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Ahead of Print
CASE REPORTS
Published online: 2018-08-31
Submitted: 2018-07-08
Accepted: 2018-07-29
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An atypical biceps brachii and coracobrachialis muscles associated with multiple neurovascular aberrations: a case report with clinical significance

Maria Piagkou, Trifon Totlis, Nikolaos Anastasopoulos, Nikolaos Lazaridis, Konstantinos Natsis
DOI: 10.5603/FM.a2018.0081
·
Pubmed: 30178460

open access

Ahead of Print
CASE REPORTS
Published online: 2018-08-31
Submitted: 2018-07-08
Accepted: 2018-07-29

Abstract

Neural and vascular variations in the axilla and upper limb area are usually paired, but coexistence of muscular aberration on top of this is uncommon. The current case report emphasizes on the unilateral coexistence of a three-headed (tricipital) biceps brachii muscle, a two-headed coracobrachialis with an accessory muscle bundle joining the superficial and deep heads of coracobrachialis muscle. On the ipsilateral side of the 72-year old male cadaver, a connecting branch originated from the musculocutaneous nerve and joined the median nerve after surpassing the accessory muscle bundle. A large diameter subscapular trunk originated from the 2nd part of the axillary artery and after giving off the 1st lateral thoracic artery trifurcated into a common stem which gave off the 2nd and 3rd lateral thoracic arteries, the circumflex scapular artery and a common branch that gave off the 4th and 5th lateral thoracic arteries and the thoracodorsal artery, as the ultimate branch. All lateral thoracic arteries were accompanied by multiple intercostobrachial nerves. Documentation of such muscular and neurovascular variants and their embryologic origin increases awareness of their potential impact on diagnosis and treatment of upper limb pathology. To the best of our knowledge, the currently reported cadaveric observations seem to constitute a unique finding.

Abstract

Neural and vascular variations in the axilla and upper limb area are usually paired, but coexistence of muscular aberration on top of this is uncommon. The current case report emphasizes on the unilateral coexistence of a three-headed (tricipital) biceps brachii muscle, a two-headed coracobrachialis with an accessory muscle bundle joining the superficial and deep heads of coracobrachialis muscle. On the ipsilateral side of the 72-year old male cadaver, a connecting branch originated from the musculocutaneous nerve and joined the median nerve after surpassing the accessory muscle bundle. A large diameter subscapular trunk originated from the 2nd part of the axillary artery and after giving off the 1st lateral thoracic artery trifurcated into a common stem which gave off the 2nd and 3rd lateral thoracic arteries, the circumflex scapular artery and a common branch that gave off the 4th and 5th lateral thoracic arteries and the thoracodorsal artery, as the ultimate branch. All lateral thoracic arteries were accompanied by multiple intercostobrachial nerves. Documentation of such muscular and neurovascular variants and their embryologic origin increases awareness of their potential impact on diagnosis and treatment of upper limb pathology. To the best of our knowledge, the currently reported cadaveric observations seem to constitute a unique finding.

Get Citation

Keywords

biceps brachii, variation, coracobrachialis, lateral thoracic artery, intercostobrachial nerve, anastomosis, median nerve, musculocutaneous nerve

About this article
Title

An atypical biceps brachii and coracobrachialis muscles associated with multiple neurovascular aberrations: a case report with clinical significance

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2018-08-31

DOI

10.5603/FM.a2018.0081

Pubmed

30178460

Keywords

biceps brachii
variation
coracobrachialis
lateral thoracic artery
intercostobrachial nerve
anastomosis
median nerve
musculocutaneous nerve

Authors

Maria Piagkou
Trifon Totlis
Nikolaos Anastasopoulos
Nikolaos Lazaridis
Konstantinos Natsis

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