Cadaveric Study of Variation in the Formation of Trunks of Brachial Plexus, Embryological Basis and its Clinical Significance

Authors

  • Gulam Anwer Khan Department of Anatomy, Chitwan Medical College, CMC, Bharatpur, Nepal Author
  • Shekhar K Yadav Department of Anatomy, Chitwan Medical College, CMC, Bharatpur, Nepal Author
  • S Khatiwoda Department of Anatomy, Chitwan Medical College, CMC, Bharatpur, Nepal Author
  • R Chetri Department of Anatomy, College of Medical sciences, CMS, Bharatpur, Nepal Author

DOI:

https://doi.org/10.21276/3wkj5637

Keywords:

Brachial plexus, Upper trunk, Middle trunk, Lower trunk

Abstract

Background: Brachial plexus is the plexus of nerves that supplies the upper limb. Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare.

Methods: Here, we report one of such rare variations in the formations of the upper trunk, middle trunk, and lower trunk of the brachial plexus in the right and left upper limb of a male and female cadaver.

Results: In the present study1 limb (1.6%), there was absence of the upper trunk on the left side of a male cadaver with approximate age of 20 years. And In 1 limb (1.6%), upper trunk of the brachial plexus was found unilaterally on the right side of a male cadaver aged approximately 55 years. the upper trunk was present in 2 limbs (3.3%), both on the right side of male cadavers with approximate age of 55 and 50 years In both cases, C5 and C6 roots were split in anterior and posterior divisions (Figure No. 5). Both anterior divisions joined to give origin to an “anterior superior trunk” and both posterior divisions joined to give origin to a “posterior superior trunk”. These trunks joined to give origin to the superior (upper) trunk. In 2 limbs (3.3%) The middle trunk was absent. in the right upper limb (1.6%) of a male cadaver with approximate age of 35 years the lower trunk was formed by the union of ventral rami of C7, C8 and T1 nerve roots. ConclusionsThe knowledge of variations in the formation of brachial plexus is very useful for the anatomists, radiologists, anesthesiologists, neurosurgeons and orthopedic surgeons.

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References

Standring S, Ellis H, Healy JC, Johnson D, Williams A, Collins P et al. Gray’s Anatomy. In: Pectoral girdle, shoulder region and axilla. 39th ed. Elsevier Churchill Livingstone. Philadelphia. 2005; p. 846-8.

Datta AK. Essentials of Human Anatomy- Superior and Inferior Extremities. In: The Axilla. 4th ed. Current Books International. Kolkata. 2009. p. 49-52.

Brown MC, Hopkins WG and Keynes R J. Axon guidance and target recognition. In: Essentials of neural development. Cambridge University Press. Cambridge. 1991; p. 46-66.

Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE et al. Gray’s Anatomy. In: Embryology and Development of Nervous System and Special Sense Organs. 38th ed. Churchill Livingstone. London. 1999; p. 231-2.

Larsen WJ. Human Embryology. In. Development of limbs. 2nd ed. Churchill Livingstone. Edinburgh. 1997; p. 311-39.

Uysal II, Seker M, Karabulut AK et al. Brachial plexus variations in human fetuses. Neurosurgery. Sep 2003; 53(3): 676-84; discussion 684.

Harry WG, Bennett JD, Guha SC. Scalene muscles and the brachial plexus: anatomical variations and their clinical significance. Clin. Anat. 1997; 10: 250–2

Abhaya A, Khanna J and Prakash R. Variation of the lateral cord of brachial plexus piercing coracobrachialis muscle. Journal of the Anatomical Society of India. 2003; 52(2): 168-70.

Matejcik V. Aberrant formation and clinical picture of brachial plexus from the point of view of a neurosurgeon. Bratisl. Lek. Listy. 2003; 104: 291–9.

Matejcik V. Variations of nerve roots of the brachial plexus. Bratisl. Lek. Listy. 2005; 106: 34–6.

Lee HY, Chung IH, Sir WS et al. Variations of the ventral rami of the brachial plexus. J. Korean Med. Sci. 1992; 7:19–24.

Matejcik V. Anatomic variations in the brachial plexus trunks and nerve roots. Rozhl. Chir. 2003; 82:456–9.

Moore KL, Persaud TV. Before we are born. The musculoskeletal system. 7th ed. Saunders Elsevier; Philadelphia. 2003; 243-4.

Morgan BA, Tabin C. Hox genes and growth: early and late roles in limb bud morphogenesis. Dev Suppl. 1994; p 181-6.

Satheesha N, Nagabhooshana S, Venkata R et al. A rare variation in the formation of the upper trunk of the brachial plexus. Neuroanatomy. 2005; 4: 37-8.

Kumar B, Vishnumaya G. Variation in the branching pattern of posterior cord of brachial plexus. J Neuro anatomy. 2008; 7:10.

Raphael DT, Mclntee D, Suruda JS et al. Frontal Slah composite magnetic resonance neurography of the brachial plexus: implications for infraclavicular block approaches. J Anesthesiolog. 2005; 103:1218-24

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Published

10.04.2024

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Section

ORIGINAL ARTICLES ~ General Surgery

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