Incidence of the Third and Fourth Head of the Biceps Brachii Muscle in Caucasian Race – A Study and Review of Literature

Abstract

Anatomic variations in the heads of biceps brachii are not uncommon. It varies from one head to seven heads but two heads (long and short) are considered normal. In this study, 56 arms from 28 cadavers were studied for third and fourth heads in the anatomy laboratory of Weill Cornell Medicine. We observed supernumerary heads in 5 cadavers (8.92%), out of which three heads were seen in 4 cadavers (7.14%) and four heads in only one cadaver (1.78%). Clinically, these kinds of anomalies are important because supernumerary heads could compress neighboring blood vessels and nerves.

Accessory heads of the biceps brachii muscle: A systematic review and meta‐analysis

“…The accessory heads express a wide spectrum of possible origins. A total of 69 studies (9054 upper limbs) provided detailed description of the various origin sites (Adachi, 1909; Agarwal & Gopal, 2020; Al‐Kushi, 2013; Asvat et al, 1993; Avadhani & Chakravarthi, 2012; Bagoji et al, 2014; Ballesteros et al, 2014; Bharambe et al, 2015; Chandrupatla & Sultana, 2016; Chauhan, 2010; Cheema & Singla, 2011; Chitra & Kalaiyarasi, 2016; Cucca et al, 2010; da Silva, 2016; da Silva Leal, 1926; Duran & Arquez, 2016; Gheno et al, 2010; Gindha et al, 2015; Greig et al, 1952; Guerrero et al, 2018; Gupta & D'Souza, 2014; Gupta et al, 2020; Ilayperuma et al, 2011; Kervancioglu & Orhan, 2011; Khaledpour, 1985; Kopuz et al, 1999; Kosugi et al, 1992; Kumar et al, 2008; Kumar et al, 2012; Kumar & Baidya, 2018; Le Double, 1897; Lee, 2013; Lingaswamy et al, 2015; Manoj et al, 2012; Mantraratnam & Bhattam, 2016; Morampuri et al, 2015; Mori, 1964; Nalluri et al, 2016; Nasr & Hussein, 2013; Nayak et al, 2006; Neto et al, 1998; Patel et al, 2016; Pathak et al, 2016; Poudel & Bhattarai, 2009; Radhika et al, 2017; Rai et al, 2007; Ravi et al, 2020; Rincon et al, 2002; Rodriguez‐Niedenführ et al, 2003; Ruiz et al, 2017; Salve et al, 2013; Sandeep et al, 2012; Sato, 1969; Sawant et al, 2012; Schwerdtf...…”

“…A total of 26 studies (2800 upper limbs) reported the occurrence of the accessory heads of biceps brachii muscle in relation to gender (Al‐Kushi, 2013; Asvat et al, 1993; Ballesteros et al, 2014; Cheema & Singla, 2011; Duran & Arquez, 2016; Gindha et al, 2015; Ilayperuma et al, 2011; Kervancioglu & Orhan, 2011; Koizumi, 1934; Kopuz et al, 1999; Kosugi et al, 1992; Kumar & Baidya, 2018; Le Double, 1897; Lee, 2013; Nasr & Hussein, 2013; Nayak et al, 2006; Rodriguez‐Niedenführ et al, 2003; Ruiz et al, 2017; Salve et al, 2013; Sato, 1969; Sawant et al, 2012; Schwerdtfeger et al, 2018; Shalini & Anupama, 2013; Techataweewan et al, 2016; Verma & Sakthivel, 2019; Wahengbam et al, 2015). Meta‐analysis of the relevant studies revealed that the accessory heads are more prevalent in males (10.2%; 95% CI 7–13%) than in females (7.3%; 95% CI 4–10%).…”

“…Proportional analysis was performed with the use of 36 studies (628 upper limbs with the accessory head of the biceps brachii muscle) (Al‐Kushi, 2013; Asvat et al, 1993; Chandrupatla & Sultana, 2016; Cheema & Singla, 2011; Chitra & Kalaiyarasi, 2016; da Silva Leal, 1926; Duran & Arquez, 2016; Gindha et al, 2015; Gupta & D'Souza, 2014; Ilayperuma et al, 2011; Kervancioglu & Orhan, 2011; Koganei et al, 1903; Koizumi, 1934; Kopuz et al, 1999; Kosugi et al, 1992; Kumar et al, 2008; Kumar & Baidya, 2018; Le Double, 1897; Lee, 2013; Nasr & Hussein, 2013; Nayak et al, 2006; Poudel & Bhattarai, 2009; Rai et al, 2007; Rodriguez‐Niedenführ et al, 2003; Salve et al, 2013; Sato, 1969; Sawant et al, 2012; Schwalbe & Pfitzner, 1894; Schwerdtfeger et al, 2018; Shalini & Anupama, 2013; Techataweewan et al, 2016; Ughade et al, 2012; Varlekar et al, 2011; Verma & Sakthivel, 2019; Wahengbam et al, 2015; Wood, 1868). The number of studies is higher than in the overall gender prevalence analysis because several studies had to be excluded from the overall investigation since the gender of the cohort was not mentioned in the material and methods section and the gender was reported only in the results section in relation to the findings so that the overall male to female ratio could not be obtained for the prevalence investigation.…”

“…The side distribution was sufficiently described in 51 studies (5877 upper limbs) (Agarwal & Gopal, 2020; Al‐Kushi, 2013; Asvat et al, 1993; Avadhani & Chakravarthi, 2012; Bagoji et al, 2014; Ballesteros et al, 2014; Bharambe et al, 2015; Chandrupatla & Sultana, 2016; Chauhan, 2010; Cheema & Singla, 2011; Chitra & Kalaiyarasi, 2016; da Silva, 2016; Duran & Arquez, 2016; Gindha et al, 2015; Guerrero et al, 2018; Gupta & D'Souza, 2014; Gupta et al, 2020; Kervancioglu & Orhan, 2011; Khaledpour, 1985; Kopuz et al, 1999; Kosugi et al, 1992; Kudo & Bando, 1965; Kumar et al, 2008; Kumar et al, 2012; Kumar & Baidya, 2018; Lingaswamy et al, 2015; Manoj et al, 2012; Mantraratnam & Bhattam, 2016; Morampuri et al, 2015; Nalluri et al, 2016; Nasr & Hussein, 2013; Nayak et al, 2006; Patel et al, 2016; Pathak et al, 2016; Poudel & Bhattarai, 2009; Radhika et al, 2017; Rai et al, 2007; Ravi et al, 2020; Rodriguez‐Niedenführ et al, 2003; Salve et al, 2013; Sandeep et al, 2012; Sato, 1969; Schwalbe & Pfitzner, 1894; Sthapak et al, 2016; Sugavasi et al, 2015; Suhani et al, 2013; Tenchini, 1879; Ughade et al, 2012; Varlekar et al, 2011; Verma & Sakthivel, 2019; Wahengbam et al, 2015; Zlabek, 1933). The accessory heads occur on the right side with an overall prevalence of 3.4% (95% CI 2–4%), and 3.2% (95% CI 2–4%) on the left side (Table…”

“…Further analysis of 46 studies (4782 upper limbs) showed that accessory heads are found more frequently unilaterally (4.4%; 96% CI 3–6%) than bilaterally (2.6%; 95% CI 2–3%) (Al‐Kushi, 2013; Asvat et al, 1993; Avadhani & Chakravarthi, 2012; Bagoji et al, 2014; Ballesteros et al, 2014; Chandrupatla & Sultana, 2016; Chauhan, 2010; Cheema & Singla, 2011; Chitra & Kalaiyarasi, 2016; da Silva, 2016; da Silva Leal, 1926; Duran & Arquez, 2016; Gindha et al, 2015; Guerrero et al, 2018; Gupta & D'Souza, 2014; Gupta et al, 2020; Kervancioglu & Orhan, 2011; Kopuz et al, 1999; Kosugi et al, 1992; Kumar et al, 2008; Kumar et al, 2012; Kumar & Baidya, 2018; Le Double, 1897; Lingaswamy et al, 2015; Manoj et al, 2012; Mantraratnam & Bhattam, 2016; Morampuri et al, 2015; Nalluri et al, 2016; Nayak et al, 2006; Patel et al, 2016; Pathak et al, 2016; Poudel & Bhattarai, 2009; Radhika et al, 2017; Ravi et al, 2020; Salve et al, 2013; Sandeep et al, 2012; Sawant et al, 2012; Schwerdtfeger et al, 2018; Shalini & Anupama, 2013; Sthapak et al, 2016; Sugavasi et al, 2015; Suhani et al, 2013; Techataweewan et al, 2016; Ughade et al, 2012; Varlekar et al, 2011; Wahengbam et al, 2015). Detailed results are shown in Table 3.…”