Moasses Zia, Aryan Arefeh, Hassanpour-Dehnavi Ashraf, Zarenezhad Mohammad, Dorodchi Alireza
Department of Anatomical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Anatomy, Faculty of Medicine, Lorestan University of Medical Sciences, Khoram Abad, Iran.
Anat Cell Biol. 2024 Mar 31;57(1):18-24. doi: 10.5115/acb.23.229. Epub 2024 Jan 15.
The origin and distribution of median nerve varies among the different individuals. The median nerve variations in axillary region were reported by many authors previously. Understanding of these variations is especially necessary for clinicians to prevent iatrogenic nerve damage. The current work aimed to evaluate the possible anatomical variations of median nerve in the axillary region in a sample of the Iranian cadavers (Shiraz, Fars). We dissected 26 upper limbs from 13 male cadavers to investigate the different variations of median and musculocutaneous nerves according to Venieratos and Anagnostopoulou classification. In 23.07% of specimens (n=6), the medial root united with 2 lateral roots and formed the median nerve proximal to the coracobrachialis muscle. In one case, a communicating branch separated from the musculocutaneous nerve distal to the coracobrachialis and connected to the median nerve in upper arm. Our results suggest that there are anatomical variations of the median nerve in terms of its origin and its communication with the musculocutaneous nerve in the population of southern Iran. The anatomical knowledge of the median nerve variations is important for clinicians to improve patient health outcome. Theses variations of the median nerve should be considered during surgical procedures of the axillary region and nerve block of the infra clavicular part of the brachial plexus.
正中神经的起源和分布在不同个体之间存在差异。此前已有许多作者报道过正中神经在腋窝区域的变异情况。对于临床医生而言,了解这些变异对于预防医源性神经损伤尤为必要。当前的研究旨在评估伊朗尸体样本(设拉子,法尔斯省)中正中神经在腋窝区域可能存在的解剖变异。我们解剖了13具男性尸体的26条上肢,根据韦涅拉托斯和阿纳格诺斯托普洛分类法研究正中神经和肌皮神经的不同变异情况。在23.07%的标本(n = 6)中,内侧根与2条外侧根合并,并在肱二头肌短头肌近端形成正中神经。在1例标本中,一条交通支在肱二头肌短头肌远端从肌皮神经分出,并在上臂与正中神经相连。我们的研究结果表明,在伊朗南部人群中,正中神经在起源及其与肌皮神经的连通方面存在解剖变异。正中神经变异的解剖学知识对于临床医生改善患者健康结局非常重要。在腋窝区域的外科手术以及臂丛神经锁骨下部分的神经阻滞过程中,应考虑正中神经的这些变异情况。