Multiple variations involving all the terminal branches of the brachial plexus and the axillary artery-a case report (original) (raw)
Related papers
Journal of Brachial Plexus and …, 2007
BackgroundBrachial Plexus innervates the upper limb. As it is the point of formation of many nerves, variations are common. Knowledge of these is important to anatomists, radiologists, anesthesiologists and surgeons. The presence of anatomical variations of the peripheral nervous system is often used to explain unexpected clinical signs and symptoms.Case PresentationOn routine dissection of an embalmed 57 year old male cadaver, variations were found in the formation of divisions and cords of the Brachial Plexus of the right side. Some previously unreported findings observed were; direct branches to the muscles Pectoralis Minor and Latissimus dorsi from C6, innervation of deltoid by C6 and C7 roots and the origin of lateral pectoral nerve from the posterior division of upper trunk. The median nerve was present lateral to axillary artery. The left side brachial plexus was also inspected and found to have normal anatomy.ConclusionThe probable cause for such variations and their embryological basis is discussed in the paper. It is also concluded that although these variations may not have affected the functioning of upper limb in this individual, knowledge of such variations is essential in evaluation of unexplained sensory and motor loss after trauma and surgical interventions to the upper limb.
The Australasian medical journal, 2014
During the routine dissection of upper limbs of a Caucasian male cadaver, variations were observed in the brachial plexus. In the right extremity, the lateral cord was piercing the coracobrachialis muscle. The musculocutaneous nerve and lateral root of the median nerve were observed to be branching inferior to the lower attachment of coracobrachialis muscle. The left extremity exhibited the passage of the median nerve through the flat tendon of the coracobrachialis muscle near its distal insertion into the medial surface of the body of humerus. A variation in the course and branching of the nerve might lead to variant or dual innervation of a muscle and, if inappropriately compressed, could result in a distal neuropathy. Identification of these variants of brachial plexus plays an especially important role in both clinical diagnosis and surgical practice.
International Journal of Morphology
During routine dissection of the upper limbs of a Caucasian male cadaver, multiple variations of the branches of the brachial plexus were observed. On the left side, the musculocutaneous nerve was absent and the muscles of the anterior compartment of the arm were innervated by the median nerve. The median nerve was also formed from three roots viz; two from the lateral and one from the medial cord of the brachial plexus. On the right side, the musculocutaneous nerve contributed a long communicating branch to the median nerve in the distal half of the arm. There were also communicating branches between the ulnar and radial nerves in both limbs at the humeral level. The coexistence of these variations appears to be unique and has not been reported in the literature reviewed. The anatomic and clinical significance of these variations is discussed.
Anatomy & Cell Biology, 2012
A 43-year-old female cadaver showed a complete bilateral absence of the musculocutaneous nerve. The anterior compartment muscles of both arms were supplied by median nerve excepting the coracobrachialis which was innervated by a direct branch from the lateral cord of brachial plexus. The median nerve, after supplying the biceps and brachialis muscles, gave onto the lateral cutaneous nerve of the forearm. The median nerve also showed variation on the left side where it was formed by two lateral roots and one medial root. Variations of the brachial plexus are of great interest to anatomists, clinicians and surgeons, in that they may be incorporated in their day to day practice. Our present case may be noted for its clinical and surgical significance in the variations of brachial plexus which can be useful for diagnostic purposes.
Surgical and Radiologic Anatomy, 2000
A variation of the brachial plexus characterized by the absence of the musculocutaneous nerve on both sides was observed during the dissection of a 72 year-old female cadaver. The long thoracic nerve included only the fibers from C5 and C6 on the left side. The musculocutaneous nerve was absent and two branches from the lateral cord innervated the coracobrachialis muscle. The median nerve innervated the biceps brachii and brachialis muscles in the arm and also gave off the lateral antebrachial cutaneous nerve. Additionally, a communicating branch was found from the median nerve to the ulnar nerve in the forearm. The knowledge of the anatomical variations of the peripheral nerve system can help give explanation when encountering an incomprehensible clinical sign.
Negah Institute for Scientific Communication, 2020
The anatomical variations of the brachial plexus are well documented. However, it is important to review the components of the brachial plexus, as it is significant in everyday clinical practices. The lateral pectoral and musculocutaneous nerves emerge from the lateral side of the lateral cord, in the brachial plexus. Before the piercing of the coracobrachialis muscle, the cord gives a muscular branch to this muscle from its lateral side. After sending muscular branches to biceps brachii and brachialis, the cord pierces the coracobrachialis muscle. Then, it courses downwards for a long distance at the middle of the arm into the lateral forearm skin; this branch is named as lateral forearm cutaneous nerve. The variations of the musculocutaneous nerve are extremely important for surgeons and radiologists, especially in the surgical explorations involving this region. In this study, we reported the absence of musculocutaneous nerve on the left side of a 25-year-old male cadaver. The case was detected during the routine dissection of the upper limb, in the dissection hall of the Bam University of Medical Sciences. The left median nerve supplied the coracobrachialis, biceps brachii, and brachialis, thereafter, it gave way to the lateral forearm cutaneous nerve, close to the elbow joint. These branches crossed the brachial artery to supply the muscles. This absence of musculocutaneous nerve and such type of variations are very rare during the embryologic development. Thus, the awareness of such variations helps for the diagnosis of the related neurological disorders and in surgical procedures.
Variant Nerves in the Infraclavicular Part of Brachial Plexus
2015
Ulnar nerve usually is a branch of the medial cord of brachial plexus. In a study conducted on 20 upper limbs, variation in its origin was observed in one right upper limb. Ulnar nerve had two roots of origin, one arising from the medial cord and another from the lateral cord. The rest of the course of the ulnar nerve was as usual. In another left upper limb a communicating branch was observed between the musculocutaneous nerve and median nerve. This type of variation would be important while planning surgery in the region of axilla or arm as these nerves is more liable to be injured during operations.
Acta medica (Hradec Králové) / Universitas Carolina, Facultas Medica Hradec Králové, 2012
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 ofmusculocutaneous. 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.
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.
VARIATIONS OF THE BRACHIAL PLEXUS (A CASE REPORT
of the seventh spinal nerve continues as middle trunk, and the eight cervical and first thoracic form behind posterior scalenus muscle the lower trunk of the brachial plexus. The trunks divide in an anterior and a posterior part. The anterior parts of the upper and middle trunks form the lateral cord, the anterior division of the lower trunk forms the medial cord and all posterior parts unite to posterior cord of the brachial plexus.