International Journal of Anatomy and Research

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Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 2 | Page No. 2444-2449

Date of Publication: 30-06-2016



Denize Augusto da Silva 1, Kiyoshi Goke 1,2, Claudia Maria Soares Savedra 1,3, Lucas Alves Sarmento Pires 4, Tulio Fabiano de Oliveira Leite 1,5, Carlos Alberto Araujo Chagas 1,*4.

1 Anatomy Laboratory, Biological and Health Sciences Centre, Gama Filho University, Rio de Janeiro, Brazil.

2 Anatomy Laboratory, Estácio de Sá University, Rio de Janeiro, Brazil.

3 Veiga de Almeida University, Rio de Janeiro, Brazil.

4 Anatomy Laboratory, Morphology Department, Federal Fluminense University, Rio de Janeiro, Brazil.

5 Medical School, Paulista State University, São Paulo, Brazil.

Address: Carlos Alberto Araujo Chagas, Federal Fluminense University, Rua Professor Ernani Mello, 101, São Domingos - Niterói - Rio de Janeiro - Brazil ZIP CODE 24210-150. Phone: +55 (21) 2629-2335, +55 (21) 98821-0066


Background: The biceps brachii muscle usually has two portions: the long portion, which originates from the supra-supraglenoid tubercle and the short portion that originates from the coracoid process. This study aims to determine the incidence of an accessory head of the biceps and its innervation.
Materials and Methods: 74 cadavers were dissected and observed in one year at the Anatomy Laboratory of the Gama Filho University and the Anatomy Laboratory of the Federal Fluminense University.
Results: There were variations in 10 cadavers (13,5%), nine of them were male and one were female. We found 8 different types of variations in 14 arms: (1) a biceps with four heads in the right side, where the accessory muscle belly fibers converged to the short portion (1 case); (2) a third head that originated from the lesser tubercle (bilateral); (3) a third portion of humeral origin (5 cases); (4) a third portion originating near the insertion of the pectoralis major muscle and a fourth accessory muscle belly  situated near the origin of the short portion and converging to the long portion (bilateral); (5) a case in which a third portion allowed passage of the brachial vessels and the median nerve; (6) a single case where the third head originated from the insertion of the pectoralis major muscle; (7) a case where the third head originated between the pectoralis major and deltoid muscles; (8) the long portion originated near the insertion of the deltoid muscle (1 case). All reported cases were innervated by the musculocutaneous nerve.
Conclusions: We believe that the biceps brachii muscle is not as variable as reported in the literature and some of these variations may be clinically significant.
Key Words: Anatomic Variations, Biceps Brachii, muscle, Brazilians, Embryology.


  1. Novaro A. A proposito di una interessante variazione muscolare del bicipite brachiale nell’ uomo. Quad Anat Prat. 1960;16(1-4):152-7.

  2. Poudel PP, Bhattarai C. Study on the supernumerary heads of biceps brachii muscle in Nepalese. Nepal Med Coll J. 2009;11(2):96-8.

  3. Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rakesh V. Multiple accessory structures in the upper limb of a single cadaver. Singapore Med J. 2008;49(9):e254-e8.

  4. Warner JJ, Paletta GA, Warren RF. Accesory head of the biceps brachii. Case report demonstrating clinical relevance. Clin Orthop. 1992(280):179-81.

  5. Testut L, Latarjet A. Tratado de Anatomia Humana. 9th ed. Barcelona: Salvat Editores; 1960.

  6. Williams PL, Warwick R, Dyson M, Bannister LH, editors. Gray's Anatomy. 37th ed. New York: Churchill Livingstone; 1989.

  7. Kaur P, Kumar R, Jain A. Variations in Innervation of Muscles in Anterior Compartment of Arm - A Cadaveric Study. J Clin Diag Res. 2014;8(5):AC01-AC3.

  8. Mehta V, Yadav Y, Arora J, Kumar H, Suri R, Rath G. A new variant in the brachium musculature with reinforced from a median-musculocutaneous nerve communication. Morphologie. 2009;93(301):63-6.

  9. Bergman R, Afifi STA. Catalogue of human variation. Munich: Urban and Schwartzenberg; 1984.

  10. Macalister A. Additional observations on muscular anomalies in human anatomy (third series), with a catalogue of the principal muscular variations hitherto published. Trans Roy Irish Acad. 1875;25:1-134.

  11. Rodríguez-Niedenführ M, Vázquez T, Choi D, Parkin I, Sañudo JR. Supernumerary Humeral Heads of the Biceps Brachii Muscle Revisited. Clin Anat. 2003;16:197-203.

  12. Nakatani T, Tanaka S, Mizukami S. Bilateral four-headed biceps brachii muscles: The median nerve and brachial artery passing through a tunnel formed by a muscle slip from the acessory head. Clin Anat. 1998;11(3):209-12.

  13. Nayak SR, Krishnamurthy A, Kumar M, Prabhu LV, Saralaya V, Thomas MM. Four-headed biceps and triceps brachii muscles, with neurovascular variation. Anat Sci Int. 2008;83(2):107-11.

  14. Nayak SR, Krishnamurthy A, Prabhu LV, Jiji PJ, Ramanathan LA, Kumar S. Multiple supernumerary muscles of the arm and its clinical significance. Bratisl Lek Listy. 2008;109(2):74-5.

  15. Nayak SR, Krishnamurthy A, Ramanathan LA, Prabhu LV, Kumar CG, Tom DK, et al. Multiple muscular anomalies of upper extremity: a cadaveric study. Rom J Morphol Embryol. 2008;49(3):411-5.

  16. Dudek RW. BRS Embryology. 6th ed: Lippincott Williams & Wilkins; 2010.

  17. Catli MM, Ozsoy U, Kaya Y, Hizay A, Yildirim FB, Sarikcioglu L. Four-headed biceps brachii, three-headed coracobrachialis muscles associated with arterial and nervous anomalies in the upper limb. Anat Cell Biol. 2012;45(2):136-9.

  18. Neale R. The alleged transmigration of the long tendon of the biceps brachii. Anat Rec. 1937;67:205.

  19. Yeh L, Pedowitz R, Kwak S, Haghighi P, Muhle C, Trudell D, et al. Intracapsular origin of the long head of the biceps tendon. Skeletal Radiol. 1999;28(3):178-81.

  20. Oxnard C, Franklin D. Ghosts of the past II: muscles and fasciae in the primate forelimb domain. Folia Primatol (Basel). 2008;79:441-57.

  21. Sonntag C. On the anatomy, physiology and pathology of the chimpanzee. Proc Zool Soc. 1923;24:349-449.

  22. Cucca YY, Mclay SV, Okamoto T, Ecker J, McMenamim PG. The biceps brachi muscle and its distal insertion: observation of surgical and evolutionary relevance. Surg Radiol Anat. 2010;32(4):371-5.

  23. Öztürk NC, Uzmansel D, Öztürk H. An unreported pattern of musculocutaneous and median nerve communication with multiple variations of biceps brachii: a case report. Surg Radiol Anat. 2010;32(9):887-90.

  24. Paraskevas G, Natsis K, Ioannidis O, Papaziogas B, Kitsoulis P, Spanidou S. Accessory Muscles in the Lower Part of Anterior Compartment of the Arm that may Entrap Neurovascular Elements. Clin Anat. 2008;21(3):246-51.

  25. Hyman JL, Warren RF. Extra-articular origin of biceps brachii. Arthroscopy. 2001;17(7):e29.

  26. Rai R, Ranade AV, Prabhu LV, Pai MM, Prakash. Third head of biceps brachii in na Indian population. Singapore Med J. 2007;48(10):929-31.

  27. Kopuz C, Sancak B, Ozbenli S. On the incidence of third head of bíceps brachii in Turkish neonates and adults. Kaibogaku Zasshi. 1999;74(3):301-5.

  28. Greig HW, Anson BJ, Budinger JM. Variations in the form and attachments of the biceps brachii muscle. Q Bull Northwest Univ Med Sch. 1952;26(3):241-4.

  29. Sarikcioglu L, Yildirim FB. High origin of the radial artery accompanied by muscular and neural anomalies. Ann Anat. 2003;185(2):179-82.

  30. Gray DJ. Some Variations Appearing in the dissecting room. Stanford M Bull. 1945;3(3):120-7.

  31. Mori M. Statistics on the musculature of the Japanese. Okajimas Folia Anat Jpn. 1964;40:195-300.

  32. Kumar H, Das S, Rath G. An anatomical insight into the third head of biceps brachii muscle. Bratisl Lek Listy. 2008;109(2):76-8.

  33. Kervancioglu P, Orhan M. An anatomical study on the three-headed biceps brachii in human foetuses, and clinical relevance. Folia Morphol. 2011;70(2):116-20.

  34. Gaskin CM, Golish SR, Blount KJ, Diduch DR. Anomalies of the long head of the biceps brachii tendon: clinical significance, MR arthrographic findings, and arthroscopic correlation in two patients. Skeletal Radiol. 2007;36(8):785-9.


Silva DA, Goke K, Savedra CMS, Pires LAS, Leite TFO, Chagas CAA. VARIATIONS OF THE BICEPS BRACHII MUSCLE IN BRAZILIANS. Int J Anat Res 2016;4(2):2444-2449. DOI: 10.16965/ijar.2016.232




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