CaseReport32 Indian Journalof Anatomy Volume 7Number 3, May -June 2018 DOI: http://dx.doi.org/10.21088/ija.2320.0022.7318.24 BicepsAnatomicalAberrationinaCadavericStudy ViayAnanth K. Abstract InaroutinecadavericdissectionsinacadavertheshortheadofBicepsBrachiitendon(SBT)showedbifurcated inattachmentwiththebellyofthePronatorTeresmuscleseenalongwithitsusualcourseofattachmentwiththe radialtuberosity. Thiswas seenbilaterally on boththe upperlimbs inthesame bodyduringthe anatomical dissection.erethebicepsbrachiiwasoriginatingfromthelongheadfromthesupraglenoidtuberclefromthe capusularjointandtheshortheadfromthecoracoidprocessofscapula. KeywordsBicepsBrachiiandPronatorTeresMuscleExtrarticularInsertionCadaver. Introduction Intheupperextremitytheanteriorcompartment formstheflexorgroupmusclesofwhichalongwith thecoracobrachialistheBicepsBrachiiplaysamajor roleinflexingthearmsandtheelbowjoint.It compensatestheactionwiththeTricepsBrachiithe posteriorcompartmentmuscleofthebrachiumwhich formstheextensors. Itisalargefusiformmuscleofthatcompartment 3,8andaprimarysupinatoroftheforearm.Biceptal aponeurosis,atriangularbandformedfromthedeep fasciaoriginatesfromthebicepstendon.This aponeurosisgivesprotectiontothecubitalfossa.A thirdhead is also reportedseen posterior to the brachialartery8. Itoriginatesfromlongandshortheadsfrom supraglenoidtubercleandcoracoidsprocessof scapularespectively. Andboththeheadsconvergewiththetwobelles andgetsinsertedintotheposteriorpartofthe tuberosityofradiusbone9. Fi.Rt.SideArm Authors AffiliationLecturer,DepartmentofAnatomy, igure1showsBicepsBrachiiinthefrontof NationalInstituteofomoeopathy,Kolkata,WestBengal forearmandtheCubitalfossabelow. 70010,India. RedarrowshowstheLBTinsertingintothe CorrespondinAuthor ViayAnanth,Lecturer,Dept. radialtuberosity. ofAnatomy,NationalInstituteofomeopathy,Kolkata,West Bengal70010,India. GreenarrowshowstheSBTanditsextrarticular E-mail:[email protected] insertionwasseeninthepronatorteresmusclewhich Received 20.02.2018, Accepted 09.03.2018 isthemedialborderofCubitalossa(ig.1). Red lowerPublication Pvt.Ltd Indian JournalofAnatomy/Volume7Number3/May -June2018 Vijay Ananth K. / BicepsAnatomical Aberration in a Cadaveric Study 33 Discussion Differentoriginwasnotedinsomecasestudeslike Thesupernumeraryheadwasabulkymusclebelly and originated from the medial lip of the intertuberculargroove1.Theabsenceofthelong headofthebiceps(LB)tendonasreportedinthe fourthcaseofbilateralcongenitalanamalyoftheLB tendonunder clinicalstudiesconductedby using Ultrasonography(US)andmagneticresonance(MR) whenthepatientexperiencedanteriorshoulderpain atrestthatexacerbatedwithoverheadactivities.The painwasmoderateformonthsbutworsenedinthe lastfewweeks,speciallyseenaftersportsactivityin anotherstudybyRegoCostaandetal.. Inoneparticularstudy74cadaversweredissected andobservedinoneyearbasedonitsvariationsin shapeandinsertionoftheBicepsBrachiiwerefound in10outof74cadavers(13,).Inwhich20armsof the10cadavers,14hadvariations,thus,in148 analyedarms,only9,4varied.Bilateralvariation occurredin4arms,and2ofthemweresymmetric. Eight different typesof variationswere found in BrailiansasperDenieAugustodaSilvaand others4. Fi. Lt.Side Arm Bergman,ThompsonandAfifireportedthatthe igure2showsBicepsBrachiiinthefrontof twoheadsofbicepsbrachiimusclemaybetotally forearmandtheCubitalfossabelow. separateorfusedandeitherheadmaybeabsent.In theabsenceoflonghead,thetendonmaybefound RedarrowshowstheLBTinsertingintothe arisingfromthebicipitalgroove,oneofthetubercles radialtuberosity. ofhumerus,thecapsuleofthenshoulderjointorthe Green arrow shows the SBT and its tendonofpectoralismajor2.Inasimilarstudyby extrarticularinsertionwasseeninthepronatorteres ymanandWarrentoocameacrossanextra- musclewhichisthemedialborderofCubitalossa articularoriginofthelongheadofbicepsbrachii7. (ig.2). SharadkumarPralhadSawantandothersobserved thatinundergraduatedissectionsamaledonated cadavershowedthattheshortheadofthebiceps CaseReport brachiimusclegotinsertedintotheradialtuberosity oftheradiusseparately.Thelongheadgotinserted Intheyear201amalecadaverwasprocuredto intotheradialtuberosityandbicipitalaponeurosis theDept.ofAnatomy,National Institute of thoughtheorginwasasusual.Inadetailedstudy omoeopathyforthedissectionpurposeregarding by SubhalakshmiWahengbam andothers ina 3 teachingandtrainingtheundergraduatestudents adultcadaverswhichweredissectedandobserved which wasprocured from the R.G. Kar Medical forvariationsintheoriginandinsertionofbiceps CollegethroughtheDirectorofMedicalEducation.It brachiimusclebilaterally.Amongthe70armsstudied, isknowthatsuchanatomicalaberrationmaybeseen threehad3-headedbicepsbrachii,2ontheleftand1 duetoanycongenitalorasanatomicalanomalies. ontherightside. TheshortheadofBicepsBrachiiandthelonghead Allthethirdheadswereofhumeralorigin,which originatedfromtheirrespectivecoursebutthis insertedintotheradialtuberositybyacommontendon extrarticularinsertionwasseeninthepronatorteres withthelongandshortheads10.Allsuchanomalies musclefortheSBTbuttheLBTgotinsertedinto can be visualised during thedaily activitiesor in thetuberosityofradiusasusually.Thearterialand extremephysicalworkbutinthepresentworkasthe nervesupplywasnormal. Cadaverwasprocuredfromthemortuarynodetails Indian JournalofAnatomy/Volume7Number3/May -June2018 34 Vijay Ananth K. / BicepsAnatomical Aberration in a Cadaveric Study ofthecasehistoryisrecordedorwasavailable. AraujoChagas,Variationsofthebicepsbrachiimuscle urtheritispossibletheindividualmayhavesome in Brailians,International JournalofAnatomy and discomfortinflexingtheelbowbutthatmusthave Research,IntJAnatRes2014(2):2444-49. substantiated withthe Pronationmuscles during .Dr.SharadkumarPralhadSawant,Dr.ShaguphtaT. hislife. Shaikh,Dr.RakhiM.More,report:Varianttwo separateheadsofbicepsbrachiimuscleobserved duringroutinedissectioninK.J.SoumaiyaMedical References College,Mumbai,Dr.ShaDr.RakhiM.More,Indian JournalofBasicAppliedMedicalResearch December20122():40-3. 1. BarflgrDnme,BahadrMuratDemirel, . ranciscoRegoCosta,CtiaEsteves,andLinaMelo, Variation ofthe supernumeraryhead of the biceps indawi,CaseReport-BilateralCongenitalAgenesis brachiimuscle:twocasereportsandliteraturereview, oftheLongeadof theBicepsTendon:The TurkishSociety ofAnatomy andClinical Anatomy Beginning, PublishingCorporation Case Reports in (TSACA),CaseReport,Publishedonline:January2, Radiology,Volume201,ArticleID4309213,pages. 2010.pp.3-. 7. yman,Jl.andWarren,Rf.Extra-articularoriginof 2. Bergman,Ra.,Thompson,Sa.andAfifi,Ak.Muscular bicepsbrachii.Arthroscopy,200117:29. system.InIllustratedEncyclopediaofhuman anatomic variation. Available from: http:// 8. KeithMoore.LandArthurDalley.,Clinically th www.vh.org/adult/provider/anatomy/ Anatomi- OrientedAnatomy,4 Edition,,LippincottWilliams cvariants/muscularsystem/Text/B/02Biceps.html. Wilkins,1999.pp.720-21. Accessin:200. 9. RichardSnell.S,ClinicalAnatomy,7th edition, 3. Cheema,P.andSingla,Extra-articularoriginoflong LippincottWilliamsWilkins,2004.pp.03-10. headofbicepsbrachiiinhumancadaver:acasereport, 10. SubhalakshmiWahengbam,RenucaKaram,Kalpana R.J.Morphol.Sci.,201027(3-4):17-9. Thounaojam, Eliabeth Remei, Incidence of Third 4. DenieAugustodaSilva,KiyoshiGoke,Claudia eadof BicepsBrachii inIndian Population, MariaSoaresSavedra, LucasAlvesSarmento Pires, InternationalJournalofAnatomyandResearch,IntJ TulioabianodeOliveiraLeite,CarlosAlberto AnatRes2013(4):14-70. Indian JournalofAnatomy/Volume7Number3/May -June2018.