Multiple variations involving all the terminal branches of the brachial plexus and the axillary artery - a case report

Several case reports on variations of the brachial plexus have been reported in the literature. These reports provide valuable information for understanding the clinical signs related to neuropathy of varying origins. The authors of this report present a case that involved all the terminal branches of the brachial plexus and the axillary artery in a cadaver used for routine teaching practice. Four variations were noted: (i) the median nerve was formed by three roots: from the lateral cord, the medial cord and the musculocutaneous nerve; (ii) the ulnar nerve received a contribution from the lateral root of the median nerve; (iii) the lateral and the medial roots of the median nerve surrounded the third part of the axillary artery, and (iv) the superficial branch of the radial nerve was replaced by the lateral cutaneous nerve of the forearm. The aim of this study was to describe the course of these variant nerves and suggest how knowledge of these variations can help to interpret some uncommon clinical signs, such as the manifestations of ulnar nerve palsy resulting from damage to the lateral cord and manifestations of median nerve palsy resulting from damage to the musculocutaneous nerve.