Olson Carley M, Herstam Benjamin J, Tan Yun, Daly Daniel T
Department of Surgery, Center for Anatomical Science and Education, Saint Louis University School of Medicine, St. Louis, USA.
Department of Physical Therapy, Doisy College of Health Sciences, Saint Louis University, St. Louis, USA.
Cureus. 2023 Mar 7;15(3):e35862. doi: 10.7759/cureus.35862. eCollection 2023 Mar.
The presence of an upper subscapular nerve branching from the posterior division of the superior trunk, and it being accompanied by an accessory subscapular artery, is of both clinical and surgical significance. During routine dissection of the root of the neck in a 75-year-old male cadaver, an unusual branch from the third part of the right subclavian artery was observed lateral to the dorsal scapular artery. Continued dissection revealed that this artery traveled between the anterior divisions of the superior and middle trunks of the brachial plexus before traveling alongside a nerve from the posterior division of the superior trunk of the brachial plexus. This artery and nerve descended on the anterior aspect of the subscapularis muscle before piercing into its muscle belly. We believe this to be a previously unreported unique variation of the upper subscapular nerve that is accompanied by an accessory subscapular artery on its course to the subscapularis muscle. Knowledge of anatomical variations like this may lead to decreased complications in nerve blocks and surgical procedures related to the shoulder.
存在一条从上干后支分出的肩胛上神经，且伴有肩胛下副动脉，这具有临床和外科意义。在对一名75岁男性尸体的颈部根部进行常规解剖时，在肩胛背动脉外侧观察到一条来自右锁骨下动脉第三段的异常分支。进一步解剖发现，该动脉在臂丛上干和中干的前支之间走行，然后与臂丛上干后支发出的一条神经伴行。这条动脉和神经在肩胛下肌前方下行，然后穿入其肌腹。我们认为这是一种先前未报道的肩胛上神经独特变异，在其至肩胛下肌的行程中伴有肩胛下副动脉。了解这样的解剖变异可能会减少与肩部相关的神经阻滞和外科手术中的并发症。
