目的:该报告描述了4例连接前臂和后臂间室肌肉的辅助束(AB)或纤维。描述了ABs的形态(纯肌肉或肌肉筋膜或肌肉筋膜),强调了它们的附着点,特征为肌肉互连。
方法:解剖了4具经过福尔马林防腐处理的男性尸体。
结果:单侧识别了肌肉的相互联系。在第一种情况下,这两个ABs起源于喙臂肌(CB),从肱二头肌(BB)接收纤维,并插入肱三头肌(TB)内侧头。AB在肱血管和正中神经(MN)上形成弓形。在第二种情况下,在CB和TB内侧头之间发现了一个副肌腱膜结构,并在肱血管上延伸。在第三种情况下,BB短头和上臂筋膜之间的肌筋膜ABs,在MN的前面,肱动脉,和尺神经,方向是TB内侧头。在第四种情况下,起源于CB浅层和深头的三个肌肉ABs,与BB短头相同,连接上臂筋膜和结核内侧头,可能夹住肌皮神经,MN,和肱动脉.
结论:ABs或肌膜膜延伸可能由于其对神经和血管的潜在压迫而导致并发症。临床医生应该考虑肌肉之间可能存在这种桥接变体,在出现缺血的患者的鉴别诊断中,水肿,或MN麻痹症状。
OBJECTIVE: The report describes four cases of accessory bundles (ABs) or fibers connecting the muscles of the anterior with the posterior arm compartment. The ABs morphology (pure muscular or musculofascial or musculoaponeurotic) is described emphasizing their attachment points, characterized as muscles\' interconnections.
METHODS: Four formalin-embalmed donated male cadavers were dissected.
RESULTS: The muscles\' interconnections were unilaterally identified. In the first
case, the two ABs originated from the coracobrachialis muscle (CB), received fibers from the biceps brachii (BB), and were inserted into the triceps brachii (TB) medial head. The ABs created an arch over the brachial vessels and the median nerve (MN). In the second
case, an accessory musculoaponeurotic structure was identified between CB and TB medial head and extended over the brachial vessels. In the third
case, the myofascial ABs between the BB short head and the upper arm fascia, coursed anterior to the MN, the brachial artery, and the ulnar nerve, with direction to the TB medial head. In the fourth
case, the three muscular ABs originating from the CB superficial and deep heads, in common with the BB short head, joined the upper arm fascia and the TB medial head and possibly entrapped the musculocutaneous nerve, the MN, and the brachial artery.
CONCLUSIONS: ABs or musculoaponeurotic extensions may predispose to complications due to their potential
compression on nerves and vessels. Clinicians should consider the possible existence of such bridging variants between muscles, in the differential diagnosis of a patient presenting with ischemia, edema, or MN palsy symptoms.