Head Of Triceps Brachii Research Articles

Estimation of shoulder and elbow joint angle from linear quadratic tracking based on six muscle force vectors

Two dimensional human’s arm is one of the optimal control application. This arm model consists of joint angles consisting of shoulder joint and elbow joint. Beside that, there are also muscle force vectors consisting of pectoralis major, posterior deltoid, brachialis, lateral head of triceps brachii, biceps brachii, and longhead of triceps. Linear Quadratic Tracking (LQT) is constructed to obtain solution of state and optimal control. From state solution and optimal control obtained, they will be used estimation by Backpropagation and ANFIS. From data resulted from LQT simulation, the input used are muscle force vectors. They will be used for estimation the output i.e. angle of shoulder joint and angle of elbow joint. From the LQT simulation, the angle position can follow the given reference function. Then Backpropagation and ANFIS can make estimation in angle of shoulder joint and angle of elbow joint based on six muscle force vectors with small RMSE. In Backpropagation, the estimation result of angle of shoulder joint between target and output with RMSE is 0.0954 and the estimation result of angle elbow joint between target and output with RMSE is 0.2528. In ANFIS, the estimation result of angle of shoulder joint between target and output with RMSE is 0.0062 and the estimation result of angle elbow joint between target and output with RMSE is 0.0526.

AXILLARY NERVE SUPPLYING MOTOR BRANCH TO LONG HEAD OF TRICEPS BRACHII MUSCLE: A CASE REPORT AND REVIEW OF LITERATURE

All three heads of the triceps brachii are classically described as being innervated by the radial nerve in the textbooks. Some clinical observations of traumatic injuries of the axillary nerve with associated paralysis of the long head of triceps and cadaveric studies have suggested that the axillary nerve may innervate the long head of triceps. During routine dissection to undergraduate M.B.B.S students, we found axillary nerve giving a motor branch to long head of triceps brachii on right side, in an adult male cadaver aged about 60 years. We conducted extensive literature search to analyse the previous studies reporting such variations and the studies conducted on the radial nerve or triceps brachii innervation pattern. This variation is clinically important for surgeons, orthopedicians and anaesthetist while performing surgeries and pain management therapies on the upper limb.

Subject-Specific EMG Modeling with Multiple Muscles: A Preliminary Study.

Modeling of surface electromyographic (EMG) signal has been proven valuable for signal interpretation and algorithm validation. However, most EMG models are currently limited to single muscle, either with numerical or analytical approaches. Here, we present a preliminary study of a subject-specific EMG model with multiple muscles. Magnetic resonance (MR) technique is used to acquire accurate cross section of the upper limb and contours of five muscle heads (biceps brachii, brachialis, lateral head, medial head, and long head of triceps brachii). The MR image is adjusted to an idealized cylindrical volume conductor model by image registration. High-density surface EMG signals are generated for two movements - elbow flexion and elbow extension. The simulated and experimental potentials were compared using activation maps. Similar activation zones were observed for each movement. These preliminary results indicate the feasibility of the multi-muscle model to generate EMG signals for complex movements, thus providing reliable data for algorithm validation.

Specific prime movers’ excitation during free-weight bench press variations and chest press machine in competitive bodybuilders

The current study compared the muscle excitation in free-weight bench press variations and chest press machine. Ten competitive bodybuilders were recruited. The EMG-RMS amplitude of clavicular and sternocostal head of pectoralis major, long head of triceps brachii and anterior and lateral deltoid was recorded while performing horizontal (BP), inclined (45°) (IBP) or declined (−15°) bench press (DBP) and chest press machine (CP). Four non-exhaustive repetitions were performed using 80% of 1-repetition maximum of each exercise. Both concentric and eccentric phases were recorded. During the concentric phase, [d effect size: 2.78/7.80] clavicular head was more excited in IBP and less excited in CP (d: −9.69/−4.39) compared to all other exercises. The sternocostal head was similarly excited in DBP vs. BP and BP vs. CP and more excited (d: 2.42/9.92) compared to IBP. Triceps brachii excitation was overall greater (d: 2.01/6.75) in BP and DBP compared to all other exercises. Anterior deltoid was less excited (d: 3.84/19.77) in DBP compared to all other exercises. Lateral deltoid excitation was greater (d: 0.96/3.10) in BP, IBP and DBP compared to CP. Muscle excitation during the eccentric phase followed a similar pattern, with the exception of the greater (d: 3.89/11.32) excitation in the clavicular head in BP compared to all other exercises. The present outcomes showed that the excitation of the clavicular and sternocostal head of pectoralis major depends on the bench inclination angle. The use of BP variations vs. CP allows overall greater triceps brachii and lateral deltoid excitation, due to the greater instability.

Surgical treatment of disabling shoulder hypertonia in patients with brain injury

Little is known about shoulder hypertonia in patients with brain injury. The principal aim of our study was to assess the results of spastic shoulder surgery in our team experience. Sixteen patients (18 shoulders) were retrospectively reviewed. The following were studied: etiology of hypertonia, shoulder deformation schemes, initial aims of surgery, shoulder pre- and postoperative mobility, impact of surgery on limb function when possible. None limb was functional preoperatively. Spontaneously, shoulders were all in a medial rotation, in adduction in 15 cases, in abduction in 3 cases. One had spontaneous retroposition. Therapeutic aim was hygienic in all and pain-relief in 6. Ten neurotomies of the lateral pectoral nerve (LPN), 8 intramuscular lengthening of the latissimus dorsi (LD), 9 percutaneous tenotomies of the pectoralis major (PM), one neurotomy of the motor nerve for the long head of triceps brachii (LHTB) and one intramuscular lengthening of the teres major (TM) were performed. Mean age at surgery was 52.1 (24–73). Etiology was vascular in 11, anoxic in 2, one had traumatic brain injury, one multiple sclerosis, one cervicarthrosic myelopathy. Preoperatively, the mean results for passive abduction of the shoulder was 50.6° (10–90) and for the passive lateral rotation was −5° (−70; 20). Postoperatively, there were respectively improved at 87.7° (60–160) and 6.7° (−20; 20). Only 3 muscles presented with residual tightness (two PM and 1TM) in patients where an isolated neurotomy of the lateral pectoral nerve (LPN) had been achieved. All of the initial objectives of the surgery were satisfied. One patient recovered a partial functionnal limb thanks to a recovered active shoulder flexion. In classical medial rotation-adduction deformation schemes, surgery performed on the 3 main involved muscles (PM, LD, TM) offers good results in term of passive mobility of the shoulder and pain-relief.

Anatomic analysis of the whole articular capsule of the shoulder joint, with reference to the capsular attachment and thickness

BackgroundAlthough conventional Bankart repair has been the accepted procedure for traumatic anterior glenohumeral instability, the humeral avulsion of the glenohumeral ligament or an elongation of the capsule remains challenging to decide the appropriate treatment. The anatomical knowledge regarding the whole capsule of glenohumeral joint is necessary to accurately treat for the capsular disorders. The aims of the current study were to investigate the anatomical features of capsular attachment and thickness in a whole capsule of glenohumeral joint.MethodsWe used 13 shoulders in the current study. In 9 shoulders, we macroscopically measured the attachment widths of the capsulolabrum complex on the scapular glenoid, and the attachment widths of the capsule on the humerus in reference to the scapular origin of the long head of triceps brachii, and the humeral insertion of the rotator cuff tendons. We additionally used 4 cadaveric shoulders, which were embalmed using Thiel’s method, for the analysis of the thickness in a whole capsule by using micro-CT.ResultsThe glenoidal attachment of the articular capsule appeared to have a consistent width except for the superior part of the origin of the long head of triceps brachii. On the humerus, the articular capsule was widely attached to areas without overlying rotator cuffs, with the widest width (17.3 ± 0.9 mm) attached to the axillary pouch. The inferior part of the capsule, which was consistently thicker than the superior part, continued to the superior part along the glenoid and humeral side edge.ConclusionsThe current study showed that the inferior part of the glenohumeral capsule had a wide humeral attachment from the inferior edge of the subscapularis insertion to the inferior edge of the teres minor insertion via the anatomical neck of the humerus, and the thickness of it was thicker than the superior part of the capsule.

The different role of each head of the triceps brachii muscle in elbow extension

ObjectiveThe aim of this study was to investigate the functional role of each head of the triceps brachii muscle, depending on the angle of shoulder elevation, and to compare each muscle force and activity by using a virtual biomechanical simulator and surface electromyography. MethodsTen healthy participants (8 males and 2 females) were included in this study. The mean age was 29.2 years (23–45). Each participant performed elbow extension tasks in five different degrees (0, 45, 90, 135, and 180°) of shoulder elevation with three repetitions. Kinematics data and surface electromyography signal of each head of the triceps brachii were recorded. Recorded kinematics data were then applied to an inverse kinematics musculoskeletal modeling software function (OpenSim) to analyze the triceps brachii's muscle force. Correlation between muscle force, muscle activity, elbow extension, and shoulder elevation angle were compared and analyzed for each head of triceps brachii. ResultsAt 0° shoulder elevation, the long head of the triceps brachii generates a significantly higher muscle force and muscle activation than the lateral and medial heads (p < 0.05). While at 90°, 135° and 180° shoulder elevation, the medial head of the triceps brachii showed a significantly higher muscle force than the long and the lateral heads (p < 0.05). ConclusionsEach head of the triceps brachii has a different pattern of force and activity during different shoulder elevations. The long head contributes to elbow extension more at shoulder elevation and the medial head takes over at 90° and above of shoulder elevation. This study provides further understanding of triceps brachii's for clinicians and health trainers who need to investigate the functional role of the triceps brachii in detail.

“Snapping triceps”: A rare and misleading condition – a clinical case report

Snapping triceps corresponds to subluxation of the medial head of the triceps brachii over the medial epicondyle during active elbow flexion. It is a rare and misleading condition that is often associated with ulnar nerve instability. The latter can result in the snapping triceps being missed. Diagnosis requires a detailed clinical examination. Surgical treatment consists of anterior translocation of the nerve with an adipose flap to stabilize it and transfer of the distal attachment of the medial head of triceps brachii.

Super-selective cervical nerve root stimulation in contralateral C7 transfer: An intraoperative study

ObjectiveWe designed this study using super-selective intraoperative cervical nerve root stimulation aiming to support decision making about complete or partial contralateral C7 (cC7) nerve root transfer in patients with multiple cervical root avulsion injury. MethodsSuper-selective intraoperative stimulations of anterior, lateral, medial and posterior aspect of C5–C8 nerve roots were performed. Compound muscle action potentials (CMAP) were recorded in the lateral part of the deltoid (DM), long head of biceps brachii (BCM), brachioradial (BRM), long head of triceps brachii (TCM), and extensor digitorum communis (EDC) muscle. Muscle strength was documented immediately after cC7 transfer procedures and on scheduled follow-up visits according to the Medical Research Council (MRC) scale. ResultsIn the DM, stimulation of the posterior aspect of C5 resulted in the largest CMAP amplitudes (2.0 mV ± 1.9; 80% ± 28.3). The BCM CMAPs induced by the different aspects of C6 all revealed homogenous stimulation results. Stimulation of the lateral aspect of C7 induced the largest amplitude of TCM CMAPs (1.3 mV ± 1.0; 67.1% ± 43.3). CMAP amplitudes of individual muscles and individual contributions of cervical nerve roots to the TCM varied between subjects. Overall donor side morbidity was low, no permanent motor deficit occurred. ConclusionA super-selective intraoperative cervical nerve root stimulation may help minimize donor side morbidity in transfer procedures. Individual differences of cervical nerve root innervation pattern need to be addressed in future electrophysiological studies. SignificanceOur study outlines individual differences of cervical nerve root innervation pattern.

Muscle MRI of the Upper Extremity in the Myotonic Dystrophy Type 1

Background: The purpose of this study was to explore the relation between muscle MRI findings and weakness of the upper extremity muscles in patients with myotonic dystrophy type 1 (DM1). Methods: Nineteen DM1 patients from 15 families were enrolled in this study. Muscle weakness was evaluated using the modified Medical Research Council scale. Subjects also underwent a genetic study and muscle MRI of the upper extremities. Results: In patients with DM1, the flexor digitorum profundus (FDP), flexor pollicis longus, flexor digitorum superficialis (FDS), extensor pollicis, abductor pollicis longus (APL), lateral head of triceps brachii and infraspinatus (INF) muscles were frequently and severely affected. Muscle strength was significantly correlated with the severity of muscle MRI findings in the FDP, short head of biceps brachii (SBB), and medial head of triceps brachii muscles. Disease duration was correlated significantly with MRI findings in the FDP, FDS, long head of biceps brachii, INF, APL, and SBB muscles. Unexpectedly, the degree of trinucleotide expansion of myotonin protein kinase was not correlated with muscle MRI findings. Conclusion: Muscle MRI of the upper extremity is useful to detect affected muscles in DM1 patients.

Multiple Interneural Communications of Brachial Plexus-Anatomical Description and Clinical Significance

Brachial plexus blockade requires efficient and thorough understanding of the detailed anatomy of the plexus and the variations associated with the plexus. Anomalies associated with the branches of the plexus may complicate attempts of nerve blockade for anesthesia. The present case report presents an unusual variation of brachial plexus noticed during routine cadaveric dissection. A rare neural communication between ulnar and radial nerves was observed in the left axilla at high humeral level proximal to the entry of the radial nerve into the radial groove. The communicating ramus also gave a branch to the medial head of triceps brachii 0.3 cm distal to the origin of the communication. Further, there was also a communication between the musculocutaneous and median nerves in the distal half of the arm after the musculocutaneous nerve pierced the coracobrachialis muscle. Though the variations of the brachial plexus have been described in the literature, yet studies regarding the communication between ulnar and radial nerves are rare and the coexistence of this variation along with median and musculocutaneous nerve communication is unique. Knowledge of such rare variations and anomalies is important to minimize the possible complications of regional anesthesia and surgery. Such an unusual variation, as noted in the present study, may prove useful in nerve grafting and neurophysiological evaluation to diagnose peripheral neuropathies. Further, their knowledge is of immense importance in traumatology of the shoulder joint, radial neck dissections and management of fracture of the surgical neck of humerus. Anatomic variations of peripheral nerves are important for Orthopedic surgeons, Neurophysicians, Physiotherapists and Radiologists. The present article is a humble attempt to reinforce awareness of such neural variations among clinicians.

Muscle Fatigue in the Three Heads of the Triceps Brachii During a Controlled Forceful Hand Grip Task with Full Elbow Extension Using Surface Electromyography.

The objective of the present study was to investigate the time to fatigue and compare the fatiguing condition among the three heads of the triceps brachii muscle using surface electromyography during an isometric contraction of a controlled forceful hand grip task with full elbow extension. Eighteen healthy subjects concurrently performed a single 90 s isometric contraction of a controlled forceful hand grip task and full elbow extension. Surface electromyographic signals from the lateral, long and medial heads of the triceps brachii muscle were recorded during the task for each subject. The changes in muscle activity among the three heads of triceps brachii were measured by the root mean square values for every 5 s period throughout the total contraction period. The root mean square values were then analysed to determine the fatiguing condition for the heads of triceps brachii muscle. Muscle fatigue in the long, lateral, and medial heads of the triceps brachii started at 40 s, 50 s, and 65 s during the prolonged contraction, respectively. The highest fatiguing rate was observed in the long head (slope = −2.863), followed by the medial head (slope = −2.412) and the lateral head (slope = −1.877) of the triceps brachii muscle. The results of the present study concurs with previous findings that the three heads of the triceps brachii muscle do not work as a single unit, and the fiber type/composition is different among the three heads.

Muscle hardness of the triceps brachii before and after a resistance exercise session: a shear wave ultrasound elastography study.

Muscle hardness indicates muscle condition, and its measurement before and after resistance exercise is essential for preventing resistance training-induced muscle injury. To investigate muscle hardness of the triceps brachii (TB) before and immediately after a resistance exercise session involving the elbow extensors. In 18 young men, muscle hardness of the long head of TB was measured at 50%, 60%, and 70% point along the length of the upper arm from the acromial process of the scapula to the lateral epicondyle of the humerus by using shear wave ultrasound elastography. At the same sites, muscle thickness of the long head of TB was also measured by ultrasonography. Resistance exercise was performed using a dumbbell with a mass adjusted to 80% of the one-repetition maximum. Although the exercise-induced increase in muscle hardness was significant at all the regions, muscle hardness was significantly higher at 70% of the upper arm length than at the other regions before and after resistance exercise. The exercise-induced increase in muscle thickness was also significant, but the relative changes in muscle hardness before and after resistance exercise were not correlated with the corresponding relative changes in muscle thickness at each region. These results indicate the small effect of exercise-induced muscle swelling on exercise-induced changes in muscle hardness. We suggest that muscle damage and/or injury, particularly at the distal region of TB, should be carefully considered to safely perform resistance exercise.

Evaluation of repetitive isometric contractions on the heads of triceps brachii muscle during grip force exercise.

Normally, surface electromyography electrodes are used to evaluate the activity of superficial muscles during various kinds of voluntary contractions of muscle fiber. The objective of the present study was to investigate the effect of repetitive isometric contractions on the three heads of the triceps brachii muscle during handgrip force exercise. Myoelectric signals were recorded from the lateral, long and medial heads of the triceps brachii muscle in 13 healthy males during maximal isometric contractions for 10 s of concurrent handgrip force and elbow extension. The subjects were asked to perform their contraction task five times with 3 minutes interval between two successive contractions. Decreasing electromyographic activities were found for the lateral and long heads, and increasing for the medial head throughout the 5 different contractions. Electromyographic activities were found for the lateral head with mean=199.84, SD=7.65, CV=3.83%, the long head with mean=456.76, SD=18.10, CV=3.96%, and the medial head with mean=505.16, SD=8.47, CV=1.68%. Electromyographic activities among the three heads of triceps brachii were significantly different (F=3.82) at the alpha level of (p<0.05). These findings support that repetitive isometric contractions decrease the contractile activity in the lateral and long heads, and increases in the medial head of the triceps brachii muscle during handgrip force exercise with full elbow extension, and the electromyographic activity changes are observed to be more significant at the long head as compared to the lateral and medial heads.

Cadaveric investigation into the innervation of the long head of triceps brachii (726.9)

All three heads of the Triceps brachii are classically described as being innervated by the radial nerve. A previous study of 20 cadaveric shoulders revealed that in 13 specimens the long head of the triceps (LHT) was supplied by a branch of the axillary nerve, not the radial nerve. In our current study 20 cadaveric shoulders were dissected via a combined anterior and extensile dorsal approach. The dissections were photographed and nerve maps were created. Distances from proximal LHT attachment to the point of neuromuscular insertion were measured with calipers. The results indicated that in 60% of the specimens the axillary nerve contributed to the innervation of the LHT; in 15% axillary nerve alone and in 45% combined axillary and radial nerve. These findings have clinical significance in understanding why triceps brachii dysfunction is sometimes associated with axillary nerve injuries.

Muscular Anatomy of the Forelimbs of the Lesser Grison (Galictis cuja), and a Functional and Phylogenetic Overview of Mustelidae and Other Caniformia

The extrinsic and intrinsic forelimb musculature of the lesser grison (Galictis cuja), a short-legged mustelid of southern South America, is studied for the first time. We present descriptions, muscular maps, and weight data. Muscular anatomy description of the lesser grison provides the framework for discussing the myological diversity of mustelids and other caniforms, for addressing nomenclatural problems (such as synonymy and homonymy), and for highlighting some functional and phylogenetically informative traits. We recognize in the lesser grison features shared by all mustelid species, and some other caniforms, especially mephitids, such as the presence of rhomboideus profundus, an angular head of triceps brachii, and, apparently, the absence of a flexor digitorum brevis manus. An unexpected record of articularis humeri, a proximal origin of the brachioradialis, and the absence of the tensor fascia antebrachii are recorded for this species. As other ictonychines and mustelines, Galictis cuja possesses stronger and subdivided protractors and sagittal rotators of the forelimbs, as well as shoulder and elbow extensors. These features allow for resistance in landing during bounds and increase the stride length during epigean and subterranean crouched locomotion. Powerful neck musculature assists during hunting and carrying of prey. Weakness of some retractors and intrinsic flexors is related to a relatively minor importance of the forelimbs as propellers during bounding and the lack of other specializations. The configuration of the rhomboideus and the absence of coracobrachialis seem to be informative at the subfamiliar level within Mustelidae. The comprehensive and comparative review of available information leads us to propose possible solutions to old nomenclatural problems and of identification. This allows us to reassess of some myological features as diagnostic of caniform clades.

Changes of Bioelectrical Muscle Activity During Ascending Phase Flat Bench Pressing

Bench pressing is one of the most popular strength exercises, used for general conditioning by athletes in many sports. It is also part of powerlifting and a sport on its own. Twenty international-level athletes took part in this investigation. The activity of four muscles was measured: the pectoralis major (PM), the anterior deltoid (AD), the lateral head of triceps brachii (TB), and the latissimus dorsi (LD), in four tasks. The pectoralis major showed no significant differences in muscle tension in relation to the lifted load. For the ascending phase, rise in muscle tension during external load increase was greatest for the Anterior Deltoid and Triceps Brachii muscles.

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 &amp; 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

Anatomical and clinical substantiation of the long head of triceps transposition to restore active forearm flexion in patients with arthrogryposis

Purpose: to investigate anatomic features of the long head of triceps brachii in relation to its using as a pedicle flap for restoration of active forearm flexion in patients with arthrogryposis. Material and methods. Anatomical studies were performed on 15 fresh frozen human upper limbs from 9 cadavers. Arteries were perfused with radiopaque masses and following preparation, sectional roentgenography, morphometry of anatomical structures were carried. 29 patients with the lack of active elbow flexion aged from 8 months to 15 years were examined (clinical, neurological and physiological studies) and treated in Turner Scientific and Research Institute for Children's Orthopedics from 2008 to 2012. Results and conclusion. Anatomical studies demonstrated the possibility of transposition of the long head of triceps to forearm flexors position. The long head of triceps can be simply separated from the other two heads, it has independent innervation and blood supply, its vascular pedicle is easily identified, and length of extraorgan vessels and nerves is sufficient to transfer the muscle as a pedicle flap. Clinical study has shown the principal possibility and effectiveness of restoration of active forearm flexion in patients with arthrogryposis using the long head of triceps brachii.

Exercise does not increase skeletal muscle FNDC5 protein or mRNA in pigs

Endurance exercise training (EX) is reported to increase FNDC5 expression in skeletal muscle (SkM) of mice (Nature 481:463, 2012). We tested the hypothesis that EX increases FNDC5 expression in pig SkM. Castrated male Rapacz hypercholesterolemic (FH) and normal Yucatan miniature swine (Y) were divided into EX and unexercised (SED) groups. After 16–20 weeks pigs were anesthetized and tissue samples collected and FNDC5 gene expression measured by RT‐PCR. Citrate synthase activity (CS) (index of EX‐induced adaptation) was increased in SkM samples of both FH and Y EX. FNDC5 mRNA appeared 64% less deltoid and 25% less in long head of triceps brachii (LHT) SkM of FH EX pigs. EX did not appear to affect FNDC5 mRNA expression in fat or heart muscle. FNDC5 mRNA expression in subcutaneous fat was comparable to that in the SkM. EX enhanced PGC1α mRNA levels which were much higher in the SkM samples than in fat samples. The changes in PGC1α mRNA levels were not correlated with FNDC5 mRNA. Despite the increase in CS activity in SkM, there was no difference in FNDC5 protein content (Western blot) between SED and EX SkM of Y pigs. We conclude that EX does not increase FNDC5 mRNA or protein in pig SkM.