scholarly journals Variant insertion of coracobrachialis muscle-morphological significance, embryological basis and clinical importance

1970 ◽  
Vol 6 (2) ◽  
pp. 42-46 ◽  
Author(s):  
R Guha ◽  
N Satyanarayana ◽  
CK Reddy ◽  
N Jayasri ◽  
V Nitin ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Brachial Artery ◽  
Clinical Importance ◽  
Proximal Part ◽  
Medial Epicondyle ◽  
Medical Sciences ◽  
Medial Border ◽  
Male Cadaver ◽  
Anomalous Insertion

The coracobrachialis muscle in the arm is morphologically the sole representative of adductor group muscle in the arm, but such function during the process of evolution became insignificant in man. It is more important morphologically than functionally. Variant insertion of the coracobrachialis muscle was found during routine dissection of an adult male cadaver in the Department of Anatomy, College of Medical Sciences, and Bharatpur, Nepal. Normally the coracobrachialis muscle is inserted into the middle of the medial border of the humerus. In the present case an additional slender tendon passed inferiorly, crossing anterior to the median nerve and brachial artery, before attaching to the medial epicondyle of the humerus. Most of the proximal part of the tendon gave rise to an aponeurotic expansion that inserted into the distal medial border of the humerus. The tendinous insertion and aponeurotic expansion may represent a variant of the coracobrachialis longus (Wood's) muscle and the internal brachial ligament or the ligament of Struthers. The ulnar nerve was found to be traversing below the aponeurotic expansion. This type of anomalous insertion of coracobrachialis muscle may lead to compression of median nerve, brachial artery and ulnar nerve. Key words: Coracobrachialis muscle; ligament of Struthers; median nerve; brachial artery; ulnar nerve. DOI: 10.3126/jcmsn.v6i2.3616 Journal of college of Medical Sciences-Nepal, 2010, Vol.6, No-2, 42-46

scholarly journals Absence of Musculocutaneous Nerve: Embryological Basis

2013 ◽  
Vol 3 (2) ◽  
pp. 21-24
Author(s):  
Arvind Kumar Pankaj ◽  
CS Ramesh Babu ◽  
Archana Rani ◽  
Anita Rani ◽  
Jyoti Chopra ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Lateral Root ◽  
Axillary Artery ◽  
Musculocutaneous Nerve ◽  
Medical Sciences ◽  
Lateral Cord ◽  
Pectoral Nerve ◽  
Male Cadaver

Variation of brachial plexus characterized by the absence of musculocutaneous nerve in right arm was found during routine dissection of a 54 year old male cadaver. After giving lateral pectoral nerve, rest of the lateral cord continued as lateral root of median nerve. An unusual branch was arising from lateral cord which crossed the axillary artery anteriorly and then divided into two branches. One of these branches joined ulnar nerve and other medial root of median nerve. All the muscles of front of arm were supplied by branches of median nerve. These variations are important for the anesthetists, surgeons, neurologists during surgery and for anatomists during dissection in the region of axilla. DOI: http://dx.doi.org/10.3126/ajms.v3i2.6626 Asian Journal of Medical Sciences 3(2012) 21-24

A rare variation in the formation of the lower trunk of the brachial plexus its embryological basis and clinical importance - a case report

2012 ◽  
Vol 6 (4) ◽  
pp. 49-52
Author(s):  
N Satyanarayana ◽  
R Guha ◽  
P Sunitha ◽  
GN Reddy ◽  
G Praveen ◽  
...  
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Clinical Importance ◽  
Medical Sciences ◽  
Nerve Roots ◽  
Rare Variation ◽  
Lower Trunk ◽  
Male Cadaver ◽  
The Right

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727

scholarly journals A rare branching pattern of ulnar nerve in the lower arm

2014 ◽  
Vol 31 (03) ◽  
pp. 159-161
Author(s):  
O. Oyedun ◽  
O. Onatola ◽  
C. Kanu ◽  
O. Zelibe
Keyword(s):  
Case Report ◽  
Ulnar Nerve ◽  
Surgical Repair ◽  
Medial Epicondyle ◽  
Branching Pattern ◽  
Medial Aspect ◽  
Nerve Blockade ◽  
Male Cadaver

Abstract Introduction: The ulnar nerve is one of the two terminal branches of the medial cord. It passes down the medial aspect of the arm and runs posterior to medial epicondyle to enter the forearm without branching. Previously, ulnar nerve variations have been consistently located in origin or course of the distal branches. Case Report: In this present case, an unreported rare bifurcation of ulnar nerve was seen in the left lower arm of a 65 year male cadaver with the resulting posteromedial and anterolateral branches arising above the medial epicondyle in.Its phylogeny and implications are discussed in detail. Conclusion: A lack of awareness of variations might complicate surgical repair and may cause ineffective nerve blockade.

scholarly journals A RARE CASE OF TENDINOUS INSERTION OF CORACOBRACHIALIS ASSOCIATED WITH VARIANT MUSCULOCUTANEOUS NERVE

2020 ◽  
Vol 12 (2) ◽  
pp. 98-101
Author(s):  
Khizer H. A. Mookane ◽  
Sangeeta Muralidharan
Keyword(s):  
Median Nerve ◽  
Brachial Artery ◽  
Rare Case ◽  
Musculocutaneous Nerve ◽  
Surgical Reconstruction ◽  
The Novel ◽  
Medial Border ◽  
Brachialis Muscle

We report a rare case of the tendinous insertion of coracobrachialis muscle which has not been reported in the literature. The insertion of the novel coraco-brachialis muscle is usually into the medial border of the humerus in a 3-5cm impression at the mid-shaft level. Contrary to this, in the present case, it was seen getting inserted as a sharp slender tendon in the middle of the medial border of the humerus.  Variable insertion of coracobrachialis muscle may be responsible for the causation of compression of surrounding structures like median nerve, musculocutaneous nerve, and brachial artery. This article aims to point out a rare case of the unusual tendinous insertion of coracobrachialis and its association with musculocutaneous nerve, providing necessary information to surgeons performing surgical reconstruction using coracobrachialis.  

scholarly journals Abnormal Division of Axillary Artery - A Case Report

2012 ◽  
Vol 01 (01) ◽  
pp. 044-047
Author(s):  
N Ratnakar Rao
Keyword(s):  
Median Nerve ◽  
Radial Artery ◽  
Brachial Artery ◽  
Axillary Artery ◽  
Practical Importance ◽  
Lateral Side ◽  
Superficial Branch ◽  
Collateral Artery ◽  
Male Cadaver ◽  
The Right

AbstractA case of the abnormal branching of the right Axillary artery in a 60 year old male cadaver is presented here. The axillary artery divided into two trunks, a lateral and medial from the second part only in this case. The lateral branch was superficial running between two roots of median nerve, which here is referred to as superficial branch. The other was a medial trunk, running deep to median nerve on the medial, hence it is referred as deep brachial artery. The superficial branch had a similar course as radial artery coursing on the lateral side of cubital fossa, fore arm, anatomical snuff box and hand, hence it was considered as equivalent to radial artery. The deep brachial artery gave rise to anterior and posterior circumflex humeral arteries and the superior ulnar collateral artery. This variation is rare and the incidence quoted as around 0.12 - 3.2% in the available literature. The normal and abnormal anatomy of the axillary artery is having practical importance for the radiologists during angiography and surgeons for accurate diagnostic interpretation.

scholarly journals Variation in the area of distribution of the lateral pectoral nerve and a communicating branch between musculocutaneous and median nerve : A case report

2015 ◽  
Vol 05 (04) ◽  
pp. 088-091
Author(s):  
Divia Paul A. ◽  
Manisha Rajanand Gaikwad
Keyword(s):  
Median Nerve ◽  
Biceps Brachii ◽  
Clinical Importance ◽  
Lateral Cord ◽  
Pectoral Nerve ◽  
Communicating Branch ◽  
Additional Branch ◽  
Before And After ◽  
Male Cadaver ◽  
Indian Male

AbstractVariations in the distribution of the lateral cord and its branches in the infraclavicular part of the brachial plexus are common and significant to the neurologists, surgeons, anaesthetists and the anatomists [1]. The present case describes a rare variation of the lateral pectoral nerve giving an additional branch to supply biceps brachii muscle and ends by joining inferior collateral branch of brachial artery. Also it was observed that the musculo cutaneous nerve received communicating branches from the median nerve before and after piercing the coracobrachialismuscle. The above observations were observed during routine dissection of a 55 year old Indian male cadaver. The musculocutaneous nerve, lateral pectoral nerve and its branches were identified and protected. The clinical importance of the variation is discussed.

Anatomy of the palmar branch of the ulnar nerve: application to ulnar and median nerve decompressive surgery

2011 ◽  
Vol 114 (1) ◽  
pp. 263-267 ◽  
Author(s):  
R. Shane Tubbs ◽  
Jason M. Rogers ◽  
Marios Loukas ◽  
Ayhan Cömert ◽  
Mohammadali M. Shoja ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Medial Epicondyle ◽  
Palmar Arch ◽  
Medial Side ◽  
Fourth Digit ◽  
Palmar Cutaneous Branch ◽  
Cutaneous Branch ◽  
The Mean

Object The palmar cutaneous branch of the ulnar nerve (PCUN) has received little attention in the literature, and to the authors' knowledge, has received no attention in the neurosurgical literature. The present study was performed to help the surgeon minimize postoperative complications of nerve decompression at the wrist. Methods Forty cadaveric upper limbs underwent dissection of the ulnar nerve in the forearm, at the wrist, and in the palm. The PCUN was investigated and when identified, measurements were made and relationships documented between this cutaneous branch and the ulnar artery. The length and width of the PCUN were measured, as was the distance from the medial epicondyle of the humerus to the origin of the PCUN from the ulnar nerve. Results A PCUN was found on 90% of sides. The origin of the PCUN from the ulnar nerve was found to lay a mean of 14.3 cm distal to the medial epicondyle. The mean length and width of this branch were 13 and 0.08 cm, respectively. In the forearm, the PCUN traveled lateral to the ulnar artery on 75% of sides and on the medial side of this vessel on the remaining sides. The PCUN perforated the fascia of the anterior forearm just proximal to the distal wrist crease. In the palm, the PCUN traveled superficial to the superficial palmar arch on all but 5 sides, where it traveled deep to this vascular structure's distal extent. On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. The majority of the terminal fibers of the PCUN were found on the ulnar side of a hypothetical line drawn longitudinally through the fourth digit and supplied an area roughly 3 × 3 cm over the proximal medial palm. Conclusions The authors hope that the present data may be useful to the surgeon during decompressive procedures at the wrist, such as carpal tunnel and the Guyon canal. Based on this study, skin incisions of the palm made longitudinally along a line through the middle of the fourth digit would minimize injury to the PCUN.

scholarly journals A rare variation of formation of median nerve - a case report.

2015 ◽  
Vol 04 (02) ◽  
pp. 110-113
Author(s):  
Monica Diana S. ◽  
Ramesh Kumar Subramanian ◽  
Senthil Kumar S.
Keyword(s):  
Median Nerve ◽  
Lateral Root ◽  
Medial Epicondyle ◽  
Normal Pattern ◽  
Rare Variation ◽  
Medical College ◽  
Lateral Cord ◽  
Male Cadaver ◽  
Muscle Nerve ◽  
The Right

AbstractMany variations have been reported regarding formation of the brachial plexus and its branches. Here the authors report a rare variation pertaining to lateral cord of median nerve. During routine dissection, at Sri Ramachandra Medical College and Hospital, Chennai, in the department of anatomy, in a male cadaver in the right upper limb, the authors found an additional lateral root from lateral cord joining the medial root to form the median nerve. Musculocutaneous nerve did not pierce the coracobrachialis muscle instead it gave a direct branch to the muscle. Nerve supply to biceps and brachialis were of normal pattern. The musculo cutaneous nerve communicated with the median nerve before supplying other muscles. Median nerve was medial throughout the arm but about 7 cm above the level of medial epicondyle it crossed the brachial artery from medial to lateral. Morphometry of the nerves were studied by measurements. Knowledge of these variations and measurements will be helpful during surgical and anaesthetic procedures in the axilla.

scholarly journals Five Roots Pattern of Median Nerve Formation

2016 ◽  
Vol 59 (1) ◽  
pp. 26-28 ◽  
Author(s):  
Konstantinos Natsis ◽  
George Paraskevas ◽  
Maria Tzika
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Artery ◽  
Clinical Applications ◽  
Upper Arm ◽  
Lateral Cord ◽  
Unusual Combination ◽  
Male Cadaver ◽  
Embryologic Development ◽  
Fourth Root

An unusual combination of median nerve’s variations has been encountered in a male cadaver during routine educational dissection. In particular, the median nerve was formed by five roots; three roots originated from the lateral cord of the brachial plexus joined individually the median nerve’s medial root. The latter (fourth) root was united with the lateral (fifth) root of the median nerve forming the median nerve distally in the upper arm and not the axilla as usually. In addition, the median nerve was situated medial to the brachial artery. We review comprehensively the relevant variants, their embryologic development and their potential clinical applications.

scholarly journals RELATION OF MEDIAN NERVE WITH BRACHIAL ARTERY: A CADAVERIC STUDY

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Eti Sthapak ◽  
Navbir Pasricha ◽  
Rajan Bhatnagar
Keyword(s):  
Median Nerve ◽  
Brachial Artery ◽  
Anatomical Variations ◽  
Upper Limbs ◽  
Medical Sciences ◽  
Medical College ◽  
Medial Side ◽  
Appropriate Treatment ◽  
General Surgeons ◽  
Cubital Fossa

Introduction: Variation in neurovascular structure are commonly encountered in routine dissection. Brachial artery is the main artery of upper limb. In the arm, the median nerve passes at first lateral to brachial artery (near the insertion of coracobrachialis muscle), then crosses in front of the artery, descending medial to it in the cubital fossa. The knowledge of these variation could be helpful to vascular, plastic, general surgeons and orthopedicians. It is also important to prevent iatrogenic injuries. The aim of this study was to evaluate anatomical variations in course and relation of median nerve to brachial artery in the arm. Material & Methods: The study was conducted in 50 cadavers (100 upper limbs) in duration of two years. Proper cadaveric dissection was done in the Department of Anatomy, Dr. RML Institute of Medical Sciences, Lucknow, and Era’s Lucknow Medical College, Lucknow. Observation & Results: In the present series, median nerve was found to cross behind the brachial artery at about the middle of the arm in 8% cadavers. Median nerve entered the arm at first lateral to brachial artery, near the insertion of coracobrachialis. In 46 cadavers (96 upper limbs), it crossed in front of the artery from lateral to medial side. In four cadavers (5 upper limbs), it passed posterior to the brachial artery in the arm. Conclusion: Knowledge of the brachial artery and their variations are of clinical and surgical importance. An awareness of such a presence is valuable for the surgeons and radiologists in evaluation of angiographic images, vascular and re-constructive surgery or appropriate treatment for compressive neuropathies.

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