The results indicate that branches of the ACHA in the mesotenon of the LHBT provide blood supply not only to the tendon but to the osseous bicipital groove as well and here significantly more to the lateral than to the medial osseous wall. In addition, Pacini-like mechanoreceptors could be identified in the mesotenon in 9 The bicipital groove which is bounded by the lesser tuberosity medially and the greater tuberosity laterally contains the tendon of the long head of the biceps brachii muscle LHBT.
The osseous bicipital groove in zone 1 is in the average about 30 mm long, 5 mm deep and covered by the so called transverse humeral ligament formed by tendinous fibers of the subscapularis and supraspinatus muscles.
The purpose of this histological study was therefore to further analyze the distinct vascular distributional pattern of arteries in the bicipital groove and the vascularization of this segment of the LHBT.
An anatomic dissection and histologic study was performed by using 24 cadaveric formaldehyde fixated shoulders. The mean age of the specimens was Dissection was conducted in a similar fashion for all specimens by the 2 nd author. The outer skin, subcutaneous tissues and the deltoid muscle were removed with the shoulder capsule, rotator cuff and LHBT sheath covered by the transverse humeral ligament left intact.
Afterwards, the bicipital groove including the LHBT and its intact sheath is cut out en-bloc using chisels. The cranial border of the segmented block was defined the upper edges of tuberculum minus and majus and the distal border was defined by the insertion of the pectoralis major muscle.
Laterally, the incision was placed 10 mm lateral to the LHBT to include the complete lateral wall of the osseous groove.
Medially, 20 mm distance to the LHBT is kept in order to include the complete medial wall of the groove Figure 1. Humeral head after removal of the skin, subcutaneous tissues and the deltoid muscle revealing the shoulder capsule, rotator cuff and LHBT sheath covered by the transverse humeral ligament in the bicipital groove.
The blocks were then subsequently decalcified in diamine tetraacetic acid and embedded in paraffin. After staining, immersion of the sections in an ascending series of ethanol, mounting using a xylene miscible mountant Depex, SERVA Electrophoresis GmbH, Heidelberg, Germany and sealing of the slides for light microscopy was conducted.
The histological evaluation was carried out using a standard light microscope Motic, Wetzlar, Germany. The included microscope camera was used for documentation Moticam Each branch deriving from the main arteries in the mesotenon of the LHBT was identified and followed through multiple sections to identify its direction and area of supply Figure 2. Azan stain of a transverse section through the bicipital groove. The groove is covered by the transverse ligament TL.
The Chi- Square test was used for comparison of anatomical distribution of the branches to the medial and lateral wall of the groove. All authors declare that they have no competing interests. The local ethics committee approved this study registration number The LHBT was identified surrounded by synovial and loose connective tissue. Intratendinous vessels could not be found in any specimen.
The bicipital groove was covered with a thick fibrous roof representing the transverse humeral ligament whereas the posterior groove with contact to the LHBT is covered with fibrous cartilage Figure 3. Azan stain of subsequent longitudinal sections. For 3 branches 4. A nerve inside the osseous canal could be identified in 38 An accompanying nerve was identified in 15 Concerning the distinct distributional pattern, we are able to show that the significantly more branches are directed to the lateral than to the medial wall of the bicipital groove.
Our results of ascending arterial branches in the mesotenon confirm the findings of other authors. Boesmueller et al. One limitation of our study is that origin of arteries in the mesotenon was not identified by dissection prior to the histological analysis. In regard to the blood supply to the osseous humeral head, Gerber et al. In addition, we identified Pacini-like mechanoreceptors in the soft-tissue of the mesotenon in Numerous mechanoreceptors are found in the shoulder joint capsule, rotator cuff and the glenohumeral ligaments but have not been described in the soft tissue of the bicipital groove adjacent to the LHBT up to now.
Snow et al histologically analyzed the transverse humeral ligament and found free nerve endings but no mechanoreceptors.
About Recent Edits Go ad-free. Bicipital groove Last revised by Dr Osamah A. Alwalid on 04 Sep Edit article. View revision history Report problem with Article. Citation, DOI and article data. Deng, F. Bicipital groove. Reference article, Radiopaedia. Intertubercular sulcus Sulcus intertubercularis Intertubercular groove.
URL of Article. Received 14 Jul Accepted 13 Aug Published 12 Sep Abstract The variant morphometry of bicipital groove is reported to be associated with pathologies of biceps tendon and is useful in surgical procedures in this region. Introduction Bicipital groove BG is an indentation on the anterior aspect of proximal part of humerus.
Materials and Methods The study was carried out using hundred and one humeri of assorted sex and pair. Figure 1. Figure 2. Table 1. Table 2. Figure 3. Study Wafae et al. Table 3. Comparison of length, width, and depth of bicipital groove.
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