Abstract
BackgroundThe frequency of variation found in the arrangement and distribution of the branches in the brachial plexus, make this anatomical region extremely complicated. The medical concerns involved with these variations include anesthetic blocks, surgical approaches, interpreting tumor or traumatic nervous compressions having unexplained clinical symptoms (sensory loss, pain, wakefulness and paresis), and the possibility of these structures becoming compromised. The clinical importance of these variations is discussed in the light of their differential origins.MethodsThe anatomy of brachial plexus structures from 46 male and 11 female cadaverous specimens were studied. The 40–80 year-old specimens were obtained from the Universidad Industrial de Santander's Medical Faculty's Anatomy Department (dissection laboratory). Parametric measures were used for calculating results.ResultsAlmost half (47.1%) of the evaluated plexuses had collateral variations. Subscapular nerves were the most varied structure, including the presence of a novel accessory nerve. Long thoracic nerve variations were present, as were the absence of C5 or C7 involvement, and late C7 union with C5–C6.ConclusionFurther studies are needed to confirm the existence of these variations in a larger sample of cadaver specimens.
Highlights
The frequency of variation found in the arrangement and distribution of the branches in the brachial plexus, make this anatomical region extremely complicated
Anesthetic blocks, surgical approaches, the interpretation of a nervous compression having unexplained clinical symptoms, and these structures being compromised represent the clinical importance of these variations [8,9]
We found that 33.9% of upper subscapular nerves, 31.6% of lower subscapular nerves, 78.6% of thoracodorsal nerves, 20.4% of long thoracic nerves, 82.4% of suprascapularnerves and 17.9% of dorsal scapular nerves had the usual origins expected for Brachial plexus (BP) collaterals
Summary
The frequency of variation found in the arrangement and distribution of the branches in the brachial plexus, make this anatomical region extremely complicated. The medical concerns involved with these variations include anesthetic blocks, surgical approaches, interpreting tumor or traumatic nervous compressions having unexplained clinical symptoms (sensory loss, pain, wakefulness and paresis), and the possibility of these structures becoming compromised. Peripheral (collateral) nerves arise from the whole plexus trajectory. These collaterals reach proximal regions exclusively innervating some scapular belt muscles. Anesthetic blocks, surgical approaches, the interpretation of a nervous compression having unexplained clinical symptoms (sensory loss, pain, wakefulness and paresis), and these structures being compromised represent the clinical importance of these variations [8,9]. Long thoracic, suprascapular, subscapularis and (page number not for citation purposes)
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