Nation H L, Jeong S Y, Jeong S W, Occhialini A P
Department of Cell Systems and Anatomy, University of Texas-Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, United States.
Long School of Medicine, University of Texas-Health at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, United States.
Int J Surg Case Rep. 2019;65:119-123. doi: 10.1016/j.ijscr.2019.10.062. Epub 2019 Oct 31.
During an anatomical dissection of the distal upper extremities, numerous muscular and nervous anomalies were found in the forearm and hand of a 94-year-old cadaver. These anomalies are clinically relevant with regard to medical or surgical interventions.
The presence of a "flexor digiti minimi longus" muscle was observed passing through Guyon's canal; to our knowledge this passageway has never been previously reported. An aberrant first lumbrical with three origins was noted. Additionally, numerous atypical nerves were found innervating the hand; the dorsal branch of the ulnar nerve contributed to cutaneous innervation of the palm of the hand (Kaplan's anastomosis), the superficial ulnar nerve provided muscular innervation to the flexor digiti minimi brevis muscle, and two connections between the common palmar digital branches of the median and superficial ulnar nerves were observed (Berrettini anastomosis).
Here, we describe an extranumerary muscle associated with the hypothenar group of muscles. We also describe unusual origins of the first lumbrical muscle, and atypical cutaneous and muscular innervation to the palm of the hand.
Clinically, understanding the existence of these anatomical variations may influence medical care or surgical procedures.
在对一名94岁尸体的上肢远端进行解剖时，在前臂和手部发现了许多肌肉和神经异常。这些异常在医学或外科干预方面具有临床相关性。
观察到一条“小指长屈肌”穿过Guyon管；据我们所知，此前从未有过该通道的报道。发现一条异常的第一蚓状肌有三个起点。此外，还发现了许多支配手部的非典型神经；尺神经背支参与了手掌的皮肤感觉支配（卡普兰吻合），尺神经浅支为小指短屈肌提供肌肉支配，并且观察到正中神经和尺神经浅支的掌侧总指神经之间有两个连接（贝雷蒂尼吻合）。
在此，我们描述了一块与小鱼际肌群相关的额外肌肉。我们还描述了第一蚓状肌不寻常的起点，以及手掌非典型的皮肤和肌肉感觉支配。
临床上，了解这些解剖变异的存在可能会影响医疗护理或手术操作。
