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brachial plexus and anatomy

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https://www.readbyqxmd.com/read/28732521/retroclavicular-approach-vs-infraclavicular-approach-for-plexic-bloc-anesthesia-of-the-upper-limb-study-protocol-randomized-controlled-trial
#1
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
https://www.readbyqxmd.com/read/28677632/ultrasonographic-diagnosis-of-thoracic-outlet-syndrome-secondary-to-brachial-plexus-piercing-variation
#2
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
https://www.readbyqxmd.com/read/28549367/-transfer-of-the-long-head-of-triceps-for-elbow-flexion-in-braquial-plexus-sequelae
#3
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
https://www.readbyqxmd.com/read/28452166/dorsal-scapular-artery-as-a-recipient-vessel-in-the-vessel-depleted-neck-during-free-tissue-transfer-in-head-and-neck-reconstruction
#4
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
https://www.readbyqxmd.com/read/28428928/origin-branching-and-communications-of-the-intercostobrachial-nerve-a-meta-analysis-with-implications-for-mastectomy-and-axillary-lymph-node-dissection-in-breast-cancer
#5
REVIEW
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
https://www.readbyqxmd.com/read/28427870/all-endoscopic-brachial-plexus-complete-neurolysis-for-idiopathic-neurogenic-thoracic-outlet-syndrome-a-prospective-case-series
#6
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
https://www.readbyqxmd.com/read/28417040/unusual-branching-pattern-of-the-lateral-cord-of-the-brachial-plexus-associated-with-neurovascular-compression-case-report
#7
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
https://www.readbyqxmd.com/read/28417038/anomalous-innervation-of-the-median-nerve-in-the-arm-in-the-absence-of-the-musculocutaneous-nerve
#8
Khursheed Raza, Seema Singh, Neerja Rani, Raghav Mishra, Kamakshi Mehta, Saroj Kaler
The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28353299/an-unusual-case-of-accessory-head-of-coracobrachialis-muscle-involving-lateral-cord-of-brachial-plexus-and-its-clinical-significance
#9
Silvio Antonio Garbelotti, Sérgio Ricardo Marques, Paulo Ricardo Rocha, Valdemir Rodrigues Pereira, Luis Otavio Carvalho de Moraes
Knowledge of anatomical variations in the peripheral nervous system is key in the interpretation of unusual clinical signs or during physical or diagnostic imaging. This case study is a description of an anatomical variation between the coracobrachialis muscle and brachial plexus. In a routine dissection in the human anatomy laboratory, we were faced with an anatomical variation in the coracobrachialis muscle, observed in the upper right limb of a male cadaver. The coracobrachialis muscle had a common origin at the apex of the coracoid process and then divided into two heads...
March 29, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28321484/rhabdomyolysis-resulting-in-concurrent-horner-s-syndrome-and-brachial-plexopathy-a-case-report
#10
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
#11
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...
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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