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一例罕见的肱二头肌副头累及臂丛外侧束病例及其临床意义

An unusual case of accessory head of coracobrachialis muscle involving lateral cord of brachial plexus and its clinical significance.

作者信息

Garbelotti S A, Marques S R, Rocha P R, Pereira V R, de Moraes L O Carvalho

机构信息

Universidade Federal de São Paulo.

Centro Universitário São Camilo.

出版信息

Folia Morphol (Warsz). 2017;76(4):762-765. doi: 10.5603/FM.a2017.0033. Epub 2017 Mar 29.

Abstract

Knowledge of anatomical variations in the peripheral nervous system is key in the interpretation of unusual clinical signs or during physical or diagnostic imaging. This case study is a description of an anatomical variation between the coracobrachialis muscle and brachial plexus. In a routine dissection in the human anatomy laboratory, we were faced with an anatomical variation in the coracobrachialis muscle, observed in the upper right limb of a male cadaver. The coracobrachialis muscle had a common origin at the apex of the coracoid process and then divided into two heads. The lateral head followed its normal course until insertion into the middle third of the humerus, while the medial head involved the lateral cord of the brachial plexus before insertion into the intermuscular septum in the proximal third of the humerus. Atypical anatomical variations have clinical and surgical implications in procedures such as brachial plexus block and lateral cord compression. In these cases the result could be paralysis of the flexor musculature of the forearm and hypoesthesia of the forearm.

摘要

了解周围神经系统的解剖变异是解读异常临床体征或在体格检查或诊断性影像学检查过程中的关键。本病例研究描述了肱二头肌与臂丛神经之间的解剖变异。在人体解剖实验室的一次常规解剖中,我们在一具男性尸体的右上臂观察到肱二头肌的解剖变异。肱二头肌在喙突尖有一个共同起点,然后分为两个头。外侧头沿正常路径走行,直至插入肱骨中1/3,而内侧头在插入肱骨近端1/3的肌间隔之前,包绕臂丛神经外侧束。非典型解剖变异在臂丛神经阻滞和外侧束受压等手术中具有临床和手术意义。在这些情况下,结果可能是前臂屈肌麻痹和前臂感觉减退。

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