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Sternalis muscle: an underestimated anterior chest wall anatomical variant.

Raikos A, Paraskevas GK, Tzika M, Faustmann P, Triaridis S, Kordali P, Kitsoulis P, Brand-Saberi B - J Cardiothorac Surg (2011)

Bottom Line: Over the recent years, an increased alertness for thorough knowledge of anatomical variants with clinical significance has been recorded in order to minimize the risks of surgical complications.We report a rare case of bilateral strap-like sternalis muscle of the anterior chest wall in a female cadaver.Moreover, its presence may be misdiagnosed as a wide range of benign and malignant anterior chest wall lesions and tumors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr University, Bochum, Germany. a.raikos@yahoo.com

ABSTRACT
Over the recent years, an increased alertness for thorough knowledge of anatomical variants with clinical significance has been recorded in order to minimize the risks of surgical complications. We report a rare case of bilateral strap-like sternalis muscle of the anterior chest wall in a female cadaver. Its presence may evoke alterations in the electrocardiogram or confuse a routine mammography. The incidental finding of a sternalis muscle in mammography, CT, and MRI studies must be documented in a patient's medical records as it can be used as a pedicle flap or flap microvascular anastomosis during reconstructive surgery of the anterior chest wall, head and neck, and breast. Moreover, its presence may be misdiagnosed as a wide range of benign and malignant anterior chest wall lesions and tumors.

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Related in: MedlinePlus

Bilateral strap-like sternalis muscle (SM) in a female cadaver. The muscle arises from the tendon of the sternal origin of the sternocleidomastoid muscle (St) and the upper segment of the pectoralis major on each corresponding hemithorax. On the right side, it runs in convex course and terminates at the right sternocostal arch and onto the right external oblique muscle aponeurosis. While on the left, the muscle split into two bellies (arrows) and is inserted onto the left 10th-12th costal cartilages and costochondral junctions and terminates on the left sternocostal arch. PM: pectoralis major.
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Figure 1: Bilateral strap-like sternalis muscle (SM) in a female cadaver. The muscle arises from the tendon of the sternal origin of the sternocleidomastoid muscle (St) and the upper segment of the pectoralis major on each corresponding hemithorax. On the right side, it runs in convex course and terminates at the right sternocostal arch and onto the right external oblique muscle aponeurosis. While on the left, the muscle split into two bellies (arrows) and is inserted onto the left 10th-12th costal cartilages and costochondral junctions and terminates on the left sternocostal arch. PM: pectoralis major.

Mentions: During an educational thoracoabdominal dissection of a female formalin-fixed cadaver, a long well defined vertical muscle was encountered on each hemithorax. Both muscles were strap-like, flattened, located parallel to the sternum in a paramedian position, and lying superficial to the pectoralis major muscle and the pectoral fascia (Figure 1). Specifically, on the right hemithorax, the muscle tendon arose from the sternal origin of the right sternocleidomastoid muscle, and the upper segment of the pectoralis major. The muscle fibers passed downwards in a convex-shaped course and terminated at the right sternocostal arch and onto the right external oblique muscle aponeurosis. On the left side, a bicipital sternalis muscle was observed and although its tendon arose in identical pattern as in the right side, at the level of the sternal angle it split into a medial (wide) and a lateral (narrow) bundle. The muscle gradually inserted onto the left 10th-12th costal cartilages and costochondral junctions and terminated on the left sternocostal arch. The schematic representation of the findings can be seen in Figure 2.


Sternalis muscle: an underestimated anterior chest wall anatomical variant.

Raikos A, Paraskevas GK, Tzika M, Faustmann P, Triaridis S, Kordali P, Kitsoulis P, Brand-Saberi B - J Cardiothorac Surg (2011)

Bilateral strap-like sternalis muscle (SM) in a female cadaver. The muscle arises from the tendon of the sternal origin of the sternocleidomastoid muscle (St) and the upper segment of the pectoralis major on each corresponding hemithorax. On the right side, it runs in convex course and terminates at the right sternocostal arch and onto the right external oblique muscle aponeurosis. While on the left, the muscle split into two bellies (arrows) and is inserted onto the left 10th-12th costal cartilages and costochondral junctions and terminates on the left sternocostal arch. PM: pectoralis major.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117696&req=5

Figure 1: Bilateral strap-like sternalis muscle (SM) in a female cadaver. The muscle arises from the tendon of the sternal origin of the sternocleidomastoid muscle (St) and the upper segment of the pectoralis major on each corresponding hemithorax. On the right side, it runs in convex course and terminates at the right sternocostal arch and onto the right external oblique muscle aponeurosis. While on the left, the muscle split into two bellies (arrows) and is inserted onto the left 10th-12th costal cartilages and costochondral junctions and terminates on the left sternocostal arch. PM: pectoralis major.
Mentions: During an educational thoracoabdominal dissection of a female formalin-fixed cadaver, a long well defined vertical muscle was encountered on each hemithorax. Both muscles were strap-like, flattened, located parallel to the sternum in a paramedian position, and lying superficial to the pectoralis major muscle and the pectoral fascia (Figure 1). Specifically, on the right hemithorax, the muscle tendon arose from the sternal origin of the right sternocleidomastoid muscle, and the upper segment of the pectoralis major. The muscle fibers passed downwards in a convex-shaped course and terminated at the right sternocostal arch and onto the right external oblique muscle aponeurosis. On the left side, a bicipital sternalis muscle was observed and although its tendon arose in identical pattern as in the right side, at the level of the sternal angle it split into a medial (wide) and a lateral (narrow) bundle. The muscle gradually inserted onto the left 10th-12th costal cartilages and costochondral junctions and terminated on the left sternocostal arch. The schematic representation of the findings can be seen in Figure 2.

Bottom Line: Over the recent years, an increased alertness for thorough knowledge of anatomical variants with clinical significance has been recorded in order to minimize the risks of surgical complications.We report a rare case of bilateral strap-like sternalis muscle of the anterior chest wall in a female cadaver.Moreover, its presence may be misdiagnosed as a wide range of benign and malignant anterior chest wall lesions and tumors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Anatomy and Molecular Embryology, Medical Faculty, Ruhr University, Bochum, Germany. a.raikos@yahoo.com

ABSTRACT
Over the recent years, an increased alertness for thorough knowledge of anatomical variants with clinical significance has been recorded in order to minimize the risks of surgical complications. We report a rare case of bilateral strap-like sternalis muscle of the anterior chest wall in a female cadaver. Its presence may evoke alterations in the electrocardiogram or confuse a routine mammography. The incidental finding of a sternalis muscle in mammography, CT, and MRI studies must be documented in a patient's medical records as it can be used as a pedicle flap or flap microvascular anastomosis during reconstructive surgery of the anterior chest wall, head and neck, and breast. Moreover, its presence may be misdiagnosed as a wide range of benign and malignant anterior chest wall lesions and tumors.

Show MeSH
Related in: MedlinePlus