Head Of Biceps Brachii Research Articles

Biceps Tenodesis Versus Tenotomy in Treatment of Lesions of Long Head of Biceps Brachii in Patients Undergoing Arthroscopic Shoulder Surgery

Objectives:To compare subjective patient-reported outcomes and objective clinical results between biceps tenotomy and tenodesis in patients with lesions of the long head of biceps tendon (LHBT).Met...

Unilateral absence of short head of the biceps brachii in human cadaver: A case study

Anatomical variation in the head of biceps brachii is well documented in various studies in the past. As for our best knowledge with the previous publication, there are so many journals reported with multiple variation including accessory heads of biceps brachii muscle (BBM), but the absence of one head of BBM in unilateral arm is very rare. The proximal tendons of the biceps brachii are commonly involved in pathological processes and are a frequent cause of anterior shoulder pain. Disorders of the distal biceps brachii tendon typically result from partial and complete tears of the muscle. Partial tears are usually characterized by enlargement and abnormal contour of the tendon. The purpose of this study was to find some rare kind of variations in the head of biceps brachii with future enlightenment in its potential effects in the normal functioning of upper limb. In the present study, we found that absence of one head of BBM in unilateral arm of one cadaver during anatomical dissection at Windsor University School of Medicine, Brightons Estate, Cayon, P. O. Box-1621, St. Kitts and Nevis, West Indies. Strong evidence of the absence of one head of BBM may be suggestive of developmental anomaly or physical degeneration of the muscle which may lead to complete or partial dysfunction of the region (Szpinda, et al. 2013). However, further studies can reveal the real case of it.

Ultrasonographic Validation of Anatomical Landmarks for Localization of the Tendon of the Long Head of Biceps Brachii.

Objectives. To establish anatomical landmarks for biceps tendon groove localization based on intrinsic anatomical relations and to validate the localization with ultrasonographic measurement. Design. Perspective, observational, single-blinded pilot study. Participants. 25 healthy male and female volunteers ages 24–50 years. Methods. We used two anatomical landmarks, the medial epicondyle vertical line related landmark and the coracoid process landmark. The distance from the groove skin mark to the medial epicondyle vertical line and the coracoid process was measured horizontally and was measured at 0° and 45° of shoulder external rotation, respectively. Results. Medial epicondyle vertical lines were 9.3 mm/21.5 mm medial to the groove at 0°/45° of shoulder external rotation, respectively. Correlation coefficients were 0.04/0.10, 0.32/0.42, and 0.26/0.37 for weight, height, and BMI in 0°/45° of shoulder external rotation, respectively. The distance between the coracoid process and the groove was 44.0 mm/62.2 mm in 0°/45° of shoulder external rotation, respectively. Correlation coefficients were 0.36/0.41, 0.36/0.54, and 0.18/0.12 for weight, height, and BMI in 0°/45° of shoulder external rotation, respectively. Conclusions. The medial epicondyle vertical line and the coracoid process landmark are both useful anatomical landmarks to localize the biceps groove. The anatomical landmark based localization is essentially not correlated with subject's weight, height, or BMI.

Rare Inferolateral Type of Third Head of Biceps Brachii Coexisting with Triple Roots of Median Nerve

Rare Inferolateral Type of Third Head of Biceps Brachii Coexisting with Triple Roots of Median Nerve

Supernumerary heads to biceps brachii muscle and Asian population history

Supernumerary heads of biceps brachii are one of the most common anatomic variants in the muscular system and appear to develop under genetic control and vary in prevalence among populations. Variation in prevalence and morphology therefore has the potential to contribute to understanding of human population history. Until now, there has been no publication of the prevalence of the variant in Southeast Asian populations. The aim of this research is to document the prevalence and morphology of the variant in a sample of Thai cadavers and to consider the significance of the findings. The method used was dissection of arms of 162 donated cadavers at Khon Kaen University, Thailand. The sample showed high prevalence of third heads of biceps brachii in 35% of cadavers, compared with the prevalence of up to 25% reported in large samples worldwide. The sample also showed equal prevalence in males and females and one-third present bilaterally. This pattern is similar to that found in East Asia, and very different from the low prevalence found in South Asia. The morphology of the supernumerary heads does not appear to be different from elsewhere in the world based on the minimal comparable data available in the literature. The Southeast-East Asian pattern of prevalence is consistent with current theories of population history in the region and suggests anatomical variation of the postcranial soft tissues may ultimately contribute to understanding of past human migrations.

REVERSED ARTHROSC OPIC SUBACROMIAL DEC OMPRESSION FOR TREATMENT OF ROTATOR CUFF TEARS

To investigate the effectiveness of reversed arthroscopic subacromial decompression in the treatment of rotator cuff tears. Between November 2012 and January 2015, 53 patients with rotator cuff tears were treated with reversed arthroscopic subacromial decompression and rotator cuff repair. Of 53 patients, 38 were male and 15 were female, with the age of 47-61 years (mean, 53.4 years). The injury was caused by falling in 36 cases and other in 17 cases without an obvious history of trauma. All patients had shoulder pain and limited shoulder movement before operation. Visual analogue scale (VAS) was 6.4±0.9, and University of California at Los Angeles (UCLA) score was 16.3±1.9. MRI showed that distal supraspinatus tear was observed in 41 cases and distal infraspinatus tear in 12 cases; partial-thickness rotator cuff tear was observed in 9 cases and full-thickness tear in 44 cases. And the tear size was from 1 to 3 cm (mean, 1.9 cm). Combined injuries included tendinitis of long head of biceps brachii in 31 cases, Bankart lesion in 5 cases, and superior labrum anterior and posterior lesion in 2 cases. Incision healed by first intention in all patients; no infection or nerve injury occurred. Forty-nine cases were followed up from 12 to 35 months (mean, 22.8 months). After operation, shoulder pain relief was achieved in 42 cases; 7 cases had anterior shoulder pain at 3 months after operation, which was relieved after symptomatic treatment. At last follow-up, VAS score was significantly decreased to 0.5±0.6 (t=40.565, P=0.000). UCLA score was significantly increased to 33.8±1.7 (t=-79.799, P=0.000). The results were excellent in 42 cases, good in 6 cases, and fair in 1 case; the excellent and good rate was 98.0%. Reversed arthroscopic subacromial decompression can avoid coracoacromial arch injury and achieve good recovery of joint function, so it can be used in rotator cuff tears procedure.

An anatomical study of the third head of biceps brachii muscle and its innervations

Introduction: Biceps brachii muscle is the double headed flexor muscle of anterior compartment of arm, showing most common anatomical variation. Objective: To study the morphological variation of biceps brachii muscle along with its innervations. Method: 42 upper extremities of 21 formalin fixed cadavers used during routine dissection in anatomy department of LMC were studied. Biceps brachii muscles were examined for their attachments, number of heads of origin, level of fusion of muscle bellies and innervations. Appropriate photographs were taken. Result: Out of 42 upper extremities of 21 cadavers third head of biceps brachii muscle was found in two right upper extremities (9.52%). One of the specimens had dual nerve supply from musculocutaneous and median nerve where as in another specimen third head was innervated only by musculocutaneous nerve. Conclusion: Knowledge of additional head of biceps brachii is important for surgery of the fracture of shaft of humerus.

Supernumerary head of biceps brachii and branching pattern of the musculocutaneous nerve

During routine dissection by medical undergraduates, third head of the biceps brachii muscle was found on the left side of a 75-year-old male cadaver in a total of 48 arms dissected in Department of Anatomy Armed Forces Medical College, Pune. Biceps brachii is a muscle of arm having two heads hence the name. The most frequent variation of the muscle is in the number of heads with a prevalence range of 9.1-22.9%. The origin of the supernumerary head in this case was from the humerus, between the insertion of the coracobrachialis and the upper part of the origin of the brachialis, and also from the medial intermuscular septum. The supernumerary head joined the common belly. It was supplied by the musculocutaneous nerve which after emerging from brachialis pierced it near the middle and terminated by finally supplying the biceps belly. In our study, 2.08% (1 of 48) of male cadavers were found to have the third head of biceps. The incidence of this variation can be as much as 10% as, shown in previous studies on Indian population, as reported in standard textbooks of anatomy.

Multiple nerve variations and third head of biceps brachii in upper limb – A case report

Multiple nerve variations and third head of biceps brachii in upper limb – A case report

Extra-articular origin of long head of biceps brachii that is attached to the rotator cuff

Extra-articular origin of long head of biceps brachii that is attached to the rotator cuff

Ultrasonography managed by internists: The stethoscope of 21st century?

Ultrasonography in the hands of the internist can answer important clinical questions quickly at the point of patient care. This technique enhances the senses of the physicians and improves their ability to solve the problems of the patient. Point of care ultrasonography performed by clinicians has shown good accuracy in the diagnosis of diverse cardiac, abdominal and vascular pathologic conditions. It may also be useful for evaluation of thyroid, osteoarticular and soft tissue diseases. Furthermore, the use of ultrasound to guide invasive procedures (placement of venous catheters, thoracentesis, paracentesis) reduces the risk of complications. We present 5 cases to illustrate the usefulness of this technique in clinical practice: (i) peripartum cardiomyopathy; (ii) subclinical carotid artery atherosclerosis; (iii) asymptomatic abdominal aortic aneurysm; (iv) tendinitis of long head of biceps brachii and supraspinatus, and (v) spontaneous soleus muscle hematoma.

La ecografía en manos del internista: ¿el estetoscopio del siglo xxi?

Ultrasonography in the hands of the internist can answer important clinical questions quickly at the point of patient care. This technique “enhance” the senses of the physicians and improves their ability to solve the problems of the patient. Point of care ultrasonography performed by clinicians has shown good accuracy in the diagnosis of diverse cardiac, abdominal and vascular pathologic conditions. It may also be useful for evaluation of thyroid, osteoarticular and soft tissue diseases. Furthermore, the use of ultrasound to guide invasive procedures (placement of venous catheters, thoracentesis, paracentesis) reduces the risk of complications. We present 5cases to illustrate the usefulness of this technique in clinical practice: (i)peripartum cardiomyopathy; (ii)subclinical carotid artery atherosclerosis; (iii)asymptomatic abdominal aortic aneurysm; (iv)tendinitis of long head of biceps brachii and supraspinatus, and (v)spontaneous soleus muscle haematoma.

A morphological study of third head of biceps brachii in human cadavers with its clinical implications

Background: Muscular variations are relatively fewer when compared to vascular variations. A few muscles show extra heads of origin apart from their original heads. One such muscle which has extra heads of origin is biceps brachii (BB). Understanding of these extra heads is significant in handling injuries of the muscle and in tendon reconstruction operations. So, the aim of this study was to look for the incidence of the third head of the biceps brachii. Materials and Methods: The study was carried out on 24 cadaveric upper limbs. Dissection of the front of arm was done and the origin and insertion of the BB was looked. Any additional head if present was particularly looked for and photographed. Results: We found the three headed BB unilaterally in three male cadavers, one belonging to the left side and two to right side. The third head of BB originated near the insertion of the CB and at the origin of the brachialis in two cases and in both cases it goes and merges with the other two heads and insert into the posterior part of radial tuberosity. In one case it originates along with the long head of BB and its tendon goes and insert into the deep fascia of the arm. Conclusion : These all variations in the study should be known to the orthopedic surgeons during treatment of the bones fractures in this region because sometime the presence of third head may cause unusual bone displacement subsequent to fracture.

Unilateral Third Head of Biceps Brachii with Associated Neurovascular Variants in both the Upper Limbs of a Single Cadaver

During routine undergraduate dissection in the upper extremities of a 65 years old male cadaver in the department of Anatomy at Dr. PSIMS & RF, coexistence of muscular and neurovascular variants were identified .Muscular variations included presence of additional head(third) of biceps brachii in the left arm, accompanied with medially positioned median nerve in relation to brachial artery bilaterally . Teres minor muscle was not identified and the origin of long head of triceps brachii extended upto the lateral border of scapula on the left side. Both the medial cutaneous nerves of arm and forearm arouse from a single trunk bilaterally. In the right limb the axillary artery showed only four branches instead of six branches, with common trunk for thoraco-acromial and lateral thoracic artery and common trunk for subscapular and posterior circumflex humeral artery. Knowledge of coexistence of these variations would of profound importance surgically and clinically, especially in limb injuries and surgical repairs. DOI: http://dx.doi.org/10.3126/ajms.v5i1.7391 Asian Journal of Medical Science Vol.5(1) 2014 pp.81-85

English

Introduction There are a variety of anatomical variations which can be observed during dissection, diagnosis and surgical procedures. These variations are equally important from a clinical as well as an academic point of view. This report discusses the additional head of the biceps branchii. Case report We noticed the third head of biceps brachii during dissection; the head was arising from the fascia covering the brachialis muscle and getting inserted on the radial tuberosity after merging with the long and short heads of biceps. Conclusion The supernumerary head may have both positive and negative effects. Clinical significance lies in the fact that this additional head may cause compression of musculocutaneous nerve, median nerve and brachial artery, which are in close relation with it and produce compression symptoms.

English

Biceps brachii is a double headed muscle. In terms of number and morphology of its head, it is one of the most variable muscles in the human body. Most common variation is third head, but four, five or even seven heads have been reported. In the present case report third head of biceps brachii was found on the flexor compartment of left arm of an adult female cadaver .The third head of biceps brachii originated from the anteromedial surface of the humerus below the insertion of coracobrachialis and which descended and merged with the other two heads to form common tendon and was inserted on to the radial tuberosity . Third heads might be significant in producing the strong flexion as well as supination of forearm. They may cause compression of neurovascular structures because of their close relationship to brachial artery and median nerve. Variant biceps brachii may confuse a surgeon who performs procedures on the arm and may lead to iatrogenic injuries. The surgeons and traumatologists have to keep such muscular variations in mind.

Change in EMG with skin friction at different frequencies during elbow flexion

Modulation of muscle activation in superficial and deeper regions may be induced by tactile stimulation. The purpose of this study was to examine changes in muscle activation with skin friction. Subjects performed an isometric elbow flexion at 30% maximal voluntary cotraction (MVC) with skin friction at different frequencies (0.5–2.7 Hz). Surface electromyography (S-EMG) and intramuscular EMG were obtained from the elbow flexor muscles (BBS: short head of biceps brachii, BBL: long head of biceps brachii, BRA: brachialis). S-EMG activity decreased at a higher frequency of 2.7 Hz and increased linearly with an increase in skin friction frequency (0.5–2.7 Hz) in BBS. A decrease in high-threshold motor unit (HT-MU) firing rate in superficial regions and an increase in low-threshold motor unit (LT-MU) firing rate in deeper regions were observed with skin friction (2.7 Hz) in BBS. The actions of inhibitory interneurons may be influenced by cutaneous afferent input with skin friction. Muscle activation of BBS depended on the intensity of the stimulus. Skin friction over BBS results in an inhibitory response in superficial regions of BBS, most likely due to the increase in firing rate of low-threshold cutaneous mechanoreceptors.

Reply: Unusual formation of the median nerve associated with the third head of biceps brachii

Clinical AnatomyVolume 26, Issue 8 p. 920-920 Letter to the Editor Reply: Unusual formation of the median nerve associated with the third head of biceps brachii Jae-Ho Lee, Corresponding Author Jae-Ho Lee Department of Anatomy, School of Medicine, Keimyung University, Daegu, Republic of KoreaDepartment of Anatomy, School of Medicine, Keimyung University, Daegu, Republic of Korea. E-mail: [email protected]Search for more papers by this author Jae-Ho Lee, Corresponding Author Jae-Ho Lee Department of Anatomy, School of Medicine, Keimyung University, Daegu, Republic of KoreaDepartment of Anatomy, School of Medicine, Keimyung University, Daegu, Republic of Korea. E-mail: [email protected]Search for more papers by this author First published: 18 January 2013 https://doi.org/10.1002/ca.22214Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume26, Issue8November 2013Pages 920-920 RelatedInformation

Incidence of the third head of biceps brachii in population of Andhra Pradesh

Incidence of the third head of biceps brachii in population of Andhra Pradesh

Anatomic and Radiographic Comparison of Arthroscopic and Open Biceps Tenodesis Site

Objectives:Both arthroscopic and open surgical techniques are commonly utilized for proximal biceps tenodesis of the long head of biceps brachii. One concern about the arthroscopic approach is that a portion of the biceps tendon may remain in the bicipital groove, which is a possible source of persistent post-operative pain. [1] The purpose of this study was to determine the location of tendon fixation in an open subpectoral technique and an arthroscopic technique that attempted to place the biceps inferior to the bicipital groove. The null hypothesis was that there would be no difference in the tenodesis site for the arthroscopic and open techniques.Methods:With the shoulders in a beach chair position, ten matched pairs of cadaver shoulders were randomized such that within each pair one shoulder underwent a standard open subpectoral biceps tenodesis and the other underwent an arthroscopic tenodesis. The arthroscopic technique was performed through an anterior working portal directly over the tendon with the arm forward flexed and the arthroscope in a standard lateral portal. Following the procedures, specimens were carefully dissected and the distances from pertinent anatomic landmarks to the tunnel were measured with a digital caliper. AP and lateral radiographs were also obtained, and radiographic measurements were conducted using a PACS measurement system in line with the longitudinal axis of the humerus. Paired T-tests were used to compare open versus arthroscopicResults:Anatomy: Measurements from the superior border of the bicipital groove to the tenodesis tunnel averaged 32.2 ± 9.8 mm distal for the arthroscopic technique and 54.8 ± 8.4 mm distal for the open technique (p<0.001). (Figure 1, Table 1) The distance from the inferior border of the bicipital groove to the tenodesis tunnel averaged 9.8 ± 8.6 mm distal for the arthroscopic technique and 32.8 ± 7.8 mm distal for the open technique (p<0.001). The distance from the superior border of the latissimus dorsi to the tenodesis tunnel averaged 2.7 ± 9.0 mm distal for the arthroscopic technique and 24.2 ± 7.4 mm distal for the open technique (p<0.001). Radiography: On radiographic assessment, the distance from the junction of the greater tuberosity and the humeral head articular surface to the tenodesis tunnel measured 33.5 ± 7.5 mm distal for the arthroscopic technique and 54.3 ± 6.5 mm distal for the open technique (p<0.001). The distance from the most medial aspect of the lesser tuberosity to the tenodesis tunnel measured 16.6 ± 8.4 mm distal for the arthroscopic technique and 37.5 ± 6.0 mm distal for the open technique (p<0.001).Conclusion:This study found that the open subpectoral technique for proximal biceps tenodesis placed the tenodesis tunnel significantly further distal than the arthroscopic technique, generally about 2 cm. The arthroscopic technique did, however, always place the tunnel below the bicipital groove, and even below the superior border of the latissimus dorsi in most cases. This may allay concern about the bicipital groove as a pain source using this arthroscopic technique. The radiographic findings were consistent with the anatomic findings