An atypical biceps brachii and coracobrachialis muscles associated with multiple neurovascular aberrations: a case report with clinical significance

Abstract

Neural and vascular variations in the axilla and upper limb area are usually paired, but coexistence of muscular aberration on top of this is uncommon. The current case report emphasizes on the unilateral coexistence of a three-headed (tricipital) biceps brachii muscle, a two-headed coracobrachialis with an accessory muscle bundle joining the superficial and deep heads of coracobrachialis muscle. On the ipsilateral side of the 72-year old male cadaver, a connecting branch originated from the musculocutaneous nerve and joined the median nerve after surpassing the accessory muscle bundle. A large diameter subscapular trunk originated from the 2nd part of the axillary artery and after giving off the 1st lateral thoracic artery trifurcated into a common stem which gave off the 2nd and 3rd lateral thoracic arteries, the circumflex scapular artery and a common branch that gave off the 4th and 5th lateral thoracic arteries and the thoracodorsal artery, as the ultimate branch. All lateral thoracic arteries were accompanied by multiple intercostobrachial nerves. Documentation of such muscular and neurovascular variants and their embryologic origin increases awareness of their potential impact on diagnosis and treatment of upper limb pathology. To the best of our knowledge, the currently reported cadaveric observations seem to constitute a unique finding.

Coracobrachialis muscle morphology and coexisted neural variants. A cadaveric case series

“…These formations narrowed the available surface area and possibly entrapped the related adjacent nerves (MCN, and MN) and the brachial artery. In addition, the current series highlights the common coexistence of the CB variant morphology with the BB morphologic variants in 14.8% similar to other reports [5,8,21,23]. Although, CB and BB variants seem to coexist, no systematic study until now has identi ed this association that possibly is explained by the developmental background of the muscles.…”

A highly complex variant of the plantaris tendon insertion and its potential clinical relevance

“…Anatomical variations can be observed around nerves, veins, arteries and ligaments, as well as muscles and their tendons (Tubbs et al 2009 ; Sugavasi 2013 ; Polguj et al 2014 ; Angelov and Jelev 2016 ; Olewnik et al 2017a , b , 2018a , b , 2019a , b , c ; Terfera et al 2015 ; Xu et al 2019 ; Piagkou et al 2019 ). Some of these structures have a tendency to display more common variations, and these can be used to create formal classification systems (Tubbs et al 2009 ; Olewnik et al 2017b , 2018a , 2019a , b , c ).…”