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一种肌皮神经在与正中神经相连时未穿过肱二头肌短头的变异情况:一例病例报告及文献综述

A variation of Musculocutaneous nerve without piercing the coracobrachialis muscle while communicating to the median nerve: A case report and literature review.

作者信息

Nasrabadi Hamid Tayefi, Abedelahi Ali, Shoorei Hamed, Shokoohi Majid, Salimnejad Ramin, Dolatkhah Mohammad Amin, Seghinsara Abbas Majdi

机构信息

Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Int J Surg Case Rep. 2017 Nov 15;41:453-455. doi: 10.1016/j.ijscr.2017.11.020. eCollection 2017.

Abstract

INTRODUCTION

Anatomical variations of the peripheral nervous system may have not any clinical signs and symptoms. One of these variations belongs to the Musculocutaneous nerve. However, a good knowledge of nerve pathways and their variations is very important for surgeons in post-traumatic evaluations, exploratory interventions, and/or administration of neuromuscular blocks in axillary region in order to surgical therapies.

PRESENTATION OF CASE

This report describes a case of variation of the musculocutaneous nerve which was observed in an old Iranian male cadaver during routine educational dissection (Fig. 1).

DISCUSSION AND CONCLUSION

Anatomically, in the axilla region, the Musculocutaneous nerve is originated of the lateral cord of brachial plexus, then, by piercing the coracobrachialis muscle arrives enters to anterior compartment of the arm. But, in the present report, we observed that the Musculocutaneous nerve without piercing the coracobrachialis muscle has arrived in the left arm, then communicated to the Median nerve. To exploratory interventions of the arms for peripheral nerve repair and surgical therapies, a good knowledge of nerve pathways helps to surgeons for preventing possible mistakes during surgery.

摘要

引言

周围神经系统的解剖变异可能没有任何临床体征和症状。其中一种变异属于肌皮神经。然而,对于外科医生来说,充分了解神经走行及其变异对于创伤后评估、探查性干预和/或在腋窝区域进行神经肌肉阻滞以实施手术治疗非常重要。

病例展示

本报告描述了一例在常规教学解剖过程中,在一名老年伊朗男性尸体上观察到的肌皮神经变异病例(图1)。

讨论与结论

从解剖学角度来看,在腋窝区域,肌皮神经起源于臂丛神经的外侧束,然后通过穿经肱二头肌短头到达臂前区。但是,在本报告中,我们观察到肌皮神经未穿经肱二头肌短头就到达了左臂,然后与正中神经相连。对于上肢周围神经修复和手术治疗的探查性干预,充分了解神经走行有助于外科医生在手术过程中避免可能出现的错误。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eb9/5742017/9b1281f9630a/gr1.jpg

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