During gross anatomy dissection, variation in the formation of median nerve of the upper limb was discovered in the right upper extremity of a 57-year-old male cadaver. Three roots contributed to the formation of median nerve instead of usual two roots i.e. two lateral roots and one medial root. After being formed the median nerve descended medial to the axillary artery. Between the two lateral roots brachial vein passed to open into the axillary vein. Anatomical variations in the formation of nerves and their unusual relationship to the surrounding structures can be the cause of nerve compression syndromes and vascular problems.
Axillary Artery ; Axillary Vein

Knowledge of anatomic variants of veins in the arm and axilla play a key role in planning of successful venous access. Possible anatomic variants of axillary vein, brachial vein and basilic vein and their clinical implications have been well described in the literature. We report a rare case of formation of a short axillary vein associated with complex venous communications between the basilic and brachial veins forming a venous ladder in the axilla, in formalin embalmed male cadaver. Axillary vein was formed in the upper part of the axilla by the fusion of basilic vein and unpaired brachial vein, and it was about 3cm in length. The higher-up confluence of basilic and brachial veins was also associated with presence of three communicating veins between the basilic and brachial veins in the axilla. Knowledge of reported venous variations is very useful during preoperative venous mapping and also for planning and execution of various surgical invasive procedures involving these veins.
Axillary Vein

With the increased use of implantable cardiac devices, the incidence of hardware problems has also increased. Some of the hardware problems might be induced by patient factors. We experienced recurrent pacemaker lead fracture and dislocation after permanent pacemaker implantation. The patient was a bus driver who used his left arm vigorously when he turned the steering wheel. After a new lead was inserted via an axillary vein approach and the patient changed his occupation, no more lead problems have occurred. When a recurrent hardware problem with an implantable pacemaker or defibrillator occurs, patient factors related to anatomy or behavior must be considered.
Arm ; Atrioventricular Block ; Axillary Vein ; Defibrillators ; Dislocations ; Humans ; Incidence ; Occupations

No abstract available.
Axillary Vein ; Central Venous Catheters ; Jugular Veins ; Thrombosis

Anatomical variations of the nerves, muscles, and vessels in the upper limb have been described in many anatomical studies; however, the occurrence of 6 variations in an ipsilateral limb is very rare. These variations occur in the following structures: the pectoralis minimus muscle, the communication between the external jugular vein and cephalic vein, axillary arch, the Struthers ligament, the medial, lateral, and posterior cords of the brachial plexus, and the common arterial trunk from the third part of the axillary artery. The relationship of these variations to each other and their probable clinical presentation is discussed.
Axillary Artery ; Axillary Vein ; Brachial Plexus ; Cadaver ; Extremities ; Humans ; Jugular Veins ; Ligaments ; Male ; Median Nerve ; Muscles ; Upper Extremity

Traumatic arteriovenous fistula between the axillary artery and vein may present a difficult problem in treatment. There are few reports demonstrating the endovascular repair of this challenge. Herein, we present such a case of endovascular repair of traumatic arteriovenous fistula between the axillary artery and vein with false aneurysm formation. The patient was discharged 11 days after successful operation. Oral clopidogrel and aspirin were administered for 18 months. At one year follow-up, the patient was in good condition and showed no evidence of neurological deficit in the left upper limb.
Adult ; Arteriovenous Fistula ; surgery ; Axillary Artery ; injuries ; surgery ; Axillary Vein ; injuries ; surgery ; Endovascular Procedures ; methods ; Humans ; Male

Persistence of jugulocephalic vein is one of the extremely rare variations of the cephalic vein. Knowledge of such a variation is of utmost importance to orthopedic surgeons while treating the fractures of the clavicle, head and neck surgeons, during surgery of the lower part of neck, for cardiothoracic surgeons and radiologists during catheterization and cardiac device placement. We report the persistent jugulocephalic vein in an adult male cadaver, observed during the routine dissection classes. The right cephalic vein ascended upwards, superficial to the lateral part of the clavicle and terminated into the external jugular vein. It also gave a communicating branch to the axillary vein below the clavicle. We discuss the embryological and clinical importance of this rare variation.
Adult ; Axillary Vein ; Cadaver ; Catheterization ; Catheters ; Clavicle ; Head ; Humans ; Jugular Veins ; Male ; Neck ; Orthopedics ; Subclavian Vein ; Surgeons ; Veins*

Lead insertion for cardiac implantable electronic devices requires venous access into the right side of the heart. The access route commonly used is from the axillary vein, through the subclavian vein and the superior vena cava. However, in patients with congenital heart malformations or those with vascular stenosis, and/or those who have undergone previous cardiac surgery, the passage of leads might be difficult, and the implantation procedure would show restricted scope. In such cases, insertion of leads through the hepatic vein is known to be a safe procedure. We report 2 cases of patients with limited vascular access who underwent lead implantation using the transhepatic approach—1 patient who underwent placement of an implantable cardioverter defibrillator and the other who underwent placement of a permanent pacemaker.
Axillary Vein ; Constriction, Pathologic ; Defibrillators ; Defibrillators, Implantable ; Heart ; Hepatic Veins ; Humans ; Subclavian Vein ; Thoracic Surgery ; Vena Cava, Superior

BACKGROUND: The ability to explore the anatomy has improved our appreciation of the brachial anatomy and the quality of regional anesthesia. Using real-time ultrasonography, we investigated the cross-sectional anatomy of the brachial plexus and of vessels at the axillary fossa in Koreans. METHODS: One hundred and thirty-one patients scheduled to undergo surgery in the region below the elbow were enrolled after giving their informed written consent. Using the 5-12 MHz linear probe of an ultrasound system, we examined cross-sectional images of the brachial plexus in the supine position with the arm abducted by 90degrees, the shoulder externally rotated, and the forearm flexed by 90degrees at the axillary fossa. The results of the nerve positions were expressed on a 12-section pie chart and the numbers of arteries and veins were reported. RESULTS: Applying gentle pressure to prevent vein collapse, the positions of the nerves changed easily and showed a clockwise order around the axillary artery (AA). The most frequent positions were observed in the 10-11 section (79.2%) for the median, 1-2 section (79.3%) for the ulnar, 3-5 section (78.4%) for the radial, and 8-9 section (86.9%) for the musculocutaneous nerve. We also noted anatomical variations consisting of double arteries (9.2%) and multiple axillary veins (87%). CONCLUSIONS: Using real-time ultrasonography, we found that the anatomical pattern of the major nerves in Koreans was about 80% of the frequent position of individual nerves, 90.8% of the single AA, and 87% of multiple veins around the AA.
Anatomy, Cross-Sectional ; Anesthesia, Conduction ; Arm ; Arteries ; Axilla ; Axillary Artery ; Axillary Vein ; Brachial Plexus* ; Elbow ; Forearm ; Humans ; Musculocutaneous Nerve ; Shoulder ; Supine Position ; Ultrasonography* ; Veins

M. supracostalis anterior is a rare varlation which occurs on the external aspect of the upper thoracic wall. This thin, short-like musc1e lies deep to the pectoralis major and minor muscles, and extends longitudinally over the upper four or five ribs. It is known that the muscle usually occurs bilaterally but sometimes unilaterally. In the present report, a case of unilateral (right) M.supracostalis anterior, observed in a 58-year-old man cadaver, is described. Because the muscle had not been reported in Korea, morphological characteristics and nerve innervation of the muscle were investigated. 1. M. supracostalis anterior, observed only on the right side, extended longitudinally from the first rib to the fourth rib deep to the pectoralis minor. 2. The suprarostalis anterior arose from the antero-inferior surface below the groove for subclavian vein of the first rib. After arising from the first rib, the smaller, more media part of the muscle inserted into the upper border of the fourth rib and the larger, more lateral part inserted into the upper border of the fourth rib. 3. The length of the musce is 9.9cm, and the width is 0.8cm at its origin, 1.7cm at the upper border of the third rib and 2.4cm at the upper border of the fourth rib. 4. It was confirmed, under stereomicroscope, that the muscle was innervated by the terminal branches of the nerve to the first external intercostal muscle deriving from Thl and Th2. Blood supply of the M. supracostalis anterior was provided mainly by the lateral thoracic artery arising from the axillary artery.
Axillary Artery ; Cadaver ; Humans ; Intercostal Muscles ; Korea ; Middle Aged ; Muscles ; Ribs ; Subclavian Vein ; Thoracic Arteries ; Thoracic Wall