Study of Variations in the Course of Brachial Artery: A Cadaveric Study

Background: Brachial artery begins as a continuation of axillary artery at the distal border of teres major, runs downward at first medial to the humerus and then inclines to lie in front of the bone until it appears in the cubital fossa, where it ends at the level of the neck of radius by dividing into radial and ulnar arteries. Objectives: To know the variations in the course of brachial artery. Methods: Dissection was done on 40 upper limbs from embalmed adult human cadavers in the Department of Anatomy, Kamineni Institute of Medical Sciences, Narketpally. Dissection of Brachial artery was carried out according to Cunningham’s manual of practical anatomy. Results: In all 40 specimens (100%), the brachial artery begins at the inferior border of the teres major muscle as the continuation of the axillary artery. In 37 specimens (92.5%), single brachial artery (BA) was present in the arm. It runs inferiorly on the medial side of the biceps brachii muscle to the cubital fossa. It divides into the radial artery (RA) and ulnar artery (UA) opposite the neck of radius at elbow. In 3 specimens (7.5%), doubling of the brachial artery in its course was observed. In these specimens, the brachial artery was divided into two divisions in the arm. Both divisions runs inferiorly on the medial side of the biceps brachii muscle to the cubital fossa. In these two divisions, one lies superficial to the median nerve and was called the superficial brachial artery (SBA) and other division continues as the brachial artery proper (BAP). In all these 3 specimens (7.5%), the superficial brachial artery (SBA) continued as the radial artery (RA) and brachial artery proper (BAP) continued as the ulnar artery (UA) in the cubital fossa. Interpretation and Conclusion: The present study is important for Surgeons, Orthopedicians, Vascular surgeons, Clinicians and Anatomists as it provides the knowledge of variations in the course of brachial artery in the arm and cubital fossa.

Arterial And Neural Variations In The Right Upper Limb: A Case Report

Background: Variations of the arteries, nerves and muscles of the upper limb have both clinical and surgicalimportance. The superficial brachial artery origination from the third part of the axillary artery, communicationsbetween the musculocutaneous and median nerves, variant formation of the brachial plexus, origination of theProfunda brachii artery from the posterior circumflex humeral artery have been well documented. We describehere the other variations in the upper limbs of a male cadaver.Case Report: During our routine dissection studies on a 50year old male cadaver we encountered variations inRight upper limb.Observations: In this case we observed the axillary artery gives two terminal branches the first was the superficialbrachial artery and the second was a common trunk for the sub scapular,brachial, posterior circumflex humeral and anterior circumflex humeral arteries. Superficial brachial arterygive Radial and Ulnar arteries. Variant formations of the brachial plexus i.e., medial root of median nerveoriginate from both lateral and medial cord.Conclusion: We think that such variations should be kept in mind during surgical and diagnostic procedures.Variation in the brachial plexus medial root of median nerve originate from both lateral and medial cord mightbe of significance in diagnostic clinical neurophysiology.

Nerve Entrapment In The Osseoaponeurotic Tunnel Mimicking Struther’s Ligament Associated With Superficial Brachial Artery: An Embryological Error

Introduction: Coracobrachialis muscle is well known for its morphological variations. Anatomical variation ofcoracobrachialis near its insertion can cause compression of median nerve and brachial artery by mimickingstruther’s ligament. Our aim of the study was to examine and record the variations in origin and insertion ofcoracobrachialis muscle and to see their relationship with the median nerve and brachial artery.Methodology: During routine dissection for undergraduate students in KFMSR, 64 upper limbs were dissectedand observed for any variations in origin and insertion of Coracobrachialis muscle.Results: Of the 64 upper limbs dissected, we noted that in one cadaver, there were two heads of origin forcoracobrachialis muscle and there was also a variation in the insertion as abnormal slips, which were attachedto antebrachial fascia. The blood supply to this muscle was from the muscular branches of superficial brachialartery.Conclusion: The knowledge of this type of variations is important for surgeons, radiologists, neurologists andphysiotherapists for proper decision making during surgical considerations and injuries around elbow joint.Neurovascular structures like median nerve and superficial brachial artery may be compressed by the abnormalslips of coracobrachialis close to insertion.

Origen alto de la arteria radial (Arteria braquirradial superficial): Presentación de 3 casos / High origin of the radial artery (superficial brachialarterial artery): Presentation of 3 cases

Se presentan tres casos de nacimiento alto de la arteria radial, todos en el miembro derecho, uno a nivel del tercio superior de la arteria braquial, el segundo caso a nivel del tercio medio de la misma y en el tercer caso el nacimiento de la arteria radial se produce a nivel de la arteria axilar. En todos los casos tienen un trayecto superficial en el brazo y antebrazo. En la mano forman el arco palmar arterial profundo de manera habitual. Estos casos representan el 7,5% de los 40 miembros disecados. El origen alto de la arteria radial es la variante más frecuente dentro de las anomalías del árbol arterial del miembro superior. Su importancia radica en el aumento de los procedimientos percutáneos sobre la arteria radial en cateterismos coronarios y en el cada vez más utilizado colgajo radial en las cirugías reconstructivas. Su trayecto superficial favorece los traumatismos y la confusión con venas, situación que puede ocasionar inyecciones medicamentosas accidentales en estas arterias con sus graves consecuencias.

We present three cases of high birth of the radial artery, all on the right limbone at the upper third of the brachial artery, the second at the middle third of the artery, and in the third case the radial artery arises at the level of the axillary artery. In all cases they have a superficial path in the arm and forearm. In the hand they form the deep arterial arch of the palmar in the usual way. These cases represent 7.5% of the 40 dissected members. The high birth of the radial artery is the most frequent variant within the arterial tree anomalies of the upper limb. Its importance lies in the increase of the percutaneous procedures on the radial artery in coronary catheterisms and in the increasingly used radial flap in the reconstructive surgeries. Its superficial pathway favors trauma and confusion with veins, a situation that can cause accidental drug injections in these arteries with their serious consequences.

Superficial Ulnar Artery Rerouted with Embryological Basis- A Case Report.

Variations in course of the arteries are well documented. Knowledge of the variation of the arterial system is important during vascular and reconstructive surgeries, in the evaluation of angiographic images. During routine anatomical dissection of upper limb ,of adult male cadaver of 55 years in Department of anatomy, SNMC, Agra, we came across a variant origin of the ulnar artery, instead of terminal division of brachial artery it arose from the brachial artery at its lower 1/3 part ,also it followed a superficial course. Brachial artery in the cubital fossa divided into radial artery and common interosseous artery, also the anterior and posterior ulnar recurrent branches arose from the common interosseous branch instead of ulnar artery. Knowledge of this variation is important for anatomist, embryologist, radiologists keep pace with new emerging variations, also for orthopaedicians, surgeons for planning appropriately operative procedures involving this region.

Unilateral Superficial Brachial Artery With High Origin Of Profunda Brachii Artery.

Abstracts: Variations of the axillary artery have been frequently observed during routine anatomy dissection classes. These variations of vascular system are of considerable significance for surgical and radiological procedures. Accurate knowledge of these variations is desirable as well as essential as they may be mistaken for veins that may lead to formation of gangrene and even loss of hand during surgical procedures. Reported here is one such case of A unilateral superficial brachial artery with a high origin of Profunda Brachii artery (PBA) as observed during routine dissection class of medical students at Rohilkhand Medical College, Bareilly, India.

Median nerve’s loop in the arm penetrated by a superficial brachial artery: case report and neurosurgical considerations.

Median nerve is commonly formed by the union of the lateral and medial cord of the brachial plexus, which embrace the third part of the axillary artery. Formation of a median nerve’s loop is a very rare condition. We present a cadaveric case, in which the right median nerve was found at the upper arm forming a fusiform neural loop penetrated by a superficial brachial artery, which continued over the forearm as the radial artery. The literature concerning nerve loops and traversing arteries is discussed, as well as the relevant embryology. We consider that such nerve loops constitute vulnerable sites of the nerve trunk since it is compressed by the pulsation of the abnormal traversing artery. Moreover, neurosurgeons should keep in mind that in case of existing arterial variation, variation of the associated neural structures may co-exist.

Superficial Brachial Artery: Its Embryological and Clinical Significance.

The principal arteries of the upper limb show a wide range of variations that are of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of bilateral superficial brachial artery found during the routine dissection of the upper limbs of a 50-year-old female cadaver. In both the limbs, the third part of the axillary artery divided into superficial brachial and deep brachial arteries; denominated according to their relation to the median nerve. The superficial brachial artery continued in the arm without giving any branches and ended in the cubital fossa dividing into radial and ulnar arteries. The deep brachial artery gave rise to anterior circumflex humeral, posterior circumflex humeral and profunda brachii arteries. Earlier superficial brachial artery has been reported with a prevalence rate varying from 0.2% to 25% but bilateral variation is extremely rare. The great variability of this arterial pattern may be attributed to the failure of regression of some paths of the embryonic arterial trunks.1 The embryological and clinical significance of this variant are also discussed in detail.

Arteria braquial superficial bilateral. una variación anatómica infrecuente con implicancias clínicas y quirúrgicas / Bilateral superficial brachial artery. a rare anatomical variation with clinical and surgical implications

Las variaciones del sistema arterial en el miembro superior son relevantes debido a la gran cantidad de procedimientos diagnósticos, invasivos y terapéuticos realizados en la actualidad. Reportamos una variante poco frecuente de la arteria braquial superficial (ABS) encontrada bilateralmente en los miembros superiores. En ambos miembros la ABS descendió superficial y lateral al nervio mediano y medial a la cabeza corta del músculo bíceps braquial. La ABS derecha terminó en la fosa cubital se unió a la arteria braquial en un tronco común, una variación anatómica rara de tipo isla, mientras que la ABS izquierda terminó en el antebrazo como arteria radial. La presencia unilateral de la ABS se ha informado con una frecuencia relativa, pero una variación bilateral es extremadamente rara. La relevancia de la embriología, incidencia y clínica de esta variación anatómica se discuten.

Variations of the upper limb arterial system are an important consideration due to the large number of invasive, diagnostic and therapeutic procedures performed in this region. We report a rare variant of the superficial brachial artery (SBA) found bilaterally in the upper limbs. In both limbs the SBA desending superficial and lateral of median nerve, and medial to the short head of bicep brachii muscle. Right SBA finished in the cubital fossa joined the deep brachial artery in a common trunk, a rare anatomical variation of island type, while the left SBA finished in the forearm and radial artery. The unilateral presence of the SBA reported with relative frequency, but a bilateral variation is extremely rare. The relevance of embryology, and clinical incidence of this anatomical variation are discussed.

A Morphological Study of Axillary Artery and Its Branching Pattern.

The vascular anatomy of the human upper limb which is man’s important earning tool, is a complex and challenging area. The arterial supply of the upper limb is mainly maintained by brachial artery through its branches. Recent progress in vascular surgery has engendered a need for precise knowledge of the frequency of anatomical variations in the branching pattern of axillary artery. Upperlimb injuries are the most frequent occupational accidents. Awareness of variations in the anatomy of brachial artery and its branches is important to avoid serious complications while treating the cases of arterio-venous fistulae, aneurysms and abscess drainage in the region of axilla, arm and cubital fossa. The present study was undertaken on 54 upper limbs of both sexes from embalmed adult human cadavers . The specimens were studied by detailed dissection method. In the present study, 59.3% of specimens showed variations of axillary artery. Better anatomical knowledge about the branches of brachial artery and their variations are important for surgeons, physicians, radiologists and interventionists, because based on anatomical study, new diagnostic and therapeutic approaches can be proposed.

A case report on variant ulnar artery.

During routine dissection for 1st MBBS students on 65 year old donated embalmed male cadaver in the Department of Anatomy, K.J.Somaiya Medical College, Sion, Mumbai, India, we observed an unusual branch of the brachial artery. The brachial artery terminated in the cubital fossa into radial and common interosseous arteries. The radial artery had normal course and branches. The common interosseous artery was deeper and gave anterior and posterior ulnar recurrent arteries, and terminated into anterior and posterior interosseous arteries. The unusual large branch from the brachial artery was a variant of ulnar artery, arose from the lateral side of the brachial artery, descended on the lateral side upto the cubital fossa and crossed the fossa from lateral to medial, superficial to median nerve. It then descended superficial to the muscles arising from medial epicondyle of the humerus and was covered by the deep fascia of the forearm, pierced the deep fascia proximal to the wrist, crossed the flexor retinaculum, and formed the superficial palmar arch. Throughout its course, this artery gave no branch. There was no associated altered anatomy of the nerves observed in the specimen. The left upper limb of the same cadaver was normal. The photographs of the variations were taken for proper documentation and for ready reference. The embryological basis of the variation is presented.

Variations of the Superficial Brachial Artery in Korean Cadavers

The superficial brachial artery (SBA), a branch of the axillary artery, is one of the most common arterial variations in this area. While it is more vulnerable to accidental arterial injection or injury, it could be useful for the nourishment of a medial arm skin free flap. To analyze the relationship between the SBA of axillary origin and segmental variation of the axillary artery, we dissected 304 arms of Korean cadavers. We found an SBA of axillary origin in 12.2% of cadaveric arms. Unilateral occurrence was detected in 16 cadavers and bilateral in 10. SBAs gave rise to radial and ulnar arteries in the cubital fossa (8.9%), continued in the forearm as the radial artery (2.3%), or ended in the upper arm (1.0%). The SBA ended as ulnar artery was not found in any of the cadavers. The bifurcation of the SBA into the radial and ulnar arteries, presence of an SBA that ends in the upper arm, and the lack of continuation as the ulnar artery are characteristics of SBAs in Korean cadavers.

A Case of Superficial Brachial Artery / 체질인류학회지

We observed a case of superficial brachial artery in the left arm of a Korean male cadaver. It was compared with the previously reported ones, and its characteristics were summarized as follows. 1. The superficial brachial artery, which arose from the axillary artery at the superior border of the teres major muscle, passed in front of the medial root of the median nerve and subsequently became to lie on the medial side of the median nerve. This artery crossed the median nerve anteriorly in the middle of the upper arm, then lay lateral to the median nerve in the lower part of the upper arm to the cubital fossa. 2. After giving off the deep brachial artery, several muscular branches and inferior ulnar collateral artery, the superficial brachial artery terminated in the cubital fossa by dividing into its two terminal branches, the radial and ulnar arteries. The superior ulnar collateral artery arose from the deep brachial artery, and the common interosseous artery from the ulnar artery. The course and distribution of the ulnar and radial arteries were normal. 3. It has been reported that a deeper artery, which takes the normal course of the brachial artery and continues as the common interosseous artery, usually coexists with the superficial brachial artery, even if the superficial brachial artery gives off both radial and ulnar arteries in the cubital fossa. But in our case, there was no deeper artery which passes deep to the median nerve. 4. It was presumed that this type of variation is produced by an unusual development of the superficial brachial artery that has been formed during early development as the main artery at the cost of complete degeneration of the normal brachial artery.