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brachial plexus and anatomy

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https://www.readbyqxmd.com/read/28321484/rhabdomyolysis-resulting-in-concurrent-horner-s-syndrome-and-brachial-plexopathy-a-case-report
#1
Susan C Lee, Christian Geannette, Scott W Wolfe, Joseph H Feinberg, Darryl B Sneag
This case report describes a 29-year-old male who presented with immediate onset of Horner's syndrome and ipsilateral brachial plexopathy after sleeping with his arm dangling outside a car window for 8 h. Outside workup and imaging revealed rhabdomyolysis of the left neck musculature. Subsequent electrodiagnostic testing and high-resolution brachial plexus magnetic resonance imaging at the authors' institution attributed the Horner's syndrome and concurrent brachial plexopathy to rhabdomyolysis of the longus colli and scalene musculature, which had compressed-and consequently scar tethered-the cervical sympathetic trunk and brachial plexus...
March 20, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28135679/an-unusual-case-of-neurogenic-thoracic-outlet-syndrome
#2
Yash Vaidya, Rajan Vaithianathan
INTRODUCTION: Neurogenic thoracic outlet syndrome (nTOS) is the most common manifestation of thoracic outlet syndrome (TOS), accounting for more than 95% of cases. It is usually caused by cervical ribs, anomalies in the scalene muscle anatomy or post-traumatic inflammatory changes causing compression of the brachial plexus. CASE PRESENTATION: We present an unusual case of nTOS caused by a cystic lymphangioma at the thoracic outlet, with only one case reported previously in the literature...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28115867/sonographic-tracking-of-trunk-nerves-essential-for-ultrasound-guided-pain-management-and-research
#3
Ke-Vin Chang, Chih-Peng Lin, Chia-Shiang Lin, Wei-Ting Wu, Manoj K Karmakar, Levent Özçakar
Delineation of architecture of peripheral nerves can be successfully achieved by high-resolution ultrasound (US), which is essential for US-guided pain management. There are numerous musculoskeletal pain syndromes involving the trunk nerves necessitating US for evaluation and guided interventions. The most common peripheral nerve disorders at the trunk region include thoracic outlet syndrome (brachial plexus), scapular winging (long thoracic nerve), interscapular pain (dorsal scapular nerve), and lumbar facet joint syndrome (medial branches of spinal nerves)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28096728/high-resolution-imaging-of-neural-anatomy-and-pathology-of-the-neck
#4
REVIEW
Jeong Hyun Lee, Kai-Lung Cheng, Young Jun Choi, Jung Hwan Baek
The neck has intricately connected neural structures, including cervical and brachial plexi, the sympathetic system, lower cranial nerves, and their branches. Except for brachial plexus, there has been little research regarding the normal imaging appearance or corresponding pathologies of neural structures in the neck. The development in imaging techniques with better spatial resolution and signal-to-noise ratio has made it possible to see many tiny nerves to predict complications related to image-guided procedures and to better assess treatment response, especially in the management of oncology patients...
January 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28049512/a-stab-wound-to-the-axilla-illustrating-the-importance-of-brachial-plexus-anatomy-in-an-emergency-context-a-case-report
#5
Diogo Casal, Teresa Cunha, Diogo Pais, Inês Iria, Maria Angélica-Almeida, Gerardo Millan, José Videira-Castro, João Goyri-O'Neill
BACKGROUND: Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. CASE PRESENTATION: We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28048472/tu-h-campus-jep3-04-factors-predicting-a-need-for-treatment-replanning-with-proton-radiotherapy-for-lung-cancer
#6
C Teng, G Janssens, C Ainsley, B Teo, G Valdes, B Burgdorf, A Berman, W Levin, Y Xiao, L Lin, P Gabriel, C Simone, T Solberg
PURPOSE: Proton dose distribution is sensitive to tumor regression and tissue and normal anatomy changes. Replanning is sometimes necessary during treatment to ensure continue tumor coverage or avoid overtreatment of organs at risk (OARs). We investigated action thresholds for replanning and identified both dosimetric and non-dosimetric metrics that would predict a need for replan. METHODS: All consecutive lung cancer patients (n = 188) who received definitive proton radiotherapy and had more than two evaluation CT scans at the Roberts Proton Therapy Center (Philadelphia, USA) from 2011 to 2015 were included in this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047372/su-f-t-128-dose-volume-constraints-for-particle-therapy-treatment-planning
#7
R Stewart, W Smith, K Hendrickson, J Meyer, N Cao, E Lee, O Gopan, G Sandison, U Parvathaneni, G Laramore
PURPOSE: Determine equivalent Organ at Risk (OAR) tolerance dose (TD) constraints for MV x-rays and particle therapy. METHODS: Equivalent TD estimates for MV x-rays are determined from an isoeffect, regression-analysis of published and in-house constraints for various fractionation schedules (n fractions). The analysis yields an estimate of (α/β) for an OAR. To determine equivalent particle therapy constraints, the MV x-ray TD(n) values are divided by the RBE for DSB induction (RBEDSB ) or cell survival (RBES )...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28041767/-nerve-transfer-between-the-intercostal-nerves-and-the-motor-component-of-the-musculocutaneous-nerve-anatomical-study-of-feasibility
#8
M Fleury, D Lepage, I Pluvy, J Pauchot
INTRODUCTION: The intercostal nerves (ICN) transfer to the musculocutaneous nerve (MCN) can restore elbow flexion in complete brachial plexus palsy. The last cases our service dealt with, allowed our staff to observe two different situations. In the 2 first patients, we were able to proceed with an intraneurodissection of the MCN motor component up to the axillary cavity level, while on the third case such dissection could not be performed as high. The aim of this work is to assess the feasibility of a transfer on the MCN's motor component...
December 29, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/27911674/cross-sectional-imaging-anatomy-and-pathologic-conditions-affecting-thoracic-nerves
#9
Kristopher W Cummings, Sreevathsan Sridhar, Matthew S Parsons, Cylen Javidan-Nejad, Sanjeev Bhalla
While in many cases they are not directly visualized, awareness of the thoracic nerves and their courses at cross-sectional imaging is important for radiologists. An understanding of the normal function of each nerve is important, as many patients present with neurologic signs and symptoms that can be used to reinforce search patterns for disease and detection of supportive radiologic abnormalities. In the case of primary neoplasms, understanding the expected presence of a nerve in the location of a mass can enhance and improve the accuracy of differential diagnoses...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27830483/variations-in-the-innervation-of-the-long-head-of-the-triceps-brachii-a-cadaveric-investigation
#10
Alexandra J Erhardt, Bennett Futterman
BACKGROUND: Some leading anatomy texts state that all three heads of the triceps brachii are innervated by the radial nerve. The posterior cord of the brachial plexus bifurcates to terminate as the radial and axillary nerves. Studies have noted the presence of axillary innervation to the long head of the triceps brachii muscle, patterns different from the classic exclusive radial nerve supply. An understanding of these variations may assist the clinician in the assessment of shoulder weakness and in preoperative and operative planning of radial and axillary neuropathies...
January 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27725357/coracobrachialis-muscle-and-the-musculocutaneous-nerve-a-study-using-human-embryonic-sections
#11
Masahito Yamamoto, Takeshi Takayama, Hiromasa Takata, Yasuhito Shiraishi, Naomitsu Tomita, Kouichirou Sakanaka, Gen Murakami, Jose Francisco Rodríguez-Vázquez, Shin-Ichi Abe
In comparative anatomy, the musculocutaneous nerve is hypothesized to pass between the superficial and deep muscle bellies of the coracobrachialis muscle. The superficial belly is supplied by nerve branches of the lateral cord of the brachial plexus, while the deep belly by the musculocutaneous nerve. Observations of longitudinal sections of ten human embryonic arms (7 weeks; crown-rump length 26-32 mm) demonstrated that the coracobrachialis muscle was always continuous with the short head of the biceps muscle...
2016: Okajimas Folia Anatomica Japonica
https://www.readbyqxmd.com/read/27471875/coracoid-process-the-lighthouse-of-the-shoulder
#12
Hussan Mohammed, Matthew R Skalski, Dakshesh B Patel, Anderanik Tomasian, Aaron J Schein, Eric A White, George F Rick Hatch, George R Matcuk
The coracoid process is a hook-shaped bone structure projecting anterolaterally from the superior aspect of the scapular neck. Surgeons often refer to the coracoid process as the "lighthouse of the shoulder" given its proximity to major neurovascular structures such as the brachial plexus and the axillary artery and vein, its role in guiding surgical approaches, and its utility as a landmark for other important structures in the shoulder. The coracoid also serves as a critical anchor for many tendinous and ligamentous attachments...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27351936/surgical-anatomy-of-the-radial-nerve-at-the-elbow-and-in-the-forearm-anatomical-basis-for-intraplexus-nerve-transfer-to-reconstruct-thumb-and-finger-extension-in-c7%C3%A2-%C3%A2-t1-brachial-plexus-palsy
#13
Lei Zhang, Zhen Dong, Chun-Lin Zhang, Yu-Dong Gu
Background C7 - T1 palsy results in complete loss of finger motion and poses a surgical challenge. This study investigated the anatomy of the radial nerve in the elbow and forearm and the feasibility of intraplexus nerve transfer to restore thumb and finger extension. Methods The radial nerves were dissected in 28 formalin-fixed upper extremities. Branching pattern, length, diameter, and number of myelinated fibers were recorded. Results Commonly, the branching pattern (from proximal to distal) was to the brachioradialis, extensor carpi radialis longus, superficial sensory proximal to the lateral epicondyle, extensor carpi radialis brevis, supinator, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis distal to the lateral epicondyle...
November 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27203394/ultrasound-guided-interscalene-block-reevaluation-of-the-stoplight-sign-and-clinical-implications
#14
COMPARATIVE STUDY
Carlo D Franco, James M Williams
BACKGROUND AND OBJECTIVES: The "stoplight" sign is a frequently described image during ultrasound-guided interscalene block, referring to 3 hypoechoic structures found between the anterior and middle scalene muscles.This study was designed to establish the ultrasound-anatomy correlation of this sign and to find any other anatomical features within the roots that could help with the interpretation of the ultrasound images obtained at the interscalene level. METHODS: We performed 20 dissections of the brachial plexus in 10 embalmed human cadavers and systematically analyzed and measured the roots of C5 to C7 and then correlated these findings with ultrasonographic images on file...
July 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27168533/ultrasound-and-gross-anatomy-of-the-brachial-plexus-and-major-nerves-of-the-forelimb-an-anesthetic-approach-using-the-domestic-rabbit-oyctolagus-cuniculus-as-an-experimental-model1
#15
Rodrigo Mencalha, Carlos Augusto Dos Santos Sousa, Orlando Costa, Marcelo Abidu-Figueiredo
PURPOSE: To update the gross and sonographic anatomy and propose landmarks to perform ultrasound-guided (US-guided) axillary brachial plexus block (BPB) in rabbits. METHODS: Forty New Zeeland's rabbit (NZR) cadavers were dissected and the nerves were trimmed, identified, measured, and photographed. Additionally, in twenty NZRs, sonographic images of brachial plexus (BP) were performed through a simple-resolution ultrasound device. The US-guided block was achieved through a minimum volume of lidocaine necessary to surround the BP roots...
April 2016: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/27133185/anatomical-variations-in-the-brachial-plexus-roots-implications-for-diagnosis-of-neurogenic-thoracic-outlet-syndrome
#16
Vanessa Leonhard, Riley Smith, Gregory Caldwell, Heather F Smith
Neurogenic thoracic outlet syndrome (NTOS) is the most common type of TOS. Typically it results from impingement of the neurovasculature as it passes between the anterior and middle scalene muscles; this classic anatomical relationship being the foundation of clinical diagnosis. Positional testing relies on vascular compromise occurring when the subclavian artery is compressed in this space. This study describes several anatomical variations observed in this relationship. Sixty-five cadavers (35m/30f) were assessed to determine the frequency and extent of brachial plexus branching variants...
July 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/27071641/anatomical-study-of-prefixed-versus-postfixed-brachial-plexuses-in-adult-human-cadaver
#17
Edengenet Guday, Asegedech Bekele, Abebe Muche
BACKGROUND: The brachial plexus is usually formed by the fusion of anterior primary rami of the fifth to eighth cervical and the first thoracic spinal nerves. Variations in the formation of the brachial plexus may occur. Variations in brachial plexus anatomy are important to radiologists, surgeons and anaesthesiologists performing surgical procedures in the neck, axilla and upper limb regions. These variations may lead to deviation from the expected dermatome distribution as well as differences in the motor innervation of muscles of the upper limb...
April 12, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27035461/anatomic-basis-for-brachial-plexus-block-at-the-costoclavicular-space-a-cadaver-anatomic-study
#18
Xavier Sala-Blanch, Miguel Angel Reina, Pawinee Pangthipampai, Manoj Kumar Karmakar
BACKGROUND AND OBJECTIVES: The costoclavicular space (CCS), which is located deep and posterior to the midpoint of the clavicle, may be a better site for infraclavicular brachial plexus block than the traditional lateral paracoracoid site. However, currently, there is paucity of data on the anatomy of the brachial plexus at the CCS. We undertook this cadaver anatomic study to define the anatomy of the cords of the brachial plexus at the CCS and thereby establish the anatomic basis for ultrasound-guided infraclavicular brachial plexus block at this proximal site...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26860655/high-resolution-neurography-of-the-brachial-plexus-by-3-tesla-magnetic-resonance-imaging
#19
C Cejas, C Rollán, G Michelin, M Nogués
The study of the structures that make up the brachial plexus has benefited particularly from the high resolution images provided by 3T magnetic resonance scanners. The brachial plexus can have mononeuropathies or polyneuropathies. The mononeuropathies include traumatic injuries and trapping, such as occurs in thoracic outlet syndrome due to cervical ribs, prominent transverse apophyses, or tumors. The polyneuropathies include inflammatory processes, in particular chronic inflammatory demyelinating polyneuropathy, Parsonage-Turner syndrome, granulomatous diseases, and radiation neuropathy...
March 2016: Radiología
https://www.readbyqxmd.com/read/26654179/a-cadaveric-microanatomical-study-of-the-fascicular-topography-of-the-brachial-plexus
#20
Sumit Sinha, G Lakshmi Prasad, Sanjeev Lalwani
OBJECT Mapping of the fascicular anatomy of the brachial plexus could provide the nerve surgeon with knowledge of fascicular orientation in spinal nerves of the brachial plexus. This knowledge might improve the surgical outcome of nerve grafting in brachial plexus injuries by anastomosing related fascicles and avoiding possible axonal misrouting. The objective of this study was to map the fascicular topography in the spinal nerves of the brachial plexus. METHODS The entire right-sided brachial plexus of 25 adult male cadavers was dissected, including all 5 spinal nerves (C5-T1), from approximately 5 mm distal to their exit from the intervertebral foramina, to proximal 1 cm of distal branches...
August 2016: Journal of Neurosurgery
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