THE NEUROVASCULAR COMPRESSION DUE TO THE THIRD HEAD OF BICEPS BRACHII IN THE RIGHT ARM - A CASE REPORT

During routine dissection of a 70 years old embalmed male cadaver in the department of Anatomy at K. J. Somaiya Medical College, Sion, Mumbai, INDIA, the triple variations i.e. the unusual course of median nerve and brachial artery in relation to the third head of biceps brachii muscle were observed in the right upper limb. The variant median nerve was piercing the third head of biceps brachii muscle. The brachial artery travelled posterior to the third head of biceps brachii muscle. The short and long heads have their normal origin, third head had originated from the anteromedial surface of the superior part of the shaft of the humerus. The common tendon then got inserted into the posterior rough part of the radial tuberosity. The thorough and meticulous dissection of axilla, arm, forearm and palm of both the upper limbs were done. The variations were unilateral and the left upper limb was normal. The photographs of the variations were taken for proper documentation. Conclusion: The variations of median nerve and brachial artery in relation to the third head of biceps brachii muscle are clinically important for surgeons, orthopaedicians, anaesthetist performing pain management therapies on the upper limb and plastic surgeons doing flap surgery. A lack of awareness of these variations might complicate surgical repair and may cause ineffective nerve blockade.