Radial artery running beneath the biceps tendon and its interrelation between the radial recurrent arteries

A radial artery running beneath the biceps tendon was found in the cadaver of a Japanese woman during a student dissection course at Kumamoto University School of Medicine in 2006. The brachial artery bifurcated into the radial artery and the ulnar artery in the cubital fossa, and the radial artery twisted laterally running beneath the biceps tendon, and when it was situated laterally to the tendon, twisted distally at the level of the radial tuberosity, and then twisted medially again. After the radial artery passed over the biceps tendon, it turned distally and continued as a normal radial artery. The superficial brachial artery, which coexisted with the brachial artery, was given off from the axillary artery and it continued to the final twist of the radial artery. The course of this radial artery is similar to the arterial rings surrounding the biceps tendon, found during the same dissection course. The arterial rings were formed between the brachial artery and the radial artery, and their proximal origins ran beneath the biceps tendon, while the distal origins were superficial. The present arterial variation is thought to have occurred when the normal part of the radial artery in the cubital fossa was substituted by the arterial ring, coexisting with the superficial brachial artery, which usually disappears during normal development. Furthermore, it is suggested that a part of the arterial ring always remains as a radial recurrent artery.     

Multiple variations in the paired arteries of the abdominal aorta

Variations in the origin of arteries in the abdomen are very common. The arteries that show frequent variations include the celiac trunk, renal arteries, and gonadal arteries. We observed multiple variations in a 45-year-old male cadaver. The variations found on the left side were: one accessory renal artery, two testicular arteries, and middle suprarenal and inferior phrenic arteries that branched from the celiac trunk. On the right side, the inferior phrenic and middle suprarenal arteries arose from the right renal artery.     

Multiple arterial variations in the upper limb of a South Indian female cadaver

In a routine dissection of a female cadaver, a variation in the course of the radial artery in the cubital fossa and a communication between the brachial artery and radial artery were observed. A rare origin and course of the median artery was also found. These anomalies are discussed in detail and their clinical relevance is highlighted.     

小脑下前动脉的应用解剖

在63个成人脑上,应用手术显微镜观测了小脑下前动脉的起始、分支、外径和该动脉在脑桥小脑角区的形态特征及其与Ⅵ、Ⅶ、Ⅷ对脑神经的局部位置关系,为临床分析脑桥小脑角综合症、血管造影及肿瘤切除等提供形态学依据。     

Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature

A total of 192 embalmed cadavers were examined in order to present a detailed study of arterial variations in the upper limb and a meta-analysis of them. The variable terminology previously used was unified into a homogenous and complete classification, with 12 categories covering all the previously reported variant patterns of the arm and forearm.     

Superficial brachial artery crossing over the ulnar and median nerves from posterior to anterior: Embryological significance

A rare variation of the superficial brachial artery was found in the right arm of an 82-year-old male cadaver in student dissection practice. In this case, the axillary artery passed normally between the medial and lateral roots of the median nerve and then bifurcated into a large superficial brachial artery and the deep brachial artery (A. brachialis profunda). The superficial brachial artery passed medially to the ulnar nerve and then crossed over to take a lateral course to the median nerve at the midpoint of the upper arm. It finally divided into the radial and ulnar arteries at the cubital fossa. The deep brachial artery terminated as the inferior ulnar collateral artery. These findings indicate that the present variant was a well-developed medial type of the superficial brachial artery that gave off the ulnar and radial arteries. The anatomical and embryological significance of the findings are discussed.     

用旋前方肌肌桥修复正中神经缺损的应用解剖

在30侧成人上肢标本上,观测了旋前方肌的形态和血供.旋前方肌血供来自骨间前动脉、桡动脉和尺动脉的旋前方肌肌支.肌的血供主要来自骨间前动脉,以骨间前血管为蒂,依据神经损伤平面的不同,可设计以旋前方肌上、中、下不同部位的肌桥为桥接体、     

Trifurcation of brachial artery with variant course of radial artery: Rare observation

Variations in the arterial pattern of the upper limb have been observed frequently, either in the routine dissections or in clinical practice. The aim of the present study was to describe the anatomical, surgical and embryological importance of major arteries of upper limbs of human beings. The present article is the report of low division and trifurcation of brachial artery and abnormal course of radial artery (passing deep to the pronator teres muscle) found in a 45-year-old embalmed male cadaver. Knowledge of the arterial variations in the upper limb is of considerable importance during invasive and non-invasive investigative procedures or orthopedic, reconstructive, or surgical procedures.     

膝下外侧动脉腓骨上段骨皮瓣移植的应用解剖

目的:为膝下外侧动脉蒂腓骨上段骨皮瓣的设计提供应用解剖学基础。方法:在42侧经动脉内灌注红色乳胶的成人下肢标本上重点观测膝下外侧动脉的起始、走行、分支、分布和吻合。结果:膝下外侧动脉始于动脉,起点距腓骨头尖上方(1.9±0.7)cm,起始部外径(1.7±0.3)mm。从起点至第一下行骨膜支距离(3.2±0.8)cm,至第一皮支距离(3.9±0.2)cm。结论:膝下外侧动脉可携带腓骨上段骨皮瓣。皮瓣面积约为9.0cm×6.0cm。     

Arterial, neural and muscular variations in the upper limbs of a single cadaver

Arterial, neural and muscular variations were observed in both upper limbs of a female adult cadaver during routine student dissection. Two superficial radial arteries were observed, which originated from the brachial and axillary arteries in the left and right upper limbs respectively. In the right upper limb, an ulnar nerve with a lateral root from the lateral cord of the brachial plexus in the axilla and, in the left forearm, an accessory muscle belly inserting into the muscle belly of the flexor digitorum superficialis were also observed. Formation of these variations is discussed on the basis of the embryological development of the upper limb structures. The clinical importance of the variations is emphasized.     

Multiple variations of the arterial pattern in upper extremities: A case report and embryological pathogenesis

During a routine dissection at the Department of Anatomy, Collegium Medicum, Jagiellonian University, one cadaver was found to have multiple variations of the arteries of the upper limbs. The variations pertained to the course of the brachial artery as well as to its distribution. An unusual formation of the superficial palmar arch was observed in both upper limbs. The anatomical peculiarities encountered included: in the left upper limb—the brachioradial artery, which formed the superficial palmar arch by turning to the palmar side of the hand and connecting with the ulnar artery and in the right upper limb—a subscapular‐circumflex humeral‐deep brachial trunk that correlated with a high division of the brachial artery (in the upper third of the biceps brachii muscle), a large anastomosis between the radial and the ulnar artery, the presence of a persistent median artery, and the unusual formation of the superficial palmar arch, which was created by the median, ulnar, and radial arteries. In this report, we will trace the path of the axillary artery and its branches in detail and emphasize its embryological significance. Clin. Anat. 26:1031–1035, 2013. © 2012 Wiley Periodicals, Inc.     

小腿前外侧和足背外侧岛状皮瓣的应用解剖

目的:为临床施行经小腿骨间膜前方游离腓动、静脉的小腿前外侧岛状皮瓣和足背外侧岛状皮瓣转位术提供解剖基础。方法:用46侧成尸下肢标本动脉灌注红色乳胶,观测腓动脉穿支及其外径,外踝前动脉弓和足背外侧动脉弓的外径及其皮支。结果:腓动脉下1/3段紧贴小腿骨间膜后方走行,发出2～5支穿支营养小腿前外侧皮肤,动脉外径(1.2±0.4)mm,穿支之间相距10～20mm不等。外踝前动脉弓外径(1.3±0.5)mm,两条伴行静脉外径分别为(1.7±0.5)mm和(1.3±0.4)mm。足背外侧动脉弓外径(1.1±0.5)mm,两条伴行静脉外径分别为(1.3±0.5)mm和(1.1±0.4)mm,发出皮支营养足背外侧皮肤。皮瓣切取范围为小腿外侧和足背外侧。结论:经小腿骨间膜前方游离腓动脉及其穿支与外踝前动脉和跗外侧动脉吻合形成的小腿前外侧和足背外侧串联岛状皮瓣,增加了血管蒂的长度,扩大了皮瓣的切取面积,增加了临床应用的灵活性。     

Aberrant axillary artery descending deep beneath the brachial plexus

An aberrant axillary artery that descended deep beneath the brachial plexus during its course was observed. The artery passed between the lateral and medial cords, as would an ordinary axillary artery, but further passed between the posterior divisions forming the posterior cord. The axillary artery turned medially to emerge from the lower border of the medial cord and finally ran as an ordinary artery. The aberrant axillary artery is judged to reach deeper to the brachial plexus, because it penetrated the posterior division of the brachial plexus from superficial to deep. It is possible to account for the formation of this artery as one of the combinations of the ordinary axillary artery and its branches, with the positional relationships between the brachial plexus.     

以膝下外血管为蒂的成人腓骨上段移植术

在24侧灌注红色乳胶的成人下肢标本和2侧新鲜截肢标本上,对腓骨上段的血供来源进行了应用解剖学研究.我们设计了以膝下外血管为蒂的成人腓骨上段移植术,已成功应用于临床.本文详细介绍了手术操作方法及其注意事项.     

Duplication of the inferior vena cava associated with other variations

Multiple vascular variations, including duplication of the inferior vena cava, double renal arteries and anomalies of the testicular blood vessels, were observed during dissection of the retroperitoneal region of a cadaver of an 87-year-old Japanese man. The right inferior vena cava arose from the union of right common iliac veins and a thinner interiliac vein. This interiliac vein ascended obliquely from right to left and joined the left common iliac veins to form the left inferior vena cava. The right and left inferior venae cavae were of approximately equal width. The right testicular vein consisted of medial and lateral venous trunks. The two venous trunks coalesced to form a single vein, which drained into the confluence of the right inferior vena cava and right renal vein. The left testicular vein was composed of the medial and lateral testicular veins, which drained into the left renal vein. Double renal arteries were seen bilaterally, which originated from the lateral aspects of the abdominal aorta. The right testicular artery arose from the right inferior renal artery and accompanied the lateral trunk of the right testicular vein running downwards. The left testicular artery arose from the ipsilateral inferior renal artery and ran downwards accompanied by the left lateral testicular vein. In addition, the bilateral kidneys showed multicystic changes.     

弧形阴茎阴囊联合皮瓣设计的解剖学基础

目的：为弧形阴茎、阴囊联合皮瓣的设计提供解剖学基础。方法：采用显微解剖、皮瓣血管透明、Ｘ线造影等方法，对３６侧阴茎和阴囊外侧皮瓣的血供来源、动脉主干走行、分支分布及吻合进行观测。结果：阴茎和阴囊外侧皮瓣的血供分别来自阴茎背浅和阴囊前动脉，前者起点外径为０．８±０．２ｍｍ，行于阴茎浅筋膜的疏松组织层。在阴茎阴囊交界区，两动脉的分支相互吻合。阴茎皮瓣的静脉回流有二套，其中阴茎背浅静脉为血液回流的主要血管。结论：阴茎、阴囊交界区动脉间有吻合，可设计成阴茎阴囊弧形联合皮瓣。该型皮瓣较长，足以满足重度尿道下裂的修复。     

A previously unreported variation related to the insertion of the tibialis anterior muscle and the superficial fibular (peroneal) nerve

During dissection classes in 2003 in the Department of Anatomy at Ege University Faculty of Medicine, an unexpected variation of the insertion of the tibialis anterior tendon was determined on the right side of a formalin-fixed cadaver of a 40-year-old man without any trace of scars, adhesions or signs of trauma or operation. The insertion of the tibialis anterior tendon was very abnormal, not on the medial side of the foot but on the lateral side. The tibialis anterior is an important muscle because of its function and use in tendon transfer as a treatment of recurrent congenital clubfoot and paralytic equinovarus foot deformities in cerebral palsy and arthroscopy, as discussed herein.