Nerves of the Upper Extremity

Mahan, Mark A.; Spinner, Robert J.

doi:10.1002/9781118430309.ch91

Cited by 11 publications

(15 citation statements)

References 252 publications

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“…Anatomical studies of embryos suggest, that the musculocutaneous nerve is derived from the median nerve [6]. Thus, different anatomical variations of the formation of the median and musculocutaneous nerves may be examples of atypical pathways of the nerve growth.…”

Section: Discussionmentioning

confidence: 99%

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

et al. 2019

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The use of the term “brachioradial artery” was introduced for the high origin of the radial artery. Although the prevalence of the brachioradial artery reported by different authors varies from 4.67 to 15.6%, the presence of the hypoplastic brachial segment of the brachioradial artery is rare with an occurrence rate of 0.83%. Moreover, in just 0.6% of cases the loop of the median nerve may be placed near half of the length of the brachial artery, as in the case described in our report. A comprehensive understanding of anatomical variations of neurovascular structures in the upper limb is of great clinical significance. The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb (persistent, hypoplastic brachial segment of the superficial brachioradial artery), coexisting with atypical formation of the median and musculocutaneous nerves. Anatomical variations of vessels and nerves may coexist which should be taken into account when performing vascular, reconstructive or orthopedic surgery.

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Section: Discussionmentioning

confidence: 99%

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

et al. 2019

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“…It then runs between the biceps brachii and brachialis muscles. It provides branches to both those muscles and travels to the lateral side of the biceps, where it pierces the brachial fascia lateral to biceps brachii muscle to emerge lateral to its distal tendon and brachioradialis muscle, and then continues as the lateral antebrachial cutaneous nerve, also known as the lateral cutaneous nerve of the forearm [22,31].…”

Section: Introductionmentioning

confidence: 99%

“…In most cases (about 85%) the median nerve (MN) arises from two roots (the terms "branches", "heads" or "radices" are occasionally used), lateral and medial, which take origin from the lateral and medial cords of the brachial plexus, respectively [22]. The lateral root provides fibers derived from ventral roots of the C5-C7 spinal nerves, while the medial cord typically contains contributions from C8 and T1.…”

Section: Introductionmentioning

confidence: 99%

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Unusual formation of the musculocutaneous and median nerves: a case report refined by intraneural dissection and literature review

et al. 2021

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This report presents a detailed anatomical investigation of an upper limb specimen showing an atypical formation of the musculocutaneous (MCN) and median (MN) nerves. The study was refined by intraneural dissection, which supplements earlier descriptions of similar anatomical variations and allows for revision of the accepted classification. The case described in this report was an incidental finding during routine dissection of a fixed isolated upper limb. Intraneural dissection revealed partial fusion between the MCN and aberrant bundles of the MN. Those aberrant bundles joined the main steam of the MN at the level at which the MCN branched off as an independent nerve. The procedure allowed the aberrant fibers of the MN to be differentiated from the MCN. The presence of separate bundles in a territory corresponding to the MCN was confirmed, although those bundles and the aberrant MN bundles were covered by a common epineurium. The aberrant MN bundles running within the MCN did not contribute to innervation of the forearm muscles. They rejoined the main nerve trunk in the arm. A comprehensive understanding of the diverse anatomical variations of the upper limb nerves could be crucial for the safety and success of surgical procedures, especially procedures for reconstructing the brachial plexus or its branches.

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“…Anatomical studies of lower vertebrate embryos suggest that the MCN derives from the MN (Mahan and Spinner, ). Indeed, this developmental pattern, or its modification during the segregation of fibers into typical nerves, is evident while analyzing variations.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of musculocutaneous nerve variations: Systematic review and meta‐analysis

et al. 2018

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We aimed to establish the prevalence of the musculocutaneous nerve (MCN) variations and the probability of the variation being pure or mixed in the same plexus. We applied the principles of evidence-based anatomy to find, appraise, and synthesize data through a meta-analysis of anatomical studies. The variations were grouped based on the presence and location of the communicating branch with the median nerve and the origin of branches to anterior arm muscles. Forty-three cadaveric studies met the inclusion criteria, providing data from 4124 plexuses. The overall pooled prevalence of plexuses with MCN variations was 20%. Based on the classification applied in our study, the pooled prevalence of variations was 17% in region 1A, 20% in region 1B, 36% in region 2 and 49% in region 3. Importantly, 64.58% of variations in region 1A and 74.14% of variations in region 1B were mixed, that is, associated with a variation in another region. The odds of finding another variation in the presence of a variation in region 2 or 3 were equal 0.37 and 0.52, respectively, demonstrating a significantly lower probability of finding mixed variations involving these regions, when compared with region 1A. Variations of the MCN are most common in the part distal to the exit from within or beneath the coracobrachialis muscle. Proximal variations are more often associated with another variation located along the nerve. These findings can assist health care professionals in the treatment of brachial plexus lesions. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

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Nerves of the Upper Extremity

Cited by 11 publications

References 252 publications

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

Unusual formation of the musculocutaneous and median nerves: a case report refined by intraneural dissection and literature review

Prevalence of musculocutaneous nerve variations: Systematic review and meta‐analysis

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