
Kumar M R Bhat

El músculo pectoral mayor es propenso a varias incongruencias morfológicas. Diferentes deslizamien-tos musculares son comunes entre ellos. Sin embargo, durante la disección rutinaria de un cadáver masculino de 55 años por estudiantes de pregrado, se encontró una variante rara de la extensión tendinosa del músculo pectoral mayor. Surgía de la lámina profunda del tendón muscular bilaminar cerca de su inserción en el húmero. En su camino a unirse al tabique intermuscular medial del brazo y finalmente al epicóndilo medial del húmero, cruzó todas las estructuras en la parte delantera del brazo de lateral a medial. Considerando la extensión tendinosa de forma proximal, no se observó formación muscular separada. Esta variante de deslizamiento puede ser nombrada como músculo pectoral epicondilario. El conocimiento de esta variación particular puede ser de especial interés para los radiólogos y médicos en procedimien-tos tales como transformación de músculo, trasplante de tendón y uso en los colgajos miocutáneos durante cirugías reconstructivas. The pectoralis major muscle is prone to various morphological incongruities. Variant muscular slips are common among them. However during routine dissection for undergraduate students in a 55-year-old male cadaver, a rare variation of the tendinous extension of the pectoralis major muscle was found. It was arising from the deep lamina of the muscular bilaminar tendon close to its insertion to the humerus.  On its way to be attached to the medial intermuscular septum of the arm and finally to the medial epicondyle of the humerus, it crossed all the structures in the front of the arm from lateral to medial. Tracing this tendinous extension slip proximally, no separate muscular extension was observed. this variant slip may be named as pectoro-epicondylaris muscle. The know-ledge of this particular variation could be of special interest to radiologists and clinicians in procedures such as muscle transformation, tendon transplantation and use of myo-cutaneous flaps during reconstructive surgeries.


2018 ◽  
Vol 46 (2) ◽  
pp. 155
Author(s):  
Dionysios Venieratos ◽  
Alexandros Samolis ◽  
Maria Piagkou ◽  
Stergios Douvetzemis ◽  
Alexandrina Kourotzoglou ◽  
...  

<div class="WordSection1"><p><strong>Objective</strong>. The study adds important information regarding the descriptive anatomy of a very rarely reported unilateral chondrocoracoideus muscle (of Wood). Additionally it highlights the concomitant muscular and neural alterations. <strong>Case report. </strong>The current case presents the occurrence of a chondrocoracoideus muscle situated left-sided, as an extension of the abdominal portion of the pectoralis major muscle (PM). The chondrocoracoideus coexisted with a contralateral atypical PM, partially blended with the clavicular fibers of the deltoid muscle. There was an accessory head of the biceps brachii while the palmaris longus was absent on the right side of a 78-year-old Greek male cadaver. <strong>Conclusion</strong>. The above mentioned muscular abnormalities are shown as disturbances of embryological pectoral muscle development, and their documentation is essential in order to increase awareness among clinicians of their potential impact on the diagnosis and treatment of several pathologies.</p></div>


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