On the muscles of the upper arm

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On the muscles of the upper arm of macacus cyclopsis by Akira Hadano First Department of Anatomy (Director: Professor Jun-ichiro Satoh) Faculty of Medicine, Nagasaki University I. Foreword The musculature of mammals, particularly primates, has been. studied in comparative detail and numerous reports have been published. However, all of these previous reports were done on the comparative anatomy in only a small series and, it is felt, that statistical investigation of a large sample of the same species are extremely few. Now, in order to study the normal standard condition of any animal, it is necessary to limit the error due to individual variation to a minimum for which the examination of a large number of a single species is required. In this sense, Professor Satoh of this Department has -collected a large number of macacus dyclopsis upon which an attempt is being made to determine the normal condition of this animal by the scupulous morphological study of each organ and system. The author, participating in this work, has studied the muscles of the upper arm. The results that have been obtained are presented below. II. Material and Method The material consisted of formalin fixed cadavers of macacus cyclopsis preserved in this Department. Both upper extremities of a total of 52 bodies, 30 male and 22 female, were seen but since one arm proved to be unsatisfactory for this study, actually a total of 103 limbs were observed. In the examination, each muscle was carefully dissected and observed grossly. When it was necessary a magnifying glass was used. Extremely careful inspection was made of the nerve supply as well as of the relation to blood vessels.

54 A. Hadano III. Findings and Considerations Howell and Straus have classified the muscles of the upper arm into those of the shoulder girdle and those of the limb proper. The later has been further divided into flexor and extensor groups. Included among the flexors are the m. coracobrachialis, m. biceps brachii and m. brachialis. The extensors are the m. triceps brachii, m. dorsoepitrochlearis and m. anconaeus lateralis. The author will discuss the findings according to this classification. 1. M. coracobrachialis (Fig. 1, 2) The coracobrachialis, in macacus cyclopsis, is divided into 2 parts. One, the coracobrachialis profundus or brevis. situated in the deep layer, arises from the processus coracoides and inserts at the collum chirurgicum of the humerus. The other, the coracobrachialis medius, located in the superficial layer, arises in common with the preceding upon which it lies, and not only is it adhered to the former but unites by a common tendon to the back of the caput breve of the biceps brachii and descends to about the middle of the anterior surface of the humerus where it ends medial to the insertion of the deltoides. Furthermore, the muscular fibers of the coracobrachialis medius were noted to converge toward the anterior angular process of the brachialis in all of the cases. This muscle is supplied by the musculocutaneous nerve. The first branch supplies the coracobrachialis brevis while the second branch goes to the medius. However, as a rule, the main trunk of the musculocutaneous nerve passes between the brevis and the medius. In only 1 case (0.97%) was this nerve seen penetrating the muscle, as is the case in man. J. Wood, who has discussed the comparative anatomy of this muscle in detail, claims that the primitive form of this muscle consists of 3 parts, i. e. the coracobrachialis brevis which arises from the processus coracoides of the scapula and inserts at the collum anatomicum of the humerus, the coracobrachialis medius which ends at about the middle of the humerus and the coracobrachialis longus which ends more distal to the middle of the humerus and at times reaches the epicondylus ulnaris or the septum intermusculare brachii ulnare. In man, the venter is one, which Hepburn claims is a blending of the coracobrachialis medius and longus. On the other hand, Parson

On the muscles of the upper arm of macacus cyclopsis 55. et al deny the merger theory between the medius and the longus and advocate that the coracobrachialis longus had formed the septum intermusculare brachii ulnare with only the coracobrachialis medius remaining. In anthropoid ape, it is said that, generally, the structure consists of only the coracobrachialis medius but, in some species, both the medius and the longus can be present. In the case of monkey it is usual for it to consist of both the coracobrachialis brevis and medius. Parson, who has studied the appearance rate of the coracobrachialis brevis, fod that it was extremely rare for this muscle to be absent in primitive monkeys and was present in almost 100% of his cases. However, in chimpanzee the appearance rate was about 30% with even lower rates for orang and gorilla. Further, in man the rate was only about 3%. Consequently, he concluded that there was a tendency for this muscle to disappear with advance in the animal towards anthropoid ape and could only rarely be seen in man. On summary and deliberation of the results of various workers as well as my own, it appears that though the basic form for this muscle consists of 3 parts ; the coracobrachialis brevis, medius and longus, the coracobrachialis longus has regressed in most mammals with the brevis and medius remaining in monkeys and in further advanced anthropoid ape this muscle is represented by only the coracobrachialis medius. In mammals, the muscplocutaneous nerve generally runs along the surface of the coracobrachialis medius and though there are occasional instances of perforation of the muscle in monkey or anthropoid ape penetration of the muscle is not seen in the majority of the cases. According to Howell and Straus the piercing of the coracobrachialis medius by the musculocutaneous nerve, as a rule, is limited to man and anthropoid ape. My results are not in disagreement with this rule. 2. M. biceps brachii (Fig. 1, 2) This muscle arises from two heads, the caput longum and caput breve, as it does in man. The caput longum arises by a long tendon from the tuberositas supraarticularis of the shoulder joint, while the caput breve located on the surface of the coracobrachialis arises from the processus coracoides by a common tendon with the coracobrachialis. These two heads unite at about the middle of the humerus to form a powerful fusiform venter which covers the front of the brachialis and inserts

56 A. Hadano (Fig. 1) at the tuberositas radii by a flat tendon. Furthermore, the lacertus fibrosus on the ulnar side of the forearm was absent except in 2 cases (1.94%). This muscle is supplied by a third branch of the musculocutaneus nerve after it has supplied the coracobrachialis brevis and medius by the first and second branches. In man the caput longum and caput breve, it is said, usually join high up on the arm but in lower animals this junction is farther

On the muscles of the upper arm of macacus cyclopsis 57 down and, in extreme, this muscle is completely separated into twoparts. However, Loth has reported cases of remarkable separation of the two heads in negroes and Furuizumi has presented one case each of high and low junction in Japanese adults. Also, Wagenseil has reported of his work on the Chinese. in which the junction was lower than the mid-arm in over half of his cases. Therefore, it appears that this joining in man is not necessarily high on the arm. The presence of the lacertus fibrosus is reported to be limited tohumans by Howell and Straus while Sonntag has found it to be present in lemurst-but regressed in ape. Its existance in orang has been denied by Fick. However, it is present in primates as I have reported. The appearance of additional heads of the biceps brachii becomes a problem both in comparative anatomy and anthropology. The frequency of such appearance is higher among the Japanese, Ainu,. etc. than Europeans. In anthropoid ape, they are occasionally seen in orang and gibbon but is so rare in chimpanzee that it is generally considered not to appear. Such divisions of this muscle are regarded. as primitive form (Vallois, Loth) but we did not find a single case in. our series. For example, the third head in gibbon claimed by Loth is the caput tuberculo-septale and since the caput breve is usually absent in these instances actually there are two heads present and Sonntag regards this third head to be the caput breve. There was 1 case (0.97%) in our series which had a narrow accessory tendon approximately 6 cm. wide which branched from the medial part of the tendon of origin of the caput breve at about a point 1/5 up on the brachium and joined with the tendon of origin of the caput longum slightly above the middle of the humerus. This is felt to be the broad tendon of origin said to be present in marsupial animals. (fig. 3) 3. M. brachialis (Fig. 2, 4) This muscle arises at a point between the insertion of the deltoid, des and the elbow joint. The upper tip is divided into 2 angular processes, anterior and posterior, which embrace the insertion of the deltoides. The venter covers the brachium below the insertion of the deltoid, and enters the capsule of the elbow joint to attach to the tuberosity of the ulna. The anterior angular process of this muscle has a muscular origin from the anterior surface of the brachium between the insertion of

SB A. Hadano (Fig. 2) the Coracobrachialis medius and insertion of the deltoid while the posterior angular process arises by a tendinous origin from the collum chirurgicum of the humerus or its vicinity and occasionally from the septum intermusculare brachii ulnare. Furthermore, in the central region, emkraced by these two processes, transition of muscle fiber from the deltoid is noted. The origin of the posterior angular process did not reach as far as the collum chirurgicum of the humerus in 12 cases (11.65%) of which the height in one case (0.97%) was almost the same as the

On the muscles of the upper arm of macacus cyclopsis 59' insertion of the deltoid. This muscle is supplied by the musculocutaneous nerve and occa; sionally by an anastomosed ramus of the median nerve and the musculocutaneous nerve. In the primitive form, it is said, this muscle is divided into two heads and this tendency is observed in all primates. Such findings have been described in humans, by Le Double in negroes and by Iwami in Japanese fetus. In our sample of macacus cyclopsis, a tendency for the radial nerve to separatehe lateral part of this muscle into upper and lower portions was noted but it was not possible to conclude that definite separation occurs. Also, according to Parson, the posterior angular process of this muscle is seen extending to the collum chirurgicum, a so-called high origin, among mammals in general including anthropoid ape but this process is regressed in humans. Further, in regards to the location of the anterior and posterior processes, Furuizumi has described cases of the anterior process arising higher than the posterior process in Japanese adults. However, this finding could not be found in macacus cyclopsis. In our cases, a portion of the fascia, prior to the entry of the tendon of insertion into the articular capsule, branches off and continues with the fascia of the brachioradialis. Also, in one case, an accessory bundle, 2.8 cm. long and 0.5 cm. wide, was seen at the distal end of this muscle. The lower tip of this slip arose from the lower portion of the area where this muscle crossed the barchioradialis to which it ran parallel and finally attached to the medial surface thereof. These fascia and accessory bundle remind one of the slip from, the upper lateral region of this muscle to the fascia of the forearm, seen in chimpanzee by Champneys, the slip to the fascia of the forearm described by Sonntag and, further, the fascia which transforms to the fascia of the forearm reported by Loth. These were considered to have the same significance as the exchange or union of the muscle fibers of this muscle and the brachioradialis said to be frequently seen in humans. 4. M. triceps brachii (Fig. 1, 2, 4) The triceps brachii is a powerful muscle consisting of three heads, the long head, the radial (lateral) head and the ulnar (medial) head. The ulnar head has an origin from the posterior surface of the

60 A. Hadano -h umerus and extends from the neck of the humerus to the elbow joint. The radial head which extends over 1/3 to 1/4 of the humerus below the neck of the humerus, arises from the radial side of the (Fig. 3) -ulnar head on the posterior surface of the humerus. The long head has an origin from the tuberositas infraarticularis and an area about 1/3 of the axillary border of the scapula. The long head and the radial head, firmly united by a common tendon, covers the ulnar head, to which they are adherd. They form a powerful muscular belly on the posterior surface of the humerus and stops at the head of the ulna. This muscle is supplied by the radial nerve. It is said, generally, that the long head of this muscle is particularly powerful in primitive primates and has a wider area of origin than in man. It has been reported that the origin in macacus rhesus covers 1/2 of the axillary border (Howell and Straus), 1/2 to 1/3 in anthropoid ape (Hepburn) and 1/3 of the axillary border in chimpanzee (Sonntag). In our sample of macacus cyclopsis also the origin covered a wide area, 1/3 of the axillary border. In the relation of the long head and teres minor, among humans, they may be joined or not. They have been reported to be adhered

On the muscles of the upper arm of macacus cyclopsis 61 (Fig. 4) in 3 cases out 10 in Ainu (San-o).and in 26 out of 100 cases in Japanese fetus (Iwami). In macacus cyclopsis, adhesion was noted in 14 cases out of 103 (13.59%). As for the mutual relationship in height of the ulnar and radial

62 A. Hadano heads, it is found that the ulnar head in macacus cyclopsis did not go above the radial head even in one case. The radial head was superior in 93 cases (90.29%) while the two were either equal or no appreciable difference in height noted in 10 cases. (9.7%). When compared with the results for Japanese adults (Furuizumi), Ainu (Sano) and Japanese fetus (Iwami), it was found that these results were most similar to those for Japanese adults and differed the greatest from the Ainn. Japanese ( adult Ainu Japanese fetus Macacus Cyclopsis Furuizurni) (Sano) (Iwarni) (Hadano) Radial head higher 94 % 50%72%90 Equal height 40280.97 Ulnar head higher than radial head 2 50 0.29% ulnar head than The fusion of the radial and ulnar heads which is said to occur occasionally in humans, could not be demonstrated but the mutual transition of muscle fiber described by Iwami was noted in 16 out of 103 cases (15.53%). Loth has described the tendinous union of this muscle with the latissimus dorsi or the junction with the teres major and the latissimus dorsi. However, no evidence of such was found in this study. 5. M. dorsoepitrochlearis (Fig. 4) This muscle is considered to be the joining of a portion of the triceps brachii with the latissimus dorsi. In macacus cyclopsis this muscle, on the posterior surface of the triceps brachii, separates from the latissimus dorsi before its insertion to the humerus. This soon forms a fascia which unites with the fascia of the triceps brachii on the posterior surface thereof and stops at the head of the ulna. The muscular belly of this muscle is generally round and the length of Oe muscular region and the fascia region are almost equal. The nerve supply to this muscle, as in macacus rhesus, is from the radial nerve. Though this muscle is absent in man with only fascia present, it may be found rarely. There have been reports that it was seen in 10 cases out of 53 Japanese (Adachi), 4 cases out of 36 Englishmen (Wood), 53 in 200 Russians (Gruber), 52 in 204 cases of Frenchmen (Le Double) and in 19 out of 64 Chinese (Wagenseil),

On the muscles of the upper arm of macacus cyclopsis 63 6. M. anconeus lateralis (Fig. 4) This muscle may be considered to be the extension of the distal portion of the triceps brachii with no definite demarkation between the two. It is a small muscle from the ulnar head and lateral epicondyle to the posterior surface of the ulna and fuses with the extensor carpi ulnaris. Consequently, it is innervated by a branch from the radial nerve which supplies the triceps brachii. IV. Summary The muscles of the upper arm of 103 stet limbs from 52 cadavers of macacus cyclopsis were studied. The following are the results : 1. M. coracobrachialis This muscle, as described by J. Wood, is separated into two parts, the coracobrachialis brevis and coracobrachialis medius. Origin : Processus coracoides Insertion : Coracobrachialis brevis collum chirurgicum Coracobrachialis medius middle of humerus Nerve supply : Musculocutaneous nerve Variation : Penetration of coracobrachialis by the musculocutaneous nerve in 1 case (0.97%). 2. M. biceps brachii This muscle has fwo heads, the caput longum and caput breve, which unite at about the middle of the humerus. Generally, the lacertus fibrosus is absent.. Origin : Caput longum tuberositas supraarticularis Caput breve processus coracoides Insertion : Tuberositas radii Nerve supply : Musculocutaneous nerve Variations : The lacertus fibrosus was present in 2 cases (1.9%). An accessory tendon uniting the caput longum and the caput breve was noted in 1 case (0.97%). 3. M. brachialis Origin : The upper tip is divided into 2 angular processes. The middle portion includes the area from the end of the deltoid to the elbow joint. Anterior process muscular origin from between the insertion of the deltoides and the attachment of the coracobrachialis medius. Posterior process tendinous origih from the collum chi-

64 A. Hadano rurgicum of the humerus, septum intermusculare brachii ulnare. Insertion Tuberositas ulnae A portion of the fascia was continuous with the fascia of the barchioradialis. Nerve supply Musculocutaneous nerve or by an anastomosed ramus of the musculocutaneous nerve and the median nerve. Variations : An accessory bundle was seen running from the posterior surface of this muscle to the medial surface of the brachioradialis in 1 case (0.97% ). 4. M. triceps brachii This muscle consists of 3 heads, caput longum, caput radiale and,caput ulnare. Origin : Caput longum tuberositas infraarticularis and axillary border. Caput radiale posterior surface of humerus. Caput ulnare posterior surface extending from the neck of humerus to the elbow joint. Insertion : The 3 heads unite and insert at the head of ulna. Nerve supply : Radial nerve. Variations : Adhesion to teres minor seen in 14 cases (13.58%). 5. M. dorsoepitrochlearis The joining of a portion the triceps brachii with the latissimus dorsi which ends at the head of the humerus. This muscle was present in all cases. Nerve supply : Radial nerve. 6. M. anconeus lateralis This muscle is the distal portion of the triceps brachii and extends from the ulnar head and lateral epicondyle to the posterior surface of the ulna. Nerve supply : Radial nerve. As presented above the origin, insertion, nerve supply and variations in the various muscles of the upper arm in macacus cyclopsis have been studied and their normal conditions clarified. Further, these findings were compared with those for man and it was fornd that though the muscular system of macacus cyclopsis was generally primitive but variations were not so great. In other words, their condition appeared to be relatively stable.

On the muscles of the upper arm of macacus cyclopsis 65 Literature 1) Adachi, B.; Beiträge zur Anatomie der Japaner. Zeitschr. Morph. Anthr. Bd. 12, 1909. 2) Bolk u. Gdppelt; Handbuch der vergleichenden Anatomie der Wirbeltiere. Bb. 5, Berlin. 1922. 3) Champneys, F.; On the muscles and nerves of the chimpanzee (Troglodytes niger) and a Cynocephlus anubis. Jour. Anat. Physiol. Vol. 6, 1871. 4) Furuizumi, K.; Studies on the musculature of the shoulder and arm of the Japanese. (Japanese) Nippon. I. Z. Vol. 5, 1934. 5) Fick, R.; Vergleichende anatomische Studien an einem erwachsenen Orang-utang. Arch. Amt. Entwickl. 1895. 6) Hepburn, D.; The comparative anatomy of the muscles and nerves of the superior and inferior e xtremities of the anthropoid apes. Jour. Anat. Physiol. Vol. 26, 1892. 7) Hartman, R.; The Anatomy of the Rhesus Monkey. Baltimore. 1933. 8) Iwami, S.; Studies on the musculature of the upper extremities of the Japanese fetus. 1 Report On the muscles of the brachium. (Japanese) Igaku Kenkyu. Vol. 20, 1950. 9) Loth, E.; Anthropologic des Parties mollies. Paris. 1931. 10) Loth, E.: Anthropologie des Negerweichteile. Stuttgart. 1912. 11) Parson, F. G.; The muscles of the manmals, with special relation to human myology. Jour. Anat. Physiol. Vol. 32, 1898. 12) Raven, H. C.; The Anatomy of the Gorilia. New York. 1950. 13) Sano, K.; Studies on the musculature of the upper extremities of the Ainu. (Japanese) Fukuoka Igk. Z. Vol. 24, 1913. 14) Sonntag, C. F.; On the anatomy, physiology and pathology of the chimpanzee. Proc. Zool. London, 1923. 15) Sonntag, C. F.; The Morphology and Evolution of the Apes and Man. London. 1924. 16) Wagenseil, F.; Untersuchung Ober die Muskulature des Chinese. Zeitschr. Morph. Anthrop. Bd, 36, 1936. 17) Wood, J.; On human muscular variation and their relation to comparative anatomy. Jour. Anat. Physiol. Vol. 1, 1867. cited