Type of Article: Original Research
Year: 2016 | Volume 4 | Issue 1 | Page No. 1795-1801
Date of Publication: 31-01-2016
VARIATIONS IN ATTACHMENTS AND NERVE SUPPLY OF THIRD HEAD OF BICEPS BRACHII: A STUDY IN SOUTH INDIAN POPULATION
Hima Bindu Nalluri *1, Parimala Sirikonda 2, Vasanta Leela 3.
*1 Associate Professor, Department of Anatomy, Bhaskar Medical College, Hyderabad, Telangana, India.
2 Assistant Professor, Department of Anatomy, Bhaskar Medical College, Hyderabad, Telangana, India.
3 Professor, Department of Anatomy, Deccan College of Medical Sciences, Hyderabad, Telangana, India.
Address: Dr. Hima Bindu Nalluri, Associate Professor, Department of Anatomy, Bhaskar Medical College, Amdapur X Road, Yenkapally, Moinabad, Ranga Reddy, Hyderabad, Telangana 500075, India.
Background: Biceps brachii muscle normally has two heads; the long head and the short head. Sometimes it has a third head or supernumerary head. Variations in the attachments of the third head of biceps brachii are clinically important.
Aim: This study was undertaken to evaluate the incidence, attachments, relations and nerve supply of the third head of biceps brachii in a South Indian Population.
Material and methods: Both the upper limbs of 40 formalin-fixed cadavers (80 upper limbs) were studied for the possible presence of supernumerary heads of biceps brachii. The anterior compartment of arm was dissected and the biceps brachii muscle was exposed. The attachments, relations and nerves supplying biceps brachii, were delineated.
Results: It was found that Biceps brachii had two heads in 36 cadavers. A third head was observed in 4 cadavers. It was bilateral in one cadaver and unilateral in three cadavers. This third head of biceps brachii arose from the coracoid process along with its short head, bilaterally, in one cadaver. It originated from the medial surface of the shaft of humerus at the insertion of coracobrachialis, in left upper limb of one cadaver. The third head originated from the shaft of humerus along with the medial fibers of brachialis in the right upper limb of one cadaver; and both from shaft of the humerus and medial intermuscular septum in the right upper limb of another cadaver. In three cases it was innervated by the musculo-cutaneous nerve. In one case it was innervated by the branches of the median nerve, where the musculo- cutaneous nerve was absent. All the three heads fused before the formation of bicipital tendon and inserted into the radial tuberosity. But in one case, a few fibers of the third head inserted into the bicipital aponeurosis.
Conclusion: In our study the incidence of third head was 10%. In published literature, its incidence varies from 0.18% to 21.5% in different populations. Variation in the attachments of third head of biceps brachii is important in surgical interventions, neurovascular compression syndromes and unexplained pain syndromes in arm and forearm regions.
KEY WORDS: Biceps brachii, third head of biceps, supernumerary head, median nerve compression, brachial artery compression, absent musculo-cutaneous nerve
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Hima Bindu Nalluri, Parimala Sirikonda, Vasanta Leela. VARIATIONS IN ATTACHMENTS AND NERVE SUPPLY OF THIRD HEAD OF BICEPS BRACHII: A STUDY IN SOUTH INDIAN POPULATION. Int J Anat Res 2016;4(1):1795-1801. DOI: 10.16965/ijar.2015.337