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A new type of the coracobrachialis muscle
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
- Department of Orthopaedics Surgery, Hospital Santa Cristina, Madrid, Spain
- Department of Human Anatomy and Embryology, Facultad de Medicina, Universidad Complutense de Madrid, Spain
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, United States
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, United States
- Department of Anatomical Sciences, St. George’s University, Grenada, West Indies
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, United States
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, United States
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, United States
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Abstract
The coracobrachialis muscle belongs to the anterior group of the brachial region. Its main functions are flexion and adduction at the glenohumeral joint. It is highly morphologically variable, especially in the number of bellies, place of origin or insertion, and its relationship to the musculocutaneous nerve. Accessory structures associated with the coracobrachialis muscle include the coracobrachialis brevis or coracobrachialis longus muscle. The present case describes a three-headed coracobrachialis muscle with two such additional structures. One of these has a tendinous origin connected to the periosteum and located on the surgical neck of the humerus. Its insertion is fused with the third head of the coracobrachialis muscle. The other has a proximal attachment fused with the capsule of the shoulder joint, and its distal attachment is fused with the third head of the coracobrachialis muscle in place of its connection with the short head of the biceps brachii. This could result in better stabilisation of the glenohumeral joint; on the other hand, it could limit operational access during treatment of subscapularis
tears.
Abstract
The coracobrachialis muscle belongs to the anterior group of the brachial region. Its main functions are flexion and adduction at the glenohumeral joint. It is highly morphologically variable, especially in the number of bellies, place of origin or insertion, and its relationship to the musculocutaneous nerve. Accessory structures associated with the coracobrachialis muscle include the coracobrachialis brevis or coracobrachialis longus muscle. The present case describes a three-headed coracobrachialis muscle with two such additional structures. One of these has a tendinous origin connected to the periosteum and located on the surgical neck of the humerus. Its insertion is fused with the third head of the coracobrachialis muscle. The other has a proximal attachment fused with the capsule of the shoulder joint, and its distal attachment is fused with the third head of the coracobrachialis muscle in place of its connection with the short head of the biceps brachii. This could result in better stabilisation of the glenohumeral joint; on the other hand, it could limit operational access during treatment of subscapularis
tears.
Keywords
coracobrachialis muscle, accessory muscle, case report, coracocapsularis longus, coracobrachialis brevis, morphological variation, embryological development, embryogenesis
Title
A new type of the coracobrachialis muscle
Journal
Issue
Article type
Case report
Pages
439-444
Published online
2022-02-28
Page views
2368
Article views/downloads
960
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(2):439-444.
Keywords
coracobrachialis muscle
accessory muscle
case report
coracocapsularis longus
coracobrachialis brevis
morphological variation
embryological development
embryogenesis
Authors
N. Zielinska
P. Aragonés
J. R. Sañudo
P. Łabętowicz
R. S. Tubbs
Ł. Olewnik
- Bauones S, Moraux A. The accessory coracobrachialis muscle: ultrasound and MR features. Skeletal Radiol. 2015; 44(9): 1273–1278.
- Beattie PH. Description of bilateral coraco-brachialis brevis muscle, with a note on its significance. Anat Rec. 1947; 97(1): 123–126.
- Bergman R, Afifi A, Miyauchi R. Illustrated Encyclopedia of Human Anatomic Variations. Anatomy Atlas, 2017 .
- Catli MM, Ozsoy U, Kaya Y, et al. Four-headed biceps brachii, three-headed coracobrachialis muscles associated with arterial and nervous anomalies in the upper limb. Anat Cell Biol. 2012; 45(2): 136–139.
- Chouke KS. Variation of the coracobrachialis muscle. Anat Rec. 1924; 27(3): 157–163.
- Cruveilhier J. Traité d’anatomie descriptive I. Asselin, Paris 1862.
- El-Naggar MMA. study on the morphology of the coracobrachialis muscle and its relationship with the musculocutaneous nerve. Folia Morphol. 2001; 60: 217–224.
- El-Naggar MM, Al-Saggaf S. Variant of the coracobrachialis muscle with a tunnel for the median nerve and brachial artery. Clin Anat. 2004; 17(2): 139–143.
- Garbelotti SA, Marques SR, Rocha PR, et al. An unusual case of accessory head of coracobrachialis muscle involving lateral cord of brachial plexus and its clinical significance. Folia Morphol. 2017; 76(4): 762–765.
- Georgiev GP, Landzhov B, Tubbs RS. A novel type of coracobrachialis muscle variation and a proposed new classification. Cureus. 2017; 9(7): e1466.
- Georgiev GP, Tubbs RS, Landzhov B. Coracobrachialis longus muscle: humeroepitrochlearis. Cureus. 2018; 10(5): e2615.
- Guha R, Satyanarayana N, Reddy CK, et al. Variant insertion of coracobrachialis muscle-morphological significance, embryological basis and clinical importance. J Coll Med Sci. 1970; 6(2): 42–46.
- Iwanaga J, Singh V, Ohtsuka A, et al. Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat. 2021; 34(1): 2–4.
- Kopuz C, Içten N, Yildirim M. A rare accessory coracobrachialis muscle: a review of the literature. Surg Radiol Anat. 2003; 24(6): 406–410.
- Kyou-Jouffroy M, Lessertissur J, Saban R, et al. Musculature des membres, membre pectoral, groupe branchial ventral. Grassé PP. 1971.
- Lenart BA, Ticker JB. Subscapularis tendon tears: Management and arthroscopic repair. EFORT Open Rev. 2017; 2(12): 484–495.
- Loukas M, Aqueelah H. Musculocutaneous and median nerve connections within, proximal and distal to the coracobrachialis muscle. Folia Morphol. 2005; 64: 101–108.
- Mori M. Statistics on the musculature of the Japanese. Okajimas Folia Anat Jpn. 1964; 40: 195–300.
- Olewnik Ł, Zielinska N, Karauda P, et al. The co-occurrence of a four-headed coracobrachialis muscle, split coracoid process and tunnel for the median and musculocutaneous nerves: the potential clinical relevance of a very rare variation. Surg Radiol Anat. 2021; 43(5): 661–669.
- Olewnik Ł, Paulsen F, Tubbs RS, et al. Potential compression of the musculocutaneous, median and ulnar nerves by a very rare variant of the coracobrachialis longus muscle. Folia Morphol. 2021; 80(3): 707–713.
- Park YB, Park YE, Koh KH, et al. Subscapularis tendon repair using suture bridge technique. Arthrosc Tech. 2015; 4(2): e133–e137.
- Szewczyk B, Polguj M, Paulsen F, et al. A proposal for a new classification of coracobrachialis muscle morphology. Surg Radiol Anat. 2021; 43(5): 679–688.
- Tatar I, Brohi R, Sen F, et al. Innervation of the coracobrachialis muscle by a branch from the lateral root of the median nerve. Folia Morphol. 2004; 63(4): 503–506.
- Vollala VR, Nagabhooshana S, Bhat SM, et al. Multiple accessory structures in the upper limb of a single cadaver. Singapore Med J. 2008; 49(9): e254–e258.
- Wood J. On human muscular variations and their relation to comperative anatomy. J Anat Physiol. 1867: 44–59.
- Zielinska N, Olewnik Ł, Karauda P, et al. A very rare case of an accessory subscapularis muscle and its potential clinical significance. Surg Radiol Anat. 2021; 43(1): 19–25.
- Zielinska N, Tubbs RS, Podgórski M, et al. The subscapularis tendon: A proposed classification system. Ann Anat. 2021; 233: 151615.