Compendium of Vascular Variations in the Anterior Cervical Region and Right Upper Limb – A Case Report

Abstract

It is axiomatic that knowledge of variations of the major vessels is crucial, not only from anatomical standpoint, but also clinically. During the routine dissection for undergraduate study in Department of Anatomy, Faculty of Medicine, University of Jaffna, Sri Lanka, we came across compendium of vascular variations. Brachiocephalic trunk originated to the left of midline and its branches, the right common carotid and subclavian arteries, crossed the cervical trachea in front from left to right just above the left brachiocephalic vein. The right axillary artery divided into radial and ulnar arteries at the level of lower border of the teres major and these two branches travelled between the biceps brachial and median nerve. Radial artery took the course of the brachial artery in the arm and cubital fossa. Ulnar artery passed in a deeper plane in the arm medial to the biceps brachii and radial artery and passed deep to pronator teres and continued in the forearm lateral to the ulnar nerve as usual. The lateral root of median nerve crossed in front of axillary to unit with the medial root to form the median nerve, which coursed medial to the radial and ulnar arteries in the brachium The aim of this case reportis to compare with the variations reported and to discuss its clinical implications. In conclusion, we present a report of multiple arterial variations in the anterior cervical region and upper limb. Correct identification of variations is necessary for clinical practice, appropriate invasive techniques and to avoid complications.