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At least 19 recordsLinked to original sources
PubMed1975

Long thoracic nerve palsy: a follow-up study.

Twelve patients who had previously been treated for palsy of the long thoracic nerve of Bell and resultant serratus anterior paralysis were examined in a follow-up study designed to determine their extent of recovery and/or residual disability. The patients' histories were reviewed, following which they were recalled for updating of the history and reexamination. It was found that those patients whose lesions were due to acute trauma had only partial or no recovery of serratus function, while those with infectious, toxic, allergic or idiopathic etiologies had partial or complete recovery. The occurrence of a prolonged interval between onset of symptoms and institution of therapy was found to adversely affect prognosis. Among those patients with no recovery of serratus anterior function, some were able to maintain relatively good active motion in the affected shoulder by substituting with the trapezius.

Adolescent↗
PubMed2026

[Efficacy and safety of thoracic paravertebral block combined with thoracic nerve block for acute herpes zoster neuralgia involving upper thoracic dermatomes in middle-aged and elderly patients].

To investigate the clinical efficacy and safety of ultrasound-guided thoracic paravertebral block (TPVB) combined with pectoral nerve block (Pecs) in the treatment of acute herpetic neuralgia (AHN) involving the upper thoracic segments in middle-aged and elderly patients, a prospective study was conducted. A total of 70 middle-aged and elderly patients with upper thoracic AHN who visited the Department of Pain Medicine at Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, from June to December 2023, were enrolled and randomly divided into a control group and an experimental group using a random number table, with 35 patients in each group. The control group received TPVB once weekly for a total of 3 sessions, while the experimental group received TPVB combined with Pecs block using the same regimen. Outcome measures included the Visual Analogue Scale (VAS) for pain, Pittsburgh Sleep Quality Index (PSQI), 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), treatment satisfaction score, incidence of postherpetic neuralgia (PHN), rescue analgesia, and adverse events. Assessments were conducted at 1, 4, 8, and 12 weeks post-treatment, and between-group differences were compared. Ultimately, 33 patients in the experimental group and 31 in the control group completed the follow-up and were included in the final analysis. The results showed that both groups demonstrated significant improvements in VAS scores, PSQI, GAD-7, PHQ-9, and satisfaction scores compared with baseline (all P<0.05). Compared with the control group, the experimental group exhibited significantly lower VAS scores and higher satisfaction scores at 1, 4, and 8 weeks post-treatment (P<0.05), as well as significantly lower PSQI, GAD-7, and PHQ-9 scores at 4 and 8 weeks (P<0.05). There were no statistically significant differences between the two groups in the incidence of PHN, rescue analgesia, or adverse events (all P>0.05). This study demonstrates that compared with TPVB alone, the combination of TPVB and Pecs block provides better pain relief, improves sleep quality, and alleviates anxiety and depression in middle-aged and elderly patients with upper thoracic AHN, with a favorable safety profile.

Humans↗
PubMed1979

Involvement of thoracic nerve afferents in the respiratory response to chest compression.

Chest compression elicits extravagal neural reflexes which can alter the respiratory pattern. Experiments were conducted to determine the source of the afferents responsible for the respiratory response to chest compression (CC). The effects of CC on VT, f, TI, TE, blood gases, end-tidal CO2, and blood pressure were studied in anesthetized, vagotomized dogs and cats. In dogs, thoracic wall afferents were eliminated by thoracic dorsal rhizotomies (TDR) and/or spinal blocks (SB). There were two different respiratory responses to CC. In one (I), Tt decreased and TE increased, resulting in a decreased f. The second (II) resulted in a decreased TI and TE. The I response was still present, but weaker, in animals after TDR (1--4), TDR (5--9), TDR (1--9, T5 or T10 SB and absent in those with T1SB. The II response was still present after TDR ()--4), TDR (5--9), TDR (1--9), or T10SB and absent after T5SB. The results indicate that: (1) afferents responsible for the I response to CC arise from the upper, middle and lower thoracic wall, (2) afferents responsible for the II response arise from the middle and lower thoracic wall, and (3) the responses are not due to changes in chemical drive, blood pressure or lung receptors.

Afferent Pathways↗
PubMed1977

Responses of the canine myocardium to stimulation of thoracic cardiac nerves.

The thoracic cardiac nerves were stimulated in each of 21 dogs anesthetized with alpha chloralose. Recordings were made of heart rate, blood pressure, and contractile force from all four cardiac chambers. Walton-Brodie strain-gauge arches were sutured to both atria, and to three locations of each ventricle, representing both anterior and posterior surfaces. The functional autonomic components of each nerve were summarized and classified into four basic types. Types I and II were both located medial to the thoracic vagi. These were shown to contain both sympathetic and parasympathetic components traveling to all four chambers of the heart. The sympathetic componnent of the type II nerves produced reflex changes in force of contraction and systemic blood pressure. Nerves classified as types III and IV produced no parasympathetic effect on the heart. These were all located lateral to the thoracic vagi. While the type III nerves carried sympathetic efferent fibers to all four chambers, the type IV nerve carried sympathetic fibers predominantly to the right atrium.

Animals↗
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↗
PubMed1979

Serratus anterior paralysis in the young athlete.

Ten cases of isolated, complete paralysis of the serratus anterior muscle were diagnosed in young athletes during a three-year period. One patient had recurrent partial paralysis of the serratus anterior muscle, the first such case reported. From studies on cadavera and clinical observations, we concluded that paralysis of the serratus anterior muscle results from a traction injury to the long thoracic nerve of Bell. Since full recovery usually occurs in an average of nine months, surgical methods of treatment should be reserved for patients in whom function fails to return after a two-year period. Non-strenuous use of the involved extremity with avoidance of the precipitating activity, followed by exercises designed to maintain the range of motion of the shoulder and to increase the strength of associated muscles, is advocated for treatment of acute or repetitive injuries to the long thoracic nerve of Bell.

Adult↗
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↗
PubMed1977

Reflex effects of thoracic sympathetic afferent nerve stimulation on the kidney.

Thoracic sympathetic afferents may play a role in the reflex control of renal vascular resistance during hypotension. Mongrel dogs were anesthetized with ketamine hydrochloride and maintained on a 50-50, O2-N2O mixture supplemented with 0.5%-1.0% halothane. Systemic arterial blood pressure was lowered to 50 mmHg with use of a constant pressure hemorrhage technique. The renal circulation was perfused with a constant-flow perfusion system. Low-frequency (3 Hz) stimulation of thoracic sympathetic afferents produced renal vasodilation. A reduction of renal vascular resistance was measured as a decrease in constant-flow perfusion pressure. Vagotomy accentuated the dilator response to stimulation. High-frequency (30 Hz) afferent stimulation produced renal vasoconstriction. Renal efferent nerve activity and renal blood flow responded to afferent stimulation (3 Hz) by transient inhibition of efferent activity and increases in renal blood flow. Afferent stimulation (30 Hz) caused increases in renal efferent nerve activity and decreases in renal blood flow. The thoracic sympathetic afferents carry information from cardiopulmonary structures that alter renal efferent nerve activity and renal hemodynamics during hypotension.

Animals↗
PubMed1977

Neural repair for sensory restoration in a groin flap.

A preliminary study of the recovery of sensation in groin flaps, after suture of the lateral cutaneous branches of the twelfth thoracic nerve supplying the groin flap with those of the hand, is described. This appears to be a worthwhile procedure.

Abdomen↗
PubMed1979

Localized pruritus-notalgia paresthetica.

Notalgia paresthetica, possibly an isolated sensory neuropathy involving the posterior primary rami of thoracic nerves T2 through T6, and appearing as pruritus of the back, is apt to be encountered by both dermatologists and neurologists. Two cases illustrate this disorder.

Adult↗
PubMed1976

The association of octopamine with specific neurones along lobster nerve trunks.

Octapamine and its synthetic enzyme, tyramine beta-hydroxylase (TBH), are found in high concentrations at two points along second thoracic nerve roots in lobsters. The first is in the proximal section of the second root between the ventral nerve cord and the bifurcation of the root into medial (to flexor muscles) and lateral (to extensors) branches. The second region of high concentration is within a well known crustacean neurosecretory system, the pericardial organ, located close to the ends of the lateral branches of the roots. 2. With several different staining procedures, small clusters of nerve cell bodies are found within the connective tissue sheath in the proximal regions of the second roots. No cell bodies are seen in the pericardial organ regions. Cell bodies are variable in number and position between corresponding roots in the same animal and homologous roots among different animals. The average numbers of cell bodies, however, correlate well with TBH and octopamine content, and with the synthesis of octopamine in these same regions of roots. 3. Small clusters of root cell bodies dissected from preparations have greater than 500-fold higher activities of TBH than isolated efferent excitatory and inhibitory or afferent sensory axons. 4. Along with octopamine, the preferential synthesis of acetylcholine and serotonin is also seen in proximal segments of roots. Acetylcholine synthesis in these regions may represent transmitter synthesized in the nerve terminals innervating the root cells. The role of serotonin in these regions is not understood at this time but the amounts of endogenous serotonin found are only a tenth of the amounts of octopamine present. 5. Dopamine is not synthesized from tyrosine in second thoracic roots. However, if DOPA or dopamine are used as precursor compounds, then noradrenaline, which is usually not found in lobsters, can be accumulated in proximal segments of roots. 6. Phenolamines are converted to two further metabolites by lobster tissues. The compounds are unidentified and are named fast and slow product on the basis of their migration on electrophoresis at acid pH. Some partial characterization of slow product reveals that it is a mixture of compounds that can be converted on mild acid hydrolysis to fast product and the parent phenolamine. 7. The several lines of evidence presented suggest that nerve cells found in the proximal segments of the second thoracic roots contain and can synthesize octopamine. Since not all the cells in any single root have been analysed for octopamine or TBH, however, the possibility that one or more of the cells contain physiologically interesting substances other than octopamine is not eliminated.

Animals↗
PubMed1976

A new concept of the sympathetic pathways to the eye.

The sympathetic pupillociliary pathways controlling the dilatation of the pupil in man have been recorded by many authorities as passing via the first and/or second thoracic (dorsal) rami to the lower part of the stellate (first thoracic) ganglion. It has been stated by these and other authorities that the removal of the lower part of the stellate ganglion and/or resection of the first and/or second thoracic rami would produce a Horner's syndrome. This currently accepted concept of the sympathetic pathways to the eye we believe to be incorrect. Our entire clinical experience has consistently contradicted the findings and reports of other investigators. It is suggested that the ability afforded by a new surgical approach to reach, dissect, and exactly control the line of resection without undue trauma to the stellate ganglion has made possible for the first time a definitive statement concerning the entry of the pupillociliary pathways into the sympathetic chain. It is, therefore, postulated that the preganglionic neurons controlling the pupil enter the upper portion of the stellate ganglion by a separate paravertebral route leaving the ventral roots of the eighth cervical, first and/or second thoracic nerves. Our entire clinical experience refutes the concept that these pathways pass via the first ramus communicans to the first thoracic ganglion. This thesis is based on and supported by the results of new surgical approach originally designed to permit a more direct exposure and to overcome many of the deficiencies of current surgical approaches. The anterior transthoracic, transpleural wound employed allows a more direct approach and a more accurate and complete dissection of this segment of the sympathetic supply to the head, neck, upper extremity, heart, and coronary vessels without incurring the undesirable sequela of a Horner's syndrome in 93% of patients.

Ciliary Body↗
PubMed1977

Multiple meningeal diverticula and cysts associated with duplications of the sheaths of spinal nerve posterior roots.

Multiple diverticula and cysts of the meninges were found during an anatomical dissection. They were associated with duplications of sheaths of the posterior roots of the spinal nerves. The diverticula and cysts appeared as simple flaccid corrugated dilatations of the sheaths, as ampullary expansions, as pediculated cysts, or as saccular dilatations of different sizes and locations. The duplication of the sheaths affected posterior roots of the thoracic nerves only. Some variations of the sheaths described in the literature are discussed. The possibility is considered that both conditions result from the same pathological factors in the embryo.

Adult↗