Anastomosis between Median and Musculocutaneous Nerve: Presentation of a Very Rare Anatomical Variation in Comparison to Classical Divisions (original) (raw)
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Anatomical Variations of the Musculocutaneous and Median Nerves: A Case Report
Folia Medica, 2019
The musculocutaneous nerve is a large terminal branch of the lateral cord of the brachial plexus. It passes under the pectoralis minor and penetrates the coracobrachialis muscle, descending between the biceps brachii and brachialis muscles in the arm. After dissection in upper extremities in a 28-year-old male cadaver, the median and musculocutaneous nerve were found to have variations on the right side where the musculocutaneous nerve formed communications with the median nerve. The median nerve innervated muscles of the front of the arm in this cadaver. In addition, the musculocutaneous nerve did not pierce the coracobrachialis muscle on the right side. Knowledge of these variations is extremely important when planning a surgery in the region of axilla.
Acta medica academica, 2020
OBJECTIVE The aim of our paper is to depict an anatomical variation of the brachial plexus, concerning a communicating branch between the median and the musculocutaneous nerve and its clinical significance. Anatomical variations of the brachial plexus and especially those of the musculocutaneous nerve are quite common. Awareness of these variations is of paramount importance in clinical practice, mainly in achieving best results in minimal invasive or surgical procedures. CASE REPORT After dissection in upper extremities in a 89-year-old male cadaver, a communicating branch between the median and the musculocutaneous nerve was found. This communicating branch was formed before the musculocutaneous nerve perforated the coracobrachialis muscle. It also derived from the level of the ansa medianis and its course was of an approximately 2cm length. CONCLUSION The clinical significance of our study is the entrapment of the musculocutaneous nerve that may cause clinical findings similar to...
Folia morphologica, 2001
We encountered variation in the formation of the median nerve in a 66-year-old male cadaver during dissection of the upper extremity of 20 adult cadavers. The dissections were made at the Department of Cellular Biology and Anatomy, Louisiana State University Medical Center. The median nerve was formed by fusion of four branches, three of them coming from the lateral cord and one from the medial cord. The normal radix from the lateral cord followed a very close oblique course over the axillary artery. The first unusual radix to the median nerve had an anastomoses from the musculocutaneous nerve to the median nerve in the proximal part of the left arm. The second unusual radix also came from the musculocutaneous nerve after it had pierced the coracobrachialis muscle and then joined with the median nerve. These kinds of variations are vulnerable to damage in radical neck dissection and other surgical operations of the axilla and upper arm. The communicating branch can be explained on t...
African Health Sciences
Introduction: The brachial plexus is highly variable, which is a well-known anatomical fact. Repeated observations on anatomical variations, however, constitute current trends in anatomical research. Case series: In an anatomical dissection course, three uncommon variations in the brachial plexus were identified in three young adults’ cadavers. In one case, the musculocutaneous nerve gave a branch to the median nerve, while the median nerve gave or received musculocutaneous branches in the two remaining corpses. Conclusion: Anatomical variations of the brachial plexus do occur in our setting. The cases we presented are about anatomical variations of branching patterns of the median and musculocutaneous nerves. Knowledge of those variations is essential for surgery and regional anesthesia of the upper limbs. Keywords: Anatomical variations; brachial plexus; median nerve; musculocutaneous nerve; upper limb.
Morphologie, 2012
We report here a rare variation of median nerve in an adult male cadaver observed during routine cadaveric dissection. A meticulous dissection was performed and the observations were noted. On left side, median nerve was formed from lateral cord. On right side, median nerve was formed by fusion of two slightly longer roots. The communicating branch from median nerve goes laterally to join musculocutaneous nerve. This communicating branch lies between biceps brachii and brachialis muscle and gives small branches to brachialis muscle. Knowledge of these variations is important to anatomists, radiologists, anaesthesiologists and surgeons, which may contribute to the explanation of diagnosis and surgical treatment, which can prevent any postoperative complications during surgery. The knowledge of this anatomical variation is important specially when performing plexus bloc or Latarjet's procedure.
Anastomotic branch from the median nerve to the musculocutaneous nerve: a case report
Anatomy (International Journal of Experimental and Clinical Anatomy), 2008
Anomalies of the brachial plexus and its terminal branches are not uncommon. Communicating branch arising from the musculocutaneous nerve to the median nerve is a frequent variation, whereas the presence of an anastomotic branch arising from the median nerve and joining the musculocutaneous nerve is very rare. During routine dissection of cadaver upper limbs, we observed an anastomotic branch arising from the median nerve running distally to join with the branches of the musculocutaneous nerve in a left upper extremity. The anastomotic branch originated from the median nerve 11.23 cm proximal to the interepicondylar line. After running distally and coursing between the biceps brachii and the brachialis muscles, this anastomotic branch communicated with two branches of the musculocutaneous nerve separately. The presence of the communicating branches between these nerves should be considered during surgical interventions and clinical investigations of the arm.
Normally the union of the ventral rami of the fifth, sixth, seventh and eighth cervical nerves and first thoracic nerve form the brachial plexus. These rami unit, divide and unit again to form the trunks, anterior and posterior divisions and the cords of brachial plexus and ultimately these cords and their branches appear in the axilla grouped around the axillary artery 1 . In the infraclavicular part of the brachial plexus the cords lie posterior to the first part of the axillary artery but, descending posterior to pectoralis minor, they pass into positions relative to the second part of the axillary artery which correspond to their names. The plexus ends at the lower border of pectoralis minor by dividing into a number of nerves 2 .
Anatomical Variations between Median and Musculocutaneous Nerve
Background: Anatomical variations of peripheral nerves and their connections are potentially important clinical issue. The aim of the present research was to study the variations between median and musculocutaneous nerve in the arm with respect to its branching pattern as well as communication of median with musculocutaneous nerve. Methods: Present study was carried out in 30 preserved human cadavers. The upper limbs of these cadavers were dissected and variations found were noted and photographed. Results: In one of the male cadaver (age ranging from 60-65 years) variations were observed in both the upper limbs. In the right arm the median nerve showed three roots of origin, the third root being a branch from musculocutaneous nerve. In the left arm the musculocutaneous nerve descended down with median nerve till lower end of axilla. Then it gave a branch which supplied a twig to coracobrachialis muscle and it self extended downwards to supply other muscles of arm. Conclusion: These observations are important in surgical repair of traumatic injury to shoulder joint. They also help in studying the dysfunction of upper limb related to median and musculocutaneous nerves. Thus these types of variations of the nerves of the arm should be considered prior to trauma evaluations and reconstructive interventions.
The median nerve is formed by the union of the lateral and medial roots of median nerve. The musculocutaneous nerve is the terminal branch of the lateral cord of the brachial plexus. There are documented variations in the origins, courses and distributions of these nerves. On routine dissection of an embalmed adult Nigerian male cadaver, the musculocutaneous nerve of the left side was observed to give a contribution/communication in the formation of median nerve after both roots of median nerve have united. The right side of the brachial plexus was examined and the course and distribution of the musculocutaneous and median nerves were found to be without any communication. Variations in the origins and distributions of the brachial plexus had been documented by previous researchers. The communications between median and musculocutaneous nerves were noted to occur in different types and patterns with respect to coracobrachialis muscle. There are known variations in the formation of median nerve. Knowledge of these variations is important to the anatomist, surgeon, neurologist and anaesthetist as injury proximal to the point of communication may give rise to variable clinical presentations and manifestations.
Contribution of Musculocutaneous nerve in the formation of median nerve
The median nerve is formed by the union of the lateral and medial roots of median nerve. The musculocutaneous nerve is the terminal branch of the lateral cord of the brachial plexus. There are documented variations in the origins, courses and distributions of these nerves. On routine dissection of an embalmed adult Nigerian male cadaver, the musculocutaneous nerve of the left side was observed to give a contribution/communication in the formation of median nerve after both roots of median nerve have united. The right side of the brachial plexus was examined and the course and distribution of the musculocutaneous and median nerves were found to be without any communication. Variations in the origins and distributions of the brachial plexus had been documented by previous researchers. The communications between median and musculocutaneous nerves were noted to occur in different types and patterns with respect to coracobrachialis muscle. There are known variations in the formation of median nerve. Knowledge of these variations is important to the anatomist, surgeon, neurologist and anaesthetist as injury proximal to the point of communication may give rise to variable clinical presentations and manifestations.