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PubMedDate not supplied

Total myelography in the evaluation of lumbar discs. With the presentation of three cases of thoracic neoplasms simulating nerve root lesions.

It has been our practice to perform total myelography in all cases of lumbar disc disease including the various syndromes of spinal stenosis, because experience has indicated that myelographic abnormalities in the cervical and thoracic areas could have clinical importance despite the presence of gross changes in the lumbar region. Failure to establish a definite diagnosis by restricted lumbar myelography makes it mandatory to evaluate all levels of the spinal axis. Recently, 3 patients with thoracic spinal cord tumors presented with primary signs and symptoms of lumbar spine disorders. Evidence of spinal cord disease was minimal and could be readily overlooked. Total myelography disclosed varying degrees of lumbar spinal pathology, but also showed evidence of lesions in the thoracic region. One proved to be an intramedullary astrocytoma of the spinal cord, and two were schwannomas. The symptoms of low-back pain and lumbar radiculopathy improved after excision of the schwannomas and following x-ray therapy and chemotherapy in the patient with the intramedullary neoplasm.

Adult↗
PubMed1996

An anatomical analysis of the relationships between the intercostal nerves and the thoracic and abdominal muscles in man. II. Detailed analysis of innervation of the three lateral abdominal muscles.

Minute dissection was performed in one male adult cadaver in order to elucidate the detailed distribution of muscular branches of intercostal nerves within the lateral abdominal muscles as well as the segmental relationships. In the obliquus internus and transversus abdominis, as well as in the upper half of the obliquus externus, each muscle fascicle receives the nerve of the corresponding segmental attachment to the rib. On the other hand, in the lower half, the obliquus externus abdominis receives a twig from the lower adjacent segmental nerve, because within the muscle the corresponding segmental nerve first runs horizontally and enters the upper adjacent fascicle before descending obliquely, parallel to the fiber direction.

Abdominal Muscles↗
PubMed1998

[Nerve compression syndrome in the thoracic outlet].

INTRODUCTION: The nerve conduction studies, F-waves and dermatosomal and lor somatosensory evoked potential have a low level of sensitivity for Thoracic Outlet Compression Syndrome (TOCS) diagnosis. A standard negative electrodiagnostic study does not exclude the presence of TOCS. OBJECTIVE: The purpose of this neurophysiological note is that the Wright's hyperabduction, costoclavicular compression and Adson's scalenus tests important in making a clinical diagnosis of TOCS can be used as neurophysiological provocative maneuvers to determine the effect of braquial position on electrodiagnostic parameters. MATERIAL AND METHODS: Nine selected TOCS patients were evaluated previous and following provocative maneuvers for 3 and 6 minutes. RESULTS: The results showed a positive electrodiagnostic study in 7/9 patients. CONCLUSIONS: It is suggested that patients with presumptive TOCS and negative electrodiagnostic findings be reevaluated immediately after 6 minutes of Wright's, Adson's or costoclavicular compression provocative tests.

Brachial Plexus↗
PubMed1993

Origin of the internal thoracic artery and its relationship to the phrenic nerves.

The internal thoracic artery was studied because of its recent use in the revascularization of the myocardium in patients with coronary artery disease. The artery of 50 cadavers of adult individuals of either sex, whose age ranged from 20 to 84 years, was studied after neoprene latex injection. Its origin, relation to the phrenic nerve and origin of the pericardiacophrenic artery were investigated. The left and right phrenic nerves cross the artery anteriorly in 54% of the cases and posteriorly in 14%. The right nerve crosses the artery anteriorly and the left posteriorly in 22%, and the reverse occurs in 10%. The origin of the internal thoracic artery is much more frequent from the subclavian artery (80%) than from a common trunk with other arteries (20%). The pericardiacophrenic artery is a branch of the internal thoracic artery in 99% of the cases and the average distance between the origins of these two arteries is 3.9 +/- 1.3 cm.

Adult↗
PubMed1987

Innervation of the dermatomes in the neck of the mouse.

The dorsal rami of the cervical and thoracic spinal nerves were investigated using both the in situ cholinesterase staining technique and cholinesterase staining on serial sections of plastic-embedded embryos. In most cases only the dorsal rami of the 2nd to 5th cervical spinal nerve possess cutaneous branches. The area innervated by the cutaneous branch of the dorsal ramus of the 5th spinal nerve borders on an area innervated by the cutaneous branch of the dorsal ramus of the 1st thoracic spinal nerve. The dorsal rami of the cervical spinal nerves 6-8 show no cutaneous branches. Therefore the gap in the series of the dorsal cutaneous branches is due only to the middle part of the nerves of the brachial plexus, which range from the 5th cervical nerve to the 1st thoracic nerve.

Animals↗
PubMed1996

Size of human lower thoracic and lumbosacral nerve roots.

BACKGROUND: Nerve root size may determine degree of blockade after epidural or spinal anesthesia, but good measures of this fundamental anatomic parameter have not been published. Models of subarachnoid anesthetic distribution have lacked valid cauda equina dimensions. In this study, the author sought to measure cross-section areas of anterior and posterior roots at different levels for basic anthropomorphic analysis. METHODS: Samples from 12 adult autopsy subjects were obtained from roots at levels T6 through S5. Cross-section area was determined by dividing the root sample weight by length and correcting for tissue density. RESULTS: Roots were variably composed of as many as five easily separable independent strands. Areas of anterior roots are approximately half the area of posterior roots. On average, the largest anterior and posterior root is at S1, but this may occur at L3 through S2. There is a large degree of interindividual variability (e.g., range of posterior L5 root is 2.33-7.71 mm2). CONCLUSIONS: The large size of low lumbar and high sacral roots may cause resistance to anesthetic effects, whereas the smaller dimensions of the thoracic roots may facilitate neural blockade. The small size of the low sacral roots may, in part, explain selective neurotoxic damage of these fibers after subarachnoid injections. Interindividual variability in root sizes may contribute to lack of predictability in anesthetic response.

Adult↗
PubMed1980

Contrasting reflexes evoked by chemical activation of cardiac afferent nerves.

Afferent neurons within cardiac sympathetic nerves can reflexly excite central sympathetic outflow. However, their contribution to cardiovascular control remains unclear because they are potentially opposed by inhibitory reflexes of cardiac vagal or arterial baroreceptor afferent origin. It was considered that sympathetically mediated, excitatory responses might be more prominent when initiated by chemical stimulation. In chloralose-anesthetized, vagotomized, sinoaortic-denervated cats, epicardial or intracoronary administration of bradykinin or potassium chloride evoked renal nerve excitation and pressor responses mediated by cardiac sympathetic afferent nerves. When upper thoracic sympathetic nerves were severed, and vagal afferent nerves remained intact, bradykinin and potassium chloride produced inhibition of renal nerve activity and depressor responses. When sympathetic and vagal components of cardiac innervation remained intact, these substances produced excitation, inhibition, or no change in sympathetic outflow. Excitation occurred as often as inhibition. A similar pattern was observed when arterial baroreceptor nerves remained intact. These data illustrate that cardiac sympathetic afferent neurons can have significant excitatory influences on the cardiovascular system in spite of opposition by inhibitory afferent groups.

Afferent Pathways↗
PubMed1986

Acute resetting of baroreceptor reflex in rabbits: a central component.

Electrical stimulation of the aortic nerve of the anesthetized rabbit was used to determine whether there is a central nervous system component to acute resetting of the baroreceptor reflex. After stimulation of the aortic nerve for 5 min at 10 Hz, a ramp test stimulus to the nerve produced a reflex arterial pressure response that was attenuated as compared with that produced by the same ramp prior to the five-min stimulation period. Renal sympathetic nerve activity was recorded simultaneously to determine whether a reduction in the magnitude of the reflex inhibition of sympathetic activity produced by the depressor nerve stimulation could account for the attenuated arterial pressure response. Renal activity during the test ramp was reduced to the same value both before and after the constant stimulus period and thus did not correlate with the attenuated pressure response. There was, however, prolonged inhibition of tonic sympathetic activity after the 5-min stimulus period such that during the test stimulus there was less sympathetic activity to inhibit. The results were similar when sympathetic activity was recorded from branches of the sciatic nerve and from thoracic postganglionic nerves. In these nerves the period of prolonged inhibition after aortic nerve stimulation was up to 5 min. The attenuated pressure response to baroreceptor nerve stimulation after a constant stimulus appears to reflect the reduced change in sympathetic activity rather than the value to which the sympathetic activity falls.

Animals↗
PubMed1987

Attenuation of phrenic motor discharge by phrenic nerve afferents.

Short latency phrenic motor responses to phrenic nerve stimulation were studied in anesthetized, paralyzed cats. Electrical stimulation (0.2 ms, 0.01-10 mA, 2 Hz) of the right C5 phrenic rootlet during inspiration consistently elicited a transient reduction in the phrenic motor discharge. This attenuation occurred bilaterally with an onset latency of 8-12 ms and a duration of 8-30 ms. Section of the ipsilateral C4-C6 dorsal roots abolished the response to stimulation, thereby confirming the involvement of phrenic nerve afferent activity. Stimulation of the left C5 phrenic rootlet or the right thoracic phrenic nerve usually elicited similar inhibitory responses. The difference in onset latency of responses to cervical vs. thoracic phrenic nerve stimulation indicates activation of group III afferents with a peripheral conduction velocity of approximately 10 m/s. A much shorter latency response (5 ms) was evoked ipsilaterally by thoracic phrenic nerve stimulation. Section of either the C5 or C6 dorsal root altered the ipsilateral response so that it resembled the longer latency contralateral response. The low-stimulus threshold and short latency for the ipsilateral response to thoracic phrenic nerve stimulation suggest that it involves larger diameter fibers. Decerebration, decerebellation, and transection of the dorsal columns at C2 do not abolish the inhibitory phrenic-to-phrenic reflex.

Afferent Pathways↗
PubMed1990

Damage of the long thoracic and dorsal scapular nerve after traumatic shoulder dislocation: case report and review of the literature.

A judo injury resulted in an anterior shoulder dislocation with a concomitant lesion of the long thoracic and the dorsal scapula nerve. This injury led to loss of function and extreme instability of the shoulder. Stabilization of the glenohumeral joint was successfully accomplished by surgery. The athlete declined further operative approaches to stabilize the scapula. The patient was able to return to the former level of athletic activity.

Adult↗