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PubMed1983

[Thoracic vertebral nerve].

When studying phylogenetic transformations of the sympathetic trunk, a theoretical possibility has been substantiated that in Mammalia a caudal continuation of the vertebral nerve in the thoracic area can exist. By means of some embryological and anatomical methods, in man and in certain animals (cat, dog), together with the cervical, the thoracic vertebral nerve has been revealed. The latter has an appearance of a plexus situating on the rudimentary thoracic vertebral artery wall and is formed at the expense of the multisegmentary distribution of the gray connective branches fibers. Anatomical manifestation of multisegmentarity of the gray connective branches connections is a division of these branches into cranial and caudal fasciculi and their spreading in the foramens between the transversal processes of the thoracic vertebrae and the necks of the corresponding ribs. In Mammalia the neck and the thoracic vertebral nerves combine into the vertebral neural trunk homologous to the secondary sympathetic trunk in birds. The thoracic vertebral nerve is a roundabout way for innervation of many somatic and vegetative structures. The pathogenetic mechanisms responsible for disturbances in the cervical vertebral nerve function, probably, somehow influence the thoracic vertebral nerve.

Animals↗
PubMed1992

Variations of the ventral rami of the brachial plexus.

We studied the variations in the ventral rami of 152 brachial plexuses in 77 Korean adults. Brachial plexus were composed mostly of the fifth, sixth, seventh and eighth cervical nerves and the first thoracic nerve (77.0%). In 21.7% of the cases examined, the fourth, fifth, sixth, seventh and eighth cervical and the first thoracic nerves contributed to the plexus. A plexus composed of the fourth, fifth, sixth, seventh and eighth cervical and the first and second thoracic nerves, and a plexus composed of the fifth, sixth, seventh eighth cervical nerves were also observed. The plexuses were classified into three groups according to cephalic limitation, and the plexus of group 2 in which the whole fifth cervical nerve enters the plexus, were observed the most frequent. The average diameter of the sixth and the seventh cervical ventral rami of the plexus was greatest and that of the fifth cervical was smallest. The largest nerve entering the plexus was the sixth or the seventh cervical nerve in about 79% of cases. The dorsal scapular nerve originated from the fifth cervical ventral ramus in 110 cases (75.8%). The long thoracic nerve was formed by joining of roots from the fifth, sixth, and seventh cervical nerves in 76.0% of cases. Also, a branch to the phrenic nerve, the suprascapular nerve, a nerve to the pectoralis major muscle and a nerve to the subscapular muscle arising from the ventral rami of the plexus were observed.

Brachial Plexus↗
PubMed2001

[An anomalous case of the thoracic cardiac nerve in the Japanese monkey].

A rare case of an anomalous right thoracic cardiac nerve that directly distributed to the left ventricle and left coronary artery was observed in a Japanese monkey. Its nerve arose from 4th and 5th thoracic ganglia on the right sympathetic trunk, descended obliquely along the thoracic vertebra toward the thoracic aorta at the level of the body of 7th thoracic vertebra. After reaching the aorta, it reflected upward and ascended along the medial-ventral surface of the aorta. Thereafter, it received a cardiac branch arising from the vagus nerve in the upper part of the thoracic aorta, and ran to the left-lateral aspect of the heart. Finally, it gave off main branches to the terminal part of the left coronary artery and the left ventricle, and small branches to the proximal part of the left coronary artery. In a human dissection, similar nerves (the thoracic splanchnic nerve or thoracic pulmonary nerve) originating at the thoracic ganglia and reaching to the lung, have also been observed. The superior, middle and inferior cervical cardiac nerves can easily reach the heart along the common carotid artery, the brachiocephalic artery and subclavian artery. But it is not easy for the thoracic cardiac nerve to reach the heart because of the topographical relationship of its thoracic origin and the peripheral distributions of the left side of the heart. Therefore, the thoracic cardiac nerve would have to run a complicated course.

Animals↗
PubMed1995

Dorsal scapular nerve compression. Atypical thoracic outlet syndrome.

The dorsal scapular nerve and long thoracic nerve of 10 cadavers (20 sides) and 36 patients with dorsal scapular nerve compression were studied anatomically. The origin of the dorsal scapular nerve of a section frequently shared a common trunk with the long thoracic nerve, and went through the scalenus medius anterointernally and posterolaterally with the presence of some tendinous tissues. Leaving the long thoracic nerve, it might give branches to the shoulder and the subaxillary region and finally have the branches join the long thoracic nerve again. The compression of the section near the origin caused discomfort and sourness of the neck, shoulder and back region. Clinically, the severance of the scalenus anterior and medius ameliorated or relieved the compression of the dorsal scapular nerve. Complete decompression required cutting of the scalenus medius and its tendinous tissue superficial to the dorsal scapular nerve. Among 24 sides of 22 patients undergoing surgery, the symptoms of 20 sides of 19 patients were completely or partially relieved.

Adult↗
PubMed2005

Distal variations of the neurovascular pedicle of the serratus anterior muscle as a flap.

The serratus anterior muscle has recently been suggested as a versatile and reliable flap for reconstruction of complex craniofacial and neck lesions, extremity and sacroiliac region injuries, as well as intrathoracic and extrathoracic reconstruction procedures. The muscle has been used as a microvascular flap or a pedicled transfer and has been transferred in combination with other muscles, bones, and skin. We performed 15 dissections of adult axilla regions that were examined under x3.5 loupe magnification to collect anatomic data regarding the neurovascular pedicle of the serratus anterior muscle. The serratus muscle and fascia were found to have a dual blood supply, with the upper part supplied by the lateral thoracic artery and the lower part by terminal branches of the thoracodorsal artery. The lateral thoracic artery was noted to supply the upper four slips but it extended into the lower serratus anterior muscle in two cases. Seven branching patterns were found in the lower serratus anterior muscle. In type I, the only branch of serrati proceeded over the long thoracic nerve. Type II had the only branch of serrati proceeding under the long thoracic nerve. In type III, double branches of serrati proceeded over the long thoracic nerve; while in type IV branches of serrati ran with a double branch under the long thoracic nerve. In type V, three serrati branches proceeded over the long thoracic nerve. Type VI serrati branches were branches of thoracodorsalis, which was hypoplastic, and the supply was maintained from the lateral thoracic artery. In type VII, one serrati branch ran over the long thoracic nerve. There was no connection between the branches of serrati and the branches of the lateral thoracic artery. The length of the long thoracic nerve, the number of motor axons and the vascular network in anatomic proximity to this nerve make it an expendable but powerful source of reconstructions of head, neck, chest wall and extremity defects. Results of this study provide an anatomic framework to improve current reconstructive or aesthetic procedures on the serratus anterior neurovascular structures.

Adult↗
PubMed2006

Imaging of a thoracic spinal nerve haemangioblastoma by three-dimensional digital angiography.

Haemangioblastomas occur sporadically or in association with Von Hippel-Lindau (VHL) disease. Occasionally, they are associated with intrathecal cauda equina nerve roots and rarely with spinal nerve roots. The occurrence of a completely extrathecal, thoracic spinal nerve haemangioblastoma is exceptional, with only one case previously described in the English-language literature. We report an extradural thoracic spinal nerve haemangioblastoma in a patient with VHL disease causing a progressive thoracic radiculopathy. The advantages of three-dimensional digital angiography will be discussed. Three-dimensional reconstruction of the images acquired by rotational digital subtraction angiography is one of the most promising developments to improve surgical planning for complex vascular lesions.

Adult↗
PubMed2006

Nerve injury: injury to the recurrent laryngeal, phrenic, vagus, long thoracic, and sympathetic nerves during thoracic surgery.

Nerve injury occurs in about 1% of patients undergoing thoracic surgery. Most commonly, it is the result of surgical trauma specific to the area of operation. Alternatively, it may be due to retraction on adjacent structures during the exposure of complex surgical procedures. This article reviews the most common types of nerve injury and discusses the pathophysiology, etiology, diagnosis, and treatment of each.

Diagnostic Imaging↗
PubMed1982

Cardiovascular effects of thoracic afferent nerve stimulation in conscious dogs.

Afferent stimulation of a severed thoracic autonomic nerve in 18 conscious dogs produced in 13 instances hypertension and in 5 instances hypotension. Reflex hypertension was usually accompanied by augmented atrial and ventricular force of contraction. The hypertension could be maintained for over 5-min duration by constant stimulation. Inotropic changes accompanying this hypertension were accentuated following atropine administration and abolished by propranolol. Blood pressure changes following atropinization were initially augmented. On the other hand reflex hypotension was accompanied by bradycardia and decreased atrial contractility. These changes were essentially abolished by atropine. Afferent nerve stimulation with frequencies as low as 1 Hz initiated reflex changes. Maximal responses were obtained by stimulation frequencies of 10-15 Hz. It is concluded that significant and relatively sustained cardiovascular reflexes can be generated by stimulation of cardiac afferent nerves in conscious dogs.

Animals↗
PubMed1999

[Upper thoracic thoracoscopic sympathectomy as the method of choice for reoperation of the thoracic sympathetic nerve].

The authors present in their paper the possibility of thoracoscopic thoracic sympathectomy as the method of choice for reoperation of the thoracic sympathetic nerve 14 years after classical surgical upper chest sympathectomy, as the original effect had receded. They mention the possibility of reoperation of the sympathetic nerve with a subsequent favourable effect by the endoscopic method which reduces the risk of complications to a minimum.

Female↗
PubMed1986

Compressive neuropathy in childhood: a report of 14 cases.

During a 6-year period, 14 of 898 patients examined at a pediatric electromyographic laboratory had a compressive mononeuropathy. These included five injuries to the peroneal nerve, four to the sciatic nerve, two to the distal radial nerve, and one each to the deep palmar branch of the ulnar nerve, the musculocutaneous nerve, and the long thoracic nerve. A potentially preventable mechanism was identified in 9 of the 14 patients, including prolonged posture in three of the four sciatic and two of the peroneal neuropathies. Four other mononeuropathies were secondary to pressure from an orthopedic appliance or procedure (one injury to the musculocutaneous nerve, one to the long thoracic nerve, two to the peroneal nerve).

Adolescent↗
PubMed1986

Intraoperative cryolysis of intercostal nerves in thoracic surgery.

Pain is a major problem associated with thoracotomy. Intraoperative cryolysis of the intercostal nerves around the incision can essentially reduce the postoperative analgesic requirement and diminish the impairment of ventilatory capacity. To obtain maximum effect, it is recommended that the sites of drainage should also be treated with cryolysis.

Cryosurgery↗
PubMed2004

Morphological variations in brachial plexus of beagle dogs: evaluation of utility as sources of allogeneic nerve grafts.

Basic studies were carried out to apply frozen allogeneic nerve grafts in dogs after wide-ranging defects of the brachial plexus due to surgical resection of tumor. In this study, morphological variations in branching patterns of the brachial plexus were examined in ten beagle dogs, to evaluate whether the brachial plexus might represent a useful source of allogeneic nerve grafts. Spatial relationships between the axillary lymph node, which had the possibility of carcinomatous metastasis, and the musculocutaneous (MC) nerve, which was important for the function of the forelimbs, were also investigated. In all ten cases examined, the brachial plexus received ventral roots from the fifth cervical nerve to the first thoracic nerve. No significant variation in the branching pattern was found in any nerve except the phrenic, MC and dorsal thoracic nerves. Four communicating branches were observed and had some morphological variations which might be negligible for nerve grafting. Considering previous physiological and anatomical reports, the most important nerve to be reunited in graft operations for functional recovery is the radial nerve. The MC nerve and median or ulnar nerve should also be considered as possibilities for reuniting. Distances between the axillary lymph nodes and the MC nerve ranged from 11.2 mm to 21 mm (mean +/- SD: 16.1 +/- 2.3 mm). In conclusion, it was suggested that morphological variations in the brachial plexus were technically acceptable to apply allogeneic nerve grafts at least in beagle dogs.

Animals↗
PubMed1997

Prognostic value of thoracic recurrent nerve nodal involvement in esophageal squamous cell carcinoma.

BACKGROUND: The determination of a simple and reliable prognostic factor that allows identification of patients at high risk of early cancer recurrence and subsequent death after resection of esophageal carcinoma should contribute to more accurate management of patients suffering from this disease. STUDY DESIGN: The aim of this study was to assess the prognostic value of thoracic recurrent nerve nodal involvement after curative resection of esophageal squamous cell carcinoma. The prognostic importance of gender, age, tumor penetration, and extent of lymph node involvement was evaluated in 55 patients after curative resection of esophageal squamous cell carcinoma. RESULTS: Thirty-four of 55 patients (62%) had nodal metastases and 10 of 55 (18%) had thoracic recurrent nerve nodes involved. The median overall survival was 28 months. By univariate analysis, survival was higher in association with the absence of adventitial invasion (p = 0.04), of nodal involvement (p = 0.03), and of thoracic recurrent nerve nodal involvement (p = 0.0001). In a Cox proportional hazards regression model, thoracic recurrent nerve nodal involvement appeared the strongest predictive factor (adjusted hazard ratio 8.4 (3.0-23.7)). CONCLUSIONS: Assessment of thoracic recurrent nerve nodes is appropriate to identify patients who are at high risk of disease-related death after surgical resection.

Adult↗
PubMedDate not supplied

Pectoralis major transfer for serratus anterior paralysis.

Serratus anterior paralysis can result in winging of the scapula and weakness of arm elevation. The etiology of the condition is injury to the long thoracic nerve. There are many proposed causes of long thoracic nerve injury including acute trauma, Parsonage-Turner syndrome, or viral illness. The long length of the long thoracic nerve makes it prone to compression injury along the chest wall. Most patients recover nerve function with conservative treatment. In those in whom nerve function fails to recover, surgical treatment involving pectoralis major transfer may be beneficial. In this study 9 patients underwent pectoralis major transfer with a fascia lata extension graft. The symptoms of most were improved, with correction of the winging and improved movement in the affected shoulder.

Adult↗
PubMed1981

Cardiac and non-cardiac preganglionic neurones of the thoracic vagus nerve: an HRP study in the cat.

Using the HRP method, we studied cardiac and non-cardiac preganglionic neurones of the thoracic vagus nerve in the cat. The inferior cardiac branches of the right thoracic vagus nerve were differentiated from the neighboring non-cardiac branches by positive cardiac slowing following electrical stimulation. A small amount of crystalline HRP was placed at the central cut end of the cardiac or non-cardiac branches. After a survival period of 2 days, the medulla oblongata, the stellate ganglion (SG), the superior cervical (SCG) and the nodose ganglion (NG) were serially sectioned and processed for histochemical demonstration of HRP. In the medulla oblongata, HRP-labeled cells were mainly located in 2 regions: (1) within and around the ambiguous complex (site A); (2) within the dorsal vagus nucleus (site X). After applying HRP to the cardiac branches, 968 HRP-labeled cells were observed in 7 animals bilaterally with the ipsilateral dominance (94%); 81% of them were found in site A. After applying HRP to the non-cardiac branches, 447 HRP-labeled cells were seen in 2 animals bilaterally with the ipsilateral dominance (92%); 79% of them were found in site X. Many HRP-labeled cells were found in the SG and NG, indicating that the cardiac branches are composed of sensory afferent and sympathetic efferent fibres as well as cardiac vagus efferent fibres.

Animals↗
PubMed1995

Thoracic spinal nerve and root conduction: a magnetic stimulation study.

We describe a technique of magnetic coil (MC) stimulation of the thoracic spinal nerves and roots in 12 normal subjects and a patient with diabetes mellitus. We kept the MC flat against the vertebral column in the midline over T-7, T-8, and T-9 spinous processes and obtained compound muscle action potentials from the upper rectus abdominis, external oblique, and intercostal muscles. We obtained mean latencies to these muscles after stimulation in the posterior axillary line. We noted that the onset latencies remained fixed despite increasing the intensity of stimulation from 30% to 100% and on moving the coil up to 3 cm lateral to the spinous processes suggesting that the stimulation of the fastest conducting fibers was occurring at a fixed site, most likely at the intervertebral foramina. Prolonged latencies in the diabetic patient confirmed the diagnosis of radiculoneuropathy.

Adult↗
PubMed1983

The organization of the thoracic spinal nerve projection in the rat dorsal horn demonstrated with transganglionic transport of horseradish peroxidase.

Transganglionic transport of horseradish peroxidase (HRP) was used to study the organization of the thoracic spinal nerve projection to the dorsal horn in rats. Labeling was found in the superficial dorsal horn 16-20 hours after application of HRP to the cut ends of various spinal nerve rami. Labeling was restricted to the outer part of the substantia gelatinosa at these stages. Longer survivals (25-48 hours) gave rise to labeling of the deep part of substantia gelatinosa and deeper parts of the dorsal horn as well. The dorsal ramus projected to the lateral third of the horn from half a segment rostral to half a segment caudal to the entry segment. The ventral ramus projected to the medial two-thirds of the horn from 1 1/2 segments rostral to half a segment caudal to the entry segment. The two branches of the ventral ramus that were examined projected to separate medial and lateral compartments for the entire ventral ramus. There was a distinct lateromedial shift of the projection found from rostral through caudal levels within the projection compartment for each nerve. The results indicate that the dorsal horn projection of thoracic spinal nerve branches is organized in longitudinal compartments which are arranged in a strictly somatotopic fashion.

Animals↗