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brachial plexus and anatomy

Orhan Beger, Uğur Dinç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
PURPOSE: The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. METHODS: Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 ± 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Eduardo de Almeida Guimarães Nogueira, Vitor Martinez de Carvalho, Marcos Vinicius de Queiroz, Gleysson Rodrigues Rosa, Yara Dadalti Fragoso
Augusta Marie Déjerine-Klumpke (1859-1927) was a formidable neurologist, neuroanatomist and researcher in France. One of the first women to be accepted for medical internship, externship and research in Paris, Augusta made her name studying and teaching anatomy, histology and dissection, attending clinical activities in neurology, obstetrics, pediatrics and neurologic trauma, performing necropsies, and writing scientific papers and book chapters. Her main research in neurology awarded her an eponym for the avulsion of the lowest root of the brachial plexus (Klumpke's palsy)...
February 2018: Arquivos de Neuro-psiquiatria
Jerry Tsung-Kai Lin, Johnny Chuieng-Yi Lu, Yenlin Huang, Tommy Nai-Jen Chang, David Chwei-Chin Chuang
Lymphangiomas are rare malformations of the lymphatic system and can often be found in the neck region, where its proximity to the brachial plexus may cause compressive neuropathy and possible iatrogenic injuries during dissection. We report 4 cases of lymphangiomas with compression of the brachial plexus that were successfully removed without permanent nerve injuries and present a literature review of the preoperative approach and surgical techniques. A preoperative multidisciplinary approach can help surgeons predict what they may encounter during the surgery...
January 24, 2018: Annals of Plastic Surgery
Alicia Skelding, Alexander Valverde, Melissa Sinclair, Jeffrey Thomason, Noel Moens
OBJECTIVES: To describe the ventral spinal nerve rami contribution to the formation of the brachial plexus (BP), and to compare ease of performing and nerve staining between three blind techniques for BP blockade in dogs. STUDY DESIGN: Prospective, randomized, blind study. ANIMALS: A total of 18 dog cadavers weighing 28.2 ± 9.7 kg (mean ± standard deviation). METHODS: Dogs were randomly assigned to two of three BP treatments: traditional approach (TA), perpendicular approach (PA), and axillary approach (AA)...
December 12, 2017: Veterinary Anaesthesia and Analgesia
Alparslan Kirik, Senem Ertuğrul Mut, Mehmet Kadri Daneyemez, Halil İbrahim Seçer
AIM: The plexus brachialis is a complex structure with anatomical variations and connections with neighboring tissues. These variations may cause disparity in the motor and sensorial innervations of the upper extremity. The knowledge of anatomy and probable variations are important for performing surgical procedures in the neck, shoulder and axilla. This study was planned to demonstrate the anatomical variations of infantile brachial plexus. MATERIAL AND METHODS: A total of 20 plexus brachialis from 11 fetal cadavers were dissected and examined microscopically...
October 18, 2017: Turkish Neurosurgery
Alexander Graf, Kai Yang, David King, William Dzwierzynski, James Sanger, Patrick Hettinger
BACKGROUND: Lipomas are common benign tumors. When they develop in proximity to peripheral nerves, they can cause neurologic symptoms secondary to mass effect. Previous reports have shown symptom resolution after removal of lipomas compressing various upper extremity peripheral nerves. However, brachial plexus lipomas are relatively rare. Our multidisciplinary experience with brachial plexus lipoma resection is reviewed in the largest case series to date. METHODS: A retrospective chart review of all patients undergoing resection of brachial plexus lipomatous tumors between 2006 and 2016 was performed...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
Neurogenic thoracic outlet syndrome is caused by a neurologic compression of the brachial plexus before it reaches the arm. Three anatomic areas are common locations for such an entrapment because of their congenital and/or acquired tightness: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Because the compression level usually remains unknown, the treatment is still controversial and most teams focus on only one potential site. We propose an all-endoscopic technique of complete brachial plexus neurolysis that can be divided into three parts, one for each entrapment area...
August 2017: Arthroscopy Techniques
S Shelby Burks, Iahn Cajigas, Jean Jose, Allan D Levi
BACKGROUND: Intraoperative ultrasound (US) has been used as a guide during surgery to better identify deep neuroanatomical structures. OBJECTIVE: To correlate histologic cross-sections from nerve samples taken at the time of surgery with axial, high-resolution US images at similar locations and validate this important tool for intraoperative guidance in nerve surgery. METHODS: Three subjects undergoing nerve repair procedures after traumatic nerve injuries were enrolled prospectively...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
Kristin Stützer, Annika Jakobi, Anna Bandurska-Luque, Steffen Barczyk, Carolin Arnsmeyer, Steffen Löck, Christian Richter
PURPOSE: Evaluation of dose degradation by anatomic changes for head-and-neck cancer (HNC) intensity-modulated proton therapy (IMPT) relative to intensity-modulated photon therapy (IMRT) and identification of potential indicators for IMPT treatment plan adaptation. METHODS: For 31 advanced HNC datasets, IMPT and IMRT plans were recalculated on a computed tomography scan (CT) taken after about 4 weeks of therapy. Dose parameter changes were determined for the organs at risk (OARs) spinal cord, brain stem, parotid glands, brachial plexus, and mandible, for the clinical target volume (CTV) and the healthy tissue outside planning target volume (PTV)...
September 18, 2017: Journal of Applied Clinical Medical Physics
Omur Ozturk, Aysu Hayriye Tezcan, Ali Bilge, Hakan Ateş, Hatice Yagmurdur, Mesut Erbas
To investigate the topographic anatomy of the median, musculocutaneous, radial and ulnar nerves with respect to the axillary artery and to seek whether these configurations are associated with baseline descriptive data including age, gender, and body-mass index. This cross-sectional trial was carried out on 199 patients (85 women, 114 men; average age: 46.78 ± 15.45 years) in the department of anaesthesiology and reanimation of a tertiary care center. Topographic anatomy of the median, musculocutaneous, radial and ulnar nerves was assessed with ultrasonography...
September 4, 2017: Journal of Clinical Monitoring and Computing
Farzan Siddiqui, Benjamin Movsas
Head and neck cancers account for approximately 3% of all cancers in the United States with 62,000 new cases diagnosed annually. The global incidence is approximately 700,000 new cases a year. There has also been a recent increase in human papilloma virus-related oropharyngeal cancers. External beam radiation therapy (RT) is commonly used as an effective therapy for head and neck (H&N) cancers. This is used as a definitive treatment (alone or in combination with chemotherapy) or as an adjuvant treatment after surgical resection of the tumors...
October 2017: Seminars in Radiation Oncology
Bernhard Gesslbauer, Laura A Hruby, Aidan D Roche, Dario Farina, Roland Blumer, Oskar C Aszmann
OBJECTIVE: Axons traveling within the brachial plexus are responsible for the dexterous control of human arm and hand movements. Despite comprehensive knowledge on the topographical anatomy of nerves innervating the human upper limbs, the definite quantity of sensory and motor axons within this neural network remains elusive. Our aim was to perform a quantitative analysis of the axonal components of human upper limb nerves based on highly specific molecular features from spinal cord level to the terminal nerves at wrist level...
September 2017: Annals of Neurology
Glenn E Woodworth, Ryan M J Ivie, Sylvia M Nelson, Cameron M Walker, Robert B Maniker
Breast surgery is exceedingly common and may result in significant acute as well as chronic pain. Numerous options exist for the control of perioperative breast pain, including several newly described regional anesthesia techniques, but anesthesiologists have an insufficient understanding of the anatomy of the breast, the anatomic structures disrupted by the various breast surgeries, and the theoretical and experimental evidence supporting the use of the various analgesic options. In this article, we review the anatomy of the breast, common breast surgeries and their potential anatomic sources of pain, and analgesic techniques for managing perioperative pain...
September 2017: Regional Anesthesia and Pain Medicine
P L Langlois, A F Gil-Blanco, D Jessop, Y Sansoucy, F D'Aragon, N Albert, P Echave
BACKGROUND: The coracoid approach is recognized as the simplest approach to perform brachial plexus anaesthesia, but needle visualization needs to be improved. With a different needle entry point, the retroclavicular approach confers a perpendicular angle between the ultrasound and the needle, which theoretically enhances needle visualization. This trial compares these two techniques. The leading hypothesis is that the retroclavicular approach is comparable to the infraclavicular coracoid approach in general aspects, but needle visualization is better with this novel approach...
July 21, 2017: Trials
Vanessa Leonhard, Gregory Caldwell, Mei Goh, Sean Reeder, Heather F Smith
Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants...
July 4, 2017: Diagnostics
E Vergara-Amador, F Vela-Rodríguez
The independent neurovascular anatomy of the long head of the triceps brachii and its suitability as a free muscle transfer have been extensively studied. Instead muscle transposition of the long head of the triceps brachii to enhance elbow flexion has been rarely described. We describe in this paper two cases of injury of brachial plexus sequel in which transposition was performed only on the long head of the triceps. The elbow flexion was improved, the extension was preserved.
November 2016: Acta Ortopédica Mexicana
Andrew J Rosko, Jesse T Ryan, Eric J Wizauer, Mohannad Ibrahim, Ashok Srinivasan, Chaz L Stucken, Matthew E Spector
BACKGROUND: The vessel-depleted neck poses a unique challenge to the microvascular surgeon. Using 3D modeling and cadaveric dissection, we describe the approach and advantages of a known but less frequently used recipient vessel, the dorsal scapular artery, during free tissue transfer. METHODS: Three patients with vessel-depleted necks required reconstruction with free tissue transfer. The dorsal scapular artery was used as a recipient vessel. Three-dimensional anatomic models were created and cadaveric dissections were performed to characterize the anatomy...
July 2017: Head & Neck
Brandon Michael Henry, Matthew J Graves, Jakub R Pękala, Beatrice Sanna, Wan Chin Hsieh, R Shane Tubbs, Jerzy A Walocha, Krzysztof A Tomaszewski
The intercostobrachial nerve (ICBN), which usually originates from the lateral cutaneous branch of the second intercostal nerve, innervates areas of the axilla, lateral chest, and medial arm. It is at risk for injury during operative procedures that are often used in the management of breast cancer and such injury has been associated with postoperative sensory loss and neuropathic pain, decreasing the quality of life. PubMed, Excerpta Medica Database (EMBASE), ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SciELO), Biosciences Information Service (BIOSIS), and Web of Science were searched comprehensively...
March 17, 2017: Curēus
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
PURPOSE: To describe an all-endoscopic technique for infra- and supraclavicular brachial plexus (BP) neurolysis and to assess its functional outcomes for patients suffering from nonspecific neurogenic thoracic outlet syndrome (NTOS). METHODS: Between January 2010 and January 2013, 36 patients presenting an idiopathic nonspecific NTOS benefited from an endoscopic decompression in our institution. The inclusion criteria were a typical clinical NTOS and failure of a 6-month well-conducted nonsurgical treatment...
August 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Hitendra K Loh, Shikha Singh, Rajesh K Suri
The brachial plexus consists of a network of nerves that innervates the upper limbs and its musculature. We report a rare formation of the lateral cord of the brachial plexus observed during the dissection of a 47-year-old male cadaver at the Department of Anatomy, Vardhman Mahavir Medical College, New Delhi, India, in 2016. The lateral cord was exceptionally long with twin lateral pectoral nerves and twin lateral roots of the median nerve. The proximal lateral root of the median nerve was thin in comparison to the medial root of the median nerve...
February 2017: Sultan Qaboos University Medical Journal
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