Abstract: The axillary arch (AA) has been thoroughly studied and described as a supernumerary muscle, present unilaterally or bilaterally. This study aims to provide an in vivo demonstration of the influence of an AA on vascular, biometrical, and hemodynamic parameters. Two-hundred thirty-nine subjects with a mean age of 21.3 ± 2.7 years participated in this study. After visual screening by two independent experts, 20 subjects (8.4%) presented with an AA unilaterally (n = 12) or bilaterally (n = 8). An echo-Doppler examination of the vena and arteria axillaris was performed to measure blood flow, velocity of circulating elements, and blood vessel diameter in different positions of the arm (abduction: 45°, 90°, 90° combined with exorotation 'ER', 120°). The arteria axillaris parameters, measured in the test (n = 9; six women, three men) and control group (n = 11; six women, five men), were equivalent for all tested positions. The axillary vein parameters, compared to variations within the groups, revealed no significant differences. However, when comparing variation between groups, significant differences were found for (i) diameter in 90° abduction + ER and 120° abduction; (ii) velocity in 90° and 120° abduction. Blood flow demonstrated no significant difference between groups in any of the positions. The results of this study indicate that there is no functional vascular implication of the AA in the test samples. This study also questions the interpretation of some hypotheses regarding the AA and entrapment syndromes.
Abstract: There is a limited understanding of the normal function of the pterygoïdeus proprius muscle and the role that this muscle may have in temporomandibular disorders. Despite a well-described anatomical in-vitro approach to this muscle, there are still difficulties in investigating the fossa pterygopalatina. This study reveals an alternative in-vivo approach by magnetic resonance imaging to visualise the muscle in the fossa pterygopalatina on 78 head halves, describe the connections with the musculus temporalis and pterygoïdeus lateralis as well as report the incidence without dealing with the known inconveniences of the dissection approach. The results show an incidence of 12.82% for the musculus pterygoïdeus proprius equally divided between both genders. Two different types of bridging between the musculus temporalis and musculus pterygoïdeus lateralis were also found: (i) 'O' shape (6.41%) and (ii) 'Y' shape (6.41%). This study suggests the use of magnetic resonance imaging to investigate the different connections between vascular and muscular structures in the fossa pterygopalatina. Further research with this approach to link the appearance of the muscle with neurovascular entrapment syndromes is warranted.
Abstract: Axillary Web Syndrome (AWS) is a complication that can arise in patients following treatment for breast cancer. It is also known variously as syndrome of the axillary cords, syndrome of the axillary adhesion, and cording lymphedema. The exact origin, presentation, course, and treatment of AWS is still largely undefined. Because so little is known about AWS, we undertook a case series study consisting of 15 women who had undergone breast cancer surgery and presented with AWS. All subjects received a clinical examination which included body size determination and detailed measurements of the size and location of the cords. The cords were found to originate from the axilla, continue on the medial aspect of the arm up to the epitrochlea region, then to the anteromedian aspect of the forearm, and finally reaching the base of the thumb. The cords averaged approximately 44% of the limb length. Correlation of the cord location with anatomical studies shows that in fact this path follows the specific course taken by the antero-radial pedicle which arises at the anterior aspect of the elbow from the brachial medial pedicule to anastomose in the axilla at the level of the lateral thoracic chain nodes. Although our series is small, the correspondence between the physical findings and the anatomical studies strongly supports the notion that the cords are lymphatic in origin.
Abstract: Based on cadaveric, neurosurgical and medico-diagnostic evidence the axillary arch of Langer (AA) is assumed to create symptoms similar to those of entrapment or obstruction type syndromes, e.g. Thoracic Outlet Syndrome. Although the incidence of a AA varies between studies and races, there are many assumptions that its frequency and its axillary location influences the motor control of the shoulder girdle. In addition to the existing anatomical evidence and based on functional reasoning it can be predicted that the AA influences the shoulder girdle kinesiology in vivo also. However no study is known that verifies these functional assumptions in vivo.
Abstract: To confirm the results of previous studies demonstrating the morphology of the levator ani muscle in the living subject is different to that described in classic anatomical works; to evaluate the anatomical-morphological differences of the pelvic floor between nulliparous and multiparous women in order to analyze the influence of pregnancy and delivery.
