Abnormal Branching Pattern of the Axillary Artery and Its Clinical Significance
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Anatomical Variations of Brachial Plexus in Fetal Cadavers
DOI: 10.5137/1019-5149.JTN.21339-17.2 Received: 27.07.2017 / Accepted: 18.10.2017 Published Online: 13.11.2017 Original Investigation Anatomical Variations of Brachial Plexus in Fetal Cadavers Alparslan KIRIK1, Senem Ertugrul MUT2, Mehmet Kadri DANEYEMEZ3, Halil Ibrahim SECER4 1Etimesgut Sehit Sait Erturk State Hospital, Neurosurgery Clinic, Ankara, Turkey 2University of Kyrenia, Faculty of Medicine, Visiting Professor, Near East University, Faculty of Medicine, Department of Neurology, Girne, Turkish Republic of Northern Cyprus 3University of Health Sciences, Gulhane Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey 4University of Kyrenia, Faculty of Medicine, Visiting Professor, Near East University, Faculty of Medicine, Department of Neurosurgery, Girne, Turkish Republic of Northern Cyprus This study has been presented as an oral presentation at the 25th Scientific Congress of the Turkish Neurosurgical Society between 22 and 26 April 2011 at Antalya, Turkey. ABSTRACT AIM: The plexus brachialis is a complex structure with anatomical variations and connections with neighboring tissues. These variations may cause disparity in the motor and sensorial innervations of the upper extremity. The knowledge of anatomy and possible variations are important for performing surgical procedures in the neck, shoulder and axilla. This study was planned to demonstrate the anatomical variations of the infantile brachial plexus. MaterIAL and METHODS: A total of 20 plexus brachialis from 11 fetal cadavers were dissected and examined microscopically. The branching patterns and variations were evaluated. The width of the nerves was assessed at the level of the nerve root, trunk and cord on the basis of all brachial plexuses and they were arranged in terms of thickness. -
Accessory Subscapularis Muscle – a Forgotten Variation?
+Model MORPHO-307; No. of Pages 4 ARTICLE IN PRESS Morphologie (2017) xxx, xxx—xxx Disponible en ligne sur ScienceDirect www.sciencedirect.com CASE REPORT Accessory subscapularis muscle — A forgotten variation? Muscle subscapulaire accessoire — Une variation oubliée ? a a a b L.A.S. Pires , C.F.C. Souza , A.R. Teixeira , T.F.O. Leite , a a,∗ M.A. Babinski , C.A.A. Chagas a Department of morphology, biomedical institute, Fluminense Federal university, Niterói, Rio de Janeiro, Brazil b Interventional radiology unit, radiology institute, medical school, university of São Paulo, São Paulo, Brazil KEYWORDS Summary The quadrangular space is a space in the axilla bounded by the inferior margin of Anatomic variations; the teres minor muscle, the superior margin of the teres major muscle, the lateral margin of Accessory the long head of the triceps brachii muscle and the surgical neck of the humerus, medially. subscapularis muscle; The axillary nerve (C5-C6) and the posterior circumflex humeral artery and veins pass through Axillary nerve; this space in order to supply their territories. The subscapularis muscle is situated into the Subscapularis muscle scapular fossa and inserts itself into the lesser tubercle of the humerus, thus helping stabilize the shoulder joint. A supernumerary muscle known as accessory subscapularis muscle originates from the anterior surface of the muscle and usually inserts itself into the shoulder joint. It is a rare variation with few reports of its existence and incidence. We present a case of the accessory subscapularis muscle in a male cadaver fixated with a 10% formalin solution. The muscle passed anteriorly to the axillary nerve, thus, predisposing an individual to quadrangular space compression syndrome. -
Evaluation of Artery Visualizations for Heart Disease Diagnosis
Evaluation of Artery Visualizations for Heart Disease Diagnosis Michelle A. Borkin, Student Member, IEEE, Krzysztof Z. Gajos, Amanda Peters, Dimitrios Mitsouras, Simone Melchionna, Frank J. Rybicki, Charles L. Feldman, and Hanspeter Pfister, Senior Member, IEEE Fig. 1. Left: Traditional 2D projection (A) of a single artery, and 3D representation (C) of a right coronary artery tree with a rainbow color map. Right: 2D tree diagram representation (B) and equivalent 3D representation (D) of a left coronary artery tree with a diverging color map. Abstract—Heart disease is the number one killer in the United States, and finding indicators of the disease at an early stage is critical for treatment and prevention. In this paper we evaluate visualization techniques that enable the diagnosis of coronary artery disease. A key physical quantity of medical interest is endothelial shear stress (ESS). Low ESS has been associated with sites of lesion formation and rapid progression of disease in the coronary arteries. Having effective visualizations of a patient’s ESS data is vital for the quick and thorough non-invasive evaluation by a cardiologist. We present a task taxonomy for hemodynamics based on a formative user study with domain experts. Based on the results of this study we developed HemoVis, an interactive visualization application for heart disease diagnosis that uses a novel 2D tree diagram representation of coronary artery trees. We present the results of a formal quantitative user study with domain experts that evaluates the effect of 2D versus 3D artery representations and of color maps on identifying regions of low ESS. We show statistically significant results demonstrating that our 2D visualizations are more accurate and efficient than 3D representations, and that a perceptually appropriate color map leads to fewer diagnostic mistakes than a rainbow color map. -
Ipsilateral Subclavian Steal in Association with Aberrant Origin of the Left Vertebral Artery from the Aortic Arch
411 Ipsilateral Subclavian Steal in Association with Aberrant Origin of the Left Vertebral Artery from the Aortic Arch John Holder1 Five cases are reported of left subclavian steal syndrome associated with anomalous Eugene F. Binet2 origin of the left vertebral artery from the aortic arch. In all five instances blood flow at Bernard Thompson3 the origin of the left vertebral artery was in an antegrade direction contrary to that usually reported in this condition. The distal subclavian artery was supplied via an extensive collateral network of vessels connecting the vertebral artery to the thyro cervical trunk. If a significant stenosis or occlusion is present within the left subc lavi an artery proximal to the origin of the left vertebral artery, the direction of the bl ood fl ow within the vertebral artery will reverse toward the parent vessel (retrograde flow). This phenomenon occurs when a negative pressure gradient of 20-40 torr exists between the vertebral-basilar artery junction and th e vertebral-subc lavian artery junction [1-3]. We describe five cases of subclavian steal confirmed by angiography where a significant stenosis or occlusion of the left subclavian artery was demonstrated in association with anomalous origin of th e left vertebral artery directly from the aortic arch. In all five cases blood flow at the origin of the left vertebral artery was in an antegrade direction contrary to that more commonly reported in the subclavian steal syndrome. Materials and Methods The five patients were all 44- 58-year-old men. Three sought medical attention for symptoms specificall y related to th e left arm . -
Redalyc.Variations in Branching Pattern of the Axillary Artery: a Study
Jornal Vascular Brasileiro ISSN: 1677-5449 [email protected] Sociedade Brasileira de Angiologia e de Cirurgia Vascular Brasil Astik, Rajesh; Dave, Urvi Variations in branching pattern of the axillary artery: a study in 40 human cadavers Jornal Vascular Brasileiro, vol. 11, núm. 1, marzo, 2012, pp. 12-17 Sociedade Brasileira de Angiologia e de Cirurgia Vascular São Paulo, Brasil Available in: http://www.redalyc.org/articulo.oa?id=245023701001 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ORIGINAL ARTICLE Variations in branching pattern of the axillary artery: a study in 40 human cadavers Variações na ramificação do padrão da artéria axilar: um estudo em 40 cadáveres humanos Rajesh Astik1, Urvi Dave2 Abstract Background: Variations in the branching pattern of the axillary artery are a rule rather than an exception. The knowledge of these variations is of anatomical, radiological, and surgical interest to explain unexpected clinical signs and symptoms. Objective: The large percentage of variations in branching pattern of axillary artery is making it worthwhile to take any anomaly into consideration. The type and frequency of these vascular variations should be well understood and documented, as increasing performance of coronary artery bypass surgery and other cardiovascular surgical procedures. The objective of this study is to observe variations in axillary artery branches in human cadavers. Methods: We dissected 80 limbs of 40 human adult embalmed cadavers of Asian origin and we have studied the branching patterns of the axillary artery. -
ANGIOGRAPHY of the UPPER EXTREMITY Printed in the Netherlands by Koninklijke Drukkerij G.J.Thieme Bv, Nijmegen ANGIOGRAPHY of the UPPER EXTREMITY
1 f - h-' ^^ ANGIOGRAPHY OF THE UPPER EXTREMITY Printed in The Netherlands by Koninklijke drukkerij G.J.Thieme bv, Nijmegen ANGIOGRAPHY OF THE UPPER EXTREMITY PROEFSCHRIFT ter verkrijging van de graad van Doctor in de Geneeskunde aan de Rijksuniversiteit te Leiden, op gezag van de Rector Magni- ficus Dr. A. A. H. Kassenaar, Hoogleraar in de faculteit der Geneeskunde, volgens besluit van het college van dekanen te verdedigen op donderdag 6 mei 1982 te klokke 15.15 uur DOOR BLAGOJA K. JANEVSKI geborcn 8 februari 1934 te Gradsko, Joegoslavie MARTINUS NIJHOFF PUBLISHERS THE HAGUE - BOSTON - LONDON 1982 PROMOTOR: Prof. Dr. A. E. van Voorthuisen REPERENTEN: Prof. Dr. J. M. F. LandLandsmees r 1 Prof. Dr. J. L. Terpstra ! I Copyright © 1982 by Martinus Nijhoff Publishers, The Hague All rights reserved. No part of this publication may be repro- duced, stored in a retrieval system, or transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise, without the prior written permission of the pub- lishers, Martinus Nijhoff Publishers,P.O. Box 566,2501 CN The Hague, The Netherlands if ••»• 7b w^ wife Charlotte To Lucienne, Lidia and Dejan h {, ,;T1 ii-"*1 ™ ffiffp"!»3^>»'*!W^iyJiMBiaMMrar^ ACKNOWLEDGEMENTS This thesis was produced in the Department of Radiology, Sirit Annadal Hospital, Maastricht. i Case material: Prof. Dr. H. A. J. Lemmens, surgeon. Technical assistence: Miss J. Crijns, Mrs. A. Rousie-Panis, Miss A. Mordant and Miss H. Nelissen. Secretarial help: Mrs. M. Finders-Velraad and Miss Y. Bessems. Photography: Mr. C. Evers. Graphical illustrations: Mr. C. Voskamp. Correction English text: Dr. -
Thoracic Outlet and Pectoralis Minor Syndromes
S EMINARS IN V ASCULAR S URGERY 27 (2014) 86– 117 Available online at www.sciencedirect.com www.elsevier.com/locate/semvascsurg Thoracic outlet and pectoralis minor syndromes n Richard J. Sanders, MD , and Stephen J. Annest, MD Presbyterian/St. Luke's Medical Center, 1719 Gilpin, Denver, CO 80218 article info abstract Compression of the neurovascular bundle to the upper extremity can occur above or below the clavicle; thoracic outlet syndrome (TOS) is above the clavicle and pectoralis minor syndrome is below. More than 90% of cases involve the brachial plexus, 5% involve venous obstruction, and 1% are associate with arterial obstruction. The clinical presentation, including symptoms, physical examination, pathology, etiology, and treatment differences among neurogenic, venous, and arterial TOS syndromes. This review details the diagnostic testing required to differentiate among the associated conditions and recommends appropriate medical or surgical treatment for each compression syndrome. The long- term outcomes of patients with TOS and pectoralis minor syndrome also vary and depend on duration of symptoms before initiation of physical therapy and surgical intervention. Overall, it can be expected that 480% of patients with these compression syndromes can experience functional improvement of their upper extremity; higher for arterial and venous TOS than for neurogenic compression. & 2015 Published by Elsevier Inc. 1. Introduction compression giving rise to neurogenic TOS (NTOS) and/or neurogenic PMS (NPMS). Much less common is subclavian Compression of the neurovascular bundle of the upper and axillary vein obstruction giving rise to venous TOS (VTOS) extremity can occur above or below the clavicle. Above the or venous PMS (VPMS). -
Anatomical Study of the Clavicular Branch of the Thoracoacromial Artery
MOJ Anatomy & Physiology Research Article Open Access Anatomical study of the clavicular branch of the thoracoacromial artery Abstract Volume 7 Issue 3 - 2020 Introduction: The etiology and the complexity of losses of substances from the chest Philippe Manyacka Ma Nyemb,1,2 Christian wall cause technical difficulties during their reconstruction. In order to obtain the best Fontaine,3 Véronique Duquennoy-Martinot,4 possible functional and morphological results, it is important to appreciate the lesions. 3,5 When considering soft tissue reconstruction, the dimensions, location and shape of losses Xavier Demondion 1Department of Anatomy and Organogenesis, Gaston Berger of substances, as well as the reliability and the arc of rotation of the chosen flap, must University, Senegal be taken into account. The perforator flap of the thoracoacromial artery and its vascular 2Department of General Surgery, Regional Hospital, Senegal anatomical bases have been recently studied, concerning the pectoral and deltoid branches. 3Department of Anatomy and Organogenesis, University de Lille The clavicular branch has only been rarely studied. We propose to study anatomically the 2, France clavicular branch of the thoracoacromial artery, in terms of constancy, dimensions and 4Department of Plastic, Esthetic and Reconstructive Surgery, direction, in order to give to practitioners an additional option in the surgery of perforator Lille University Hospital, France flaps of the cervical region. 5Department of Musculoskeletal Imaging, Lille University Hospital, France Material and methods: We carried out a direct and selective injection of 24 thoracoacromial arteries, on corpses preserved in a low-formalin solution rich in glycerin. The injected Correspondence: Philippe Manyacka MA Nyemb, Laboratory solution was made from a mixture of methylene blue and gelatin. -
Variation of the Origin of the Lateral Thoracic Artery. Case Report
Revista Română de Anatomie funcţională şi clinică, macro- şi microscopică şi de Antropologie Vol. XVII – Nr. 4 – 2018 CLINICAL ANATOMY VARiation OF THE ORIGin OF THE LatERAL THORacic ARTERY. CASE REPORT Tamás-Csaba Sipos2, Lóránd Dénes1*, Klara Brînzaniuc1, Annamária Szántó1, Zoltán Pávai1, Zsuzsánna Pap1 University of Medicine, Pharmacy, Sciences and Technology of Tîrgu-Mureş 1. Department of Anatomy and Embryology 2. Student, GM 6th year VARIATION OF THE ORIGIN OF THE LATERAL THORACIC ARTERY. Case RePORT (Abstract): Introduction: Anatomical variations of the origin of axillary artery branches are quite common. The most frequent variations are common trunks or emergence from a different segment than the classical description. Material and method: A formalin fixed male human cadaver has been dissected during teaching classes for medical students at the Anatomy and Embryology De- partment of UMFST Târgu Mureş. We observed a pattern of origins of the axillary artery branch- es different from the classical description. Results: The second part of the axillary artery provides the superior thoracic artery and the thoraco-acromial artery from its anterior surface, while the subscapular artery separates from its posterior surface. The lateral thoracic artery is a branch of the subscapular artery. The anterior and posterior circumflex humeral arteries come from the third part of the axillary artery, which corresponds to the classical description. Conclusions: Published studies report multiple variations regarding the origin of the axillary artery branches. Most com- monly, the lateral thoracic artery originates from the subscapular artery, which is the case in our study as well. Key-words: LATERAL THORACIC ARTERY, vaRIATION, SUBSCAPULAR ARTERY INTRODUCTION provides six branches, which are grouped ac- Arterial supply to the thoraco-scapulo-hu- cording to its parts: the first part gives off the meral area is provided by the branches of the superior thoracic artery, the second part pro- axillary artery. -
Vessels and Circulation
CARDIOVASCULAR SYSTEM OUTLINE 23.1 Anatomy of Blood Vessels 684 23.1a Blood Vessel Tunics 684 23.1b Arteries 685 23.1c Capillaries 688 23 23.1d Veins 689 23.2 Blood Pressure 691 23.3 Systemic Circulation 692 Vessels and 23.3a General Arterial Flow Out of the Heart 693 23.3b General Venous Return to the Heart 693 23.3c Blood Flow Through the Head and Neck 693 23.3d Blood Flow Through the Thoracic and Abdominal Walls 697 23.3e Blood Flow Through the Thoracic Organs 700 Circulation 23.3f Blood Flow Through the Gastrointestinal Tract 701 23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 705 23.3h Blood Flow Through the Upper Limb 705 23.3i Blood Flow Through the Lower Limb 709 23.4 Pulmonary Circulation 712 23.5 Review of Heart, Systemic, and Pulmonary Circulation 714 23.6 Aging and the Cardiovascular System 715 23.7 Blood Vessel Development 716 23.7a Artery Development 716 23.7b Vein Development 717 23.7c Comparison of Fetal and Postnatal Circulation 718 MODULE 9: CARDIOVASCULAR SYSTEM mck78097_ch23_683-723.indd 683 2/14/11 4:31 PM 684 Chapter Twenty-Three Vessels and Circulation lood vessels are analogous to highways—they are an efficient larger as they merge and come closer to the heart. The site where B mode of transport for oxygen, carbon dioxide, nutrients, hor- two or more arteries (or two or more veins) converge to supply the mones, and waste products to and from body tissues. The heart is same body region is called an anastomosis (ă-nas ′tō -mō′ sis; pl., the mechanical pump that propels the blood through the vessels. -
Branches of Axillary Artery for PDF 13.5.11
Diagram of branches Acromial Br lar Br icu of axillary artery Clav rtery mial a oacro Thorac Deltoid Br t 1st Par d 2n Superior thoracic artery Anterior Pectoral Br circumflex t Par Pectoralis minor humeral d artery 3r Sub- scapular artery Lateral thoracic artery Circumflex scapular artery Posterior circumflex humeral artery TheFromFrom axillary 1st2nd3rd part part artery (a)superior .(a) (a) subscapular begins The thoracoacromial thoracic at the runs outer– itdown runs border artery within along the of– a the thestoutlong firstfirst subscapularshort ribintercostal trunk,and ends nerve,which space. at projustthe- lowerjectswithin border forwardthe posterior of over terres theaxillary major inner ,fold. where boarder Near it continuesof the pectoralis lower as angle the minor brachial of theand scapula dividesartery. itinto divides four branches.into two, one (i) side clavicular, goes to runs the sideup over of the subclavius chest, the ; (ii) other pectoral to the is deep large surface and runs of Thedownthe latissimusaxillary between artery with the runsthetwo longacrosspectorals subscapular the withsuperior the nerve. externalaspect Near of anterior theits origin axilla thoracic itand gives is markednerve, off a large and by asuppliesbranch, line drawn thethese circumflexfrom muscles; the middle scapular(iii) acromial, of the artery, clavicle usually which to comes apasses point off backhalf-way a common through between trunk the “triangu withthe two the- condylesdeltoid,lar space” andof tothe runs the humerus, back dorsum beneath when of the the scapula. deltoidarm is raisedtoward(b) The to the anteriora right acromion; angle. circumflex and (iv) humeral deltoid runsartery down which beside is a smallthe cephalic artery thatvein, passes in a groove out across between the frontdeltoid of andthe pectoralishumerus, Itmajor,sending is divided and a branch endsinto threein up these to partsthe muscles. -
Neurology of the Upper Limb
Neurology of the Upper limb Donald Sammut Hand Surgeon Kings Upper Limb Anatomy plus lecture notes The$Neck$ The$Nerve$roots$which$supply$the$Upper$Limb$are$C5$to$T1$ Pre<fixed$(C4$to$C8)$and$Post<fixed$(C6$to$T2)$plexus$not$uncommon.$ Also$common$contributions$from$C4$and$from$T2$in$a$normally$rooted$plexus.$ $ The$anterior$nerve$roots$emerge$between$the$vertebrae$and$immediately$pass$ $through$the$first$area$of$possible$compression:$ The$root$nerve$canal$is$bounded$$ Anteriorly$by$the$posterior$margin$of$the$intervertebral$disc$and$$ Posteriorly,$by$the$facet$joint$between$vertebrae.$ $ Pathology$of$the$disc,$or$joint,$or$both,$can$narrow$this$channel$and$compress$ $the$nerve$root$ The$roots$emerge$from$the$cervical$spine$into$the$plane$between$$ Scalenius$Anterior$and$Scalenius$Medius.$$ $ Scalenius*Anterior:** Origin:$Anterior$tubercles$of$Cervical$vertebae$C3$to$6$(C6$tubercle$is$the$Carotid$tubercle)$ Insertion:$The$scalene$tubercle$on$inner$border/upper$surface$1st$rib$ $ Scalenius*Medius:* Origin:$Posterior$tubercles$of$all$cervical$vertebrae$ Insertion:$Quadrangular$area$between$the$neck$and$subclavian$groove$1st$rib$ $ Exiting$from$the$Scalenes,$the$trunks$lie$in$the$posterior$triangle$of$the$neck.$ The$posterior$triangle$is$bounded$anteriorly$by$SternoCleidoMastoid$and$$ posteriorly$by$the$Trapezius.$ The$inferior$border$is$the$clavicle$.$ The$apex$of$the$triangle$superiorly$is$at$the$back$of$the$skull$on$the$superior$nuchal$line$ $ $ The$Posterior$Triangle$ SternoCleidoMastoid$ Trapezius$ Scalenius$Medius$ Scalenius$Anterior$