IJAR.2018.209

Type of Article:  Original Research

Volume 6; Issue 2.3 (June 2018)

Page No.: 5306-5309

DOI: https://dx.doi.org/10.16965/ijar.2018.209

A STUDY ON ANATOMICAL VARIATIONS IN THE FORMATION OF BRACHIAL PLEXUS AND ITS BRANCHES

Jyothi Jatthavath 1, A Vijaya Lakshmi *2.

1 Assistant professor in Anatomy, RIMS, Ongole, Andhra Pradesh, India.

*2 Assistant professor in Anatomy, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India.

Corresponding author: A Vijaya Lakshmi. MD, Assistant professor in Anatomy, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India. E-Mail: vldevi.athota@gmail.com

ABSTRACT:

Background: The variable course of the nerves may be the cause of many neuralgic pains of the superior extremity. The knowledge of percentage of variations may help the surgeons in treating the cases of trauma & entrapment neuropathies.

Materials and Methods: The present study in 70 upper limbs of 35 human cadavers over a period 1year at the department of Anatomy at Siddhartha medical college and surrounding medical colleges around Vijayawada. The detailed examination of the following nerves that is musculocutaneous, median, ulnar, radial and axillary nerves was done in the arm and following variations were observed.

Results: Communication between musculocutaneous and median nerves in eleven limbs. Musculocutaneous nerve was absent in our limbs. Median nerve supplied muscles of front of arm where musculocutaneous nerve was absent in one limb. Musculocutaneous nerve did not pierce coracobrachialis muscle in seven limbs. The Communication between radial and ulnar nerve in one limb.

Conclusion: Lesions of communicating nerve may give rise to pattern of weakness that may impose difficulty in diagnosis. So it is important to be aware of the variations that are observed and discussed in our study. Knowledge of these variations is important for neurologists, orthopaedicians and traumatologists as these may give rise to variable clinical picture depending upon the variations present.

Key words: Musculocutaneous nerve, Median nerve, Coracobrachialis, Cadaveric study.

REFERENCES

  1. Fazan VPS, Amadeu AS, Caleffi AL, Rodrigues Filho OA. Brachial plexus variations in its formation and main branches. Acta Cir Bras. 2003;18:5.
  2. Babu PB, Roy AP, Bangera H. Communication between musculocutaneous and median nerves: a case report. Int J Res Med Sci 2014;2:1211-3.
  3. Kerr A.T. The brachial plexus of nerves in man, the variations in its formation and branches. American Journal of Anatomy. 1918;23:285-395.
  4. Hollinshead, W. H. 1958. Anatomy for surgeons In: General survey of the upper limb. Vol. 3 – The Back and Limbs. New York: A Hoeber Harper Book. p 225- 245.
  5. Hasan, M., Narayan, D. A single cord human brachial plexus Journal of the Anatomical Society of India.1964;13:103-4.
  6. Moore K.L., Dalley A.F. 1999: Upper limb. In: Clinically Oriented Anatomy. 4th Ed. Philadelphia: Lippincott, Williams and Wilkins. p 714-715.
  7. Williams P.L.; Bannister L.H.; Berry M.M.; Collins P.; Dyson M.; Dussek, J.E. et al. 1995: Nervous system. In: Gray’s Anatomy. 38th Ed. Edinburgh: Churchill Livingstone. p 1266-72.
  8. Gupta M, Goyal N, Harjeet. Anomalous communications in the branches of brachial plexus. J. Anat. Soc. India. 2005;54(1):22-5.
  9. Gopal K, Anurag, Singh O. Anatomical variations of brachial plexus: anomalous branching pattern. Int J Res Med Sci. 2016;4:3376- 80.
  10. Prasada Rao PV, Chaudhary SC. Absence of musculocutaneous nerve: two case reports. Clin Anat. 2001;14(1):31-5.
  11. Hayashi M, Shionoya K, Hayashi S, Hatayama N, Kawata S, Qu N, et.al. A novel classification of musculocutaneous nerve variations: The relationship between the communicating branch and transposed innervation of the brachial flexors to the median nerve. Ann Anat. 2017;209:45-50.
  12. Le Minor JM. A rare variation of the median and musculocutaneous nerves in man. Arch Anat Histol Embryol. 1990;73:33-42.
  13. Nakatani T, Mizukami S, Tanaka S. Three cases of the musculocutaneous nerve not perforating the coracobrachialis muscle. Kaibogaku Zasshi. 1997;72(3):191-4.
  14. Sud M, Sharma A. Absence of musculocutaneous nerve and the innervation of coracobrachialis, biceps brachii and brachialis from the median nerve. J Anat Soc India 2000;49(2):176-7.
  15. Gumusburun E; Adiguzel E. A variation of the brachial plexus characterized by the absence of the musculocutaneous nerve: a case report. Surg Radiol Anat. 2000;22(1):63-5.
  16. Joshi S.D., Joshi S.S., Athavale S.A. Hitch-Hiking Fibres Of Lateral Cord Of Brachial Plexus In Search Of Their Destination. J. Anat. Soc. India.2008;57(1):26-9.
  17. Hollinshead W H. 1982.The back and limbs: knee, leg, ankle and foot. In: Anatomy for surgeons. vol rd 3, 3 Ed. London : Harper and Row publishers, pp 797.
  18. Le Minor JM. A rare variant of the median and musculocutaneous nerve in man. Archives of Anatomy, Histology and Embryology. 1992; 73:33–42.
  19. Choi D.; Rodriguez-Niedenfuhr M.; Vazquez T.; Parkin I., Sanudo J. R. Patterns of connections between the musculocutaneous and median nerves in the axilla and arm. Clinical Anatomy.2002;15:11-7.
  20. Venieratos, D. and Anagnostopoulou, S.Classification of communications between the musculocutaneous and median nerves. Clinical Anatomy. 1998;11:327-31.
  21. Aktan Z, Oztunk L, Bilge O, Ozer M, Pinar Y. A cadaveric study of the anatomical variations of the brachial plexus nerves in the axillary region and arm. Turk J Med Sci. 2001;2:147–150.
  22. Kosugi K, S. Shibata, H. Yamashita. Supernumerary head of Biceps brachii and branching pattern of the musculocutaneous nerve in Japanese. Surge Radiol Anat. 1992;14:175-85.
  23. Caton A, Hacker A, Naeem A, Livet J, Maina F, Bladt F, et al. The branchial arches and HGF are growth-promoting and chemoattractant for cranial motor axons. Development. 2000;127(8):1751-66.
  24. Pandey SK, Shukla VK. Anatomical variations of the cords of brachial plexus and the median nerve. Clin Anat. 2007;2(2]):150–156.
  25. Bergman RA, Thompson SA, Afifi AK, Saadeh FA. Compendium of human anatomic variation: catalogue, atlas, and world literature. Baltimore, Munich: Urban and Schwarzenberg. 1988:139- 43.

Cite this article: Jyothi Jatthavath, A Vijaya Lakshmi. A STUDY ON ANATOMICAL VARIATIONS IN THE FORMATION OF BRACHIAL PLEXUS AND ITS BRANCHES. Int J Anat Res 2018;6(2.3):5364-5370. DOI: 10.16965/ijar.2018.209