Multiple musculovascular anomalies in the superior extremities of a cadaver: a case report

During the evolution from the lower animals to man, the upper limbs have acquired a great mobility, but at the cost of their stability. The reverse is true for the lower limbs. The muscular anomalies which are common in the upper limbs are largely explainable on a phylogenetic basis. The same is true for the vascular anomalies. However, such anomalies are usually seen singly and they are never together in the same limb or in two limbs of the same body. The upper limbs which are being reported here had multiple musculovascular anomalies and some of these were bilateral. These include the superficial brachial artery, the accessory head of the biceps brachii, the accessory muscular slips which arose from the common flexor origin and went to the tendons of the flexor digitorum profundus and the flexor pollicis longus separately, bifurcation of the tendon of insertion of the brachioradialis and bifurcated (split) insertion of the third lumbrical on the adjacent fingers. Though all these variations have been described in the standard text books of Anatomy, their occurrence, together in one limb and the bilateral presentations of some of these, have never been encountered. Almost all these variations have been explained phylogenically, thus supporting the dictum, "The ontogeny repeats the phylogeny." Furthermore, their clinical significance has also been discussed.