Brachialis Muscle Supplied by a Combined Branch of Median Nerve Roots: A Report of Anatomical Variation with Clinical Implications

Singh, Seema; Rani, Neerja; Kumar, Hitesh; Sharrif, A.; Roy, T. S.
February 2013
International Medical Journal;Feb2013, Vol. 20 Issue 1, p108
Academic Journal
Objective: To observe and document the variation of innervations of the brachialis muscle (BRM), which is the chief flexor of the forearm. This report will assist clinicians and surgeons by considering anatomical anomalies associated with the median nerve (MN) and its branch to the anterior compartment muscle of the upper arm. Material and Methods: The arm region of a 50 year embalmed male cadaver during educational gross anatomy dissection. Results: We found that the BRM was innervated by a combined branch (C5, 6, 7 and C8, Tl) arising from both medial and lateral roots of the MN which was lateral to the brachial artery. The musculocutaneous nerve (MCN) pierced the coraco- brachialis muscle and passes obliquely to the lateral side of the arm between the biceps brachii and the BRM, supplying coraco- brachialis and two heads of the biceps brachii. Later it pierces the deep facia above elbow and continues as the lateral cutaneous nerve of the forearm. The other limb of the cadaver did not show any such variation. No other neural, arterial or muscular variation was observed in either of the limbs. Conclusion: A rare anatomical variation in which BRM was innervated by a combined branch (C5, 6, 7 and C8, Tl) arising from both medial and lateral roots of the MN and not by a branch of MCN is reported. Likely clinical scenario in subjects with such variation with implication on surgical management of brachial plexus (BP) injuries is also discussed.


Related Articles

  • Absence of the musculocutaneous nerve together with unusual innervation of the median nerve. Aydin, M. E.; Kale, A.; Edizer, M.; Kopuz, C.; Demir, M. T.; Çorumlu, U. // Folia Morphologica;2006, Vol. 65 Issue 3, p228 

    During routine anatomical dissections, absence of the musculocutaneous nerve was determined in a 58-year-old male cadaver. Moreover, the biceps brachii and brachialis muscles were innervated by two separate branches which divided from the median nerve instead of the musculocutaneous nerve. From...

  • Arterial, neural and muscular variations in the upper limb. Coskun, Nigar; Sarikcioglu, Levent; Donmez, Baris Ozgur; Sindel, Muzaffer // Folia Morphologica;2005, Vol. 64 Issue 4, p347 

    During our routine dissection studies we observed arterial, neural and muscular variations in the upper limbs of an adult male cadaver. In this case we observed the superficial brachial artery origination from the third part of the axillary artery, communications between the musculocutaneous and...

  • Median: Musculocutaneous Nerve Communication. Shrivastava, T.; Yadav, Y.; Garg, L.; Mishra, Bk.; Ghatak, S. // International Medical Journal;Sep2012, Vol. 19 Issue 3, p269 

    The article discusses study on importance of the course, distribution and branching anomalies of the musculocutaneous nerve and its relation to coracobrachialis muscle, from a clinical point of view. It examines the 5 classifications of communications between median and musculocutaneous nerve....

  • Variation in the formation and course of the median nerve in relation with brachial artery. Deborah. A, Christina; Subramanian, Ramesh Kumar; Rani V. S., Ananda; Chakrabarti, Sudakshina // Indian Journal of Medical Specialities;Jan-Jun2014, Vol. 5 Issue 1, p1 

    During routine dissection, we found that the median nerve in the left upper limb of a female cadaver was formed by two lateral roots which communicated with each other and a third medial root. In the middle of the arm brachial artery anteriorly crossed the median nerve from medial to lateral...

  • Anatomical variation-Communication between musculocutaneous nerve and median nerve. Lokanadham, S.; Devi, V. Subhadra // International Journal of Biological & Medical Research;2012, Vol. 3 Issue 1, p1436 

    Variations of the musculocutaneous nerve and median nerve at the level of brachial plexus are common. During our routine dissection we observed a branch communicating between the musculocutaneous nerve and median nerve in a fifty year old male cadaver right upper limb. The communicating branch...

  • Muskulokütan Sinirin Brakiyalis Dalının Medyan Sinirin Posterior Fasiküler Grubunun Nörotizasyonunda Kullanılabilirli011Finin AraÅŸtırılması: Kadavra Çalışması Aydin, Atakan; Aydin, Hasan Utkan; Oğuz, Nurettin // Medical Journal of Trakya University / Trakya Universitesi Tip F;2009, Vol. 26 Issue 2, p109 

    Objectives: The problems encountered during recovery of traumatic brachial plexus injuries despite adequate treatment has important socioeconomic impacts. Neurotization of median nerve with brachialis muscle branch of musculocutaneous nerve has become popular recently. Whether it is superior to...

  • Supracondylar process of the humerus - a case report. KRISHNAMURTHY, Jeyanthi; LAKSHMINARAYAN, Jyothi Lakshmi Gaddehosur // International Journal of Anatomical Variations;2013, Vol. 6, p98 

    Supracondylar process of the humerus is a hook shaped process of about 2 to 20 mm in length which projects from the anteromedial surface of the humerus, proximal to medial epicondyle. When present, it is attached to the medial epicondyle by ligament of Struthers causing compression of median...

  • Absence of musculocutaneous nerve with variations in course and distribution of the median nerve. Parchand, Madhukar; Patil, Sumit // Anatomical Science International;Jan2013, Vol. 88 Issue 1, p58 

    Variations in the brachial plexus and its terminal branches are not uncommon. A communicating branch arising from the musculocutaneous nerve to the median nerve is a frequent variation, but complete merging of musculocutaneous nerve into the median nerve is very rare. Here, we observed...

  • Communication between median and musculocutaneous nerves in the forearm hooking around the origin of the median artery: a rare variation. Agarwal, Sneh; Tuli, Anita; Raheja, Shashi // Anatomical Science International;Sep2011, Vol. 86 Issue 3, p175 

    Variations of the musculocutaneous and median nerves at the level of axilla and arm are well described in the literature. We encountered a rare variation during dissection in undergraduate medical classes. The left arm of a 55-year-old male cadaver showed a communicating nerve arising from the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics