title: Marked lateral deviation of the phrenic nerve due to variant origin and course of the thyrocervical trunk: a cadaveric study.
abstract: Phrenic nerve impairment can often lead to serious respiratory disorders under various pathological conditions. During routine dissection of an 88-year-old Japanese male cadaver, a victim of heart failure, we recognized an extremely rare variation of the right thyrocervical trunk arising from the subclavian artery laterally to the anterior scalene muscle. In addition to that, the ipsilateral phrenic nerve was drawn and displaced remarkably laterad by this vessel. We examined all of the branches arising from subclavian arteries, phrenic nerves and diaphragm muscles. The embryological background of this arterial variation is considered. The marked displacement with prolonged strain had a potential to cause phrenic nerve impairment with an atrophic change of the diaphragm muscle. Recently many image diagnostic technologies have been developed and are often used. However, it is still possible that rare variations like this case may be overlooked and can only be recognized by intimate regional examination while keeping these rare variations in mind.
authors.affiliation: Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan. keiko.ogami@gmail.com.|Department of Anesthesiology, Nagasaki University School of Medicine, Nagasaki, Japan. keiko.ogami@gmail.com.
authors.forename: Keiko
authors.initials: K
authors.lastname: Ogami
authors.affiliation: Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Saiki
authors.affiliation: Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Wakebe
authors.affiliation: Department of Oral Anatomy and Dental Anthropology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Manabe
authors.affiliation: Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Imamura
authors.affiliation: Department of Macroscopic Anatomy, Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tsurumoto
mesh_terms: D000369:Aged, 80 and over; D063405:Anatomic Variation; D006801:Humans; D008297:Male; D010791:Phrenic Nerve / Q000002:abnormalities*; D013348:Subclavian Artery / Q000002:abnormalities*
keywords: Diaphragm paralysis; Phrenic nerve; Subclavian artery; Thyrocervical trunk; Variation