There is at present disagreement on the nerve supply to the M. supracostalis anterior of man with some reports describing it to be innervated by the R. muscularis externus n. intercostalis, and other reports describing it to be supplied by the R. cutaneus lateralis n. intercostalis. In order to determine the nerve supply to this muscle as well as to determine its true nature, examinations were made of the anterior chest wall of 50 sides of the body in 25 adult cadavers, The following findings and conclusions were made.
(1) Three cases were found which were considered to represent the M. supracostalis anterior. All of these cases were concluded as being the M. supracostalis anterior based on a review of their origin, insertion, the course of the muscle bundle, and the relationships with adjacent muscles in comparison with the descriptions in earlier reports on the M. supracostalis anterior.
(2) Among the muscles discovered, the nerve supply was not determined for one. The other two muscles were confirmed to be innervated by a small branch from the R. muscularis externus n. intercostalis.
Careful analysis of the nerve supply indicated that these two muscles had differentiated from the superficial layer of the M. intercostalis externus within the first intercostal space and extended caudalwards to insert onto the lower ribs. Based on comparative anatomical considerations, they were considered to be progressive anomalous muscles.
(3) A review was made of the relation between the R. muscularis externus and R. cutaneus lateralis of the N. intercostalis. The results suggested that the R. muscularis externus, when it penetrates the M. intercostalis externus to emerge to the outer surface, may possibly be mistaken as a branch from the R. cutaneus lateralis.
(4) Some investigators have reported cases in which the M. supracostalis anterior was supplied by a branch from the R. cutaneus lateralis n. intercostalis. The true nature of the muscle in such cases was assessed from the standpoint of the nerve supply and comparative anatomy. Contrary to the views of the above investigators on the true nature of this muscle, the results of the present review suggested that the muscle in such cases was homologous with the M. sterno-costalis, which is always present on the anterior chest wall of mammals excluding man, anthropoids and monotremes, and that it was an atavistic anomalous muscle.
Moreover, if the above-mentioned reports describing the nerve supply were to be accepted, the possibility could not be ruled out of there being seen on the anterior chest wall of man a M. supracostalis anterior which should be considered to belong to the same muscular system as the M. obliquus externus abdominis.
(5) The nature of the muscle for which the nerve supply was not determined can be considered to be as follows based on the state of adhesion of the muscle with the M. intercostalis externus within the first intercostal space, and its relationship with the M. intercostalis externus and the aponeurosis of origin of the M. serratus anterior within the second intercostal space. That is, this may have been a muscle which had differentiated from the superficial layer of the M. intercostalis externus within the first intercostal space and extended caudalwards to insert onto the third rib.
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