Smith Russell A, Cummings John P
Physical Therapy Program, University of North Florida, Jacksonville, FL 32224, USA.
J Orthop Sports Phys Ther. 2006 Jun;36(6):425-9. doi: 10.2519/jospt.2006.2120.
The purpose of this commentary is to describe bilateral anomalous bands of the latissimus dorsi muscle observed in an 81-year-old male embalmed cadaver, and to discuss the possible clinical implications of this anomaly. The musculotendinous bands tautened and compressed the underlying axillary vessels, and the musculocutaneous, median, and ulnar nerves during passive abduction/external rotation of the shoulder. Similar variations found in the latissimus dorsi muscles in this commentary have been reported in the anatomical and surgical literature. These reports include descriptions of the anomalous bands of the latissimus dorsi attaching to the coracoid process, pectoralis major muscle, and fascia of the coracobrachialis muscle. The potential presence of an axillary arch presents several clinical considerations for the physical therapist. The existence of an axillary arch should be considered in patients with signs and symptoms consistent with upper extremity neurovascular compromise similar to thoracic outlet syndrome. Including this variant in the differential diagnostic process may assist physical therapists in the management of patients with signs and symptoms consistent with thoracic outlet syndrome.
本评论的目的是描述在一具81岁男性防腐尸体中观察到的背阔肌双侧异常束带，并讨论这种异常可能的临床意义。在肩部被动外展/外旋过程中，肌肌腱束带拉紧并压迫其下方的腋血管、肌皮神经、正中神经和尺神经。本评论中在背阔肌中发现的类似变异在解剖学和外科学文献中已有报道。这些报道包括背阔肌异常束带附着于喙突、胸大肌和肱二头肌筋膜的描述。腋弓的潜在存在为物理治疗师带来了几个临床考量。对于有与胸廓出口综合征相似的上肢神经血管受压体征和症状的患者，应考虑腋弓的存在。在鉴别诊断过程中纳入这种变异可能有助于物理治疗师管理有与胸廓出口综合征一致的体征和症状的患者。
