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At least 127 records · Page 7Linked to original sources
PubMed2005

A standardized surgical technique for mastoscopic axillary lymph node dissection.

To standardize the surgical technique for mastoscopic axillary lymph node dissection (MALND). Mastoscopic lymph node dissection was performed consistently by a group of surgeons in 316 cases of breast cancer. The mean operation time was 46.7 minutes with minimal bleeding, and the median number of lymph nodes dissected at each operation was 17.0. There were no operative complications in any case, nor did trocar implantation or tumor diffusion occurring during the mean follow-up time of 15.1 months. MALND is distinctive and practicable in operative anatomy as well as safe and convenient. The location of critical anatomy such as the intercostobrachial nerve, lateral thoracic artery, medial thoracic nerve, and thoracoepigastric vein should be clearly identified to avoid damage to them, so that is the great advantage of MALND.

Adult↗
PubMed1991

Effect of cardiac denervation on cardiorespiratory responses to exercise in goats.

The purpose of this study was to determine whether intact cardiac innervation and a normal cardiovascular (CV) response are required for a normal ventilatory (VE) response to mild and moderate treadmill exercise in awake goats. Accordingly, we measured CV and respiratory responses to two levels of exercise in seven normal (N) and six cardiac-denervated (CD) goats. Evidence of surgical CD included 1) absence of a cardiac response during surgery when the left thoracic cardiac nerves, thoracic vagi, and right and left stellate ganglia were electrically stimulated, 2) total and 80% attenuation of baroreflex changes in heart rate (HR) when arterial blood pressure was raised or lowered, respectively, by infusion of vasoactive agents in awake goats, and 3) attenuation of the CV responses to exercise. At each level of exercise in the CD goats, the HR response was significantly reduced relative to the response observed before CD (P less than 0.05) and the recovery HR response was delayed. Cardiac index increased in a work rate-dependent manner in N and CD goats but was significantly lower in the CD animals (P less than 0.05). Hypotension was consistently observed during exercise following CD. There was no effect of CD on steady-state VE at any metabolic rate or on the VE-O2 uptake relationship (P greater than 0.05). The rest-to-work and work-to-work transition responses of arterial PCO2 were similar between N and CD goats, but there was a tendency toward greater hypocapnia at the exercise onset in CD goats at the highest work rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

The brachial plexus of the Japanese serow (Capricornis crispus).

The brachial plexus of the Japanese serow was macroscopically studied. It was composed of nerves derived from the sixth (C6), seventh (C7) and eighth (C8) cervical nerves and the first (T1) thoracic nerve (98.1%). Rarely, the second T2) thoracic nerve joined it (1.9%). C6 joined C7 and made up the cranial trunk. C8 and T1 (+T2) united to form the caudal trunk. Each trunk split into dorsal and ventral divisions. The dorsal divisions from C6-T1 formed the dorsal cord which gave off the thoracodorsal, axillary and radial nerves. The manner of union of ventral divisions and their divergence was classified into 4 types. Type I was that the ventral cord was formed by cranial and caudal ventral divisions and sprouted the musculocutaneous, median and ulnar nerves. It was found in 67.3%. Type II was that the proximal muscular ramus of the musculocutaneous nerve emerged from the median nerve and the ulnar nerve appeared from the caudal ventral division from C8-T1. It was observed in 19.2%. Type III was that the proximal muscular ramus and ulnar nerve were derived from the cranial and caudal ventral divisions, respectively. It was seen in 11.6%. Type IV was quite different from type I to III. The cranial ventral division from C6-C7 was not observed. The caudal ventral division from C8-T1 alone formed the ventral cord giving off the nerves. It was encountered in one case (1.9%) and probably represented rare variation. These findings indicate that the brachial plexus of the Japanese serow is chiefly similar to that of other ruminants.

Animals↗
PubMed1992

Architectural design, fiber-type composition, and innervation of the rat rectus abdominis muscle.

The rectus abdominis muscle is architecturally compartmentalized by tendinous intersections and is supplied by multiple thoracic nerves. In this study, the rectus abdominis of the rat has been qualitatively and quantitatively examined with regard to muscle dimensions, fiber organization, fiber-type composition, and innervation. The muscle exhibits architectural heterogeneity and different patterns of innervation among its thoracic, epigastric, and hypogastric parts. The epigastric part, adherent to the rectus sheath via tendinous intersections, represents relatively simple design. It is formed by serially arranged compartments with shorter fibers, compared with the other parts. These compartments are segmentally supplied by thoracic nerves. The hypogastric part is more complex, forms an interdigitation of muscular slips, and has segmental distribution of thoracic nerves in mediolateral direction. The thoracic part much differs from the other parts. It has smaller cross-sectional areas, compartments composed of abundant nonspanning fibers with intrafascicular termination, and non-segmental distribution of thoracic nerves. In addition to these craniocaudal specializations among the three parts, the muscle exhibits mediolateral differences in fiber-type composition. Slow-twitch oxidative fibers are more densely distributed in the medial half region than the lateral, whereas fast-twitch glycolytic fibers follow an inverse pattern. The mediolateral differences in fiber-type composition as well as the craniocaudal specializations in architectural design and innervation imply regionally differentiated recruitments of the muscle in various behaviors.

Abdominal Muscles↗
PubMedDate not supplied

Nerves of the thorax: atlas of normal and pathologic findings.

An anatomic and imaging atlas was created to provide detailed information about the six pairs of thoracic nerves (phrenic nerves, vagus nerves, recurrent laryngeal nerves, sympathetic trunks, costal nerves, long thoracic nerves). Serial axial computed tomographic (CT) scans of the normal thorax were obtained and included in the atlas, along with drawings showing the proper location of each nerve relative to adjacent anatomic structures. CT scans obtained in both symptomatic and asymptomatic patients with various thoracic diseases were paired with appropriate drawings and normal CT scans in the atlas. This format was designed to help determine the presence and severity of related disease, including injury from surgery, trauma, or penetrating injury, metastatic disease involvement, and, rarely, primary tumor. Although the nerves of the thorax are rarely identified at cross-sectional imaging, their location can be inferred by localizing easily identified anatomic landmarks. Familiarity with the functional anatomy and clinical significance of the nerves of the thorax is important for the correct interpretation of thoracic images.

Cadaver↗
PubMed1994

Axon-reflex reactions in affected and homologous contralateral skin after unilateral peripheral injury of thoracic segmental nerves in humans.

Transection and regeneration of a rat peripheral nerve on one side reduces the ability of the contralateral nerve to evoke plasma extravasation after antidromic excitation of afferent C-fibers induced by electrical nerve stimulation (afferent axon reflex). An unknown transneuronal signalling substance was postulated. In humans, axon-reflex vasodilatation was studied using cutaneous iontophoresis of histamine for C-fiber stimulation and laser Doppler flowmetry for measuring vasodilatation. As a model of peripheral nerve lesion with regeneration, patients with severe unilateral zoster neuropathy of thoracic segmental nerves were examined. Axon-reflex reactions were considerably impaired within the affected dermatome compared with the unaffected side and compared with controls. In contrast, no significant differences could be found between the unaffected corresponding sites of patients and similar dermatomes of healthy controls, indicating that this type of nerve injury does not influence the ability of the contralateral nerve to evoke axon-reflex vasodilatation.

Aged↗
PubMed1992

Pre-spinal convergence between thoracic and visceral nerves of the rat.

Dichotomizing sensory axons have been demonstrated in a number of species and are of significance in understanding the possible mechanisms underlying referred pain. The present study reviews work employing fluorescent dyes as tracers to demonstrate afferent dichotomization in the peripheral nervous system. Dichotomization between the intercostal and splanchnic nerves of the rat was demonstrated by means of intraneural transport of Diamidino yellow or Fast blue. Frequency of pre-spinal somato-visceral convergence averaged 2% (range 0.1-21%). Average frequency of convergence was 8.3% (range 2-23.1%) between internal and external intercostal nerves. Control experiments in which axoplasmic transport was inhibited by vinblastine ruled out the possibility of errors from non-axoplasmic transport of the markers. Thoraco-visceral pre-spinal convergence occurs in the rat and is variable in extent.

Afferent Pathways↗
PubMed1980

Winging of the scapula as a complication of first rib resection: a report of six cases.

Long thoracic nerve injury occurred in 6 patients as a complication of first rib resection by the transaxillary route for relief of thoracic outlet syndrome. In a review of 38 patients following 48 first rib resections, this is the second most frequent complication. This complication has rarely been reported in the literature. In 4 patients the long thoracic nerve palsy was transient, and complete recovery of serratus anterior function occurred within 6 months. In one patient, complete recovery followed repair of the long thoracic nerve.

Female↗
PubMed1995

Free vascularized double muscle transplantation for the treatment of facial paralysis.

Two cases of free neurovascular double muscle transplantation for facial paralysis are reported, with detailed descriptions of the operative technique and follow-up study. The latissimus dorsi muscle segment is placed between the nasolabial fold and the zygoma to substitute for the zygomatic and levator labii muscles, while the serratus anterior muscle segment is placed between the lower lip and the mandibular margin to substitute for the depressor labii muscles. The thoracodorsal nerve is sutured to the stump of the cross-face nerve graft, and the lateral thoracic nerve is sutured to a part of the hypoglossal nerve. The procedure is able to restore a relatively symmetrical smile, especially in patients with a full denture smile. The satisfactory results of this procedure are expected to lead to new prospects in the treatment of facial paralysis.

Adult↗
PubMed1989

A case of the scalenus anterior muscle passing behind the left subclavian artery.

The scalenus anterior muscle was found to pass behind the left subclavian artery and the first thoracic nerve in a 95-year-old Japanese woman. The scalenus anterior muscle originates from the fifth and sixth cervical vertebrae and inserts on the first rib more dorsal than typical. It is innervated by the fifth and seventh cervical nerves. The muscle belly is thin. The scalenus minimus was not found. The left vertebral artery originates from the aortic arch and enters the transverse foramen of the fifth cervical vertebra. The primary vertebral artery arises from the costocervical artery. The internal thoracic artery originates from the subclavian artery more distally than typical. The axillary artery crosses the brachial plexus between the eighth cervical and first thoracic nerves. Because the first thoracic nerve joins the brachial plexus more distally than usual, the plexus has no typical inferior trunk. Comparative anatomy shows that the muscles, nerves and arteries of the lateral cervical region of the present case maintains primitive characteristics. From the functional viewpoint, the mechanical efficiency of the scalenus anterior muscle is probably lower than usual due to the lower point of origin and the dorsal shift of the insertion.

Aged↗
PubMed1978

Ultrastructural identification of afferent fibers of cardiac origin in thoracic sympathetic nerves in the dog.

While cardiac afferent nerve activity has been recorded from the ventrolateral (VLCN) and ventromedial (VMCN) cardiac nerves, left dorsal and ventral ansae subclaviae, and left upper thoracic white rami communicantes, little anatomical evidence for the existence of afferent fibers in these nerves has been reported. This study was designed to characterize the normal ultrastructure of the above nerves and to identify afferent fibers in them through Wallerian degeneration produced by dorsal root ganglionectomy. Laminectomies followed by dorsal root ganglionectomies were performed on left thoracic roots T1-T4 in six mongrel dogs. The nerves to be examined were removed from two animals at 1, 2, and 3 weeks following ganglionectomy and prepared for electron microscopy. Control nerves were obtained from two normal dogs. Degenerating nonmyelinated fibers were characterized by watery axoplasm containing clumps of electron-dense material. Degenerating myelinated fibers were distinguished by the separation of their myelin lamellae, producing characteristic whorls. After three weeks, afferent nonmyelinated axons had degenerated in all nerves, leaving only layered processes of Schwann cells in these areas. Approximately 5-15% of the fibers in each nerve degenerated, indicating their afferent nature. Of these fibers, 85-90% were nonmyelinated C fibers and the remainder myelinated Adelta fibers. These results indicate participation of both Adelta fibers and a large population of C fibers in transmission of cardiac afferent activity.

Animals↗
PubMed1988

CT-guided nerve root block and ablation.

We report our experience in performing 52 CT-guided peripheral nerve root blocks and 27 CT-guided nerve root ablations. The nerve root block procedures were performed as diagnostic tests to determine the clinical significance of equivocal herniated disk or foraminal stenosis (n = 33) and before nerve root ablations (n = 19). To evaluate the clinical significance of these nerve root blocks, we performed 52 procedures at the vertebral level where a herniated disk or foraminal stenosis had been identified on CT or MR images. In 51 of 52 cases, the procedures were successful in anesthetizing the intended nerve root, which allowed us to determine whether that particular nerve root was the source of pain. By relieving or not relieving pain, the results of the diagnostic nerve root blocks helped determine whether a protrusion or foraminal stenosis was clinically significant. The nerve root ablations were done exclusively for treatment of pain in patients with malignant disease. Significant relief of pain was obtained in 17 (63%) of 27 patients. The thoracic nerve ablations were the most successful (9/10 or 90%) because the correct thoracic nerve innervation to the offending lesion could be identified. The lumbosacral nerve ablation procedures were the least successful (6/14 or 43%) because the innervation of the pelvic neoplasms was complex, arising from multiple lumbosacral nerves that often were bilateral. Equivocal foraminal stenosis and disk protrusion are common findings on CT and MR imaging, and CT-guided nerve block procedures can help determine which of these findings are clinically significant. CT-guided nerve root ablations have limited efficacy but can help control pain in patients with a malignant disease, especially when the pain is in the distribution of a thoracic nerve dermatome.

Ethanol↗
PubMed1992

The bimodal auditory-vibratory system of the thoracic ventral nerve cord in Locusta migratoria (Acrididae, Locustinae, Oedipodini).

In locusts the auditory receptors of the tympanal organs and many of the vibratory receptors of all 6 legs converge at the level of the thoracic ventral nerve cord, forming a combined auditory-vibratory sensory system; it is represented by the VS-, S-, and V-neurons ascending to the supraesophageal ganglion. The connections between vibratory receptors of the different legs and the dendritic inputs of the bimodal ascending neurons are investigated in this report. As an example, the dendritic branches of the G- and V3-neurons for auditory and vibratory input could be localized by simultaneous recording at 2 different positions of the axon. The vibratory input from the receptors of the different legs was determined. Segmental and/or intersegmental thoracic interneurons are intercalated between the receptors and the ascending auditory-vibratory neurons (G- and V3-neurons). The morphology and function of 2 intersegmental vibratory interneurons (VI1- and VI2-neurons) are described. They probably connect the vibratory receptors of 1 (or 2) leg(s) of 1 thoracic segment with the different bimodal auditory-vibratory neurons. The importance of the anterior Ring Tract for synaptic connection between receptor cells, first order interneurons, and bimodal auditory-vibratory neurons is discussed on the basis of morphological and physiological data.

Animal Communication↗
PubMed1986

The high thoracic sympathetic nerve system--its anatomic variability.

Upon studying microscopically and macroscopically 18 resection preparations of upper thoracic sympathectomies it is clear that the variability in the anatomy of the sympathetic nervous system in connection with the spinal nervous system is higher than has always been described. A fine network of smaller and larger nerve bundles was found which connect the sympathetic and spinal nerve systems. Light microscopical perikarya were identified in many nerve bundles. These findings have an important impact on the concept of the effectiveness of thoracic sympathectomy.

Ganglia, Sympathetic↗
PubMed2004

Detailed neurovascular anatomy of the serratus anterior muscle: implications for a functional muscle flap with multiple independent force vectors.

A functional muscle free flap with multiple muscle segments that could be oriented independently to produce different force vectors would be beneficial in facial reanimation and upper extremity reconstruction. The serratus anterior muscle has this potential because two or more individual muscle slips can be transferred on a single vascular pedicle. Although serratus anterior muscular anatomy has been studied previously, little attention has been given to the intramuscular anatomy. Muscle slips 5 through 9 (and 10, if present) in 50 specimens from 27 cadavers were studied following intraarterial latex injection. Eight specimens were injected with a radiopaque material (latex/diatrizoate/lead mixture) for x-ray delineation of the intramuscular vascular pattern. Slips 5 through 9 are consistently supplied by a single dominant branch of the thoracodorsal artery and innervated by the long thoracic nerve. Dissection revealed that the long thoracic nerve and its branches invariably follow the artery and divide proximal to the corresponding arterial division. There is a consistent vascular pattern to each muscle slip, in which the serratus artery gives rise to common slip arteries, each of which supplies adjacent muscle slips. The mean length of a muscle slip from its origin on the rib periosteum to the division of the common slip artery is 9.6 cm. These findings imply that the slips may be separated to the level of these common slip arteries, with up to five slips transferred on a single neurovascular pedicle and each slip oriented independently to provide multiple muscle force vectors. With these possibilities, the reconstructive surgeon may be able to restore more natural facial animation and better intrinsic muscle function in the upper extremity.

Adolescent↗