Abstract :
Introduction: Variation in neurovascular structure are commonly encountered in routine dissection. Brachial
artery is the main artery of upper limb. In the arm, the median nerve passes at first lateral to brachial artery (near
the insertion of coracobrachialis muscle), then crosses in front of the artery, descending medial to it in the cubital
fossa. The knowledge of these variation could be helpful to vascular, plastic, general surgeons and
orthopedicians. It is also important to prevent iatrogenic injuries. The aim of this study was to evaluate anatomical
variations in course and relation of median nerve to brachial artery in the arm.
Material & Methods: The study was conducted in 50 cadavers (100 upper limbs) in duration of two years. Proper
cadaveric dissection was done in the Department of Anatomy, Dr. RML Institute of Medical Sciences, Lucknow,
and Era’s Lucknow Medical College, Lucknow.
Observation & Results: In the present series, median nerve was found to cross behind the brachial artery at
about the middle of the arm in 8% cadavers. Median nerve entered the arm at first lateral to brachial artery, near the
insertion of coracobrachialis. In 46 cadavers (96 upper limbs), it crossed in front of the artery from lateral to medial side.
In four cadavers (5 upper limbs), it passed posterior to the brachial artery in the arm.
Conclusion: Knowledge of the brachial artery and their variations are of clinical and surgical importance. An
awareness of such a presence is valuable for the surgeons and radiologists in evaluation of angiographic images,
vascular and re-constructive surgery or appropriate treatment for compressive neuropathies.
Keyword :
Brachial artery, median nerve, variations