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01-03-2018 | Original Article

Morphology and relationships of the biceps brachii and brachialis with the musculocutaneous nerve

Authors: Masahito Yamamoto, Urara Kojyo, Nobuaki Yanagisawa, Keisuke Mitomo, Takeshi Takayama, Koji Sakiyama, Shinichi Abe

Published in: Surgical and Radiologic Anatomy | Issue 3/2018

Abstract

Introduction

Major anatomical textbooks generally state that the biceps brachii muscle (BB) is composed of long and short heads, whereas the brachialis muscle (BR) consists of a single head. However, the numbers of heads comprising the BB and the BR are very variable. The purpose of this study was to investigate how the branching patterns of the musculocutaneous nerve (MC) influence the number of heads of the BB and the BR.

Materials and methods

Morphological examinations of the BB and MC were conducted using cadavers of 22 Japanese individuals, and morphological examinations of the BR and the MC were conducted in 9 of those 22 individuals.

Results

A three-headed BB was observed in 7 of the 22 specimens (31.8%). Most of these specimens showed a Type III branch pattern (after penetrating the long head or the short head, the MC innervated the supernumerary head or communicated with the main root again). The number of BR heads was categorized into three types: Type A, two heads (superficial and deep heads, 22.2%); Type B, three or four heads (two or three superficial heads and one deep head, 44.4%); and Type C, multiple heads (33.3%). Among these categories, branches of the MC in Type A specimens were most simple.

Conclusion

A supernumerary head of the BB seemed to be present if the MC penetrates it. The BR basically consists of superficial and deep heads, and the number of superficial heads is affected by branches of the MC.

Koganei Y, Arai S, Shikinami S (1903) Statics of anomaly muscles. Tokyo J Med Sci 17:127–131

Adachi B (1909/1910) Beiträge zur Anatomie der Japaner. Die Statistik der Muskelvarietäten. Zeieschrift für Morphologie Anthropologie 12:261–312

Koizumi K (1934) Studies on the shoulder and brachial muscle. JNMS 5:1063–1083

Ishimi S (1950) Studies on the musculature of the upper extremities of the Japanese fetus. Report on the muscles of the brachium. Igaku Kenkyu 20:766–778

Higashi N, Sone C (1988) A study on the accessory head of the biceps brachii in man. Acta Anat Nippon 63:78–88PubMed

Macalister A (1875) Observations on muscular anomalies in the human anatomy. (Third series with a catalogue of the principal muscular variations hitherto published). Trans R Irish Acad Sci 25:1–130

Leonello DT, Galley IJ, Bain GI, Carter CD (2007) Brachialis muscle anatomy. A study in cadavers. J Bone Joint Surg Am 89:1293–1297CrossRefPubMed

Yamamoto M, Hayashi S, Suzuki M, Kimata K, Asamoto K, Nakano T (2013) Brachialis muscle has three heads: consideration for implication in elbow flexion contracture. Rinshokaibou Kenkyu Kiroku 13:20–21

Kosugi K, Shibata S, Yamashita H (1992) Supernumerary head of biceps brachii and branching pattern of the musculocutaneous nerve in Japanese. Surg Radiol Anat 14:175–185CrossRefPubMed

10.

Le Minor JM (1990) A rare variation of the median and musculocutaneous nerves in man. Arch Anat Histol Embryol 73:33–42PubMed

11.

Loukas M, Aqueelah H (2005) Musculocutaneous and median nerve connections within, proximal and distal to the coracobrachialis muscle. Folia Morphol (Warsz) 64:101–108

12.

Sunderland S (1978) The musculocutaneous nerve. In: Nerves and nerve injuries, 2nd edn. Churchill Livingstone, Edinburgh, pp 796–801

13.

Yang ZX, Pho RW, Kour AK, Pereira BP (1995) The musculocutaneous nerve and its branches to the biceps and brachialis muscles. J Hand Surg Am 20:671–675CrossRefPubMed

14.

Fener H (1938) Der Nervus Musculocutaneus, seine Verlaufvarianten am Oberarm und deren Beziehung zur Entwicklung eines Caput Tertium Musculi Biciopitis. Z Anat 108:567–586CrossRef

15.

Koizumi M (1981) A morphological study on the coracobrachialis muscle (in Japanese). Acta Anat Nippon 64:18–35

16.

Hayashi S, Fukuzawa Y, Rodríguez-Vázquez JF, Cho BH, Verdugo-López S, Murakami G, Nakano T (2011) Pleuroperitoneal canal closure and the fetal adrenal gland. Anat Rec (Hoboken) 294:633–44CrossRef

17.

Niikura H, Jin ZW, Cho BH, Murakami G, Yaegashi N, Lee JK, Lee NH, Li CA (2010) Human fetal anatomy of the coccygeal attachments of the levator ani muscle. Clin Anat 23:566–574CrossRefPubMed

18.

Katori Y, Yamamoto M, Asakawa S, Maki H, Rodríguez-Vázquez JF, Murakami G, Abe S (2012) Fetal developmental change in topographical relationship between the human lateral pterygoid muscle and buccal nerve. J Anat 220:384–395CrossRefPubMedPubMedCentral

19.

Abu-Hijleh MF (2005) Three-headed biceps brachii muscle associated with duplicated musculocutaneous nerve. Clin Anat 18:376–379CrossRefPubMed

20.

Lee SH, Jeon JY, Yoon SP (2014) A combined variation of the musculocutaneous nerve associated with a supernumerary head of the biceps brachii muscle. Folia Morphol (Warsz) 73:366–369CrossRef

21.

Sinnatamby CS (1999) Last’s anatomy. Regional and applied, 10th edn. Churchill Livingstone, Edinburgh

22.

Strandring S (2005) Gray’s anatomy: the anatomical basis of clinical practice, 39th edn. Elsevier Churchill Livingstone, New York

23.

Carlson BM (1994) Human embryology and developmental biology. Mosby, St. Louis, pp 196–197

24.

Yamamoto M, Takayama T, Takata H, Shiraishi Y, Tomita N, Sakanaka K, Murakami G, Rodríguez-Vázquez JF, Abe SI (2016) Coracobrachialis muscle and the musculocutaneous nerve: a study using human embryonic sections. Okajimas Folia Anat Jpn 93:15–20CrossRefPubMed

25.

Bendersky M, Bianchi HF (2012) Double innervation of the brachialis muscle anatomic-physiological study. Surg Radiol Anat 34:865–870CrossRefPubMed

26.

Jones FW (1919) Voluntary muscular movements in cases of nerve lesions. J Anat Lond 54:41–57

27.

Hollinshead WH (1958) Anatomy for surgeons, vol 3. Cassell and Co., London, p 365

28.

Frazer EA, Hobson M, McDonald SW (2007) The distribution of the radial and musculocutaneous nerves in the brachialis muscle. Clin Anat 20:785–789CrossRefPubMed

29.

Cambon-Binder A, Leclercq C (2015) Anatomical study of the musculocutaneous nerve branching pattern: application for selective neurectomy in the treatment of elbow flexors spasticity. Surg Radiol Anat 37:341–348CrossRefPubMed

30.

Thieffry C, Chenin L, Foulon P, Havet E, Peltier J (2017) Microsurgical anatomy of branches of musculocutaneous nerve: clinical relevance for spastic elbow surgery. Surg Radiol Anat 39:773–778CrossRefPubMed

Title: Morphology and relationships of the biceps brachii and brachialis with the musculocutaneous nerve
Authors: Masahito Yamamoto
Urara Kojyo
Nobuaki Yanagisawa
Keisuke Mitomo
Takeshi Takayama
Koji Sakiyama
Shinichi Abe
Publication date: 01-03-2018
Publisher: Springer Paris
Published in: Surgical and Radiologic Anatomy / Issue 3/2018
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-017-1919-7

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Springer Medicine

Morphology and relationships of the biceps brachii and brachialis with the musculocutaneous nerve

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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