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At least 199 records · Page 11Linked to original sources
PubMed1996

Effects of body immersion on postural adjustments to voluntary arm movements in humans: role of load receptor input.

1. The effect of body immersion on postural adjustments was studied in ten healthy subjects. Reaction times, for pushing or pulling a rigid handle, in response to a visual stimulus were measured. In addition EMG recordings were taken from upper arm and lower leg muscles during three levels of body immersion while standing on a platform (immersed to spinal levels: lumbar nerve root 2 (L2); thoracic nerve root 4 (T4); and cervical nerve root 7 (C7)), while floating and while standing or sitting out of water. 2. With increasing levels of body immersion there was a near linear reduction in the amplitude of the gastrocnemius (GM) EMG activity before (200 ms) the onset of a force signal from pulling, but immersion had a significantly weaker effect on the amplitude of the tibialis anterior (TA) EMG during pushing movements. There was no significant difference in the effect of body immersion on biceps femoris (BF) and rectus femoris (RF). Under free-floating conditions postural adjustments did not occur in response to pull or push movements. There were no adaptational changes of EMG adjustments during successive trials at a given immersion level. 3. Under non-immersed conditions reaction times were significantly shorter during sitting than during standing. This difference is assumed to be due to the postural adjustments required while standing before the onset of a voluntary arm movement. While standing, reaction times were significantly longer for pull compared with push movements. Under all conditions of body immersion the reaction times remained longer compared with the sitting condition, even when no leg muscle EMG adjustments were present. 4. It is assumed that the differential effect of body immersion on the antagonistic leg muscles is due to the differential neuronal control of antagonistic leg muscles with a strong influence from proprioceptive input (most probably from load receptors) on the leg extensors. The longer reaction times seen during body immersion, where no postural adjustments were evident, suggests that a supraspinal command to the leg muscles precedes the voluntary arm movement. However, because of the changed/decreased afferent input no postural adjustments are generated.

Arm↗
PubMed1999

[Paralytic shoulder secondary to post-traumatic peripheral nerve lesions in the adult].

A critical review is presented of the indications for nerve repair or transfer and for palliative operations in the management of paralytic shoulder following traumatic neurological injuries in the adult. Different situations are considered: paralytic shoulder following supraclavicular lesions of the brachial plexus, following retro- and infraclavicular lesions and following lesions to the terminal branches of the plexus (axillary, suprascapular and musculocutaneous nerves) and finally problems related to lesions of the accessory nerve and the long thoracic nerve. I. Supraclavicular lesions of the brachial plexus. In complete (C5 to T1) lesions, the possibilities for nerve repair or transfer are at best limited, and the aim is to restore active flexion of the elbow. Palliative operations may be associated in order to stabilize the shoulder. In case of a complete C5 to T1 root avulsion, amputation at the distal humerus may be considered but is rarely performed combined with shoulder arthrodesis if the trapezius and serratus anterior muscles are functioning. The shoulder may also be stabilized by a ligament plasty using the coracoacromial ligament. In cases where the supraspinatus and long head of the biceps have recovered, but where active external rotation is absent, function may be improved by derotation osteotomy of the humerus. In partial C5,6 or C5,6,7 lesions, the indications for nerve repair and transfer are wider, as well as the indications for muscle transfers. In C5,6 lesions, a neurotization from the accessory nerve to the suprascapular nerve gives 60% satisfactory results; this is also true following treatment of C5,6,7 lesions, whereas restoration of active elbow flexion is obtained in 100% of cases in C5,6 lesions but only in 86% in C5,6,7 lesions. In cases where shoulder function has not been restored, palliative operations may be considered: arthrodesis or, more often, derotation osteotomy of the humerus which can be combined with transfer of the teres major and latissimus dorsi. II. Retro- and infraclavicular lesions of the brachial plexus. Twenty-five percent of the lesions of the brachial plexus occur in the retro- or infraclavicular region and involve the secondary trunks, most commonly the posterior trunk. Nerve repair should be performed early. The shoulder may be affected owing to involvement of the axillary nerve in cases of lesions of the posterior trunk, often associated with a lesion of the suprascapular nerve. Regarding the terminal branches (axillary, suprascapular and musculocutaneous nerves), spontaneous recovery may be expected in a significant proportion of cases but is often delayed (6-9 months), and the problem is to avoid unnecessary operations while not unduly delaying surgical repair in cases where it is indicated. MRI may be useful to delineate those cases where surgery is indicated: repair is usually performed around 6 months following trauma. Isolated lesions of the axillary nerve may be repaired with good results using a nerve graft. The lesion may occur in combination with a lesion of the suprascapular nerve; the latter may be interrupted at several levels. Proximal repair may be performed using a nerve graft; distal lesions are more difficult to repair and may require intramuscular neurotization. Lesions of the musculocutaneous nerve may be repaired with good results using a nerve graft. Lesions of the axillary nerve may be seen associated with lesions of the rotator cuff. The treatment varies according to the age and condition of the patient and according to the condition of the cuff muscles and tendons: in a young patient with avulsion of the tendons from bone, cuff reinsertion is indicated; in an older patient, the cuff must be evaluated by MRI or arthroscan, and repair is indicated unless the cuff tear is not amenable to surgery or there is fatty degeneration of the muscles. Palliative surgery may be indicated in cases seen late or after failed attempts at nerve repair. (ABSTRACT

Accessory Nerve↗
PubMed1990

[A complete relief of intractable postherpetic neuralgia with intrathecal methylprednisolone acetate].

A 72-year-old man, 154 cm tall, weighing 53 kg was suffering from severe herpetic neuralgia on his left 10th intercostal nerve area. His pain continued even he was treated with frequent epidural nerve block (4 to 5 times per week) by an anesthesiologist. He was referred to our hospital on his 105th pain day. He complained severe continuous pain and numbness on his left 10th intercostal nerve area. Touching the painful skin induced lightning pain. His pain was so severe that his sleeping was disturbed and also he could not maintain his usual life. Epidural nerve block at 10th thoracic nerve was done with 20mg methylprednisolone acetate and 5ml of 1% lidocaine. After the treatment, his pain was reduced to 3/10 of the one he had on admission, and also his sleep was not disturbed further. Epidural nerve blocks with methylprednisolone weekly for a month induced no more remission. At his 154th pain day, a dose of 20mg methyl prednisolone acetate and 1% lidocaine 5ml was given intrathecally through 2nd lumber intervertebral space. The pain was relieved completely after the block. And he complained nothing about the skin area which had been disturbing his life for a long time. Auditory brainstem response which was recorded during the block showed prolongation of the latency of phase III and phase V at 40 minutes after the intrathecal injection of lidocaine.

Aged↗
PubMed1986

Fate of brachial muscles of the chick embryo innervated by inappropriate nerves: structural, functional and histochemical analyses.

The extent of interaction between brachial muscles and foreign (thoracic) nerves of the chick embryo was determined during an extended period of development in ovo from the perspectives of innervation pattern, function (motility analyses), muscle growth (quantitative analyses of muscle volume) and fibre-type expression (myosin-ATPase profiles). Results indicated that according to all parameters analysed, initially a compatible union existed between the foreign nerves and their muscle targets. During subsequent stages of development, deterioration of the once compatible relationship emerged, until eventually denervation of muscles, i.e. an actual loss of intramuscular nerve branches, was observed. The process of denervation, which proceeded at a differential rate among individual muscles, however was restricted to brachial muscles derived from the premuscle masses of the wing bud. In contrast, brachial muscles of myotomal origin were spared the fate of wing-bud-derived muscles and maintained a successful union with the foreign nerves.

Adenosine Triphosphatases↗
PubMed2006

Upper limb tremor induced by peripheral nerve injury.

We report a patient with proximal right upper limb tremor, secondary to direct peripheral nerve lesion caused by prior thoracic surgery. Electromyography demonstrated neurogenic abnormalities and tremor in muscles innervated by the thoracodorsal and long thoracic nerves. Somatosensory evoked potentials, transcranial magnetic stimulation, and MRI of the cervical and thoracic spine were normal. Tremor persisted in REM and non-REM sleep. These findings suggest a peripheral generator.

Arm↗
PubMed2001

Anatomical bases of the posterior approach to the brachial plexus for repairing avulsed spinal nerve roots.

Avulsion of nerve roots from the cervical spinal cord has always been considered as an untreatable injury, even by surgeons with expertise in this area. However, numerous experimental studies in animals, as well as a human case report, showed that if continuity is restored between the spinal cord and nerve roots, axons from spinal motor neurons can regrow into the peripheral nerve graft with a subsequent recovery of motor function. The posterior subscapular approach, based on the evolution of the posterolateral approach for removal of the first rib, is the only way to expose the entire brachial plexus from C5 to T1 from the ventral and dorsal roots to the distal nerve trunks. The purpose of this study is to investigate the topographic anatomy of the brachial plexus, with particular emphasis on the relationships important to the posterior approach and reimplantation of the ventral rootlets within the cord, either directly or using peripheral nerve grafts. The major advantage of the procedure is the proximal exposure of the plexus, with evaluation of the lesions being excellent (intradural, foraminal and proximal trunks). Reimplantation of ventral roots into the cord is relatively easy from C5 to C7, more difficult for C8 and problematic for T1, whereas reimplantation of dorsal roots into the cord is easy from C5 to T1. The disadvantages of this approach for exposure of the plexus and nerve root avulsion repair are significant: the surgical technical steps are difficult mainly because of the cervical paraspinal muscle mass, which cannot be easily "elevated and retracted" despite previous descriptions; bleeding from the venous plexus can be excessive as suggested by dissection and our own experience; the stability of the cervical spine may be compromised following extensive laminectomy with total unilateral facetectomy; exposure of the plexus distal to the division of the trunks is difficult; there may be injury to the long thoracic nerve and subsequent winging of the scapula; and pneumothorax. This approach is therefore only applicable in highly selected cases involving multiple avulsed roots with proximal lesions extending as far as the division of the trunks.

Aged↗
PubMed1993

Selective reinnervation of the rat serratus anterior muscle following denervation and partial target removal.

The rat serratus anterior (SA) muscle is reinnervated by cervical roots C6 and C7 with a topographic bias following transection or freezing of the long thoracic nerve. The study reported here was undertaken to determine the specificity of regenerating motoneurons when the size of the target SA muscle was reduced. After crush and removal of the caudal half of the muscle, a rostrocaudal map was reestablished that was no different from control or crush alone. Rostral (C6) axons dominated the innervation of muscles deprived of their caudal sectors. Input from caudal (C7) axons was significantly reduced. These results may be explained by preferential pathways or a competitive advantage held by rostral axons reinnervating rostral sectors to the detriment of caudal axons.

Animals↗
PubMedDate not supplied

Diabetic truncal mononeuropathy--a new clinical syndrome.

Although diabetic mononeuropathy affecting the cranial and peripheral nerves is well recognized, there is little known or documented about diabetic mononeuropathy affecting the thoracic nerves, i.e., the truncal nerves. This series of 40 cases attests to its frequency; equal sex distribution; significance in differential diagnosis including coronary artery disease, intra-abdominal surgical diseases such as gallbladder pathology and appendicitis, pleurisy, and neoplasms. Truncal mononeuropathy has characteristics that differ from those of other diabetic mononeuropathies in that it is primarily sensory and typically not a first manifestation of clinical diabetes, whereas the other forms of diabetic mononeuropathy are primarily motor in effect and not infrequently may be the initial clinical presenting manifestation of diabetes. Finally, diabetic truncal mononeuropathy has a good prognosis.

Adult↗