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Correspondence J. Anat. (1995) 187, pp. 503-504, with I figure Printed in Great Britain 503 Correspondence Case report: cleidocervical or levator claviculae muscle. A new embryological explanation as to its origin The cleidocervical or levator claviculae muscle is a super- together with a fascicle of levator scapulae, from the trans- numerary muscle situated in the posterior triangle of the verse process of the axis. A flat muscle belly, 10.5 cm in neck. Its reported incidence is 2-3 % (Wood, 1869; length, descended in a slightly ventral direction and ter- Macalister, 1875; Gruber, 1876; Testut, 1894; Le Double, minated by inserting into the posterior aspect of the middle 1897). The cleidocervical muscle has been described as third of the clavicle, equidistant from sternocleidomastoid having different patterns in its attachments both to the and trapezius. In its upper two-thirds the muscle was covered clavicle and to the transverse processes of the cervical verte- by sternocleidomastoid and lay anterior to omohyoid and to brae. The case presented here corresponds to a rare variant of scalenus anterior and medius. It was located lateral to the the cleidocervical muscle which has been described only once internal jugular vein, crossing superficially to the initial in the literature consulted as the cleidoepistrophicus portions of the superior cervical and suprascapular arteries, (Gruber, 1897). The muscle was unilateral and was observed the phrenic nerve and the ventral branches from the 3rd, 4th during routine dissection of the right posterior triangle of and 5th cervical nerves before they formed the greater a 65-y-old male. It was triangular in form with its vertex auricular, the transverse cutaneous nerve of the neck and the superiorly (Fig. 1). The muscle arose as a rounded tendon, supraclavicular nerves. The muscle was supplied by a branch from the 4th cervical nerve of the ascending cervical artery. These pierced the middle third of the posterior aspect of the muscle. The cadaver also displayed an additional anomaly in that omohyoid had 2 heads of origin for its superior belly: one arose from the hyoid bone and the other from the sternohyoid muscle. The cleidocervical muscle appears regularly in the neck of all anthropoid apes (Testut, 1894; Le Double, 1897) and most other mammals (Parsons, 1898; Aiello & Dean, 1990) but has been lost in modern man. Four hypotheses have been proposed to explain the embryological origin of this muscle: as arising from sternocleidomastoid (Wood, 1869), trapezius (Parsons, 1898), scalenus anterior (Griiber, 1876) or longus colli (Tomo et al. 1994). The origin of the cleidocervical muscle from the axis and its location suggest a developmental origin from the primordia of the ventro- lateral neck muscles (the scalenes, anterior vertebral and infrahyoid muscles) rather than an origin related to that of sternocleidomastoid (Wood, 1869) or trapezius (Parsons, 1898) whose primordia arise from the occipital region in relation to the spinal accessory nerve (Lewis, 1910; MacKenzie, 1962). An origin of the cleidocervical muscle from scalenus anterior (Griiber, 1876) is difficult to understand as omohyoid, the superficial cervical artery, the phrenic nerve and the inferior root of the ansa cervica-lis lie between them (Tomo et al. 1994). Recently, it has been suggested that the cleidocervical muscle is derived from longus colli through a complicated process of rotation around its origin, shown by the placement of the ansa cervicalis hooked on to the cleidocervical muscle (Tomo et al. 1994), although this explanation appears to be somewhat Fig. 1. Lateral view of the right side of the neck after removal of the contrived. sternocleidomastoid muscle to show the relations of the cleido- We suggest a possible embryological origin from the cervical muscle (CC). ac, ascending cervical artery; cl, clavicle; ga, ventrolateral muscle primordia of the neck which, in greater auricular nerve; lo, lesser occipital nerve; Is, levator addition to contributing to the formation of anterior scapulae; ph, phrenic nerve; oh, omohyoid; sc, splenius capitis; sca, vertebral, hyoid and scalene muscles (Lewis, 1910; Arey, superficial cervical artery; sc, supraclavicular nerves; ss, supra- scapular artery; st, sternothyroid; t, trapezius; tc, transverse 1965), also contribute to the formation of a new muscle with cutaneous nerve of the neck; th, thyrohyoid; ij, internal jugular an 'atavistic' character, through a migration mechanism of vein; XII, hypoglossal nerve; C2-C4, anterior branches of the the most superficial and cranial cells towards the clavicle. cervical nerves; *, supernumerary head of omohyoid. This hypothesis would justify its attachments and its 504 Correspondence superficial location in relation to omohyoid and the LE DOUBLE AF (1897) Traite des Variations du Systeme Musculaire associated neurovascular structures. de rHomme et de leur Signification au Point de Vue de X. LEON1 rAnthropologie Zoologique, vol. II, pp. 235-240. Paris: Schleicher E. MARANILLO2 Frrres. LEWIS WH (1910) The development of the muscular system. In M. QUER' Manual of Embryology (ed. F. Keibel & F. P. Mall), vol. 2, pp. J. R. SANUDO2* 455-522. Philadelphia: J. B. Lippincott. Department of Otorhinolaryngology, San Pau Hospital, MACALISTER A (1875) Additional observation on the anomalies in and human anatomy (3rd series) with a catalogue of the principal 2Anatomy and Embryology Unit, Department Of muscular variations hitherto published. Transactions ofthe Royal Morphological Science, Autonomous University of Irish Academy 20, 1-134. Barcelona, 08193-Bellaterra, Barcelona, Spain MCKENZIE J (1962) The development of the sternomastoid and * Corresponding author trapezius muscles. Contributions to Embryology, Carnegie In- stitute 37, 123-129. PARSoNs FG (1898) The muscles of mammals, with special relation REFERENCES to human myology. Journal of Anatomy 32, 428-450. ToMo S, TOH H, HIRAKAWA T, ToMo I, KOBAYASHI S (1994) Case AIELLO L, DEAN C (1990) An Introduction to Human Evolutionary report: the cleidocervical muscle with speculation as to its origin. Anatomy, pp. 210-231. London: Academic Press. Journal of Anatomy 184, 165-169. AREY LB (1965) Developmental Anatomy. A Textbook and Lab- TESTUT L (1894) Traite d'Anomalies Musculaires chez PHomme, oratory Manual ofEmbryology, pp. 426-438. Philadelphia: W. B. pp. 97-106. Paris: Masson. Saunders. WooD J (1869) On groups of varieties of the muscles of the human GRUBER W (1876) Ein Musculus cleido-cervicalis s. trachelo- neck, shoulder, and chest, with their transitional form and clavicularis imus. Archiv fur anatomische, physiologische und homologies in the mammalia. Proceedings ofthe Royal Society of wissenschaftliche Medizin, 757-758. London 18B, 1-3..
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