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Folia Morphol (Warsz). 2019 Jan 21. doi: 10.5603/FM.a2019.0005. [Epub ahead of print]

Accessory muscles of the anterior thoracic wall and axilla. Cadaveric, surgical and radiological incidence and clinical significance during breast and axillary surgery.

Author information

1
Department of Anatomy, Medical School, National and Kapodistrian University of Athens, M.Asias 75 street, 11527 ATHENS, Greece.
2
Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, Greece.
3
Department of Anatomy, Medical School, National and Kapodistrian University of Athens, M.Asias 75 street, 11527 ATHENS, Greece. mapian@med.uoa.gr.

Abstract

BACKGROUND:

The present study aims to summarize the accessory muscles of the anterior thoracic wall and axilla that can be encountered during breast and axillary surgery and record their incidence and clinical significance. Moreover, the laterality of the atypical muscles is highlighted and possible gender dimorphism is referred. Accessory anterior thoracic wall muscles include: Langer's axillary arch, sternalis muscle, chondrocoracoideus muscle, chondroepitrochlearis, chondrofascialis, pectoralis minimus, pectoralis quartus and pectoralis intermedius.

MATERIALS AND METHODS:

The anatomical, surgical and radiological literature has been reviewed and an anatomical study on 48 Greek adult cadavers was performed.

RESULTS:

Literature review revealed that there are accessory muscles of the anterior thoracic wall and axilla that have a significant incidence that can be considered high and may, therefore, have clinical significance. For the most common of these muscles, which are Langer's axillary arch and sternalis muscle, the cadaveric incidence is 10.30% and 7.67%, respectively. In the current cadaveric study, accessory thoracic wall muscles were identified in two cadavers; namely a bilateral sternalis muscle (incidence 2.08%) extending both to the anterior and posterior surface of the sternum and a left-sided chondrocoracoideus muscle (of Wood) (incidence 2.08%).

CONCLUSIONS:

Despite the fact that accessory anterior thoracic wall and axillary muscles are considered to be rare, it is evident that the incidence of at least some of them is high enough to encounter them in clinical practice. Thus, clinicians' awareness of these anatomical structures is advisable.

KEYWORDS:

accessory muscle; axillary arch; chondrocoracoideus; chondroepitrochlearis; chondrofascialis; pectoralis intermedius; pectoralis minimus; pectoralis quartus; sternalis; variation

PMID:
30664230
DOI:
10.5603/FM.a2019.0005
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