Variations In The Formation Of The Median Nerve
Variations In The Formation Of The Median Nerve
DOI:
https://doi.org/10.70284/njirm.v7i3.1068Keywords:
variation, formation, median nerve, cord, brachial plexusAbstract
Background: Variations in the formation of median nerve can result in misinterpretation of clinical signs
due to median nerve palsy and hence they are of great clinical significance. Thus this project was taken up to study
these variations and also to measure the distance of the site of formation of the median nerve from the tip of the
coracoid process of the scapula. Methodology: Ninety-eight formalin fixed upper limbs were used for the study (50
right, 48 left). The variations in the formation of the median nerve were noted. The level of formation of the median
nerve was measured from the tip of the coracoid process of the scapula. Results: The median nerve was formed from
an anterior cord of brachial plexus in two cases, both on the left side. Double lateral root of the median nerve was
present in 4 specimens, 3 on the left side and 1 on the right side. Conclusion: Variations in the formation of median
nerve have embryological basis and clinical significance and the distance of site of the union of two roots of the
median nerve from the tip of the coracoid process will be helpful to surgeons to locate median nerve in surgeries
around the shoulder. [Iyer P NJIRM 2016; 7(3):17 - 20]
References
OA. Brachial Plexus variations in its formation and
main branches. Acta Cirurgica Brasileira 2003; 18
(5): 14-18. Available from: http: //
www.scielo.br/acb/ (Accessed on 18.02.16).
2. Saeed M, Rufai AA. Median and Musculocutaneous
nerves: Variant formation and Distribution. Clinical
Anatomy 2003; 16: 453-457.
3. Sunderland S. The Median Nerve-Anatomical and
Physiological Features. In: Nerve and Nerve
Injuries, 2nd edition, Edinburgh: Churchill
Livingstone. 1978: 656-690.
4. Kerr AT. The brachial plexus of nerves in man, the
variations in its formation and branches. Am J Anat
1918; 23: 285–395.
5. Ahmet U, Sait B. Some variations in the formation
of the brachial plexus in infants. Tropical Journal of
Medical Sciences 1999; 29: 573-577.
6. Hollinshead WH. General Survey of the Upper
Limb. In: Anatomy for Surgeons, Vol. 3. Back and
Limbs, 3rd edition, New York: Harper and Row.
1982: 203-258.
7. Bergman RA, Afifi AK, Ryosuke Miyauchi. Virtual
Hospital Illustrated Encyclopedia of Human
Anatomic Variation: Opus III: Nervous System:
Nerves: Upper Limb. 2016. Available from:
http://www.anatomyatlases.org/AnatomicVariants
/NervousSystem/Images/40.shtml (Accessed on
18.02.16).
8. Bergman RA, Thompson SA, Afifi AK, Saadeh FA.
Nervous system, Median nerve. In: Compendium
of Human Anatomic Variations, Text, Atlas and
World Literature, Baltimore & Munich: Urban &
Schwarzenburg. 1988: 141.
9. Cliffton EE. Unusual innervation of the intrinsic
muscles of the hand by median and ulnar nerve.
Surgery 1948; 23: 12-31.
10. Sarala Devi K V et al., A study on variations of
median nerve formation in south Indian
population. International Journal of Anatomical
Sciences 2011,2(1):7-10Bannister LH, Berry MM,
Collins P, Dyson M, Dussek JE, Fergusson MWJ.
Surface Anatomy. In: Gray’s Anatomy-The
Anatomical Basis of Medicine and Surgery, 38th
edition, Edinburgh, Churchill Livingstone,
Edinburgh. 1995: 1924.
11. Veneiratos D, Anagnostopoulou S. Classification of
Communications between the Musculocutaneous
and Median nerves. Clinical Anatomy 1998; 11:
327-331.
12. V. Budhiraja et al., Variations in the formation of
the median nerve and its clinical correlation. Folia
Morphol 2012. 71(1): 28–30.
13. Bharti et al., Variations in the formation and
relation of the median nerve. Int J Anat Res 2015,
Vol 3(3):1298-01.
14. Nene et al., A rare variant formation of median
nerve. International Journal of Anatomical
Variations (2010) 3: 138–140
15. Talhar et al., Bilateral variation in the formation of
median nerve. IOSR Journal of Pharmacy 2012 2
(6): 05-07
16. Budhiraja et al., Anatomical variations of median
nerve formation: embryological and clinical
correlation. J. Morphol. Sci., 2011,28(4) :283-286
