ABSTRACT
SUMMARY: The variations in the serratus anterior (SA) muscle are common. Here, we report a rare variation of the muscle origin with a potentially great clinical implication. We found an aberrant SA variation in an 81-year-old Korean male cadaver during a routine dissection for medical students. Additional slip (AS) of the SA originated from the clavipectoral fascia and the pectoralis minor. It traveled inferiorly and merged to the typical SA part. Precise knowledge about SA variations is clinically valuable; therefore, clinicians should be aware of the possible variation.
RESUMEN: Las variaciones en el músculo serrato anterior (MSA) son comunes. En este trabajo informamos una variación rara del origen muscular con una implicación clínica potencialmente importante. Encontramos una variación aberrante del MSA en un cadáver masculino, coreano de 81 años, durante una disección de rutina para estudiantes de medicina, con un fascículo adicional del MSA originado en la fascia clavipectoral y el músculo pectoral menor. Este fascículo se dirigió inferiormente y se fu- sionó con la parte común de MSA. El conocimiento preciso sobre las variaciones de MSA es útil clínicamente; por lo tanto, los médicos deben ser conscientes de esta posible variación.
Subject(s)
Humans , Male , Aged, 80 and over , Muscle, Skeletal/anatomy & histology , Anatomic Variation , Cadaver , FasciaABSTRACT
Background: Frozen shoulder is defined as the painful and disabling condition with unknown etiology. It has a limited shoulder range of motion due to decreased capsular flexibility and altered muscle function. Assessment on the frozen shoulder is needed, and it is vital to know the alteration in scapular muscles in the shoulder range of motion during arm elevation. The intention of conducting this study is to reach conclusions of tightness of a muscle in the upper trapezius, pectoralis minor muscle, and frozen shoulder levator scapulae showing limited ranges. Methods: In this cross-sectional observational study, 50 subjects of age 30 and above were assessed for muscle length in the frozen shoulder and unaffected shoulder. Subjects with shoulder pain with frozen shoulder stage 2 and above are allotted into the affected shoulder, and unaffected shoulder; both groups were assessed. The following parameters were measured: ROM of the shoulder, SPADI ratings, short pectoral thickness, levator scapulae length, and upper trapezium muscle length. Results: Decreased shoulder flexion, extension, abduction, and limited rotations were the problems associated with frozen shoulder. Pearson correlation coefficient for PMI and LSI shows Positive Correlation r = 40.6% on the affected side. Pearson correlation for PMI and UTI shows Positive Correlation r = 13.4%. Pearson Correlation for LSI and UTI shows Positive Correlation r= 28.1% on the affected side. Conclusion: There was a correlation between upper trapezius, levator scapulae, and pectoralis minor muscle length. Most of the affected side shoulder showed the tightness in the pectoralis minor muscle.
ABSTRACT
Background: The axillary artery is a direct continuation of the subclavian artery. The axillary artery is usuallygives off six branches. Variation in the branching pattern of axillary artery is very commonly seen. The knowledgein variations of axillary artery is helpful in anatomy, radiology and surgery to explain unexpected clinical signsand symptoms.Materials and Methods: The present study undertaken on 30 upper limb (15 cadevers) in department of Anatomyat RKDFMCH&RC, Jatkhedi, Bhopal. None of them had any pathological lesions, traumatic lesions or surgicalprocedures in the axillary region. Bilateral dissection of axilla was conducted and the branching patterns of theaxillary artery was studied.Observations and Results: Unilateral variations were observed in two cadavers. In (6.66%) cases we observed aunique variation of early division of axillary artey. In (3.33%) cases the second part of axillary artery showsthree extra branches (alar artery) In (3.33%) we observed a subscapular artery arises from the second part ofaxillary artery. Up to 36% of it arises from a common trunk with posterior circumflex humeral artery. In (3.33 %),bilaterally a common trunk from II part gave origin to anterior circumflex humeral, post circumflex humeral andsubscapular artery. In 3.33% cases the circumflex scapular artery directly arises from the third part of axillaryartery. In 6.66% cases the anterior circumflex is three in number.In the rest of the cadavers, axillary artery wasnormal in its course and distribution.Conclusion: The detailed knowledge about anatomy of normal as well as variant axillary artery is very helpful forthe surgeons and radiologists performing interventional surgery
ABSTRACT
During a routine anatomical dissection we discovered an aberrant muscle slip associated with the pectoralis minor muscle that occurred bilaterally. The muscle slips originated from ribs five or six and inserted into the tendon of the coracobrachialis in close proximity the coracoid process of the scapula. Fibers of the muscle slip also blended with the pectoralis minor muscle on its lateral border. The muscle slips were innervated by the medial pectoral nerve. Reports and documentation of anatomical variants such as this provide an important resource for both researchers and clinicians.
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OBJECTIVE: To evaluate magnetic resonance imaging (MRI) observer variability to detect ectopic insertion of the pectoralis minor tendon (EIPMT) and to investigate changes in the rotator interval in patients with EIPMT using MRI. MATERIALS AND METHODS: A total of 507 shoulder MRIs (male:female = 259:248; mean age, 55.4 years) were classified into 1) normal type insertion of the pectoralis minor tendon, 2) complete type EIPMT, and 3) partial type EIPMT independently by two radiologists. Inter-observer agreement was calculated using the kappa coefficient. Thickness of the fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess was measured. MRIs were reviewed by consensus with regard to the grade of fibrotic scar tissue proliferation in the rotator interval. Comparisons were made between normal and EIPMT and between partial and complete type EIPMT. RESULTS: The incidence of EIPMT was 13.4% (complete type, 7.7%; partial type, 5.7%). Inter-observer agreement was substantial (kappa = 0.775). Fibrotic scar tissue in the subcoracoid triangle was thicker, and the grade of fibrotic scar tissue proliferation in the rotator interval was higher in the EIPMT group than those in the control group. No significant difference was observed in the thickness of humeral side axillary recess. The thicknesses of fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess as well as the grade of fibrotic scar tissue in the rotator interval were not significantly different between complete and partial type EIPMT. CONCLUSION: MRI enabled detection of EIPMT with substantial observer agreement. Patients with EIPMT show a high tendency for fibrotic scar tissue proliferation in the rotator interval.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Magnetic Resonance Imaging , Rotator Cuff/pathology , Shoulder/pathology , Tendons/pathologyABSTRACT
Objective We reported the rehabilitative nursing points of patients with pectoralis minor muscle transplantation for recovery of thumb oppositional function. Methods We selected 10 patients who underwent pectoralis minor muscle transplantation for recovery of thumb oppositional function and gave them perfect preoperative examination and psychological nursing. We also implemented rigorous monitoring postoperation and auxiliary electric stimulation and functional exercises. The emphasis was put on the exercise of thumb oppositional function. Results The thumb oppositional function of all the ten patients recovered. The myodynamia reached level 4 and the shape of thenar was satisfying after 6 to 12 months of follow-up visit. Conclusions Sufficient preoperative psychological nursing and effective postoperative rehabilitative treatment had pivotal significance for the success of operation and the recovery of thumb oppositional function.
ABSTRACT
Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.