A study of anatomical variations of median nerve in human cadavers

Dr. Channabasanagouda, Shrish Patil, Vijaykumar Shinde, P S Jevor, Madhumati Nidoni

Abstract


Comprehensive knowledge pertaining to anatomical variations of median nerve is extremely important in clinical and surgical procedures so as to avoid injury to it. The objectives of the study were to know about the variations of median nerve in its formation, course, and distribution in arm. Dissection method was employed and 50 upper limbs were studied for anatomical variations of median nerve obtained from the department of Anatomy.

 Median nerve was formed by two roots in 37(74%) and by three roots in 13 (26%) specimens. It was formed in axilla in 32(64%), in upper third of arm in 10 (20%), middle third of arm in 6 (12%) and lower third of arm in 2 (4%) specimens. In one specimen high division of brachial artery in the middle third of the arm was observed along with formation of median nerve at the same level. Formation of median nerve was lateral to axillary artery in 42 (84%), anterior to axillary artery in 5 (10%), medial to axillary artery in 3 (6%) specimens. Median nerve coursed lateral to brachial artery in 47 (94%), medial to brachial artery in 3 (6%) specimens Median nerve was supplying flexor muscles of arm in 6 (12%) specimens. In two of these six specimens there were concomitant neurovascular variations as well. The present study may provide additional information as such neurovascular variations encountered here are important to be noted during surgical procedures as these are more prone to iatrogenic injuries.


Keywords


Neurovascular; musculocutaneous; communications; vena comitans ; median

References


Das S, Paul S. Anomalous Branching Pattern of Lateral Cord of Brachial Plexus. Int.J. Morphol. 2005; 23(4): 289- 92.

Fazan VPS, Amadeu AS, Caleffi AL, Rodrigues Filho OA. Brachial Plexus Variations in its Formation and Main Branches. Acta Cir. Bras. 2003; 18(5): 14-8.

Tetro AM, Pichora DR. High Median Nerve Entrapments. An Obscure Cause of Upper-Extremity Pain. Hand Clin. 1996; 12(24): 691-703

Eglseder E, Goldman M. Anatomical Variations of the Musculocutaneous Nerve in the Arm. Am J Orthop 1997; 26(11):777-80.

Uzun A, Bilgic S. Some Variations in the Formation of Braichal Plexus in Infants. Turk. J Med Sci.1999; 29: 553-77.

Uzun A, Leonard L, Seelig.Jr. A Variation in the Formation of the Median Nerve: Communicating Branch Between the Musculocutaneous and Median Nerves in Man. Folia. morphol. 2001: 60 (2): 99-101.

Mohammed HM Badawoud. A Study on the Anatomical Variations of Median Nerve Formation. Bahrain Med Bull. 2003; 25(4).

Gupta M, Goyal M, Harjeet. Anomalous Communications in the Branches of Brachial Plexus. J. Anat. Soc. India. 2005; 54(1):1-3.

Nayak S, Samuel VP, Somayaji N. Concurrent Variations of Median Nerve, Musculocutaneous Nerve and Biceps Brachii Muscle. Neuroanatomy. 2006; 5: 30-2.

Pandey SK, Shukla VK. Anatomical Variations of the Cords of Brachial Plexus and the Median Nerve. Clin. Anat.2007; 20: 150-6.

Johnson D, Ellis H, Editors. Gray’s Anatomy. The Anatomical Basis for Clinical

Practice. 39th Ed: Elsevier Churchill Livingstone; 2005. p. 817-933.

R Chitra. Multiple Bilateral Neuroanatomical Variations of the Nerves of the Arm. Neuroanatomy. 2007; 6: 43-5.

R Chitra. A Rare Variant Formation of the Median Nerve: A Case Report. The Internet. J. Neuro. 2007: 8(2).

Le Minor, J M. A Rare Variation of the Median and Musculocutaneous Nerves in Man. Arch Anat Histol Embryol. 1990; 73: 33-42.

Gumusburun E, Adiguzel E. A Variation of the Brachial Plexus Characterized by the Absence of the Musculocutaneous Nerve- A Case Report. Surg. Radiol. Anat. 2000; 22(1): 63-5.

Sud M, Sharma A. Absence of Musculocutaneous Nerve and the Innervation of Coracobrachialis, Biceps Brachii and Brachialis from the Median nerve. J. Anat. Soc. India. 2000; 49(2): 176-7.

Beheiry EE. Anatomical Variations of the Median Nerve Distribution and Communication in the Arm. Folia Morphol. 2004; 63 (3): 313-8.

Guttenberg RAG, Ingolotti M. Classifying Musculocutaneous Nerve Variations. Clin. Anat. 2009; 22: 671- 83.

Arora J, Kapoor V, Suri RK, Khan RQ. Inter-Communications Between Median and Musculocutaneous Nerves With Dual Innervation of Brachialis Muscle-A Case Report. J. Anat. Soc. India. 2003; 52(1): 66-8.

Chauhan R, Roy TS. Communication between the Median and Musculocutaneous Nerve- A Case Report. J. Anat. Soc. India. 2002; 51(1): 72-5.

Ibrahim CH, Adnan E, Cem DC. Variations Between Median and Musculocutaneous Nerves. The Internet J. Surg. 2004; 6(1).

Oluyemi KA, Adesanya OA, Ofusuri DA, Okwuonu CU, Ukwenya VO, Ominiabons FA, Odion BI. Abnormal Pattern of Brachical Plexus Formation: An Original Case Report. The Internet J. Surg. 2007; 4(2).

Venierator D, Anagostopoulou S. Classification of Communications Between the Musculocutaneous and Median Nerves. Clin. Anat.1998; 11:327-31.

Aktan ZA, Ozutruk L, Bilge O, Ozer MA, Pinar YA. A Cadaveric Study of the Anatomic Variations of the Brachial Plexus Nerves in the Axillary Region and Arm. Turk J Med. Sci.2001; 31: 147-50.

Choi D, Niedenfuhr MR, Vazquez T, Parkin I, Sanudo JR. Patterns of Connections Between the Musculocutaneous and Median Nerves in the Axilla and Arm. Clin. Anat.2002; 15: 11-7.


Full Text: PDF Download

DOI: 10.7439/ijbr.v4i12.444

Refbacks

  • There are currently no refbacks.




Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

Copyright © 2008 - 2010 Scholar Science Journals All rights reserved.

120, Swagat Nagar, NGP, INDIA