Advances in Clinical and Experimental Medicine
2013, vol. 22, nr 3, May-June, p. 309–318
Publication type: original article
Language: English
Variability of the Trunks and Divisions of the Brachial Plexus in Human Fetuses
Zmienność pni i gałęzi splotu ramiennego płodów ludzkich
1 Department of Neurosurgery, academic Clinical Hospital in Wrocław, Poland
2 Department of Normal anatomy, Wroclaw Medical University, Poland
3 Institute of Machine Design and Operation, Wroclaw Technical University, Poland
Abstract
Background. The brachial plexus is an important part of peripheral nervous systems. The studies of variation of the brachial plexus and its parts in the prenatal period are extremely rare.
Objectives. The goal of the study was to assess brachial plexus trunk variability and their divisions in human fetuses.
Material and Methods. Examinations were carried out on a total of 220 brachial plexuses derived from 110 fetuses aged 4–7 months, including 50 females (45.45%) in a CRL range of 80–233 mm. The following methods were incorporated into the study: anthropological, dissection, digital image acquisition and statistical methods. Symmetry and sexual dimorphism was observed.
Results. Trunk variations were observed in 12 (5.45%) plexuses as well as divisions variants in 74 (33.6%) cases. Variants were equally common in both genders and on both sides of the body. Variants of individual trunks were of a similar percentage, usually an observed middle trunk formed by nerve roots C7 and C8. anterior division of the middle trunk (aDMT) was the most variable division, observed in 63 (28.63%) cases.
Conclusion. Trunk variants are rare and anomalies of divisions were observed in one-third of cases, regardless of the side of the body and sex. Brachial plexus variation recognition is important from a clinical point of view.
Streszczenie
Wprowadzenie.Splot ramienny jest istotną częścią obwodowego układu nerwowego. Badania zmienności splotu ramiennego i jego poszczególnych części w okresie płodowym są nieliczne.
Cel pracy. Ocena zmienności pni i gałęzi splotu ramiennego u płodów ludzkich.
Materiał i metody. Zbadano 220 splotów ramiennych wypreparowanych ze 110 płodów w wieku 4–7 miesięcy, w tym 50 płci żeńskiej (45.45%), w przedziale v-tub: 80–233 mm. W pracy zastosowano następujące metody: sekcyjna, antropologiczna, cyfrowa akwizycja obrazów, program Image J, metody statystyczne. Oceniono symetrię i dymorfizm płciowy.
Wyniki. Warianty pni obserwowano w 12 (5,45%) splotach, a anomalie gałęzi w 74 (33,6%) przypadkach. Warianty występowały jednakowo często u obu płci i po obu stronach ciała. anomalie poszczególnych pni stwierdzono w podobnym odsetku, najczęściej obserwowano pień środkowy utworzony przez gałęzie przednie korzeni nerwów C7 i C8. Najbardziej zmienną gałęzią była gałąź przednia pnia środkowego (aDMT) w 63 (28,63%) splotach.
Wnioski. Warianty pni występowały rzadko, a anomalie gałęzi w co trzecim przypadku, niezależnie od strony ciała i płci. Wiedza na temat zmienności splotu ramiennego jest ważna z klinicznego punktu widzenia.
Key words
brachial plexus, anatomy, variation, trunk, division, human fetus.
Słowa kluczowe
splot ramienny, warianty, pień, gałąź, płody ludzkie.
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