Biomedical subjects
Publications and source records attributed to A E Grant.
Some provincial regulators of nursing are setting out professional standards for the use of facsimile transmissions. While the facsimile machine is a tool that can improve client care through the timely, accurate transmission of vital information, nurses should recognize the potential hazards. Clear policies and procedures for the usage and management of facsimile transmissions are necessary to ensure that legal and professional standards are met.
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Numerous techniques that evaluate radial nerve conduction from the axilla or supraclavicular fossa to the elbow have been reported. A shortcoming of most protocols is determining the precise radial nerve length as it proceeds along the spiral groove. The present study dissected out and measured directly eight cadaver radial nerves from the axilla to the elbow. These values were compared with a new surface tape measurement technique from axilla to elbow across the bicep muscle, obstetrical calipers over this region, and a surface determination approximating the course of the radial nerve posteriorly in the spiral groove. The anterior surface tape-measuring procedure compared most favorably with the actual anatomic length. Nerve conduction velocities were then calculated in 20 volunteers using all 3 techniques and compared with the median nerve in the arm. The anterior and posterior tape measurements yielded a conduction velocity of 72.5 +/- 4.7 and 86.6 +/- 7.0 m/s, respectively, whereas the caliper resulted in 65.7 +/- 3.9 m/s. We conclude that proximal radial nerve length assessment employing an anterior tape measurement from axilla to elbow across the bicep musculature is precise and compares favorably with the actual anatomic length of the radial nerve.
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Some 6% to 21% of Charcot joints occur in the spine. The underlying disease is usually tabes dorsalis, but diabetes mellitus is another etiology. Degeneration of spinal elements is accelerated and lumbar spinal stenosis with weakness may occur, as has been reported in tabetic arthropathy. The case presented is unusual in two respects: first, the Charcot spine was secondary to diabetic complications, which resulted in a compressive cauda equina syndrome; second, the patient presented with progressive paraparesis and bowel and bladder dysfunction but physical examination by several examiners revealed no clinically evident sensory abnormality. The patient had vague and inconsistent sensory complaints for several years preceding definitive workup, but the overall picture of his disease process only could be made following multiple laboratory, electrodiagnostic, microbiologic, and radiologic testing. The patient presented with subacute paraparesis, providing a wide differential diagnosis ranging from Guillain-Barré syndrome to spinal neoplasm. The physical, radiologic, laboratory, electrophysiologic, histologic/pathologic findings, treatment, and recovery status are included in this report.
This is a case report of a 47-year-old man with C6 quadriparesis who presented with tenderness in the right lower quandrant of his abdomen which was diagnosed as iliocostalis myofascial syndrome. Diagnosis of nephrolithiasis and appendicitis were considered, but the complete blood count, abdominal x-ray, intravenous pyelogram, and sonogram were all normal. His symptoms became progressively more severe over the ensuing 2-week period. Examination at that time revealed extreme tenderness to light touch in the right lower quandrant, right flank, and right posterior subcostal area. A trigger point in the right iliocostalis muscle referred pain to the right lower quandrant. In the absence of evidence of internal derangement a diagnosis of iliocostalis myofascial syndrome was made. A 3-day course of "spray and stretch" to the iliocostalis cleared the symptoms. This case illustrates that myofascial syndrome should be considered in the differential diagnosis of soft tissue pain in the patient with spinal cord injury and sensory sparing.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.