The sternalis is an occasional muscle of the pectoral region with a reported incidence of around 7.8%. Higher rates of occurrences have been noted in females and in Asians. The muscle becomes clinically relevant as the muscle can be mis-interpreted as a pathological mass. Routine dissection was performed in a 68-year-old male and a 65-year-old female donated cadavers in the pectoral region. Gross anatomical features were meticulously noted, photographed and measurements were recorded with digital Vernier callipers. In the male cadaver, a long, slender, flat bi-tendinous sternalis was found, and in the female cadaver, tripartite sternalis possessing three distinct bellies was observed. Both the sternalis was right sided and were supplied by 2nd, 3rd and 4th intercostal nerves. Single bellied and tripartite sternalis are rare and they need to be recognized in the diagnostic images and during surgeries to avoid confusion.

• Klíčová slova
• Pectoral region, Sternalis, Sternalis muscle,
• MeSH
• kosterní svaly anatomie a histologie   MeSH
• lidé MeSH
• mrtvola * MeSH
• prsní svaly MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky 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.

• Klíčová slova
• Coracoscapularis, Omohyoid, Subclavius Posticus, Subscapularis, Suprascapular nerve entrapment, Suprascapular notch arthroscopy,
• 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

The Achilles tendon (AT) is the strongest tendon of the human body. The knowledge of AT anatomy is a basic prerequisite for the successful treatment of acute and chronic lesions. The structure of the AT results from a complicated fusion of three parts: the tendons of the medial and lateral gastrocnemius and the soleus muscles. From proximal to distal, the tendon fibers twist in a long spiral into a roughly 90° internal rotation. The tendon is narrowest approximately 5-7 cm above its calcaneal insertion and from there it expands again. The topography of the footprints of the individual AT components reflects the tendon origins. The anterior (deep) AT fibers insert into the middle third of the posterior aspect of the calcaneal tuberosity, the posterior (superficial) fibers pass over the calcaneal tuberosity and fuse with the plantar aponeurosis. A deep calcaneal bursa is interposed between the calcaneal tuberosity and the AT anterior surface. The AT has no synovial sheath but is covered along its entire length with a sliding connective tissue, the paratenon which is, however, absent on its anterior surface. The AT is supplied by the posterior tibial artery (PTA) and the peroneal artery (PA). Motor innervation of the triceps surae muscle is provided by fibers of the tibial nerve which also gives off sensitive fibers for the AT. Sensitive innervation is also provided via the sural nerve. The sural nerve crosses the AT approximately 11 cm proximal to the calcaneal tuberosity. The forces acting on the AT during exercise may be up to 12 times the body weight. Physiological stretching of AT collagen fibers ranges between 2% and 4% of its length. Stretching of the tendon over 4% results in microscopic failure and stretching beyond 8% in macroscopic failure.

Die Achillessehne (AT) ist die stärkste Sehne des menschlichen Körpers. Die Kenntnis der Anatomie der Achillessehne ist eine Grundvoraussetzung für die erfolgreiche Behandlung von akuten und chronischen Läsionen. Die Struktur dieser Sehne ergibt sich aus einer komplizierten Verschmelzung dreier Teile: der Sehnen des medialen und lateralen M. gastrocnemius und M. soleus. Von proximal nach distal verdrehen sich die Sehnenfasern in einer langen Spirale zu einer Innenrotation von etwa 90°. Die Sehne ist etwa 5‑7 cm oberhalb ihres Ansatzes am Kalkaneus am schmalsten und dehnt sich von dort aus wieder aus. Die Topographie der Footprints der einzelnen AT-Komponenten spiegelt die Sehnenursprünge wider. Die vorderen (tiefen) AT-Fasern setzen im mittleren Drittel der hinteren Seite des Tuber calcanei an, die hinteren (oberflächlichen) Fasern ziehen über den Tuber calcanei und verschmelzen mit der Plantaraponeurose. Zwischen dem Tuberculum calcanei und der vorderen Oberfläche der AT befindet sich ein tiefer Schleimbeutel (Bursa calcanei). Die AT hat keine Synovialscheide, sondern ist auf seiner gesamten Länge mit einem gleitenden Bindegewebe, dem Paratenon, bedeckt, das jedoch an seiner vorderen Oberfläche fehlt. Die AT wird von der A. tibialis posterior (PTA) und der A. peronaea (PA) versorgt. Die motorische Innervation des M. triceps surae erfolgt durch Fasern des N. tibialis, der auch sensible Fasern für die AT abgibt. Die sensible Innervation erfolgt auch über den N. suralis. Dieser suralis kreuzt die AT etwa 11 cm proximal des Tuberculum calcanei. Die Kräfte, die bei sportlicher Betätigung auf die AT einwirken, können bis zum 12-fachen des Körpergewichts betragen. Die physiologische Dehnung der Kollagenfasern der AT liegt zwischen 2 und 4% ihrer Länge. Eine Dehnung der Sehne von mehr als 4% führt zu mikroskopischem Versagen und eine Dehnung von mehr als 8% zu makroskopischem Versagen.

• Klíčová slova
• Blood supply, Calcaneal tuberosity, Retrocalcaneal bursa, Tendo calcaneus, Triceps surae muscle,
• MeSH
• Achillova šlacha * anatomie a histologie   MeSH
• kosterní svaly anatomie a histologie   inervace   MeSH
• lidé MeSH
• modely anatomické MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Whether the forelimb-digging apparatus of tooth-digging subterranean mammals has similar levels of specialization as compared to scratch-diggers is still unknown. We assessed the scapular morphology and forelimb musculature of all four solitary African mole rats (Bathyergidae): two scratch-diggers, Bathyergus suillus and Bathyergus janetta, and two chisel-tooth diggers, Heliophobius argenteocinereus and Georychus capensis. Remarkable differences were detected: Bathyergus have more robust neck, shoulder, and forearm muscles as compared to the other genera. Some muscles in Bathyergus were also fused and often showing wider attachment areas to bones, which correlate well with its more robust and larger scapula, and its wider and medially oriented olecranon. This suggests that shoulder, elbow, and wrist work in synergy in Bathyergus for generating greater out-forces and that the scapula and proximal ulna play fundamental roles as pivots to maximize and accommodate specialized muscles for better (i) glenohumeral and scapular stabilization, (ii) powerful shoulder flexion, (iii) extension of the elbow and (iv) flexion of the manus and digits. Moreover, although all bathyergids showed a similar set of muscles, Heliophobius lacked the m. tensor fasciae antebrachii (aiding with elbow extension and humeral retraction), and Heliophobius and Georychus lacked the m. articularis humeri (aiding with humeral adduction), indicating deeper morphogenetic differences among digging groups and suggesting a relatively less specialized scratch-digging ability. Nevertheless, Heliophobius and Bathyergus shared some similar adaptations allowing scratch-digging. Our results provide new information about the morphological divergence within this family associated with the specialization to distinct functions and digging behaviors, thus contributing to understand the mosaic of adaptations emerging in phylogenetically and ecologically closer subterranean taxa. This and previous anatomical studies on the Bathyergidae will provide researchers with a substantial basis on the form and function of the musculoskeletal system for future kinematic investigations of digging behavior, as well as to define potential indicators of scratch-digging ability.

• Klíčová slova
• African mole‐rats, chisel‐tooth digger, convergence, fossorial adaptations, muscle anatomy, scapula, scratch‐digger,
• MeSH
• kosterní svaly anatomie a histologie   fyziologie   MeSH
• lopatka anatomie a histologie   fyziologie   MeSH
• mikroftalmičtí podzemní hlodavci anatomie a histologie   fyziologie   MeSH
• muskuloskeletální systém anatomie a histologie   MeSH
• přední končetina * anatomie a histologie   fyziologie   MeSH
• zvířata MeSH
• Check Tag
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually observed incidentally during autopsies or imaging studies, they may at times cause concern due to associated clinical symptoms. This report presents a case of unilateral accessory flexor carpi ulnaris (AFCU) muscle observed in a human male cadaver aged 78 years. During routine cadaveric dissection, an anomalous AFCU muscle was observed in the left forearm of a human male cadaver aged 78 years. Standard institutional guidelines pertaining to the use of human cadaver for teaching and research were followed. A thorough literature review about the flexor carpi ulnaris (FCU) through the PubMed, Embase and Google scholar databases was undertaken, using the keywords - accessory flexor carpi ulnaris muscle, aberrant flexor carpi ulnaris muscle and anatomical variation of flexor carpi ulnaris muscle. Relevant gross anatomical findings were recorded and photographed. AFCU was identified on the medial aspect of the distal third of the left forearm. The AFCU was found originating from the ante-brachial fascia and the fascia covering the FCU on the left forearm, forming a small separate belly deep to the main muscle. It terminated as a thin tendon running alongside the hypothenar muscles and attached distally to the base of the proximal phalanx of the little finger. The AFCU was found to be innervated by a branch of the ulnar nerve. Awareness about the rare AFCU muscle is clinically important as a possible cause of ulnar nerve compression but also as a possible graft in reconstruction surgeries.

• Klíčová slova
• Accessory flexor carpi ulnaris muscle, Forearm flexors, Human anatomical variation,
• MeSH
• kosterní svaly * abnormality   anatomie a histologie   MeSH
• lidé MeSH
• mrtvola * MeSH
• předloktí * abnormality   anatomie a histologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND AND OBJECTIVES: Skeletal muscle is characterized by its mass, strength and performance. These normative values are pivotal in defining sarcopenia. Sarcopenia is associated with poor outcome of numerous medical and surgical conditions. This study aimed to establish normative benchmarks for skeletal muscle mass, strength and performance within the context of the Asian (Indian) population. METHODS: Our investigation utilized the computed tomography (CT) skeletal muscle index (SMI), handgrip strength (HGS), gait velocity and chair-stand test to construct reference values for muscle characteristics in the Indian population. RESULTS: The SMI analysis incorporated 1485 cases of acute abdomen (54.7%) males). The calculated SMI (kg/m2) was 38.50 (35.05-42.30) in males and 36.30 (32.20-41.20) in females (p = 0.510). The study also involved 3083 healthy individuals (67.6% males) evaluated for muscle strength and performance between August 2017 and August 2018. Notably, HGS (kg force) was recorded at 34.95 (26.50-43.30) in males and 25.50 (18.60-31.20) in females (p < 0.001). Gait velocity (metres/second) exhibited values of 1.25 (1.04-1.56) in males and 1.24 (1.03-1.56) in females (p = 0.851). Additionally, chair-stand test (seconds) results were 10.00 (9.00-13.00) in males and 12.00 (10.00-14.00) in females (p < 0.001). CONCLUSIONS: The investigation determined that males had greater muscle strength and performance than females. But gender wise, there was no significant difference in muscle mass. Interestingly, our population's muscle parameters were consistently lower compared to western literature benchmarks. These normative values will help to define sarcopenia parameters in our population, which have prognostic value in multiple ailments.

• Klíčová slova
• Asian (Indian population), Chair-stand test, Gait velocity, Hand-grip strength, Jamar dynamometer, Sarcopenia, Skeletal muscle index, Slice-O-Matic software, Version 5 (Tomo Vision), Western population,
• MeSH
• dospělí MeSH
• kosterní svaly * diagnostické zobrazování   fyziologie   anatomie a histologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• počítačová rentgenová tomografie * MeSH
• referenční hodnoty MeSH
• rychlost chůze fyziologie   MeSH
• sarkopenie * diagnóza   patofyziologie   MeSH
• senioři MeSH
• síla ruky * fyziologie   MeSH
• svalová síla * fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Indie MeSH

Although the term articularis cubiti muscle is incorporated in the official anatomical nomenclature, only sparse data about its appearance are available. It is usually described as few fibres originating from the medial head of the triceps brachii muscle and inserting to the capsule of the elbow joint. However, the most recent observations regarding the morphological relations in the posterior elbow region point towards the absence of a well-defined muscle. Therefore, this study was designed to verify the existence of the articularis cubiti muscle in question and to compile more data on the topographical features of the subtricipital area near the posterior aspect of the elbow. To address these questions, 20 embalmed upper limbs were dissected, and seven samples were collected for histological analysis. The laboratory findings were then correlated with 20 magnetic resonance imaging (MRI) scans of the elbow. Consequently, a narrative review of literature was performed to gain more information on the discussed muscle in a historical context. Upon the anatomical dissection, muscular fibres running from the posterior aspect of the shaft of the humerus to the elbow joint capsule and olecranon were identified in 100% of cases. Histologically, the connection with the joint capsule was provided via winding bands of connective tissue. On MRIs, the muscular fibres resembled a well-demarcated thin muscle located underneath the medial head of the triceps brachii muscle. Combined with the review of literature, we concluded that the constant articularis cubiti muscle originates from the posterior shaft of the humerus and attaches indirectly to the posterior aspect of the elbow joint capsule and directly to the superior portion of the olecranon. The obtained results slightly differ from the modern description, but are in agreement with the original publication, which has become misinterpreted throughout time. Presumably, the misused description has led to questioning the existence of an independent muscle. Moreover, our findings attribute to the articularis cubiti muscle, a function in pulling on the posterior aspect of the elbow joint capsule to prevent its entrapment, and possibly also a minor role in extension of the forearm. The presented results should be taken into consideration when intervening with the posterior aspect of the elbow joint because the articularis cubiti muscle poses a consistently appearing landmark.

• Klíčová slova
• Lecomte's pronator of ulna, anconeus muscle, articularis cubiti muscle, elbow joint capsule, subanconeus muscle, triceps brachii muscle,
• MeSH
• horní končetina MeSH
• kosterní svaly * diagnostické zobrazování   anatomie a histologie   MeSH
• loket MeSH
• loketní kloub * diagnostické zobrazování   anatomie a histologie   MeSH
• magnetická rezonanční tomografie MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

PURPOSE: Knowledge of the unusual arrangement of the flexor pollicis longus (FPL) muscle is important as the variable tendon may be a rare cause of carpal tunnel syndrome. METHODS: During a routine dissection at the Department of Anatomy, an unusual formation of the FPL muscle was observed in a formalin embalmed Central European cadaver. RESULTS: This report presents a variation of the FPL muscle, where the muscle split and formed a separate accessory head inserting into the first lumbrical muscle. Moreover, a tendinous interconnection was present between the FPL muscle tendon and the tendon of the aberrant muscle head. CONCLUSION: The cases described by previous literature, concerning the Linburg-Comstock variation or the accessory head of the first lumbrical muscle originating from the FPL muscle, are closest to the present case. Such variation has a clinical significance ranging from the functional limitation of the thumb and index finger movement to the potential median nerve compression.

• Klíčová slova
• Accessory muscle head, First lumbrical muscle, Flexor pollicis longus muscle, Musculotendinous interconnection,
• MeSH
• kosterní svaly anatomie a histologie   MeSH
• lidé MeSH
• muskuloskeletální abnormality * MeSH
• palec ruky MeSH
• předloktí inervace   MeSH
• prsty ruky MeSH
• šlachy MeSH
• syndrom karpálního tunelu * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The anatomy of the biceps brachii muscle has been a subject of interest to many researchers. In particular, the presence of one or more accessory heads has been reported to be the most common variation of the biceps brachii muscle. In fact, contemporary knowledge is quite inconsistent and lacks a definitive summary. Taking this into account, the present study aims to investigate the overall prevalence of the accessory heads and related questions, such as their broad morphological features, population variance, sexual dimorphism, side distribution or the changes in prevalence rates over time. A literature search of major scientific databases was conducted and produced 78 eligible articles, including 10,603 upper limbs, for our study. Relevant data were extracted and consequently analysed with the use of random-effects meta-analysis. As a result, the accessory heads occur with an overall prevalence of 9.6% (95% CI 8-11%) and by far the most common is the presence of a single accessory head (8.4%; 95% CI 7-10%). Additional sub-analyses revealed that accessory heads appear more frequently unilaterally and in males. Differences between the occurrence on the right or left side were not significant. Moreover, a decreasing trend in prevalence rates over time was observed, pointing towards an evolutionary adaptation. The innervation and blood supply of the accessory heads are nearly identical to that of the normal biceps brachii muscle. Although the accessory heads are usually asymptomatic, their potential presence must be kept in mind while interpreting various conditions. In addition, their direct clinical importance is speculated and is thought that they might be conductive to several pathological processes around the shoulder girdle and brachial region. While many of the morphological and morphometric aspects of the accessory heads are well documented, their functional value is still a matter for future investigations.

• Klíčová slova
• accessory head, biceps brachii muscle, supernumerary head, third head,
• MeSH
• horní končetina MeSH
• kosterní svaly * anatomie a histologie   MeSH
• lidé MeSH
• organogeneze MeSH
• paže * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

PURPOSE: The structure of the proximal margin of the superficial layer of the supinator muscle is of high interest to many researches. Its tendinous appearance, called the arcade of Frohse, may be clinically important because of its close relationship to the deep branch of the radial nerve passing beneath it and is considered to be the cause of several syndromes. Given the importance of this structure, we aimed to provide a comprehensive and evidence-based review with meta-analytic techniques. MATERIALS AND METHODS: The meta-analysis was performed in adherence to the PRISMA guidelines. Three medical databases were searched in order to identify all potentially eligible articles. Included studies were assessed for quality and the extracted morphological and morphometric data from the relevant articles was analyzed with the use of random effects meta-analysis. RESULTS: A total of 20 studies were included into this meta-analysis. The pooled prevalence of the arcade of Frohse was calculated to be 66% within the adult population and 0% in the fetuses. Other variations regarding the arcade of Frohse were identified as very rare. Analysis of the morphometric parameters revealed the average proportions to be 23.22 mm for the length, 11.05 mm for the width and the mean thickness is 0.67 mm. CONCLUSIONS: The arcade of Frohse is a commonly found structure in adults and thoughtful knowledge of its texture and morphology is especially useful in neurology, neurosurgery, orthopedics, trauma surgery and hand surgery, because it is considered to be the most common source of compression for the deep branch of the radial nerve.

• Klíčová slova
• Arcade of Frohse, Deep branch of radial nerve, Epicondylalgia, Posterior interosseous nerve, Supinator arch, Supinator muscle,
• MeSH
• kosterní svaly anatomie a histologie   chirurgie   MeSH
• lidé MeSH
• nervus radialis zranění   MeSH
• neuropatie nervus radialis etiologie   MeSH
• ortopedické výkony metody   MeSH
• předloktí anatomie a histologie   chirurgie   MeSH
• šlachy anatomie a histologie   chirurgie   MeSH
• úžinové syndromy etiologie   chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH