George Tsakotos, Konstantinos Natsis, George Triantafyllou, Trifon Totlis, Dimitrios Chytas, Georgia Kostare, Vasilios Karampelias, Athina Tousia, Maria Piagkou
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Between two stems, the brachial plexus (BP) lateral and medial cords were identified. The MN originated from the BP lateral cord. The SAS, continued as SBA with a tortuous course. The DAS coursed posterior to the BP medial and lateral cords and gave off the subscapular artery. A bilateral 3rd head of the biceps brachii was identified. The MN atypically originated from the BP lateral cord. At the left side, the two-headed CB was typically penetrated by the MCN. A common trunk of the circumflex humeral arteries was identified in coexistence with an interconnection of the BP lateral cord with the MN medial root. The rare coexistence of muscular, neural, and arterial variants in axillary and brachial region is emphasized, taking into consideration the AA high division and related branching pattern. 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引用次数: 0
摘要
腋动脉(AA)有多种分支模式。与众不同的是,肱动脉(BA)在正中神经(MN)前方有一条分支,即所谓的肱浅动脉(SBA)。肱浅动脉可能导致正中神经卡压。目前的尸体报告强调了 AA 的高分叉、其作为 SBA 的延续以及肌肉、神经和血管不对称畸变的共存。在右侧,腕角肌(CB)为单头,同侧肌皮神经(MCN)沿内侧走向。AA 在第 2 肋骨下缘高度分为浅茎和深茎(SAS 和 DAS)。在两茎之间,可识别出臂丛神经(BP)的外侧和内侧索。MN 起源于臂丛外侧索。SAS 继续作为 SBA,走向曲折。DAS 在臂丛内、外侧索的后方走行,并发出肩胛下动脉。双侧肱二头肌第 3 头被识别出来。MN 不典型地起源于 BP 外侧索。在左侧,双头 CB 通常由 MCN 穿出。肱骨周动脉的共同主干与肱骨外侧索和肱骨内侧根的相互连接共存。考虑到 AA 高分化和相关的分支模式,腋窝和肱骨区域肌肉、神经和动脉变异共存的罕见情况值得强调。记录这种罕见的血管变异对动脉瘤和创伤手术以及血管造影术非常重要,因为在这些手术中,由于可能出现并发症,所有治疗操作都必须准确无误。
The axillary artery high bifurcation: coexisting variants and clinical significance.
Several branching patterns of the axillary artery (AA) have been described. Unusually, the brachial artery (BA) follows a course in front of the median nerve (MN), the so-called superficial brachial artery (SBA). The SBA may result in MN entrapment. The current cadaveric report highlights a high AA bifurcation, its continuation as SBA and the coexistence of muscular, neural, and vascular asymmetric aberrations. At the right side, the coracobrachialis muscle (CB) had a single head, and the ipsilateral musculocutaneous nerve (MCN) followed a medial course. The AA was highly divided into superficial and deep stems (SAS and DAS), at the 2nd rib lower border. Between two stems, the brachial plexus (BP) lateral and medial cords were identified. The MN originated from the BP lateral cord. The SAS, continued as SBA with a tortuous course. The DAS coursed posterior to the BP medial and lateral cords and gave off the subscapular artery. A bilateral 3rd head of the biceps brachii was identified. The MN atypically originated from the BP lateral cord. At the left side, the two-headed CB was typically penetrated by the MCN. A common trunk of the circumflex humeral arteries was identified in coexistence with an interconnection of the BP lateral cord with the MN medial root. The rare coexistence of muscular, neural, and arterial variants in axillary and brachial region is emphasized, taking into consideration the AA high division and related branching pattern. Documentation of such rare vascular variants is important in aneurysm and trauma surgery, and angiography, where all therapeutic manipulations must be accurately performed due to the possibility of complications.
期刊介绍:
"Folia Morphologica" is an official journal of the Polish Anatomical Society (a Constituent Member of European Federation for Experimental Morphology - EFEM). It contains original articles and reviews on morphology in the broadest sense (descriptive, experimental, and methodological). Papers dealing with practical application of morphological research to clinical problems may also be considered. Full-length papers as well as short research notes can be submitted. Descriptive papers dealing with non-mammals, cannot be accepted for publication with some exception.