Skip to main content

Advertisement

SpringerLink
Log in

Variations in the anterior thoracic wall with sternalis muscle and accessory pectoralis major muscle

  • Anatomic Variations
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The new type of the sternalis muscle needs to be recognized, and the accessory pectoralis major muscle (AcPM) was found between the pectoralis major and minor muscle. It needs to be acknowledged those two different variations can exist in one case.

Methods

The muscle was found on a 73-year-old male cadaver during the dissection class for the anterior thoracic wall. It was proceeded to identify the adjacent structures with precise dissection.

Results

The cadaver had sternalis muscle bilaterally. Both side sternalis muscles had a medial and lateral belly and attached to pectoral fascia and rectus abdominis sheath. The pectoralis major muscle (PMaj) had a more profound slip attached to the costal cartilage of rib 4 and 5, which is AcPM. The pectoral nerve traveled through the clavipectoral fascia to the AcPM and through PMaj to the sternalis muscle.

Conclusions

This study presented a new type of sternalis muscle. Two different variations were developed along with the pectoral nerve. It needs to be recognized in the diagnostic images, the muscle rehab outcome, and the surgical complication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Arican RY, Coskun SL, Sindel M, Oguz N (2006) Co-existence of the pectoralis quartus and pectoralis intermedius muscles. Morphologie 90:157–159

    Article  CAS  Google Scholar 

  2. Arraez-Aybar LA, Sobrado-Perez J, Merida-Velasco JR (2003) Left musculus sternalis. Clin Anat 16:350–354

    Article  CAS  Google Scholar 

  3. Barlow RN (1935) The sternalis muscle in American whites and negroes. Anat Rec 64:413–426

    Article  Google Scholar 

  4. Beresford B (1983) Brachial muscles in the chick embryo: the fate of individual somites. J Embryol Exp Morphol 77:99–116

    CAS  PubMed  Google Scholar 

  5. Brandley FM, Hoover HC Jr, Hulka CA et al (1996) The sternalis muscle: an unusual normal finding seen on mammography. Am J Roentgenol 166:33–66

    Article  Google Scholar 

  6. Brown RH, Sharabi SE, Kania KE, Hollier LH, Izaddoost SA (2017) The split pectoralis flap: combining the benefits of pectoralis major advancement and turnover techniques in one flap. Plast Reconstr Surg 139(6):1474–1477

    Article  CAS  Google Scholar 

  7. Carson BM (2004) Human embryology and developmental biology. Mosby, St Louis, pp 224–225

    Google Scholar 

  8. Clemente CD (1985) Gray’s Anatomy. Williams & Wilkins, Baltimore, pp 516–520

    Google Scholar 

  9. Di Gennaro GL, Soncini G, Andrisano A, Valiserri L (1998) The chodroepitrochlearis muscle: case report. Chir Organ Mov 83:419–423

    Google Scholar 

  10. Duque-Parra JE, Barco-rios J, Velez-Garcia JF (2019) Incidence of sternalis muscle in the Caldas population (Columbia): anatomical variations. Int J Morphol 37(4):1342–1346

    Article  Google Scholar 

  11. Haladaj R, Wysiadecki G, Clarke E, Polguj M, Topol M (2019) Anatomical variations of the pectoralis major muscle: notes on their impact on pectoral nerve innervation patterns and discussion on their clinical relevance. BioMed Res Int. https://doi.org/10.1155/2019/6212039

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jelev L, Georgiev G, Surchev L (2001) The sternalis muscle in the Bulgarian population: classification of sternales. J Anat 199:359–363

    Article  CAS  Google Scholar 

  13. Kida MY, Izumi A, Tanaka S (2000) Sternalis muscle: topic for debate. Clin Anat 13:138–140

    Article  CAS  Google Scholar 

  14. Loukas M, Bowers M, Hullett J (2004) Sternalis muscle: a mystery still. Folia Morphol 63:147–149

    Google Scholar 

  15. Loukas M, Louis RG, Kwiatkowska M (2005) Chondroepitrochlearis muscle, a case report and a suggested revision of the nomenclature. Surg Radiol Anat 27:354–356

    Article  Google Scholar 

  16. Loukas M, South G, Louis RG Jr, Fogg QA, Davis T (2006) A case of an anomalous pectoralis major muscle. Folia Morphol 65(1):100–103

    CAS  Google Scholar 

  17. Maclin MM, Deigni OA, Bengtson BP (2015) The laminated nature of the pectoralis major muscle and the redefinition of the inframammary fold: clinical implications in aesthetic and reconstructive breast surgery. Clin Plast Surg 42(4):465–479

    Article  Google Scholar 

  18. Paraskevas GK, Raikos A (2010) Bilateral pectoral musculature malformation with concomitant vascular anomaly. Folia Morphol 69:187–191

    CAS  Google Scholar 

  19. Patil J, Kumar N, Swamy RS, Somayaji SN et al (2014) Accessory pectoralis muscle intervening between pectoralis major and minor muscles—a case report. Int J Health Sci Res 4(2):198–201

    Google Scholar 

  20. Raikos A, Paraskevas GK, Yusu F, Kordali P, Ioannidis O, Brand-Saberi B (2011) Sternalis muscle: a new crossed subtype, classification, and surgical applications. Ann Plast Surg 67:646–648

    Article  CAS  Google Scholar 

  21. Raikos et al (2011) Sternalis muscle: an underestimated anterior chest wall anatomical variant. J Cardiothorac Surg 6:73

    Article  Google Scholar 

  22. Shah AC (1968) The sternalis muscle. Indian J Med Sci 22:46–47

    CAS  PubMed  Google Scholar 

  23. Snosek M, Tubbs S, Loukas M (2014) Sternalis muscle, what every anatomist and clinician should know. Clin Anat 27:866–884

    Article  Google Scholar 

  24. Sonne JWH (2020) Prevalence of the sternalis muscle in a sample of routinely dissected human cadavers. Surg Radiol Anat 42:87–90

    Article  Google Scholar 

  25. Sweeney LJ (1998) Basic concepts in embryology. McGraw-Hill, New York, pp 36–138

    Google Scholar 

  26. Tessier-Lavigne M, Goodman CS (1996) The molecular biology of axon guidance. Science 274:1123–1133

    Article  CAS  Google Scholar 

  27. Turner W (1867) On the musculus sternalis. J Anat Physiol 1:246–253

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Venieratos D, Samolis A, Piagkou M, Douvetzemis S, Kourotzoglou A, Natsis K (2017) The chondrocoracoideus muscle: a rare anatomical variant of the pectoral area. Acta Med Acad 46(2):155–161

    Article  Google Scholar 

  29. Young Lee B, Young Byun J, Hee Kim H et al (2006) The sternalis muscles: incidence and imaging findings on MDCT. J Thorac Imaging 21:179–183

    Article  Google Scholar 

Download references

Acknowledgements

The author kindly thanks Dr. John Romfh, Mrs. Jo Anne Romfh, for the professional advisements and review of English.

Author information

Authors and Affiliations

  1. School of Health Sciences, Indiana Wesleyan University, Marion, IN, USA

    Pil-Woo Kim

Authors
  1. Pil-Woo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The author contributed to the study conception and design. Material preparation, data collection, visualizations, and analysis were performed by P-WK. The first draft of the manuscript was written by P-WK and the author modified on the previous versions of the manuscript. John Romfh and Joanne Romfh gave the corrections in English and suggested better descriptions. The author read and approved the final manuscript.

Corresponding author

Correspondence to Pil-Woo Kim.

Ethics declarations

Conflict of interest

The author declares that they are no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, PW. Variations in the anterior thoracic wall with sternalis muscle and accessory pectoralis major muscle. Surg Radiol Anat 44, 785–790 (2022). https://doi.org/10.1007/s00276-022-02923-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-022-02923-w

Keywords

Search

Navigation