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At least 181 records · Page 10Linked to original sources
PubMed1988

Neurotization in brachial plexus injuries. Indication and results.

In neurotization or nerve transfer, a healthy but less valuable nerve or its proximal stump is transferred in order to reinnervate a more important sensory or motor territory that has lost its innervation through irreparable damage to its nerve. In brachial plexus injuries, extraplexal nerves such as the spinal accessory nerve, rami of the cervical plexus, or intercostal nerves are transferred onto trunks, cords, or individual nerves or else segments of the brachial plexus that maintain continuity with the spinal cord may be coapted to trunks or cords the surgeon wishes to innervate. This method is particularly indicated in root avulsion injuries that occur frequently following traction trauma to the brachial plexus. The authors convey their experience with neurotization using the long thoracic nerve in seven cases, the accessory nerve in 30 cases, intercostal nerves in 66 cases, and various nerve transfers within the plexus in 31 cases. Results of other authors are also reported. With these methods, it is possible to obtain good elbow flexion in more than one-half of patients; however, only limited shoulder function and no useful finger function are obtained.

Brachial Plexus↗
PubMed1986

Sensory neurons supplying touch domes near the body midlines project bilaterally in the thoracic spinal cord of rats.

Sensory neurons that project bilaterally to laminae III-V of the dorsal horns in the thoracic spinal cord of rats were described in a previous anatomical study. The electrophysiological experiments reported here show that these neurons innervate skin near the dorsal and ventral midlines. Three series of experiments were undertaken: the regions of skin supplied by subdivisions of thoracic nerves were mapped by recording from the subdivisions while mechanically stimulating the skin; subdivisions containing the axons of contralaterally projecting sensory neurons were identified by antidromic activation from the contralateral dorsal horn; the receptive fields of individual sensory neurons and dorsal horn neurons were characterized by single-unit recording methods. Contralaterally projecting sensory neurons had axons in subdivisions of the thoracic nerves that supply skin adjacent to the body midlines. Their receptive fields were located near the dorsal or ventral midline but did not extend onto the contralateral side of the body. Most of the neurons were slowly adapting "type I" units supplying touch domes. Dorsal horn neurons receiving input from contralateral sensory neurons had receptive fields that overlapped the dorsal or ventral midline. This bilateral representation of skin near the midlines may be important for the fusion of the sensory maps of the right and left sides of the body.

Action Potentials↗
PubMed1988

A case of isolated paralysis of serratus anterior.

The authors present a case of isolated paralysis of the serratus anterior due to compression of the long thoracic nerve by a cervical rib. The clinical and diagnostic features are described. Removal of the vertical rib resulted in complete functional recovery of the muscle involved.

Adult↗
PubMed1994

[Neuritis of the serratus anterior muscle associated with Borrelia burgdorferi infection].

A long thoracic nerve palsy developed in two patients with Borrelia burgdorferi infection. In both cases, pain in the shoulder preceded a scapula detachment suggesting first a diagnosis of neuralgic shoulder amyotrophia. In the first case, there was a context of typical meningoradiculitis, while the second patient had an isolated right shoulder amyotrophia without any other neurologic signs and with normal CSF analysis. A detailed anamnesis, the serology profile, and the good response to an adequate antibiotic treatment allowed us to attribute these two long thoracic nerve palsies to B. burgdorferi. This infection is important to consider as a possible etiology in cases of peripheral neuritis without other obvious causes.

Adult↗
PubMed1990

The human vertebral column at the end of the embryonic period proper. 3. The thoracicolumbar region.

The present study of the thoracicolumbar region continues an investigation of the vertebral column at 8 postovulartory weeks (the end of the embryonic period proper) by means of graphic reconstructions. The cartilaginous vertebrae have short neural processes associated with the normal spina bifida occulta present at this time. The separate cartilaginous centres that several authors believe to exist in the cervical and lumbar costal elements, but which have not been observed by the present authors, have been thought to be the forerunners of extrathoracic ribs. A distinction needs to be made, however, between such centres and ribs. Similarly, in the fetal period, ossific loci in the costal elements of CV 7 are very frequent, whereas cervical ribs in the adult are relatively rare. The neurocentral joints, and hence the boundaries between neural arches and centra, are unclear before ossification has begun and has progressed during the fetal period. The sternal bands are almost completely united and the scapula is high in position. Neural relationships aid in the determination of homologous parts within the vertebral column, but clarification of corresponding parts has not previously been possible within the embryonic period. Areas ventral to the dorsal rami are ribs in the thoracic region and costal elements in other regions. Areas underlying the dorsal rami are transverse processes in the thoracic region and minute 'true' transverse elements in the cervical and lumbar regions. Thus, the descriptive lumbar transverse processes correspond to the true transverse processes and the ribs in the thoracic region. The dorsal rami of the thoracic nerves pass between the transverse processes and the tubercles of the ribs and then divide. The ventral rami of lumbar Nerves 1 and 2 resemble the thoracic in their course, whereas those of Nerves 3-5 are similar to the sacral. The thoracic dorsal roots are sloping and, associated with the greater height of the lumbar centra, the lumbar roots even more so. The directions of the various dorsal roots reflect differences in growth gradients between vertebral column and spinal cord. The thoracic and lumbar portions of the column change little in proportion during the embryonic period proper.

Anthropometry↗
PubMed2006

Anatomy of the thoracic splanchnic nerves in pigs.

The anatomical features of the autonomous nerves, including the greater, lesser and least splanchnic nerves, were examined in 4 female and 4 male adult pigs (Sus scrofa). The origin and course of these nerves were examined with regard to sex and the side of the body. The greater splanchnic nerve was present in all of the animals included in the study, whereas the lesser splanchnic nerve was present at a rate of 87.5% on the right side and 75% on the left side of the median plane. On the other hand, the least splanchnic nerve was present on the right side at a rate of 62.5% and on the left side at a rate of 37.5%. The greater, lesser and least splanchnic nerves on the right side of the median plane were determined to originate from a more cranial location. Furthermore, these nerves were observed to be longer and larger on the right side in comparison with the left side. Evaluation of the findings revealed no significant difference between both sides of the median plane with regard to the origin, course and dimensions of these nerves. Similarly, no significant difference was detected between sexes.

Animals↗
PubMedDate not supplied

Afferent innervation of the lower esophageal sphincter of the cat. Pathways and functional characteristics.

The sensory vagal and 'sympathetic' innervation of the lower esophageal sphincter (LES) has been investigated in cats using both electrophysiological and histochemical techniques. Histochemical studies produced evidence that 'sympathetic' afferents run in: (i) the splanchnic nerves; (ii) the sympathetic thoracic nerves; and (iii) the sympathetic cardiac branch. Electrophysiological studies allowed us to describe different kinds of LES receptors: (i) mucosal vagal receptors acting as rapidly adapting mechanoreceptors or as slowly adapting chemoreceptors; (ii) vagal and 'sympathetic' endings located in the muscular layers, adapting slowly and mainly activated by LES contractions; and (iii) vagal and 'sympathetic' endings located in the serous membrane behaving as rapidly adapting receptors sensitive to stretching.

Animals↗
PubMed2001

Thoracic splanchnic nerves: implications for splanchnic denervation.

Splanchnic neurectomy is of value in the management of chronic abdominal pain. It is postulated that the inconsistent results of splanchnicectomies may be due to anatomical variations in the pattern of splanchnic nerves. The advent of minimally invasive and video-assisted surgery has rekindled interest in the frequency of variations of the splanchnic nerves. The aims of this study were to investigate the incidence, origin and pattern of the splanchnic nerves in order to establish a predictable pattern of splanchnic neural anatomy that may be of surgical relevance. Six adult and 14 fetal cadavers were dissected (n = 38). The origin of the splanchnic nerve was bilaterally asymmetrical in all cases. The greater splanchnic nerve (GSN) was always present, whereas the lesser splanchnic nerve (LSN) and least splanchnic nerve (ISN) were inconsistent (LSN, 35 of 38 sides (92%); LSN, 21 of 38 sides (55%). The splanchnic nerves were observed most frequently over the following ranges: GSN, T6-9: 28 of 38 sides (73%); LSN, when present, T10-11: (10 of 35 sides (29%); and ISN, T11-12: 3 of 21 sides (14%). The number of ganglionic roots of the GSN varied between 3 and 10 (widest T4-11; narrowest, T5-7). Intermediate splanchnic ganglia, when present, were observed only on the GSN main trunk with an incidence of 6 of 10 sides (60%) in the adult and 11 of 28 sides (39%) in the fetus. The higher incidence of the origin of GSN above T5 has clinical implications, given the widely discussed technique of undertaking splanchnicectomy from the T5 ganglion distally. This approach overlooks important nerve contributions and thereby may compromise clinical outcome. In the light of these variations, a reappraisal of current surgical techniques used in thoracoscopic splanchnicectomy is warranted.

Abdominal Pain↗
PubMed1988

Thoracoabdominal radiculopathy.

Thoracic nerve root dysfunction (TNRD) manifested as abdominal pain is an infrequently reported condition. We present data on six patients who had chronic intermittent thoracoabdominal pain originating in the back. Diabetes and osteoarthritis of the spine were the chief causes of these symptoms. The electromyogram in all patients showed changes consistent with an acute radiculopathy. All patients responded to anti-inflammatory therapy in combination with phenytoin, carbamazepine, amitriptyline, or local nerve block. TNRD is a condition that may be diagnosed earlier if clinical suspicion is increased, thus sparing patients excessive testing and surgery, and affording quicker relief.

Abdomen, Acute↗
PubMed1988

The control of post-thoracotomy pain. A comparative evaluation of thoracic epidural fentanyl infusions and cryo-analgesia.

This is a comparative study of two methods to relieve postoperative thoracotomy pain. Continuous thoracic epidural infusion of fentanyl produced superior analgesia when compared with cryo-analgesia of the relevant thoracic nerves. Linear analogue pain scores were consistently lower in the epidural group reaching significance (p less than 0.05) at 32 and 40 hours after operation. All 36 patients in the cryo-analgesia group required additional analgesia, while 12 out of the 32 patients in the epidural group did not. This difference was significant at p less than 0.001. Respiratory and cardiovascular measurements were similar in both groups and the only side effect attributable to the epidural fentanyl was itching but this was not a problem.

Analgesia↗
PubMed2006

The deep axillary artery.

An aberrant axillary artery running deep to the brachial plexus during its course was observed. The brachial plexus in this case was formed by the fourth cervical nerve to the first thoracic nerve and the radial nerve received a small nerve bundle (accessory radial nerve root) from the posterior aspect of the lower trunk. The axillary artery passed between the lateral and the medial cords of the brachial plexus, the same as for an ordinary axillary artery. In addition, it passed between their posterior divisions, forming the posterior cord, and further ran between the radial nerve root and the accessory radial nerve root from deep to superficial. This axillary artery was recognized as the deep axillary artery, the same as the axillary artery we have reported previously. It was thought that the branches to the subscapularis and serratus anterior muscles, nutrient branch to the radial nerve root and the subscapular artery played important roles in its formation.

Aged, 80 and over↗