IJAR.2018.322

Type of Article:  Case Report

Volume 6; Issue 3.3 (Septmber 2018)

Page No.: 5719-5721

DOI: https://dx.doi.org/10.16965/ijar.2018.322

ACCESSORY BRANCH OF MEDIAN NERVE: AN ANATOMICAL VARIATION IN THE INNERVATION OF BRACHIALIS MUSCLE WITH ITS CLINICAL IMPLICATIONS

Uchewa O. Obinna *1, Egwu A. Jude 1, Egwu O. Augustin 1, Ebube N. Linda 1.

1 Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, Federal University Ndufu-Alike, Ikwo (FUNAI), Ebonyi State, Nigeria.

Corresponding Author: UCHEWA, Obinna Onwe, Department of Anatomy, Faculty of Basic Medical Sciences, College of Medicine, Federal University Ndufu-Alike, Ikwo (FUNAI), Ebonyi State, Nigeria. Tel: +2348172628746 or +2347061644732 E-Mail:  euchewa1@gmail.com

ABSTRACT:

The median nerve (MN) is widely known among Anatomists to innervate the forearm. It usually gives out a branch to the Pronator Teres muscle as it enters the arm, while the muscles of the anterior compartment of the arm are majorly innervated by the musculocutaneous nerve (MCN). An accessory branch of MN was noticed in the left arm during student’s dissection of a male cadaver to innervate the lower part of the Brachialis muscle (BM). The branch was given out at the infero-lateral side of the nerve and it coursed lateral to the lateral brachial vein and after small distance it disappeared into the Brachialis muscle to supply it. It is in view of the above that we are advocating that surgeons, neurologists and anaesthists should also be conscious of these variations and be meticulous in their efforts to interpret some of the symptoms induced by nerve lesion. This branch could be vital in reduce Brachialis muscle palsy in event of damage to MCN.

Key words: Accessory, Innervation, Variation, Nerve, Brachialis.

REFERENCES

  1. Chaurasia BD. Regional and Applied Dissection and Clinical Human Anatomy 6th (2): 93. 2013; Editors: Krishna G, Mital PS. and Mrudula C.
  2. Moore LK, Dalley FA, Agur AMR. Clinically Oriented Anatomy 7th 2014; Lippincott Williams and Wilkins Publishers, Philadephia.
  3. Budhiraja V, Rastogi R, Asthana, AK. Anatomical variations of median nerve formation: embryological and clinical correlation. Morphol. Sci. 2011;28(4):283-286.
  4. Samarawickrama MB. A study of anatomical variations of median nerve formation and its relation to the arteries in the axilla and arm. J. Morphol. 2017;35(2):698-704.
  5. Bhanu PS, Sankar KD, Susan PJ. Formation of median nerve without the medial root of medial cord and associated variations of the brachial plexus. J. Anat. Var. 2010;3:27-9.
  6. Williams PL (ed). Gray’s Anatomy. 38th 1995; Churchill Livingstone, Edinburgh.
  7. Paraskevas G, Nikolaos A, Zoi N, Panagiotis K, Ioannis S. Accessory Branch of Median Nerve Supplying the Brachialis Muscle: A Case Report and Clinical Significance. Journal of Clinical and Diagnostic Research. 2014;8(12):1-2.
  8. Gacek RR. Neck dissection injury of a brachial plexus of anatomical variant; Archives of Otolaryngology – Head & Neck Surgery, 1990;116:356-358.
  9. Standring S, Ellis H, Berkovitz BK. Gray´s The Anatomical Basis of Medicine and Surgery. 40th ed. 2008; Elsevier Churchill    Livingstone, Edinburgh.
  10. Hall-Craggs ECB. Anatomy as a basis for clinical medicine. 3rd 1995; Williams and Wilkins, London.
  11. Ip-MC, Chang KS. A study on the radial supply of the human brachialis muscle. Anat Rec. 1968;162:363-71.
  12. Srimathi T, Umapathy S. A study on the radial nerve supply to the human brachialis muscle and its clinical correlation. J Clin Diag Res. 2011;5(5):986-89.
  13. Blackburn SC, Wood CPJ, Evans DJR, Watt DJ. Radial nerve contribution to Brachialis in the UK Caucasian population: position is predictable based on surface landmarks. Clin Anat. 2007;20: 64-67.
  14. Bergman RA, Thompson SA, Afifi AK, Saadeh FA. Compendium of Human Anatomic Variation. Munich: Urban & Schwarzeberg. 1988;139-43.
  15. Carlson BM. Human embryology and developmental biology, 1994; St Louis: Mosby.
  16. Le Minor JM. A rare variant of the median and musculocutaneous nerves in man. Anat Histol Embryol. 1990;73:33-42.
  17. Maeda S, Kawai K, Koizumi M, Ide J, Tokiyodhi A, Mizuta H. Morphological study on the communication between the musculocutaneous and median nerves. Anat Sci Int. 2009;86:34-40.
  18. Kaur P, Kumar R, Jain A. Variations in innervation of muscles in anterior compartment of arm-a cadaveric study. J Clin Diagn Res. 2014;8(5).
  19. Guerri-Guttenberg RA, Ingolotti M. Classifying musculocutaneous nerve variations. Anat. 2009;22:671-683.
  20. Hur MS, Woo JS, Lee KS. Median nerve branch innervating the brachialis muscle. Korean J Phys Anthropol. 2010;23-24.
  21. Won SY, Cho YH, Choi YJ, Farero V, Woo HS, Chang KY, et al.Intramuscular innervation patterns of the brachialis muscle. Clin Anat. 2014. (doi:10.1002/ ca.22387).

Cite this article: Uchewa O. Obinna, Egwu A. Jude, Egwu O. Augustin, Ebube N. Linda. ACCESSORY BRANCH OF MEDIAN NERVE: AN ANATOMICAL VARIATION IN THE INNERVATION OF BRACHIALIS MUSCLE WITH ITS CLINICAL IMPLICATIONS. Int J Anat Res 2018;6(3.3):5719-5721. DOI: 10.16965/ijar.2018.322