Brief Report- Unusual nerve supply of biceps from ulnar nerve andmedian nerve and a third head of biceps
2007
Variations in branching pattern of the brachial plexus are common and
have been reported by several investigators. Of the four main nerves
traversing the arm, namely median, ulnar, radial and musculocutaneous,
the ulnar and median nerve do not give any branches to muscles of the
arm. Ulnar nerve after taking origin from medial cord of brachial
plexus runs distally through axilla on medial side of axillary artery
till middle of arm, where it pierces the medial intermuscular septum
and enters the posterior compartment of arm. Ulnar nerve enters forearm
between two heads of flexor carpi ulnaris from where it continues
further. It supplies flexor carpi ulnaris , flexor digitorum profundus
and several intrinsic muscles of hand . We recently observed dual
supply of biceps muscle from ulnar and median nerves in arm.
Musculocutaneous nerve was absent. Although communications between
nerves in arm is rare, the communication between median nerve and
musculocutaneous nerve were described from the 19th century which could
explain innervation of biceps from median nerve. But no accurate
description of ulnar nerve supplying biceps could be found in
literature. Knowledge of anatomical variation of these nerves at level
of upper arm is essential in light of the frequency with which surgery
is performed to transfer nerve fascicles from ulnar nerve to biceps in
case of brachial plexus injuries. We also observed third head of
biceps, our aim is to describe the exact topography of this variation
and to discuss its morphological.
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