Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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Review Meta Analysis
Surgical anatomy of the pectoral nerves and the pectoral musculature.
The pectoral nerves (PNs) may be selectively injured through various traumatic mechanisms such as direct trauma, hypertrophic muscle compression, and iatrogenic injuries (breast surgery and axillary node dissection, pectoralis major muscle transfers). The PN may be surgically recovered through nerve transfers. They may also be used as donors to the musculocutaneous, axillary, long thoracic, and spinal accessory nerves and for reinnervation of myocutaneous free flaps. ⋯ In 50%-100% of cases, it may pass, at least with some branches, through the pectoralis minor muscle. The LPN supplies the upper portions of the pectoralis major muscle; the MPN innervates the lower parts of the pectoralis major and the pectoralis minor muscle. Among the accessory muscles of the pectoral girdle, the LPN may also innervate the tensor semivaginae articulationis humero-scapularis, pectoralis minimus, sternoclavicularis, axillary arch, sternalis, and infraclavicularis muscles; the MPN may innervate the pectoralis quartus, chondrofascialis, axillary arch, chondroepitrochlearis, and sternalis muscles.
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The anatomical variations of the brachial plexus in humans have clinical significance for surgeons, radiologists, and anatomists. In a study of 60 brachial plexuses, four trunked brachial plexuses were encountered in three limbs (two female and one male), all of them being post fixed and on left side of cadavers. The third trunk in all these limbs gave rise to two anterior divisions (upper and lower) and one posterior division. ⋯ No medial cord was formed as such. Further, it is inferred that in postfixed brachial plexus, there is a tendency to failure on part of T1 and T2 to join C8 which continues as the third trunk while T1 and T2 continue as the fourth trunk. Since it was seen in all postfixed brachial plexuses of the present study, it is emphasized to be given a place in the textbooks of anatomy or to conduct a study on a larger database.