Bilateral anatomic variation in the relation of the upper trunk of the brachial plexus to the anterior scalene muscle

Radunović, Miroslav; Vukčević, Batrić; Abramović, Marija; Vukcevic, Nemanja; Radojević, Nemanja; Vuksanović-Božarić, Aleksandra

doi:10.5603/fm.a2018.0056

Cited by 3 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding variations of the musculocutaneous nerve, Radunovic et al (2013) indicate that these reach an average of 20 % among the different studies of this nerve. Complementing the above, Sirico et al (2019) mention that when variations in the supraclavicular portion of the brachial plexus are observed, it is more likely to find a mixed variation that involves other variations along the same brachial plexus.…”

Section: Discussionmentioning

confidence: 97%

“…The upper limb develops from mesenchymal tissue during the fourth week of fetal development (Radunovic et al, 2019). Brachial plexus begins its formation on day 33 of development (Moore et al, 2016), and muscle mass of the scalenes approximately on day 50 (Som & Laitman, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…This muscle mass is initially unique and subsequently traversed by the brachial plexus and subclavian artery (Milliez & Sakka, 1993). The interaction of this muscle mass with the nervous primordium (Radunovic et al, 2013) and blood vessels is decisive in establishing their anatomical relations and generating anatomical variations in the neck and upper limb.…”

Section: Discussionmentioning

confidence: 99%

“…During the 5th week of development the outline of the upper limb is placed in front of spinal segments C5 to T1. Specifically, nerves are formed and attach on days 32 and 33, thereby constituting the brachial plexus (Radunovic et al, 2019). Axons are introduced into the general outlines of the upper limb, and develop into dorsal and ventral muscle masses, fusing with a specific pattern, where sensitive axons use motor axon guidance.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Positional Anomaly Between the Brachial Plexus and the Scalene Muscles, Concomitant with an Anomalous Path of the Musculocutaneous Nerve. Case Report and Clinical Implication

et al. 2020

View full text Add to dashboard Cite

Anatomical variations of the scalene muscles are frequent, as are those of the brachial plexus and its terminal nerves. Nonetheless, these variations are reported separately in the literature. The aim of this work is to present a variation of scalene muscles, concomitant with an abnormal path of the musculocutaneous nerve. During a routine dissection of the cervical region, axilla and right anterior brachial region in an adult male cadaver, a supernumerary muscle fascicle was located in the anterior scalene muscle, altering the anatomical relations of C5 and C6 ventral branches of the brachial plexus. This variation was related to an anomalous path of the musculocutaneous nerve that did not cross the coracobrachialis muscle. It passed through the brachial canal along with the median nerve. It then sent off muscular branches to the anterior brachial region and likewise, communicating branches to the median nerve. The concomitant variations of the brachial plexus and scalene muscles they are not described frequently. Knowledge of these variations improves diagnosis, enhancing therapeutic and surgical approaches by reducing the possibility of iatrogenesis during cervical, axillary and brachial region interventions.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Positional Anomaly Between the Brachial Plexus and the Scalene Muscles, Concomitant with an Anomalous Path of the Musculocutaneous Nerve. Case Report and Clinical Implication

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Variations among the positioning of the roots relative to the scalene muscles has also been documented [ 6 , 9 , 17 ]. In a typical brachial plexus, the roots pass posterior to the anterior scalene muscle.…”

Section: Discussionmentioning

confidence: 99%

A Prefixed Four-Trunk Brachial Plexus with Anomalous Anatomy of All Subsequent Divisions, Cords, and Terminal Branches: A Cadaveric Case Report

Mendonsa,

Busch,

Faheem

et al. 2024

Am J Case Rep

View full text Add to dashboard Cite

Patient: Female, 100-year-old Final Diagnosis: Brachial plexus anatomical variation Symptoms: None Clinical Procedure: — Specialty: Anatomy Objective: Unknown etiology Background: The brachial plexus is a complex neural structure providing motor and sensory innervation to structures of the arm, shoulder, and upper chest. The anatomical structure is typically divided into roots, trunks, divisions, and cords. Due to the presence of multiple nerve roots and branches, anatomical variations are common. Awareness of variations from normal anatomy is important in imaging, administration of nerve blocks, and surgical procedures of the neck and shoulder region. Case Report: We present a case of multiple anatomic variations of the right brachial plexus identified in a cadaver during routine dissection. To summarize, we identified a prefixed plexus with anomalous contributions from the C4 nerve root. Nerve roots C4 and C5 emerged anterior to the anterior scalene muscle. Furthermore, 4 trunks, rather than the typical 3, gave rise to multiple anomalies in the branching pattern of the distal divisions and cords. To the best of our knowledge, this is the first such case reported in the published literature. Conclusions: The current case report presents a combination of brachial plexus anomalies not previously described in the medical literature – specifically, a prefixed (C4-T1) brachial plexus positioned anterior to the anterior scalene muscle with anomalies of the trunks, divisions, cords, and terminal branches. The variations presented have implications in neurogenic compression, interscalene blocks, and trauma to the upper limb. Knowledge of these anomalies may better equip anatomists and clinicians to understand pathology and intervention of the upper limb.

show abstract

The Brachial Plexus and The Anterior Scalene Muscle: A Bilaterally Different Variation and Its Clinical Significance

Yang

Shen

Fang

et al. 2023

Preprint

View full text Add to dashboard Cite

PURPOSE Anatomical variations of the brachial plexus (BP) are revealed in clinical practice and affect the pathogenesis of certain illnesses, including thoracic outlet syndrome (TOS), brachial plexus block anesthesia, and brachial plexus injuries. While the possibility of BP variations is high, bilaterally different variations are rare. METHODS A variation of the BP was observed during dissection of a 49-year-old female cadaver. The body was placed in a supine position and the root of the neck was exposed after removing the skin, superficial fascia, sternocleidomastoid muscle, clavicle and omohyoid muscle in turn. RESULTS This report presents a case of a bilateral variation of the 5th cervical nerve (C5) and its relation to the anterior scalene muscle (ASM). The left 5th cervical nerve passes anterior to the left anterior scalene muscle, while the right 5th cervical nerve penetrates through the right anterior scalene muscle. CONCLUSION Herein, this case report, accompanied by photographs of an actual cadaver, can help clinicians understand TOS, optimize the brachial plexus block procedure, and manage BP injuries better.

show abstract

Bilateral anatomic variation in the relation of the upper trunk of the brachial plexus to the anterior scalene muscle

Cited by 3 publications

References 20 publications

Positional Anomaly Between the Brachial Plexus and the Scalene Muscles, Concomitant with an Anomalous Path of the Musculocutaneous Nerve. Case Report and Clinical Implication

Positional Anomaly Between the Brachial Plexus and the Scalene Muscles, Concomitant with an Anomalous Path of the Musculocutaneous Nerve. Case Report and Clinical Implication

A Prefixed Four-Trunk Brachial Plexus with Anomalous Anatomy of All Subsequent Divisions, Cords, and Terminal Branches: A Cadaveric Case Report

The Brachial Plexus and The Anterior Scalene Muscle: A Bilaterally Different Variation and Its Clinical Significance

Contact Info

Product

Resources

About