{"title":"双侧五头肱二头肌的结构和功能分析及临床启示","authors":"Ethan L. Snow , Wyatt E. Lanik","doi":"10.1016/j.tria.2024.100289","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The biceps brachii (BB) muscle is a two-headed muscle of the arm composed of one long head (LH) and one short head (SH). Accessory heads have been described and classified; however, reports of three concurrent accessory heads are especially rare, and their structural and functional analyses still require investigation. This study aims to analyze the structural and functional properties of a bilateral case of BB muscles each with three accessory heads.</p></div><div><h3>Methods</h3><p>A case of bilateral BB muscles with three accessory heads were discovered during routine human cadaver dissection. The muscles were carefully cleaned of extraneous tissue and photographed in situ. All five heads were examined bilaterally for gross structural features, and sarcomere states were examined via light microscopy. Maximal isometric force (<em>F</em><sub><em>max</em></sub>) and contralateral comparability (<em>δ</em>) were calculated for each head.</p></div><div><h3>Results</h3><p>The three accessory heads originated sequentially from the mid-shaft of the humerus. The proximal accessory head inserted into the distal end of the SH, while the middle and distal accessory heads inserted separately into the adjoined LH and SH muscle mass just before the common tendon. All accessory heads were structurally similar (<em>δ</em> ≤ 0.17; mass = 2.10 g; length = 10.33 cm; <em>PCSA</em> = 0.23 cm<sup>2</sup>; <em>F</em><sub><em>max</em></sub> = 5.24 N) and were innervated by the musculocutaneous nerve. The left and right LH and SH collectively generated a <em>F</em><sub><em>max</em></sub> of 49.91 N and 53.05 N while the left and right accessory heads collectively generated a <em>F</em><sub><em>max</em></sub> of 18.04 N and 13.38 N, respectively.</p></div><div><h3>Conclusions</h3><p>The bilateral BB muscles with their accessory heads generated an almost equivalent total <em>F</em><sub><em>max</em></sub> (67.95 N vs. 66.43 N, respectively), ∼23.35% of which was generated by the accessory heads. Despite the conceivable advantage the accessory heads may offer to generating additional force, accessory muscles can also cause serious clinical implications. The gross imaging, biomechanical analyses, contralateral comparability data, and relevant clinical insights presented in this study may help guide diagnosis and treatment in related clinical cases.</p></div>","PeriodicalId":37913,"journal":{"name":"Translational Research in Anatomy","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214854X24000098/pdfft?md5=4ad24626799937649fded363a9e597da&pid=1-s2.0-S2214854X24000098-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Structural and functional analysis of bilateral five-headed biceps brachii muscles with clinical insights\",\"authors\":\"Ethan L. Snow , Wyatt E. Lanik\",\"doi\":\"10.1016/j.tria.2024.100289\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>The biceps brachii (BB) muscle is a two-headed muscle of the arm composed of one long head (LH) and one short head (SH). Accessory heads have been described and classified; however, reports of three concurrent accessory heads are especially rare, and their structural and functional analyses still require investigation. This study aims to analyze the structural and functional properties of a bilateral case of BB muscles each with three accessory heads.</p></div><div><h3>Methods</h3><p>A case of bilateral BB muscles with three accessory heads were discovered during routine human cadaver dissection. The muscles were carefully cleaned of extraneous tissue and photographed in situ. All five heads were examined bilaterally for gross structural features, and sarcomere states were examined via light microscopy. Maximal isometric force (<em>F</em><sub><em>max</em></sub>) and contralateral comparability (<em>δ</em>) were calculated for each head.</p></div><div><h3>Results</h3><p>The three accessory heads originated sequentially from the mid-shaft of the humerus. The proximal accessory head inserted into the distal end of the SH, while the middle and distal accessory heads inserted separately into the adjoined LH and SH muscle mass just before the common tendon. All accessory heads were structurally similar (<em>δ</em> ≤ 0.17; mass = 2.10 g; length = 10.33 cm; <em>PCSA</em> = 0.23 cm<sup>2</sup>; <em>F</em><sub><em>max</em></sub> = 5.24 N) and were innervated by the musculocutaneous nerve. The left and right LH and SH collectively generated a <em>F</em><sub><em>max</em></sub> of 49.91 N and 53.05 N while the left and right accessory heads collectively generated a <em>F</em><sub><em>max</em></sub> of 18.04 N and 13.38 N, respectively.</p></div><div><h3>Conclusions</h3><p>The bilateral BB muscles with their accessory heads generated an almost equivalent total <em>F</em><sub><em>max</em></sub> (67.95 N vs. 66.43 N, respectively), ∼23.35% of which was generated by the accessory heads. Despite the conceivable advantage the accessory heads may offer to generating additional force, accessory muscles can also cause serious clinical implications. The gross imaging, biomechanical analyses, contralateral comparability data, and relevant clinical insights presented in this study may help guide diagnosis and treatment in related clinical cases.</p></div>\",\"PeriodicalId\":37913,\"journal\":{\"name\":\"Translational Research in Anatomy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2214854X24000098/pdfft?md5=4ad24626799937649fded363a9e597da&pid=1-s2.0-S2214854X24000098-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Translational Research in Anatomy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214854X24000098\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational Research in Anatomy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214854X24000098","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Structural and functional analysis of bilateral five-headed biceps brachii muscles with clinical insights
Introduction
The biceps brachii (BB) muscle is a two-headed muscle of the arm composed of one long head (LH) and one short head (SH). Accessory heads have been described and classified; however, reports of three concurrent accessory heads are especially rare, and their structural and functional analyses still require investigation. This study aims to analyze the structural and functional properties of a bilateral case of BB muscles each with three accessory heads.
Methods
A case of bilateral BB muscles with three accessory heads were discovered during routine human cadaver dissection. The muscles were carefully cleaned of extraneous tissue and photographed in situ. All five heads were examined bilaterally for gross structural features, and sarcomere states were examined via light microscopy. Maximal isometric force (Fmax) and contralateral comparability (δ) were calculated for each head.
Results
The three accessory heads originated sequentially from the mid-shaft of the humerus. The proximal accessory head inserted into the distal end of the SH, while the middle and distal accessory heads inserted separately into the adjoined LH and SH muscle mass just before the common tendon. All accessory heads were structurally similar (δ ≤ 0.17; mass = 2.10 g; length = 10.33 cm; PCSA = 0.23 cm2; Fmax = 5.24 N) and were innervated by the musculocutaneous nerve. The left and right LH and SH collectively generated a Fmax of 49.91 N and 53.05 N while the left and right accessory heads collectively generated a Fmax of 18.04 N and 13.38 N, respectively.
Conclusions
The bilateral BB muscles with their accessory heads generated an almost equivalent total Fmax (67.95 N vs. 66.43 N, respectively), ∼23.35% of which was generated by the accessory heads. Despite the conceivable advantage the accessory heads may offer to generating additional force, accessory muscles can also cause serious clinical implications. The gross imaging, biomechanical analyses, contralateral comparability data, and relevant clinical insights presented in this study may help guide diagnosis and treatment in related clinical cases.
期刊介绍：
Translational Research in Anatomy is an international peer-reviewed and open access journal that publishes high-quality original papers. Focusing on translational research, the journal aims to disseminate the knowledge that is gained in the basic science of anatomy and to apply it to the diagnosis and treatment of human pathology in order to improve individual patient well-being. Topics published in Translational Research in Anatomy include anatomy in all of its aspects, especially those that have application to other scientific disciplines including the health sciences: • gross anatomy • neuroanatomy • histology • immunohistochemistry • comparative anatomy • embryology • molecular biology • microscopic anatomy • forensics • imaging/radiology • medical education Priority will be given to studies that clearly articulate their relevance to the broader aspects of anatomy and how they can impact patient care.Strengthening the ties between morphological research and medicine will foster collaboration between anatomists and physicians. Therefore, Translational Research in Anatomy will serve as a platform for communication and understanding between the disciplines of anatomy and medicine and will aid in the dissemination of anatomical research. The journal accepts the following article types: 1. Review articles 2. Original research papers 3. New state-of-the-art methods of research in the field of anatomy including imaging, dissection methods, medical devices and quantitation 4. Education papers (teaching technologies/methods in medical education in anatomy) 5. Commentaries 6. Letters to the Editor 7. Selected conference papers 8. Case Reports
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