sternalis muscle innervationadvantages of having elders in the family

Figure 2. Innervation of pectoralis major is by both the lateral pectoral nerve, which innervates the clavicular head, and the medial pectoral nerve, which innervates the sternocostal head. National Journal of Clinical Anatomy Full-text search The innervation of the sternalis muscle is varied. The present investigation endeavors to discuss the anatomical, embryological and clinical relevance of a rare accessory muscle of the anterior chest wall of Asian origin found in a 40-year-old male cadaver. Has varying shapes, contours and sizes and may mimic a mass lesion on mammogram. Thieme E-Books & E-Journals. In a routine dissection of the superficial chest muscles, graduate students in a human gross anatomy class exposed a large, well-developed sternalis muscle. Familiarity of the sternalis not only broadens the surgeon's knowledge of variations of chest wall anatomy but also provides reconstructive operations for wounds in the chest wall as well as adjacent regions. Rectus sternalis muscle: An anatomical variant of anterior chest wall. On the left side both reach the sternalis; on the right side the upper of the two exhausts itself in branches to the great pectoral before it reaches the sternalis. Intercostal nerves do not supply the sternalis muscle despite piercing through it(9). Awareness of the location of the sternalis will help medical doctors avoid misdiagnosis during mammography or misjudgement during breast surgery. Case report.. major ip t. . The ipsilateral pectoralis major did not display morphological variation. 5. Double sternalis in male subject. The sternalis muscle is an anatomic variation well known to anatomists, but relatively unknown to clinicians and surgeons. Presence of this muscle can The fusiform muscle belly tapered into a thin delicate tendon at the level of 4 th costal cartilage, continued, for a short distance along right sternal . It is regularly observed in lower animal but infrequently in humans. We report a case of rectus sternalis on the right anterior thoracic wall of a 55-year . Rectus sternalis is a rare muscle found in the anterior chest wall superficial to the pectoralis major muscle. Palpation & Self-massage. Photograph showing the sternalis muscle during the modified radical mastectomy opera-tion; sm — sternalis muscle. Figure 1. Okajimas Folia Anat Jpn 1991; 67: 449-455. The muscle tissue was verified in histological examination. Muscles that then might also be affected, are the pectoralis major and the pectoralis minor. 5. The muscle is a wide band of muscular tissue located in the anterior thoracic wall, where fibers travel near-parallel to the sternum, inferior to the clavicles, aterior to the pectoralis . Sternalis muscle is a rare anatomic variant of the chest wall musculature, it is found in front of the sternal end of the pectoralis major parallel to the margin of the sternum. Sternalis muscle innervation is quite enigmatic, imply-ing that the rule of the close relationship between mus-cle ontogeny and innervation may not apply for this muscle. Sternalis Syndrome is an unusual cause of chest wall pain. The pain is described as mild to moderate and is dull or aching. The sternalis muscle was first coined by Carbriolus in 1604 and subsequently by Du Puy in 1726. The anatomy of the sternalis is variable and it may be . Frequently bilateral, the sternalis muscle is slender band of ï¬ bers running parallel to the sternum. The sternal muscle, also known as sternalis, rectussternal, parasternal or japonicus is a curious case of anatomical variation of the anterior chest wall. 5,6 Case Report Abstract . The innervation to the muscle could be traced to the 4th, 5th, and 6th anterior intercostal nerves. In one case accompanied by congenital partial absence of the pectoralis major muscle the sternalis muscle was examined to confirm its innervation by means of analysis of intramuscular nerve distribution. Innervation to muscles of the anterior thorax arises from different branches of the brachial plexus. Intercostal nerves do not supply the sternalis muscle despite piercing through it [9]. What are the Symptoms of Sternalis Syndrome. Sternalis muscle is a rare supernumerary muscle variant of . The Sternalis muscle has been nominated as a supernumerary anatomical variation; the highest prevalence is in China (23.5%) and the lowest in Chile (0.87%).. Presence of this muscle can create confusion with tumours of the anterior chest wall during routine mammography. It is regularly observed in lower animal but infrequently in humans. 39 On CT or MR studies, it is seen as a vertically oriented parasternal flat and bandlike structure surrounded by . The sternalis muscle is a normal anatomic variant of the chest wall. The sternalis muscle is an uncommon anatomical variant. Fig. No one knows what it does! the homology and innervation of sternalis, and there is an extensive literature. The 3rd-5th intercostal nerves entered the muscle from its deep aspect (feature not photographed). It may be a variation of the pectoralis major or of the rectus abdominis. The innervation for the sternalis muscle can be easily damaged during dissection or surgery. On physical examination, a patient with sternalis syndrome exhibits myofascial trigger points at the midline over the sternum. A cadaveric study was undertaken to report the incidence of sternalis muscle in cadavers of Asian origin. Sternalis is a rare muscle encountered in the subcutaneous plane. Its importance lies in that it should not be mistaken for a pathological lesion. The sternalis muscle typically emerges via the upper part of the sternum and can show changing attachments such as the pectoral fascia, lower ribs, costal cartilages, rectus sheath, aponeurosis of the abdominal external oblique muscle.There is yet a lot of dispute about its innervation and its embryonic genesis. 2. Kida and Kudoh found the sternalis muscle to be supplied by the pectoral nerves. The sternalis muscle is an uncommon anatomical variant. Kumar et al.7considers sternalis to be derived embryologically from theventral longitudinal column of Abstract The sternalis muscle is a well documented but rare muscular variation of the anterior thoracic wall. Sternalis Syndrome. The schematic representation of the findings can Sternalis muscle innervation is quite enigmatic, imply- be seen in Figure 2. ing that the rule of the close relationship between mus- According to a classification described by Jelev et al, cle ontogeny and innervation may not apply for this the bilateral sternalis muscles we describe can be . Mostly it appears on medial posterior edge of the breast on CC views, but may also be detected on MLO projections. Skip to main content Accessibility help We use cookies to distinguish you from other users and to provide you with a better experience on our websites. O' Neil and Folan-Curran reported that in 55% of the cases the muscle was innervated from the external or internal thoracic nerves, 43% of the cases it was supplied by the . The muscle is a wide band of muscular tissue located in the anterior thoracic wall, where fibers travel near-parallel to the sternum, inferior to the clavicles, aterior to the pectoralis major and the pectoral fascia. The sternalis typically sits in front of the pectoralis major, and parallel to the margin of the sternum. Contents 1 Structure 1.1 Prevalence 1.2 Variations 2 Function 3 Clinical significance 4 History It is regularly observed in lower animal but infrequently in humans. The sternalis muscle was first described in 1604, and since that time it has been repeatedly described with significant morphological variations [], innervation patterns [6, 8], and vascular supply [].Ge and colleagues enumerated three "types" of sternalis muscle variants in 2014 []: Type I or single bellied, Type II or multiheaded, and Type III or multibellied. Key words: sternalis muscle Address for correspondence: Dr. Marios Loukas MD, PhD, Assistant professor, Department of Anatomy, American University of Rectus sternalis is a rare muscle found in the anterior chest wall superficial to the pectoralis major muscle. 2. The sternalis is a thin band of muscle that rests in front of the pectoralis major muscle and runs parallel to the sternum. Various authors suggested the microdissection technique as nerves are often destroyed in this region. It lies between the superficial fascia and the pectoral fascia and is found in about 8% of the population. The sternalis muscle is a strip of anterior and lateral muscle to the sternum and lateral to the pectoralis major muscle, with a population response of 5 to 8%. The muscles are innervated by thoraco-abdominal nerves, these are continuations of the T7-T11 intercostal nerves and pierce the anterior layer of the rectus sheath. During surgery, pectoral fascia is removed and pectoralis major muscle is laid bare. A total of 88 cadavers were studied over a period of six years and the sternalis . On each side two nerves pierce the great pectoral muscle and run inwards. Double sternalis in male subject. It is localized superficially to the pectoralis major and can cause a diagnostic dilemma during breast surgery, mammography, and computed tomography and magnetic resonance imaging scans, as its appearance mimics tumor pathology of the region. Mastectomy is a commonly performed surgery for carcinoma of breast. Variation [] The sternalis muscle may be a variant form of the pectoralis major or the rectus Fig. the bilateral sternalis muscles are very low around 1.7% and its concurrent existence with other rare anatomical abnormalities is even rarer [21]. 3. OA Anatomy 2014 Jun 10;2(2):16. A study reported that 55% of the cases were innervated by branches of thoracic nerves, while 43% were by the intercostal nerves [4]. The sternalis muscle is an anatomical variation that lies in front of the sternal end of the pectoralis major parallel to the margin of the sternum. Saeed found the Sternalis muscle to be innervated by intercostal nerves. A matter of debate is the sternalis muscle. Sternalis lie vertically alongside the sternum. Innervation of the sternalis muscle is provided by branches of pectoral nerves (55%) and/or intercostal nerves (43%). It was proved that the sternalis muscle was supplied only by the pectoral nerves even in the cas … The sternalis muscle was removed with the breast and was found to be a cylindrical muscle of approximately 8 cm in length and 2 cm in diameter. Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Sternalis Muscle sternalis muscle such as "parasternalis" and "rectus sterni" muscle. Barlow opines that morphologically, rectus sternalis represents the remains of panniculus carnosus. The Sternalis muscle has been nominated as a supernumerary anatomical variation; the highest prevalence is in China (23.5%) and the lowest in Chile (0.87%). Plentiful examples of additional muscles can be found in the literature, for example, an accessory head of the pectoralis major, one or more sternalis muscles, various slips of muscle originating or inserting at unusual locations, and even a double pectoralis major [1-3, 6-8]. The sternalis muscle .Ind J Med Sci 1968; 22: 46-47. On the left side both reach the sternalis; on the right side the upper of the two exhausts itself in branches to the great pectoral before it reaches the sternalis. Sternalis Muscle in 83 year old Female A) Sternalis muscle within a . the sternal membrane slightly below the angle of Louis; the Sternalis muscle has been encountered by many anatomists, inferior portion directly continued into the right pectoralis and its morphology, innervation and probable origin have major fibers. Sternalis is a muscle that runs along the anterior aspect of the body of the sternum.. Sternalis muscle innervation is quite enigmatic, implying that the rule of the close relationship between muscle ontogeny and innervation may not apply for this muscle. Shah AC. Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. of the sternalis muscles were innervated by branches of the internal and external thoracic nerves, 43% by branch-es of the intercostal nerves and 2% both from the inter-costal and thoracic nerves.13 In their case, the sternalis muscle was innervated by the intercostal nerve. There are two different theories as to what the Sternalis was meant to be connected to. injury. The sternalis has been grouped with the pectoral muscle group (pectoralis major) and with the abdominal muscle group (rectus abdominis and external oblique) because of common innervations. This muscle has been reported both in males and females, and in whites, blacks and Asians (Barlow, 1934; Kida & Kudoh, 1991; Shen et al. Furthermore, the blood supply It presents in several morphological variants both unilaterally and bilaterally and has no apparent physiological function. Often the variant anatomy was rare but benign, as in the case of this sternalis muscle dissected and prepared by Trinity's Professor of Anatomy Daniel John Cunningham (1850-1909). Various theories attribute towards the origin of the rectus sternalis muscle. It is regularly observed in lower animal but infrequently in humans. Sarikcioglu L et al. There is no known muscle test that causes it to contract. during clinical approaches. Presence of this muscle can create confusion with tumours of the anterior chest wall during routine mammography. Kida MY, Kudoh H. Innervation of the sternalis muscle accompanied by congenital partial absence of the pectoralis major muscle. Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. The function of sternalis is unknown. 2. Case 1. A cadaveric study was undertaken to report the incidence of sternalis muscle in cadavers of Asian origin. This muscle has been reported both in males and females . Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Sternalis Muscle According to them, it is a composite type of muscle [17]. Supply by more than one nerve may result from fusion of separate muscle bellies into a single sternalis muscle [ 8 ]. Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. Presence of this muscle can create confusion with tumours of the anterior chest wall during routine mammography. It lies superï¬ cial to the pectoral fascia, arises from the sheath of the rectus abdominis muscle or adjacent structures and terminates upon the pectoral fascia, upper sternum, costal cartilages, or the sternal or medial heads of the . In a study be Saeed, et al. Various authors suggested the microdissection technique as nerves are often destroyed in this region. The unique feature of present case study was the appearance of anterior thoracic wall having triangular pectoralis major muscle inspite of fan shaped. Unlike most muscles, its innervation varies considerably, but usually is served by intercostal nerves or the medial pectoral nerve. Its synergists and its antagonists remain Sensory supply is from the 7-12 thoracic nerves. (8) Recent surge in medical imaging and surgical procedures has brought this sternalis muscle into relevance in clinical practise. It is mostly unilateral (in 70%.) Description. The sternalis muscle ( TA: musculus sternalis 8 ), also known as rectus sternalis or parasternalis 7, is an uncommon chest wall accessory muscle and is of uncertain aetiology and function. A unilateral rectus sternalis muscle was observed in a 80-year-old male cadaver. External or internal thoracic nerve innervates the muscle in 55% of cases whereas 43% of cases are innervated by intercostal nerve and remaining by both [4]. This article will discuss the anatomy and function of the spinalis muscle. It is inserted at the level of the manubriosternal junction and arises from the sternal handlebar and with myofascial continuity with the sternocleidomastoid muscle. We examined the operative records of 1,152 patients who underwent modified radical mastectomies between 1990 and 2000. One is the Pectoralis major, the other is the rectus abdominus, as in several cases the sternalis was actually found to have interlaced fibers with the rectus abdominus, but be enervated by the same nerve . Although less is known about its origin and . But it is known that it may develop trigger points with acute angina pectoris or myocardial infarction. 7. muscular slips of pectoralis major muscle as well sternalis muscle were getting innervation from medial and lateral pectoral nerves as in (Figure 2). Fig. Arterial supply of sternalis muscle is from perforating branches of internal thoracic artery. 2. incidence of musculus sternalis in the population of Caldas (Colombia) and, therefore, 68 cadavers of adult individuals were us ed during a period of twenty years to determine the incidence of this muscle and describe its anatomical characteristics. Occasionally, a coexistent trigger point is located in the pectoralis muscle or sternal head of the sternocleidomastoid muscle. The homology debate from the literature reviewed Table 2 shows that the sternalis has been The question of the double innervation of the sternalis muscle [8] this muscle would have derived from the pectoralis major with its innervations from pectoral nerves or from the rectus abdominis with innervation from intercostal nerves. The sternalis muscle is a relative rarity that is believed to be prevalent in around 7-8% of the population. Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. Like the other two, it is made up of three parts. We present a review of the literature of the sternalis muscle with special emphasis on its clinical anatomy. External or internal thoracic nerve innervates the muscle in 55% of cases whereas 43% of cases are innervated by intercostal nerve and remaining by both [4]. Relation of intercostal nerves displayed. O' Neil and Folan-Curran reported that in 55% of the cases the muscle was innervated from the exter- . A total of 88 cadavers were studied over a period of six years and the sternalis was reported only in a single case and that too unilaterally. The sternalis is a muscle that is uncommonly but occasionally found in the human chest. Spinalis and longissimus both have capitis, cervicis and thoracis parts, while iliocostalis has cervicis, thoracis and lumborum parts. Situation between the anterior thoracic superficial fascia and the pectoral fascia. sternalis muscle is from internal or external thoracic or pectoral nerve in 55% of cases, intercostal nerves in 43% of cases, and both in 2% of cases [1,5]. 6. Located on the right side, the muscle took origin by a small fleshy belly from the lower part of pectoral fascia, at the level of 7 th costal cartilage. The sternalis muscle may be a variation of the pectoralis major or of the rectus abdominis . Relation of intercostal nerves displayed. Arterial supply of sternalis muscle is from perforating branches of internal thoracic artery. 1996). It is located on the human anterior pectoral wall, superficial to pectoralis major. It is supplied by the anterior thoracic nerves and is probably a misplaced part of the pectoralis [1]. Present in less than ten percent of the population . 1992; Bradley et al. 38 The function of the sternalis muscle still remains unknown, but it may help to elevate the lower chest wall. The first report which described it in alive subjects was made by Roubinowitch . The pain of sternalis syndrome is intermittent. In the literature it is also known as episternalis, presternalis . Sternalis muscle does not follow the relationship between muscle ontogeny and innervation. Below you'll find a list of all posts that have been tagged as "sternalis" The Evidence of Anatomy Trains Myofascial Meridians Strain transmission along myofascial meridians might explain referred pain and offer a rationale for the development of more body-wide holistic approaches. Fig. As the muscle has no function, there are no activities that are known to overwork the sternalis. The sternal muscle also called 'presternalis,' sternalis, rectus sterni or 'sternalis brutorum,' 'thoracicus' 1 is an interesting case of anatomical variation, being described in the literature as a small Fusion of separate muscle bellies into a single cadaver, one on right side two... Physiological function year old Female a ) sternalis muscle to be connected to 2! Left side, cervicis and thoracis parts, while iliocostalis has cervicis, thoracis and lumborum.. Mimic a mass lesion on mammogram sternalis muscle in 83 year old a... 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