scholarly journals Anatomical variations of the brachial plexus terminal branches in Ethiopian cadavers

1970 ◽  
Vol 6 (1) ◽  
pp. 896-905
Author(s):  
Edengenet Guday Demis ◽  
Asegedeche Bekele
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Surgical Procedures ◽  
Upper Limb ◽  
Anatomical Variations ◽  
Axillary Nerve ◽  
Musculocutaneous Nerve ◽  
Clinically Significant

Anatomical variations are clinically significant, but many are inadequately described or quantified. Variations in anatomy of the brachial plexus are important to surgeons and anesthesiologists performing surgical procedures in the neck, axilla and upper limb regions. It is also important for radiologists who interpret plain and computerized imaging and anatomists to teach anatomy. This study aimed to describe the anatomical variations of the terminal branches of brachial plexus on 20 Ethiopian cadavers. The cadavers were examined bilaterally for the terminal branches of brachial plexus. From the 40 sides studied for the terminal branches of the brachial plexus; 28 sides were found without variation, 10 sides were found with median nerve variation, 2 sides were found with musculocutaneous nerve variation and 2 sides were found with axillary nerve variation. We conclude that variation in the median nerve was more common than variations in other terminal branches.

scholarly journals Cadaveric Study of Anatomical Variations in the Musculocutaneous Nerve and in the Median Nerve

2019 ◽  
Vol 36 (02) ◽  
pp. 122-125
Author(s):  
Abhilasha Priya ◽  
Chandni Gupta ◽  
Antony Sylvan D'souza
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Peripheral Nerves ◽  
Anatomical Variations ◽  
Musculocutaneous Nerve ◽  
Branching Pattern ◽  
Kasturba Medical College ◽  
Upper Limbs ◽  
Medical College ◽  
Lateral Cord

Introduction The musculocutaneous nerve and the median nerve are branches from the lateral cord of the brachial plexus with a root value of C5, C6, and C7. The medial root of the median nerve is a branch of the medial cord. The present study aims at observing any variations in these peripheral nerves, so that this knowledge can be utilized by surgeons, anesthesiologists, and orthopedicians during surgical procedures and nerve block. Materials and Methods The present study was carried on 30 adult embalmed cadavers (60 upper limbs) in the department of anatomy of the Kasturba Medical College , Manipal, India. The infraclavicular part of the brachial plexus was dissected, and any anatomical variations in the formation and in the branching pattern of the musculocutaneous nerve and of the median nerve were noted and photographs were taken. Results The median nerve was noted to be formed from 3 roots in 8 out of 60 dissected upper limbs (13.33%). The musculocutaneous nerve was absent in 5% of the dissected limbs, and communications between these 2 nerves were noted in 13.33% of the dissected limbs. Conclusions Noted variations of the nerves may be of help to surgeons operating in the axillas and in the arms.

Brachial Plexus Variations in Human Fetuses

Neurosurgery ◽  
2003 ◽  
Vol 53 (3) ◽  
pp. 676-684 ◽  
Author(s):  
İsmihan İlknur Uysal ◽  
Muzaffer Şeker ◽  
Ahmet Kağan Karabulut ◽  
Mustafa Büyükmumcu ◽  
Taner Ziylan
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Surgical Procedures ◽  
Distal Part ◽  
Axillary Nerve ◽  
Human Fetuses ◽  
Anatomic Variations ◽  
Normal Position ◽  
Morphological Variations ◽  
Posterior Division

Abstract OBJECTIVE We examined the anatomic variations of the brachial plexus (BP) in human fetuses. METHODS This study was performed with 200 BPs from spontaneously aborted fetuses without detectable malformations. The plexuses were dissected, and the normal position and/or morphological variations of the BP were determined and photographed. RESULTS There were no variations in 93 plexuses, and 107 plexuses were observed to have different variations. Morphological variations were observed more frequently among female fetuses and right sides. The BPs were composed mostly of the C5, C6, C7, and C8 nerves and the T1 nerve (71.5%). A prefixed plexus was observed in 25.5% of cases, and a postfixed plexus was observed in 2.5% of cases. In one case (0.5%), the C4 and T2 nerves joined the formation. The inferior trunk was not formed in 9% of cases. The superior trunk was not formed in 1% of cases. In one plexus, the superior trunk was formed by the ventral rami of the C4 and C5 nerves. In one case, the inferior trunk was formed by the ventral rami of the T1 and T2 nerves. Division variations were observed most frequently. There were also variations in the terminal branches, such as the roots of the median nerve joining in the distal part of the arm (8.5%), the axillary nerve being separate from the posterior division of the superior trunk (2.5%), and a connection existing between the median and musculocutaneous nerves (1%). CONCLUSION Knowledge of BP variations is important for surgeons who perform surgical procedures in the cervical and axillary regions.

scholarly journals Asymmetric Bilateral Variations in the Musculocutaneous and Median Nerves with High Branching of Brachial Artery

2012 ◽  
Vol 55 (4) ◽  
pp. 189-192
Author(s):  
Vandana Tomar ◽  
Surbhi Wadhwa
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Upper Limb ◽  
Brachial Artery ◽  
Musculocutaneous Nerve ◽  
The Other ◽  
Arterial Supply ◽  
Reconstructive Procedures

Brachial Plexus is formed by the union of the anterior rami of cervical 5, 6, 7, 8 and thoracic 1 nerves. These nerves unite and divide to form the key nerves innervating the upper limb. Variations in the course of these nerves are clinically important to anesthetists, neurologists and orthopedicians. We report bilateral variations in the arterial and neural structures in the upper limb of a 65 year old cadaver. The muscles of the arm on one side were innervated by the median nerve with absence of musculocutaneous. While on the other side the musculocutaneous nerve contributed to the formation of the median nerve. There was a presence of high bifurcation of brachial artery on both sides. Knowledge of such variations in the innervations of muscles and the arterial supply of the limbs are important to remember before performing any reconstructive procedures or interventions on the limb.

scholarly journals Formation, trajectory and distribution variants of the median nerve of the fetus

2017 ◽  
Vol 23 (3) ◽  
pp. 142-149
Author(s):  
I. S. Tudorache ◽  
P. Bordei ◽  
D. M. Iliescu
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Upper Limb ◽  
Lateral Root ◽  
Axillary Artery ◽  
Single Case ◽  
Musculocutaneous Nerve ◽  
Single Nerve ◽  
Nerve Fascicle ◽  
Medial Nerve

AbstractOur study was performed by dissection on a number of 54 nervous trunks of the median nerve of the fetus. We found that the median nerve is always formed from two roots, their joining being at different levels of the upper limb, between the axilla and the elbow. The axilla nerve trunk was formed at the level of the axillary region, in 38.89% of the cases, in 22.22% of the cases the union was made at the middle part of the arm, and in 38.89% of the cases in the elbow. The lateral root of the medial nerve was formed in 55.56% of cases from a single nerve fascicle, in 44.44% of cases consisting of two nerve fascicles. The medial root was formed in 61.11% of cases from a single nerve fascicle, in 38.89% of the cases being made up of two nerve fascicles. In 27.78% of cases, the medial root passed behind the axillary artery. Regarding the volume of the two roots, we found that in 44.44% of the cases, the lateral root was more voluminous, in 27.78% of cases, the median root was larger and in 27.78% of cases, the two roots were approximately equal. We have encountered situations where a ramification for the forearms muscles emerged from the lateral root. Occasionally, a ram for the brachial muscle was detached from the medial root, and from the lateral root a ram for the biceps muscle, both muscles receiving branches also from the musculocutaneous nerve. We have encountered a single case where the median nerve inches the anterior muscles of the arm, missing the musculocutaneous nerve. In cases of low joining of the roots, we have encountered cases where a lateral root formed a ram for forearm muscles. The anastomoses between the two median nerve roots can sometimes be located just above their union or anterior to the lower portion of the axillary artery. In one case, we encountered between the two roots, above their union, the existence of three oblique anastomoses, the two upper ones from the lateral to the medial root, and the third from the medial root to the lateral root. Common are anastomoses between the roots of the roots and the root on the opposite side. The most common are the anastomosis between the medial fascicle of the lateral root and the medial root of the median nerve. In one case, we encountered a double overlap between the musculocutaneous nerve and the lateral nerve root. In one case, we encountered a strong anastomosis between the medial nerve fascicle of the medial root and the radial nerve. Common and at all levels of the upper limb are the anastomoses between the median and ulnar nerves. In the case of a low union of the two median roots, we encountered anastomoses between a root of the root and the ulnar nerve, or between a root and the ulnar nerve. I encountered a single case with an anastomosis, Martin- Gruber, which was previously passing through the ulnar and interos-like arteries and from which the anterior forearm muscles were detached.

Anatomical variations of the cords of brachial plexus and the median nerve

2007 ◽  
Vol 20 (2) ◽  
pp. 150-156 ◽  
Author(s):  
S.K. Pandey ◽  
V.K. Shukla
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Anatomical Variations

scholarly journals Variations in the course and branching pattern of musculocutaneous nerve

2013 ◽  
Vol 02 (04) ◽  
pp. 195-199
Author(s):  
Amar Jayanthi A. ◽  
Arunkumar K G.
Keyword(s):  
Median Nerve ◽  
Growth Cone ◽  
Single Case ◽  
Clinical Importance ◽  
Anatomical Variations ◽  
Musculocutaneous Nerve ◽  
Axonal Pathfinding ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test

Abstract Background and aim: The variations in the course and communicating branches of musculocutaneous nerve is of clinical importance in the treatment of recurrent compression neuropathies and in the diagnosis of median nerve lesions. Most of the reports on anatomical variations of musculocutaneous nerve are single case studies and such studies with emphasis on gender difference in a sample of Keralite population are rarely reported. The objective of the present study is to observe the variations in the course of musculocutaneous nerve with special reference to communications with other nerves of the arm and to study the correlation between gender and variations of the nerve. Materials and Methods: Two hundred and sixty four arms were dissected in the department of Anatomy, Government medical college, Thrissur and studied for variations of muculocutaneous nerve. Analysis was done with epi info, using proportions, confidence interval and Chi Square test. The communications noted were classified using the available classifications of Le Minor, Venieratos and Anagnostopoulou and Choi et al. Results: Nerve variations were seen in 24.2 % cases which include, absence of the nerve (3.4%), nerve not piercing coracobrachialis (12.4%) and communication to median nerve (15.1 %). All the variations observed were statistically not significant. The embryological basis for the axonal pathfinding is considered as a result of both guidance molecules and electrical activity that change the calcium homeostasis within the growth cone to regulate growth cone turning. Conclusion: Variations that were observed in the present study may give sufficient and relevant data on the nerves, among Keralite population in which studies are few.

End-to-side neurorrhaphy in brachial plexus reconstruction

2013 ◽  
Vol 119 (3) ◽  
pp. 689-694 ◽  
Author(s):  
Pavel Haninec ◽  
Libor Mencl ◽  
Radek Kaiser
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Nerve Repair ◽  
Experimental Studies ◽  
Deltoid Muscle ◽  
Axillary Nerve ◽  
Musculocutaneous Nerve ◽  
Biceps Muscle ◽  
Nerve Reconstruction ◽  
Nerve Suture

Object Although a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy (ETSN) have been published to date, there is still a considerable lack of clinical trials investigating this technique. Here, the authors describe their experience with ETSN in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy. Methods From 1999 to 2007, out of 791 reconstructed nerves in 441 patients treated for brachial plexus injury, the authors performed 21 axillary and 2 musculocutaneous nerve sutures onto the median, ulnar, or radial nerves. This technique was only performed in patients whose donor nerves, such as the thoracodorsal and medial pectoral nerves, which the authors generally use for repair of axillary and musculocutaneous nerves, respectively, were not available. In all patients, a perineurial suture was carried out after the creation of a perineurial window. Results The overall success rate of the ETSN was 43.5%. Reinnervation of the deltoid muscle with axillary nerve suture was successful in 47.6% of the patients, but reinnervation of the biceps muscle was unsuccessful in the 2 patients undergoing musculocutaneous nerve repair. Conclusions The authors conclude that ETSN should be performed in axillary nerve reconstruction but only when commonly used donor nerves are not available.

scholarly journals Brachial Plexus Injuries – Review of the Anatomy and the Treatment Options

PRILOZI ◽  
2021 ◽  
Vol 42 (1) ◽  
pp. 91-103
Author(s):  
Sofija Pejkova ◽  
Venko Filipce ◽  
Igor Peev ◽  
Bisera Nikolovska ◽  
Tomislav Jovanoski ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Tendon Transfer ◽  
Treatment Options ◽  
Axillary Nerve ◽  
Nerve Graft ◽  
Muscle Transfer ◽  
Lower Trunk ◽  
Functional Deficit ◽  
Bionic Reconstruction

Abstract Brachial plexus injuries are still challenging for every surgeon taking part in treating patients with BPI. Injuries of the brachial plexus can be divided into injuries of the upper trunk, extended upper trunk, injuries of the lower trunk and swinging hand where all of the roots are involved in this type of the injury. Brachial plexus can be divided in five anatomical sections from its roots to its terminal branches: roots, trunks, division, cords and terminal branches. Brachial plexus ends up as five terminal branches, responsible for upper limb innervation, musculocutaneous, median nerve, axillary nerve, radial and ulnar nerve. According to the findings from the preoperative investigation combined with clinically found functional deficit, the type of BPI will be confirmed and that is going to determine which surgical procedure, from variety of them (neurolysis, nerve graft, neurotization, arthrodesis, tendon transfer, free muscle transfer, bionic reconstruction) is appropriate for treating the patient.

scholarly journals Neurofibrolipoma of the dorsum of hand: a case report

2017 ◽  
Vol 4 (9) ◽  
pp. 3180
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Jayaganesh Parthasarathy
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Median Nerve ◽  
Upper Limb ◽  
Benign Lesion ◽  
Fibrolipomatous Hamartoma

Neurofibrolipoma, also called fibrolipomatous hamartoma, is a rare benign lesion which commonly involves the upper limb and its nerves with the median nerve being frequently involved. It also affects other nerves such as the ulnar, radial and brachial plexus.

scholarly journals Unusual nerve supply of biceps from ulnar nerve and median nerve and a third head of biceps

2006 ◽  
Vol 39 (02) ◽  
pp. 172-174
Author(s):  
L Arora ◽  
R Dhingra
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Axillary Artery ◽  
Anatomical Variation ◽  
Musculocutaneous Nerve ◽  
Flexor Digitorum Profundus ◽  
Medial Side ◽  
Flexor Carpi Ulnaris ◽  
The 19Th Century

ABSTRACTVariations in branching pattern of the brachial plexus are common and have been reported by several investigators. Of the four main nerves traversing the arm, namely median, ulnar, radial and musculocutaneous, the ulnar and median nerve do not give any branches to muscles of the arm. Ulnar nerve after taking origin from medial cord of brachial plexus runs distally through axilla on medial side of axillary artery till middle of arm, where it pierces the medial intermuscular septum and enters the posterior compartment of arm. Ulnar nerve enters forearm between two heads of flexor carpi ulnaris from where it continues further. It supplies flexor carpi ulnaris , flexor digitorum profundus and several intrinsic muscles of hand . We recently observed dual supply of biceps muscle from ulnar and median nerves in arm. Musculocutaneous nerve was absent. Although communications between nerves in arm is rare, the communication between median nerve and musculocutaneous nerve were described from the 19th century which could explain innervation of biceps from median nerve. But no accurate description of ulnar nerve supplying biceps could be found in literature. Knowledge of anatomical variation of these nerves at level of upper arm is essential in light of the frequency with which surgery is performed to transfer nerve fascicles from ulnar nerve to biceps in case of brachial plexus injuries. We also observed third head of biceps, our aim is to describe the exact topography of this variation and to discuss its morphological.

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