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At least 505 records · Page 28Linked to original sources
PubMed1988

Low volume intercostal injection. A comparative study in patients and cadavers.

This study compared the spread of 3 ml of a solution of bupivacaine-methylene blue in the intercostal space of patients and cadavers. There were 51 successful injections in each group which demonstrated in 86% of patient injections and 84% of cadaver injections that spread was confined to one intercostal space. Spread was more extensive in cadavers, probably as a result of autolysis. It would therefore still appear necessary, when low volumes of local anaesthetic are used, to block each intercostal nerve individually.

Adult↗
PubMed1969

Supraspinal control of reflex activity in renal nerves.

1. In anaesthetized cats distension of carotid sinus inhibited renal nerve activity and intercostal-renal nerve reflexes. The degree of inhibition was dependent on the amount of rise in sinus pressure. Intercostal-intercostal reflexes were not inhibited.2. Inhibition of renal nerve activity and intercostal-renal nerve reflexes could be obtained on stimulating in the dorsal reticular formation but mainly in the ventromedial reticular formation at the level of the obex. The intercostal reflex could also be inhibited at several of these points.3. The possibility that two inhibitory mechanisms are available is suggested, at least one projecting on to spinal reflex arcs.4. Other ways of inhibiting renal nerve activity were shown. One was similar to that produced by single shocks to peripheral skin and muscle nerves, and the other was due to a subnormal excitability of vasomotor neurones following intense activation.

Animals↗
PubMed1985

The detection of monosynaptic connexions from inspiratory bulbospinal neurones to inspiratory motoneurones in the cat.

Simultaneous recordings were made of the discharges of inspiratory bulbospinal neurones and phrenic or external intercostal alpha-motoneurones in the anaesthetized cat. The connexions between these neurones were studied by the construction of cross-correlation histograms from their discharges. Peaks observed in the cross-correlation histograms were divided into three groups on the basis of their time courses: narrow, medium-width and high-frequency oscillations (h.f.o.). Narrow peaks were defined as having half-widths less than 1.1 ms and medium-width peaks as having half-widths greater than this, while h.f.o. was characterized by periodic waves in the range 60-120 Hz. H.f.o. peaks were interpreted as being derived from the well known periodic synchronization of medullary inspiratory neurones in this frequency range. The time courses and latencies of the medium-width peaks could be quantitatively explained by a simple model representing excitation of the motoneurones by bulbospinal neurones whose discharges showed synchronization within +/- 1 ms of the reference spike, together with temporal dispersion in bulbospinal axons having a distribution of conduction velocities given by the measurements of this study. Such an explanation was essential for some of the medium-width peaks, whose latencies were short compared to the conduction times to the spinal cord for their own axons, but for other medium-width peaks oligosynaptic excitation of the motoneurones from the identified bulbospinal neurones was another possible explanation. The narrow peaks were of appropriate durations for monosynaptic connexions and were all at appropriate latencies (0.6-2.4 ms after the calculated arrival time of the bulbospinal impulse in the segment concerned). It is concluded from the observations of narrow peaks that monosynaptic excitation exists between inspiratory bulbospinal neurones and both phrenic and external intercostal motoneurones. However, because of the existence of presynaptic synchronization, as shown by the presence of the medium-width peaks, such a conclusion is predicated upon being able to discriminate against such an effect. The model showed that this restriction applies just as much to the measurements of excitatory post-synaptic potentials (e.p.s.p.s) by spike-triggered averaging as it does to cross-correlation measurements. We suggest that the discrimination against presynaptic synchronization here was possible only because the long conduction distance created temporal dispersion in the synchronized presynaptic impulses.

Action Potentials↗
PubMed1985

Acupuncture points of the brachial plexus.

This publication is the third of a total of six papers intended to name acupuncture points following the anatomic nomenclatures. In the first publication, acupuncture points in the head are named using terminal branches of the trigeminal nerve and the muscles of facial expression. In the second publication, acupuncture points in the neck are named using the cutaneous nerves of the cervical plexus and neuromuscular attachments formed by the spinal accessory nerve on the trapezius muscle. In this third publication, acupuncture points existing on the upper limbs are described following the terminal branches of the brachial plexus.

Acupuncture Therapy↗
PubMed1994

Canine liver releases neuropeptide Y during sympathetic nerve stimulation.

To determine whether the liver or gut releases neuropeptide Y (NPY) from their sympathetic nerves, we performed bilateral thoracic sympathetic nerve stimulation (BTSNS) in halothane-anesthetized dogs and calculated gut and liver NPY spillover. BTSNS markedly increased hepatic NPY spillover (delta = +32 +/- 8 ng/min) and arterial NPY concentration (delta = +220 +/- 56 pg/ml), despite no effect on gut NPY spillover (delta = +8 +/- 7 ng/min). To determine the liver's contribution to this increase of circulating NPY, hepatic nerves were selectively stimulated (HNS). Liver NPY spillover increased markedly (delta = +114 +/- 42 ng/min, P < 0.025) during HNS, causing a large increase of arterial NPY (delta = +586 +/- 237 pg/ml, P < 0.025). Using this ratio of liver spillover to arterial increments of NPY, we calculated that the liver makes a major contribution (70%) to circulating NPY levels during BTSNS. The predominant form of canine NPY coeluted with synthetic [Met17]NPY and the minor form of canine NPY coeluted with the oxidized form of [Met17]NPY on high-performance liquid chromatography. We therefore conclude that dog NPY is likely [Met17]NPY and that the liver, rather than the gut, is a major source of circulating NPY during sympathetic nerve stimulation and perhaps stress.

Animals↗
PubMed2004

Nerve transfers for severe brachial plexus injuries: a review.

Nerve transfer procedures are increasingly performed for repair of severe brachial plexus injury (BPI), in which the proximal spinal nerve roots have been avulsed from the spinal cord. The procedure essentially involves the coaption of a proximal foreign nerve to the distal denervated nerve to reinnervate the latter by the donated axons. Cortical plasticity appears to play an important physiological role in the functional recovery of the reinnervated muscles. The author describes the general principles governing the successful use of nerve transfers. One major goal of this literature review is to provide a comprehensive survey on the numerous intra- and extraplexal nerves that have been used in transfer procedures to repair the brachial plexus. Thus, an emphasis on clinical outcomes is provided throughout. The second major goal is to discuss the role of candidate nerves for transfers in the surgical management of the common severe brachial plexus problems encountered clinically. It is hoped that this review will provide the treating surgeon with an updated list, indications, and expected outcomes involving nerve transfer operations for severe BPIs.

Accessory Nerve↗
PubMed1976

[Connections between inspiratory medullary neurons and phrenic or intercostal motoneurones (author's transl)].

10 The activity of 107 medullary inspiratory neurones has been recorded extracellularly in anesthetized cats (urethane-chloralose). According to their localization in the medulla and to their axonal pathways (tested by antidromic activation), these neurones were classified as: bulbo-spinal neurones (NBSI) which send their axons to the spinal cord; they are located in the dorsal or the ventral respiratory nucleus; propriobulbar neurons (NPBI) whose axons are probably entirely located within the medulla; they are found only in the ventral nucleus. 20 Summation of gross discharges from phrenic (C5 ventral root) or inspiratory intercostal (from T4 to T10) nerves was triggered by spikes from medullary respiratory neurones. If the studied neurone controls the activity of the recorded motor fibres, after sommation of a great number of sweeps (3,000 to 5,000), the summed nerve activity displays a short delay excitatory wave, indicating that the activity of the motoneurones is increased after the onset of the medullary potential. On the other hand, there is a flat summed nerve activity if the nerve discharge is not directly dependent on the medullary recorded activity. 30 The dorsal nucleus NBSIs send their axon to the contralateral phrenic motoneurones (as it is revealed by the excitatory wave noted on the summed phrenic nerve activity, fig. 1 and 4) and not to the intercostal motoneurones (fig. 4). 40 The ventral nucleus NBSIs control contralateral intercostal motoneurones (fig. 5). Some of them send their axons only to these motoneurones, but the majority also act on phrenic motoneurones (fig. 2 and 5). 50 Connections between NBSIs and phrenic motoneurones are monosynaptic and probably also those between NBSIs and intercostal motoneurones. 60 No excitatory wave has been observed on phrenic or intercostal summed activity when summation was triggered by NPBI spikes (fig. 3). This confirms the accuracy of the "antidromic stimulation test" used to classify medullary respiratory neurons.

Animals↗
PubMed1989

Nerve supply to and the true nature of anterior supracostal muscle: three cases of the anterior supracostal muscle innervated by the external muscular branch of the first intercostal nerve having lateral cutaneous branch.

316 body-halves were examined in order to clarify nerve supply to human anterior supracostal muscle and to reveal the true nature of this particular muscle. 14 body-halves were found to have this muscle. It was innervated by the external muscular branch of the first intercostal nerve having lateral cutaneous branch in 3 out of 14 cases, and by the external muscular branch of the first intercostal nerve lacking lateral cutaneous branch in the remaining 11. As the former 3 cases have not been reported yet, we have examined the anatomy of these muscles in detail, and nerve supply to the anterior supracostal muscle and the true nature of this muscle were discussed in the present study. As a result, it was found that the anterior supracostal muscle is innervated essentially by an element of the components of the external muscular branch, and the muscle is derived from the first external intercostal muscle or rarely from the first and second external intercostal muscles. Moreover, it was inferred that the frequency of occurrence of the anterior supracostal muscle innervated by the intercostal nerve having lateral cutaneous branch is very low.

Female↗
PubMed1989

[Continuous intercostal nerve block for chronic pain].

21 ambulatory patients with acute or chronic pain localized to the chest, were treated successfully by continuous intercostal block. They included 6 women and 15 men, aged 39-70. Treatment was initiated in the outpatient clinic and continued at home for usually 5-6 days. Between 15-20 ml of 0.5% marcaine were continuously injected over the course of 6-12 hours through a catheter introduced into the intercostal space by a Touhy needle. 76% of the patients had substantial relief of pain during the block and required only minimal systemic medication. During a 3 month follow-up after cessation of the block, up to 65% were still pain-free. Results were poor or only fair in those with malignancy and long-standing intercostal neuralgias. There were no serious side-effects during treatment. This method is an important new tool in the treatment of pain.

Acute Disease↗