Vascular patterns of upper limb: an anatomical study with accent on superficial brachial artery

Abstract

Th e aim of the study was to evaluate the terminal segmentation of the axillary artery and to present four cases of anomalous branching of the axillary artery, the superfi cial brachial artery (arteria brachialis superfi cialis), which is defi ned as the brachial artery that runs superfi cially to the median nerve. Totally,  cadaveric upper arms embalmed by classical formaldehyde technique from collections of the Department of Anatomy, Th ird Faculty of Medicine, Charles University in Prague, were macroscopically dissected with special focus on the branching arrangement of the axillary artery. Th e most distal part of the axillary artery (infrapectoral part) terminated in four cases as a bifurcation into two terminal branches: the superfi cial brachial artery and profunda brachii artery, denominated according to their relation to the median nerve. Th e profunda brachii artery primarily gave rise to the main branches of the infrapectoral part of the axillary artery. Th e superfi cial brachial artery descended to the cubital fossa where it assumed the usual course of the brachial artery in two cases and in the other two cases its branches (the radial and ulnar arteries) passed superfi cially to the fl exors. Th e incidence of the superfi cial brachial artery in our study was  of cases. Th e reported incidence is a bit contradictory, from . to  of cases. Th e anatomical knowledge of the axillary region is of crucial importance for neurosurgeons and specialists using the radiodiagnostic techniques, particularly in cases involving traumatic injuries. Th e improved knowledge would allow more accurate diagnostic interpretations and surgical treatment.

A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

“…Th ere are two diff erent types of the BrA. If the artery courses superfi cially to the muscles of the forearm, it should bear the name of the superfi cial brachioradial artery (arteria brachioradialis superfi cialis, SBrA), but if the artery stays deep to the muscles (as usual RA), it should be denominated as the brachioradial artery only [2,3]. Th e precise defi nition of the BrA runs as follows: It is abnormal RA originating proximal to the interepicondylar line, either from the AA or the BA [12,13].…”

“…Th e course of the BrA is then either similar to the BA, i.e. it descends along the proper brachial artery, situated more ventrally and laterally, or more rarely, it can get more superfi cial and cross the median nerve (nervus medianus) ventrally; then it should be termed as the superfi cial brachioradial artery (arteria brachioradialis superfi cialis) [1,2]. Th e incidence of the BrA is reported to be 13.8 on average [3].…”

Relation of median nerve to brachial artery: variations, embryological basis and clinical significance

“…Originally SBA was observed in only 1-3% of cases; later studies in 1940s reported a 12-25% incidence whereas in the last 10 years, the incidence is documented to be only 5-6%. They have attributed the reasons for this sinusoid characteristic of the SBA incidence to new specification guidelines, classification of the variations & melioration in study methods, which have been improved due to conclusion of the previous findings and observations [10].…”

A Cadaveric Study on Division of Brachial Artery with Its Embyological Basis and Clinical Significance

“…This is mainly because of their multiple and plexiform sources, the temporal succession of emergence of principle arteries, anatomises and periarticular networks and functional dominance followed by regression of some path. Arey and jurjus mentioned six explanations for the variations in the blood vessels of upper limb (6) . 1.…”