open access

Ahead of Print
Case report
Published online: 2020-10-12
Submitted: 2020-08-20
Accepted: 2020-09-07
Get Citation

Unusual formation of the musculocutaneous and median nerves: a case report refined by intraneural dissection and literature review

E. Clarke, R. S. Tubbs, M. Radek, R. Haładaj, M. Tomaszewski, G. Wysiadecki
DOI: 10.5603/FM.a2020.0121
·
Pubmed: 33084011

open access

Ahead of Print
CASE REPORTS
Published online: 2020-10-12
Submitted: 2020-08-20
Accepted: 2020-09-07

Abstract

This report presents a detailed anatomical investigation of an upper limb specimen showing an atypical formation of the musculocutaneous (MCN) and median (MN) nerves. The study was refined by intraneural dissection, which supplements earlier descriptions of similar anatomical variations and allows for revision of the accepted classification.

The case described in this report was an incidental finding during routine dissection of a fixed isolated upper limb. Intraneural dissection revealed partial fusion between the MCN and aberrant bundles of the MN. Those aberrant bundles joined the main steam of the MN at the level at which the MCN branched off as an independent nerve. The procedure allowed the aberrant fibers of the MN to be differentiated from the MCN. The presence of separate bundles in a territory corresponding to the MCN was confirmed, although those bundles and the aberrant MN bundles were covered by a common epineurium. The aberrant MN bundles running within the MCN did not contribute to innervation of the forearm muscles. They rejoined the main nerve trunk in the arm.

A comprehensive understanding of the diverse anatomical variations of the upper limb nerves could be crucial for the safety and success of surgical procedures, especially procedures for reconstructing the brachial plexus or its branches.

Abstract

This report presents a detailed anatomical investigation of an upper limb specimen showing an atypical formation of the musculocutaneous (MCN) and median (MN) nerves. The study was refined by intraneural dissection, which supplements earlier descriptions of similar anatomical variations and allows for revision of the accepted classification.

The case described in this report was an incidental finding during routine dissection of a fixed isolated upper limb. Intraneural dissection revealed partial fusion between the MCN and aberrant bundles of the MN. Those aberrant bundles joined the main steam of the MN at the level at which the MCN branched off as an independent nerve. The procedure allowed the aberrant fibers of the MN to be differentiated from the MCN. The presence of separate bundles in a territory corresponding to the MCN was confirmed, although those bundles and the aberrant MN bundles were covered by a common epineurium. The aberrant MN bundles running within the MCN did not contribute to innervation of the forearm muscles. They rejoined the main nerve trunk in the arm.

A comprehensive understanding of the diverse anatomical variations of the upper limb nerves could be crucial for the safety and success of surgical procedures, especially procedures for reconstructing the brachial plexus or its branches.

Get Citation

Keywords

anatomical variation, brachial plexus, median nerve, musculocutaneous nerve, peripheral nerves

About this article
Title

Unusual formation of the musculocutaneous and median nerves: a case report refined by intraneural dissection and literature review

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2020-10-12

DOI

10.5603/FM.a2020.0121

Pubmed

33084011

Keywords

anatomical variation
brachial plexus
median nerve
musculocutaneous nerve
peripheral nerves

Authors

E. Clarke
R. S. Tubbs
M. Radek
R. Haładaj
M. Tomaszewski
G. Wysiadecki

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl