FETAL ANATOMICAL VARIABILITY OF MUSCLES AND NEUROVASCULAR BUNDLES OF THE ANTERIOR BRACHIAL REGION

Abstract

Introduction. Performing surgical manipulations and interventions on neurovascular bundles located in the anterior brachial region of human fetuses and newborns requires comprehensive knowledge of their topographical and anatomical features. The objective of the study was to establish the fetal topography peculiarities of both nerves and vessels in the anterior brachial muscle region. Materials and methods. The study was carried out on 32 human fetuses of 4-8 months with 81.0-310.0 mm crown-rump length (CRL) using macro microscopic dissection, vascular injections and morphometry. Results. We describe the main and additional sources of muscle blood supply and innervation of the anterior brachial region in human fetuses. Two to 4 branches of the musculocutaneous nerve take part in the innervation of both coracobrachialis and brachialis muscles, as well as the biceps brachii muscle. Some fetuses possess additional sources of innervation: for the coracobrachialis muscle there is a branch of the lateral bundle of the brachial plexus, the biceps brachii muscle has median nerve and for the brachialis muscle there is radial nerve. The largest number of arterial and nerve branches goes to the proximal and middle parts of the coracobrachialis and brachialis muscles, as well as the biceps brachii muscle. Conclusions. The established neurovascular correlations and features of the fetal anatomy of the anterior brachial muscle region determine the presence of relatively favourable conditions for cutting muscle flaps that are well innervated and supplied with blood.

Keywords

• anterior brachial region
• musculocutaneous nerve
• brachial artery
• anatomical variability
• fetus