Anat Cell Biol.  2012 Dec;45(4):288-290. 10.5115/acb.2012.45.4.288.

Duplicated axillary arch muscles arising from the latissimus dorsi

Affiliations
  • 1Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. iamsaard_sitt@yahoo.com
  • 2Integrative Complementary Alternative Medicine (ICAM) Research and Development Group, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Abstract

Many origins and insertions of an axillary muscular slip (also known as Langer's or axillary arch muscles) have been documented previously. In this report, we found duplicated axillary arch muscles (two variant muscular slips) originating from the inferolateral border of the right side latissimus dorsi muscle. Obviously, these axillary arch muscles can be distinguished as short and long muscular strips. While the origin was the same, the short muscular slip inserts into the fascia covering on the pectoralis minor, whereas the longer one inserts on/into the aponeurosis of pectoralis major. For the surgery in the axillary region, this rare variation should be considered a cause of surgical interventions.

Keyword

Duplicated axillary arch; Muscular slip; Latissimus dorsi; Aponeurosis

MeSH Terms

Fascia
Muscles

Figure

  • Fig. 1 Dissected right axilla showing (A) duplicated axillary arch muscles (two variant muscular slips) originating from latissimus dorsi muscle, (B) schematic sketching, and (C) their aponeurotic insertions, considered as the axillary arch of langer. A1, short axillary arch muscular slip 1; A2, long axillary arch muscular slip 2; A1*, aponeurosis of A1; A2*, aponeurosis of A2; Co, coracobrachialis; De, deltoid; LD, latissimus dorsi; MdN, median nerve; PMa, pectoralis major (reflected); PMi, pectoralis minor; SeA, seratus anterior; ULN, ulnar nerve.


Reference

1. Spinner RJ, Carmichael SW, Spinner M. Infraclavicular ulnar nerve entrapment due to a chondroepitrochlearis muscle. J Hand Surg Br. 1991. 16:315–317.
2. Rao TR, Shetty P, Rao S. Additional slip of pectoralis major muscle: the costohumeralis. Int J Anat Var. 2009. 2:35–37.
3. Besana-Ciani I, Greenall MJ. Langer's axillary arch: anatomy, embryological features and surgical implications. Surgeon. 2005. 3:325–327.
4. Guy MS, Sandhu SK, Gowdy JM, Cartier CC, Adams JH. MRI of the axillary arch muscle: prevalence, anatomic relations, and potential consequences. AJR Am J Roentgenol. 2011. 196:W52–W57.
5. Bergman RA, Thompson SA, Afifi AK. Catalog of human variation. 1988. 8th ed. Baltimore: Urban and Schwartzenberg;26–27.
6. Soubhagya RN, Latha VP, Ashwin K, Madhan KS, Ganesh CK. Coexistence of an axillary arch muscle (latissimocondyloideus muscle) with an unusual axillary artery branching: case report and review. Int J Morphol. 2006. 24:147–150.
7. Loukas M, Noordeh N, Tubbs RS, Jordan R. Variation of the axillary arch muscle with multiple insertions. Singapore Med J. 2009. 50:e88–e90.
8. Lama P, Tamang BK. A common insertion of thoracoepicondylaris and an axillary arch of Langer: a case report. Int J Anat Var. 2010. 3:63–64.
9. Daniels IR, della Rovere GQ. The axillary arch of Langer: the most common muscular variation in the axilla. Breast Cancer Res Treat. 2000. 59:77–80.
10. Ucerler H, Ikiz ZA, Pinan Y. Clinical importance of the muscular arch of the axilla (axillopectoral muscle, Langer's axillary arch). Acta Chir Belg. 2005. 105:326–328.
11. Bertone VH, Ottone NE, Lo Tartaro M, García de Quirós N, Dominguez M, Gonzalez D, López Bonardi P, Florio S, Lissandrello E, Blasi E, Medan C. The morphology and clinical importance of the axillary arch. Folia Morphol (Warsz). 2008. 67:261–266.
12. Mérida-Velasco JR, Rodríguez Vazquez JF, Mérida Velasco JA, Sobrado Pérez J, Jiménez Collado J. Axillary arch: potential cause of neurovascular compression syndrome. Clin Anat. 2003. 16:514–519.
13. Smith RA Jr, Cummings JP. The axillary arch: anatomy and suggested clinical manifestations. J Orthop Sports Phys Ther. 2006. 36:425–429.
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