Anat Cell Biol.  2014 Jun;47(2):138-140. 10.5115/acb.2014.47.2.138.

Anomalous cutaneous branch of median nerve in arm: a report of anatomical variation with clinical implications

• Singh S
• Rani N
• Kaushal P
• Kumar H
• Sharrif A
• Roy TS

• KMID: 1882586
• DOI: http://doi.org/10.5115/acb.2014.47.2.138

Abstract

The objective of the study was to observe and document the variation on the subject of branches of the median nerve. This report will assist clinicians and surgeons by considering anatomical variation associated with the median nerve in interpreting atypical clinical presentations. The arm and forearm region of a 55 year embalmed male cadaver during educational gross anatomy dissection. We found that an anomalous cutaneous branch arising from the median nerve in the right arm which was passing deep to the tendon of the biceps brachii. Later it enters the cubital fossa and then it is accompanied by the superficial vein of the forearm. The other limb of the cadaver did not show any such variation. No other neural, arterial or muscular variation was observed in either of the limbs. A rare anatomical variation in which the anomalous cutaneous branch arising from the median nerve in the right arm which is later accompanied by a superficial vein in the forearm. Such knowledge is advantageous in nerve grafting and neurophysiological evaluation for diagnosing peripheral neuropathies.

Keyword

Median nerve; Forearm; Anomalous; Arm

MeSH Terms

Arm*
Cadaver
Extremities
Forearm
Humans
Male
Median Nerve*
Peripheral Nervous System Diseases
Tendons
Transplants
Veins

Figure

• 

  Fig. 1 Right axilla and arm. Anterior view. 1, median nerve; 2, anomalous cutaneous branch of median nerve; 3, biceps brachii; 4, deltoid muscle; 5, musculocutaneous nerve; 6, lateral root of median nerve.

• 

  Fig. 2 Right arm, cubital fossa and forearm. Anterior view. 1, median nerve; 2, anomalous cutaneous branch of median nerve; 3, brachialis muscle; 4, biceps brachii; 5, brachioradialis; 6, pronator teres; 7, superficial vein with anomalous cutaneous branch of median nerve; 8, musculocutaneous nerve.

Reference

1. Linell EA. The distribution of nerves in the upper limb, with reference to variabilities and their clinical significance. J Anat. 1921; 55(Pt 2-3):79–112.

2. Nakatani T, Tanaka S, Mizukami S. Absence of the musculocutaneous nerve with innervation of coracobrachialis, biceps brachii, brachialis and the lateral border of the forearm by branches from the lateral cord of the brachial plexus. J Anat. 1997; 191(Pt 3):459–460.

3. Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC, Johnson D, Mahadevan V, Newell RL, Wigley CB. Gray's anatomy: the anatomical basis of clinical practice. 40th ed. London: Churchill Livingstone;2008. p. 828p. 836p. 837p. 853–855.

4. Chauhan R, Roy TS. Communication between the median and musculocutaneous nerve: a case report. J Anat Soc India. 2002; 51:72–75.

5. Morgan BA, Tabin C. Hox genes and growth: early and late roles in limb bud morphogenesis. Dev Suppl. 1994; 181–186.

6. Larson WJ. Development of peripheral nervous system. 3rd ed. Philadelphia: Churchill Livingstone;2001. p. 115–116.

7. Sarsilmaz M, Şendemır E, Çelık HH, Gümüşalan Y, Şmşek C. Some variations of the brachial plexus in man. Turk Klin J Med Res. 1993; 11:161–165.

8. Yogesh A, Joshi M, Chimurkar V, Marathe R. Unilateral variant motor innervations of flexure muscles of arm. J Neurosci Rural Pract. 2010; 1:51–53.

9. Beheiry EE. Anatomical variations of the median nerve distribution and communication in the arm. Folia Morphol (Warsz). 2004; 63:313–318.

10. Horowitz SH. Peripheral nerve injury and causalgia secondary to routine venipuncture. Neurology. 1994; 44:962–964.