Subclavius posticus
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BACKGROUND: The subclavius muscle runs underneath the clavicle. However, there have been a few reports of a duplicated subclavius muscle which is commonly referred to as subclavius posticus muscle due to its orientation being posterior to the proper subclavius muscle. Its occurrence seems to potentially create a narrowing interval at the superior thoracic aperture as it crosses over the brachial plexus. It might also have functional influence on the shoulder girdle. PURPOSE: To provide comprehensive gross anatomy description of the variant "subclavius posticus muscle" and to investigate its reported clinical implications with emphasis on its involvement in causing brachial plexus compression. BASIC PROCEDURES: A scoping review with meta-analysis of the gross anatomy of the subclavius posticus muscle was conducted along with investigating its correlation to the thoracic outlet syndrome. Forty-seven articles were pooled through two rounds of the selection process. The relevant information was extracted and meta-analyzed. MAIN FINDINGS: The scoping review and meta-analysis of the 47 articles revealed a total prevalence of 11/2069 (4.9%); 10/1369 (5.1%) in cadaveric studies, and 1/700 (5.0%) in MRI studies. The subclavius posticus muscle is a short triangular muscle with an average length of 12 cm and an average width of 1 cm. It originates from the sternal end of the first rib in most cases with reported variants of one case originating from the costoclavicular ligament and one case where it was fused with the proper subclavius muscle. Its insertion is more variable: on the superior border of the scapula with variable length in 71.35%, on the coracoid process of the scapula in 25.42%, and on the clavicle in 0.90%. The subclavian nerve seems to be the dominant nerve supply with a 57.6% prevalence, while 25.8% are innervated by the suprascapular nerve. Other reported nerves were the nerve to the myolohyoid (4.5%), accessory phrenic nerve (4.5%), and a direct branch from the brachial plexus (2.0%). The blood supply was reported (only once) to be from the suprascapular artery. However, the venous drainage was not established at all. PRINCIPAL CONCLUSIONS: The subclavius posticus muscle is a variant muscle occurring with a reported overall prevalence of 4.9%. It can compress the brachial plexus as it runs across at the space of the superior thoracic aperture with exquisite contact, and this can lead to a neurogenic thoracic outlet syndrome. It also can be involved in the vascular thoracic outlet syndrome. Lastly, it is important not to omit its potential influence in shoulder joint instability to some extent.
- MeSH
- kosterní svaly inervace MeSH
- lidé MeSH
- plexus brachialis * anatomie a histologie MeSH
- prevalence MeSH
- rameno MeSH
- syndrom horní hrudní apertury * etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- přehledy MeSH
PURPOSE: This study provides an insight on the extent of muscular variability at the suprascapular notch and elaborates on its anatomical interference in suprascapular nerve arthroscopic decompression procedures. METHODS: The suprascapular notch was dissected and its muscular topography was observed in 115 cadaveric specimens. High resolution imaging of the suprascapular notch was captured by a handheld digital microscope (Q-scope). The supraspinatus and subscapularis muscles were traced as they course at the suprascapular notch vicinity. The omohyoid muscle attachment onto the suprascapular ligament was measured. A scoping review and meta-analysis were done to investigate the observed rare muscular variants. RESULTS: In 3.48%, the suprascapular notch anterior surface was fully covered by the subscapularis muscle. The omohyoid muscle inserted onto the suprascapular ligament in 31.25% and extended up to 3/4th of the suprascapular ligament length in 2.61%. Two rare variant muscles were encountered: subclavius posticus muscle and a newly reported "coracoscapularis muscle". CONCLUSIONS: Four categories of muscles with topographical relationship to the suprascapular notch and its arthroscopic feasibility have been classified: (1) constant muscles not intervening with the suprascapular notch space - supraspinatus muscle; (2) constant muscles with variable positions that can intervene with the suprascapular notch space - subscapularis muscle; (3) constant muscles with variable positions that can intervene with the surgical approach - omohyoid muscle; (4) variable muscles intervening with the suprascapular notch space and surgical approach - subclavius posticus and coracoscapularis muscles. This study elucidates the necessity to assess/secure the omohyoid muscle attachment onto the suprascapular ligament in suprascapular nerve decompression ligamentectomy. LEVEL OF EVIDENCE: V Basic Science Research.
- MeSH
- anatomická variace * MeSH
- artroskopie * metody MeSH
- chirurgická dekomprese metody MeSH
- kosterní svaly * inervace anatomie a histologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lopatka inervace anatomie a histologie MeSH
- mrtvola * MeSH
- ramenní kloub inervace chirurgie anatomie a histologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie proveditelnosti MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
... Das untere seitliche Halsdreieck 116—119 -- 57) Arteria subclavia 116 59) Nervus subcutaneus colli 119 ... ... Obere Extremität a) Schultergegend -- 101) Arteria subclavia 185 -- 102) Arteria thoracica suprema. 187 ... ... —244 -- Gesässgegend . 211—213 -- 141) Arteria glutaea superior 211 143) Nervus cutaneus femoris posticus ... ... Ursprungs 232 -- Unterschenkel. — Rückfläc -- 170) Truncus tibio-peronealis 234 -- 171) Arteria tibialis postica ... ... ) Nervus suralis externus. . . 238 -- 175) Nervus suralis medius . . 240 -- 176) Nervus tibialis posticus ...
Zweite vermehrte und verbesserte Auflage XI, 323 s. : il. ; 26 cm
- MeSH
- chirurgie operační metody MeSH
- Publikační typ
- učebnice MeSH
- Konspekt
- Ortopedie. Chirurgie. Oftalmologie
- NLK Obory
- chirurgie
... Axillaris, Behandlung der Venenwunden etc -- Verletzungen der Achselhöhle, Blutung -- Unterbindung der Subclavia ... ... Verletzungen der Sehnen und Luxation derselben -- (Luxation der Peronei, des Tibialis posticus, Trennung ... ... Luxation des Tibialis posticus -- Ruptur und Durchschneidung der Achillessehne -- Tenotomie an der Achillessehne ... ... Tenotomie der Achillessehne, Plantaraponeurose des Tibialis • posticus etc 577 -- §. 166. ...
5. Aufl. xvi, 674 s. : il. ; 25 cm
... - Gasphlegmone 39» 4° -- Tetanus 40, 41 -- Unterbindungen 42—55 -- Carotis communis 42> 43 -- A. subclavia ... ... 48,49,51 -- A. poplitea 5°> 51 -- A. tibialis antica 52* 53 -- A. dorsalis pedis 52*53»55 -- A. tibialis postica ...
Taschenbuch des Feldarztes ; 1. Th.
4., verm. und verb. Aufl. xii, 226 s. : il. ; 18 cm
- MeSH
- chirurgie metody MeSH
- rány a poranění chirurgie MeSH
- vedení války MeSH
- vojenské lékařství MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Lékařské vědy. Lékařství
- NLK Obory
- vojenské lékařství
- chirurgie
... Subclavius -- 2. Pectoralis minor -- ?. Dritte Schichte -- Serratus anticus b. ... ... Subclavia 2f?8 -- * Aus dem aufsteigenden Theil des Bogens 259 -- 1. ... ... A. intermetatarsea dorsalis prima 281 -- IL A. plantaris prof 281 -- IL Tibialis postica 282 -- 1. ... ... Vene der Oberextremität 292 -- Subclavia 292 -- Collateraler Ast der Cava sup 293 -- V. azygos 293 -- ... ... N. subclavius 363 b. Lange Nerven 363 a. Hautnerven 363 -- 1. N. cutaneus medialis 363 -- 2. ...
Zweite verbesserte Auflage 2 svazky : ilustrace ; 23 cm
... . a) -- 01 -- 71 -- 35 -- 33 -- 95 -- 11 -- 25 -- 11 -- Art. lingualis -- „temporalis -- 13 -- „„subclavia ... ... Unterbindung der Art. poplitaea -- 19. 20. 21. 22 -- 22 -- 23 tibialis antica -- 73 -- 17 -- „postica ...
3. Aufl. XVI, 387 s. : il. ; 19 cm
... . • 53 -- I postica ) -- Unterbindung -- II. Amputationen und Exartikulationen. ... ... Unterbindung der Art. thyreoidea sup 273 -- Unterbindung der Art. lingualis 274 -- Unterbindung der Art. subclavia ...
Lehmann's medicin Handatlanten ; Bd. 16
2. verm. u. verb. Aufl. xxxii, 416 s. [40] l. obr. příl. : il. ; 19 cm
... im Hunter’schen Kanal -- Unterbindung der Art. poplitea -- Unterbindung der Art. tibialis antica postica ... ... Unterbindung der Art. thyreoidea sup 312 -- Unterbindung der Art. lingualis 312 -- Unterbindung der Art subclavia ...
Lehmanns medicin Handatlanten ; Bd. 16
3., vermehrte und verbesserte Aufl. xx, 498 s., [41] l. obr. příloh, 16 s. reklam : il.
... und subclavia an der Trachealseite der m. scalenus . 67 -- Art. mamaria interna . . . . . . . . . .73 ... ... interna -- Art. iliaca externa -- Art. glutea -- Art. femoralis -- Art. popliten -- Art. tibialis postica ...
2 sv. : il. ; 22 cm
- MeSH
- chirurgie operační MeSH
- Publikační typ
- příručky MeSH
- Konspekt
- Ortopedie. Chirurgie. Oftalmologie
- NLK Obory
- chirurgie
