Uysal Ismihan Ilknur, Karabulut Ahmet Kagan, Büyükmumcu Mustafa, Unver Dogan Nadire, Salbacak Ahmet
Department of Anatomy, Selcuk University, Meram Medical Faculty, Konya, Turkey.
Clin Anat. 2009 Apr;22(3):337-45. doi: 10.1002/ca.20734.
The course and branches of the musculocutaneous nerve (MCN) were dissected in 140 human fetal arms. The MCN entered the superior, middle, and inferior part of coracobrachialis in 43%, 37%, and 17% of arms, respectively, and the remaining 3% did not pierce coracobrachialis. The motor branches to biceps were classified as follows: Type 1 (83.6%): a single branch that bifurcated to supply the two heads of biceps; Type 2 (14.3%): two separate branches each innervating one head of biceps; Type 3 (2.1%): a single branch that bifurcated to supply each head of biceps plus an additional branch that innervated the distal part of biceps. The motor branches to brachialis were classified as follows: Type 1 (93.6%): a single branch to brachialis; Type 2 (6.4%): a single branch that bifurcated into two branches both supplying brachialis. Communications between the MCN and the median nerve (MN) were observed in 10% of specimens, of which three types (A, B, C) could be identified depending on their origin and union. In the most frequently observed type (B, 50% of cases) the communicating branch arose from the proximal part of the MCN and joined the MN in the middle or distal part of arm. The data presented here will be of use to surgeons, especially pediatric surgeons who undertake surgical procedures in the axilla and arm.
在140例人类胎儿手臂标本中解剖了肌皮神经(MCN)的走行和分支。MCN分别在43%、37%和17%的手臂中进入肱二头肌的上、中、下部分,其余3%未穿过肱二头肌。至肱二头肌的运动分支分类如下:1型(83.6%):单一分支,分支后支配肱二头肌的两个头;2型(14.3%):两个独立分支,分别支配肱二头肌的一个头;3型(2.1%):单一分支,分支后支配肱二头肌的每个头,外加一个支配肱二头肌远端的分支。至肱肌的运动分支分类如下:1型(93.6%):单一分支至肱肌;2型(6.4%):单一分支,分支为两个分支,均支配肱肌。在10%的标本中观察到MCN与正中神经(MN)之间存在交通支,根据其起源和汇合情况可分为三种类型(A、B、C)。在最常见的类型(B,占病例的50%)中,交通支起源于MCN近端,在手臂中部或远端与MN汇合。本文提供的数据将对外科医生有用,尤其是在腋窝和手臂进行手术的小儿外科医生。