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Accessory Head(s) of the Palmaris Longus Muscle in an 86-Year-Old White Female Cadaver and an 81 Year-Old White Male Cadaver Ariana Sheridan, MD1; Shiloh Jones, PhD2; Gary Wind, MD, FACS3; Guinevere Granite, PhD3 1Directorate for Education, Training, and Research, Walter Reed National Military Medical Center, Bethesda, MD 2 Georgetown University School of Medicine, Washington, DC 3 Department of Surgery, Uniformed Services University of the Health Sciences (USUHS), Bethesda, MD ABSTRACT CONCLUSION INTRODUCTION DISCUSSION REFERENCES It is known that the palmaris longus muscle (PLM) is one of the most variable muscles in the human body. The PLM has a high morphological diversity and variations are frequently reported in the literature. Recognizing anatomical variation in the PLM and tendon is important for clinical associations such as neurovascular entrapment and compression, as well as tendon graft and transfer for reconstruction. While neglecting to identify PLM variations rarely leads to an increase in mortality, it is essential to identify for clinical relevance. During anatomical dissection of fifty cadavers in the 2020 undergraduate first-year anatomy course at the Uniformed Services University of Health Sciences (USUHS), we found two separate cases of accessory heads of the PLM. The first case involved a preserved 86-year-old White Female who had one unilateral accessory head of the left PLM. The second case involved a preserved 81-year-old White Male who had a unilateral pair of accessory heads of the right PLM. • High morphological diversity and variations are frequently reported in the literature [1-5] • Variations in the belly and tendon are not uncommon and include absence of the muscle and tendon, duplicate muscle belly, fusion with another muscle, bifurcated or trifurcated tendon, tendinous, digastric, or inverted reversed muscle • Its belly and tendon may also vary by the tendon course and insertion [6] • There are also reports of an anomalous PLM with, RITM0020806, It is known that the palmaris longus muscle (PLM) is one of the most variable muscles in the human body. The PLM has a high morphological diversity and variations are frequently reported in the literature. Recognizing anatomical variation in the PLM and tendon is important for clinical associations such as neurovascular entrapment and compression, as well as tendon graft and transfer for reconstruction. While neglecting to identify PLM variations rarely leads to an increase in mortality, it is essential to identify for clinical relevance. During anatomical dissection of fifty cadavers in the 2020 undergraduate first-year anatomy course at the Uniformed Services University of Health Sciences (USUHS), we found two separate cases of accessory heads of the PLM. The first case involved a preserved 86-year-old White Female who had one unilateral accessory head of the left PLM. The second case involved a preserved 81-year-old White Male who had a unilateral pair of accessory heads of the right PLM.