SEARCH · Search PubMed

Results for “INTERCOSTAL MUSCLES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources

PubMed2002

Musculoskeletal problems of the chest wall in athletes.

Chest pain in the athlete has a wide differential diagnosis. Pain may originate from structures within the thorax, such as the heart, lungs or oesophagus. However, musculoskeletal causes of chest pain must be considered. The aim of this review is to help the clinician to diagnose chest wall pain in athletes by identifying the possible causes, as reported in the literature. Musculoskeletal problems of the chest wall can occur in the ribs, sternum, articulations or myofascial structures. The cause is usually evident in the case of direct trauma. Additionally, athletes' bodies may be subjected to sudden large indirect forces or overuse, and stress fractures of the ribs caused by sporting activity have been extensively reported. These have been associated with golf, rowing and baseball pitching in particular. Stress fractures of the sternum reported in wrestlers cause pain and tenderness of the sternum, as expected. Diagnosis is by bone scan and limitation of activity usually allows healing to occur. The slipping rib syndrome causes intermittent costal margin pain related to posture or movement, and may be diagnosed by the 'hooking manoeuvre', which reproduces pain and sometimes a click. If reassurance and postural advice fail, good results are possible with resection of the mobile rib. The painful xiphoid syndrome is a rare condition that causes pain and tenderness of the xiphoid and is self-limiting. Costochondritis is a self-limiting condition of unknown aetiology that typically presents with pain around the second to fifth costochondral joints. It can be differentiated from Tietze's syndrome in which there is swelling and pain of the articulation. Both conditions eventually settle spontaneously although a corticosteroid injection may be useful in particularly troublesome cases. The intercostal muscles may be injured causing tenderness between the ribs. Other conditions that should be considered include epidemic myalgia, precordial catch syndrome and referred pain from the thoracic spine.

Adolescent↗

PubMed2005

Rowing injuries.

Participation in the sport of rowing has been steadily increasing in recent decades, yet few studies address the specific injuries incurred. This article reviews the most common injuries described in the literature, including musculoskeletal problems in the lower back, ribs, shoulder, wrist and knee. A review of basic rowing physiology and equipment is included, along with a description of the mechanics of the rowing stroke. This information is necessary in order to make an accurate diagnosis and treatment protocol for these injuries, which are mainly chronic in nature. The most frequently injured region is the low back, mainly due to excessive hyperflexion and twisting, and can include specific injuries such as spondylolysis, sacroiliac joint dysfunction and disc herniation. Rib stress fractures account for the most time lost from on-water training and competition. Although theories abound for the mechanism of injury, the exact aetiology of rib stress fractures remains unknown. Other injuries discussed within, which are specific to ribs, include costochondritis, costovertebral joint subluxation and intercostal muscle strains. Shoulder pain is quite common in rowers and can be the result of overuse, poor technique, or tension in the upper body. Injuries concerning the forearm and wrist are also common, and can include exertional compartment syndrome, lateral epicondylitis, deQuervain's and intersection syndrome, and tenosynovitis of the wrist extensors. In the lower body, the major injuries reported include generalised patellofemoral pain due to abnormal patellar tracking, and iliotibial band friction syndrome. Lastly, dermatological issues, such as blisters and abrasions, and miscellaneous issues, such as environmental concerns and the female athlete triad, are also included in this article.Pathophysiology, mechanism of injury, assessment and management strategies are outlined in the text for each injury, with special attention given to ways to correct biomechanical or equipment problems specific to rowing. By gaining an understanding of basic rowing biomechanics and training habits, the physician and/or healthcare provider will be better equipped to treat and prevent injuries in the rowing population.

Athletic Injuries↗

PubMed2001

Rhabdomyolysis triggered by an asthmatic attack in a patient with McArdle disease.

We describe a patient with McArdle disease who developed rhabdomyolysis triggered by a bronchial asthmatic attack. A 64-year-old man had chronic pulmonary emphysema with asthma, and an asthmatic attack led to severe rhabdomyolysis that required continuous hemodiafiltration. After 2 years, a physical examination revealed atrophy of the extremities compared with previous examinations, especially of the intercostal muscles. During that time, he suffered two severe bronchial asthmatic attacks. His serum level of creatinine kinase remained between 4,000 and 7,000 IU/l when he did not suffer from asthmatic attacks and rhabdomyolysis had abated. Therefore, we suspected that his recent muscle atrophy was caused by asthmatic attacks, and discussed the possibility of his respiratory muscle weakness due to McArdle disease in relation to his severe bronchial asthmatic attacks as well as chronic obstructive pulmonary disease.

Asthma↗

PubMed1986

Respiratory myoclonus. Report of a case with electromyographic study.

A case of respiratory myoclonus in a 45 year-old male was studied by electromyography. He complained of anorexia, involuntary swinging movement of the thorax and trunk, and epigastric pulsation. Electromyographic studies showed synchronous rhythmic grouped discharges at the of 2 to 3 Hz from the bilateral 8th to 10th intercostal muscles, the right iliocostalis lumborum muscle, and the left hemidiaphragm only during the expiratory phase. They disappeared on inspiration and forced expiration. Anesthetic block of the left phrenic nerve abolished both the voluntary and myoclonic movements of the left hemidiaphragm. Abnormal excitation of the central nervous system and possible irritation of the afferent pathways were postulated.

Afferent Pathways↗

PubMed1995

Actinobacillus actinomycetemcomitans pneumonia with chest wall and subphrenic abscess.

A 14-year-old girl had progressive dyspnea and right lower chest pain for about 1 1/2 months and a weight loss of 3 kg in 2 months. Chest X-ray revealed right pleural effusion and a round infiltration over the right lower chest, initially suspected to be malignant. Image study revealed consolidation in the right middle and lower lobes with abscess-like lesions around the right lower pleura and transdiaphrenic involvement to the subphrenic region. The lesion had also invaded the intercostal muscle. The pleural abscess was obtained by fiberoptic thoracoscopy, and culture of the pus grew typical colonies of Actinobacillus actinomycetemcomitans. After the causative microorganism had been identified, cefoxitin was given for 2 weeks followed by oral amoxicillin (250 mg/6 h) for a total period of 3 months. Follow-up chest X-ray revealed resolution of the lung lesions and the patient recovered gradually without any sequelae.

Abscess↗

PubMed1997

One-stage operation for treatment after delayed diagnosis of thoracic esophageal perforation.

Perforation of the thoracic esophagus can be fatal unless diagnosed promptly and treated effectively. The high mortality with delayed treatment is principally due to the inability of effectively closing the perforation and preventing the leakage. We operated one patient with a delayed diagnosis of thoracic esophageal perforation developed after a rigid esophagoscopic procedure. The perforation was closed with primary sutures and reinforced with a intercostal muscle flap wrap. Radical decortication and wide mediastinal and pleural toilet were also done. Total parenteral nutrition was begun and antibiotics were administered according to the results of cultures. Esophagography and esophagoscopy performed 10 days after the operation showed a well healed esophagus without stenosis or leakage. We conclude that primary closure of the perforation and muscle flap wrap can provide a one-stage operation with good results for repair of thoracic esophageal perforations which are not diagnosed on time.

Adult↗

PubMedDate not supplied

Two cases of fetal akinesia/hypokinesia sequence.

Two cases of fetal akinesia sequence are described. Both showed facial anomalies, arthrogryposis multiplex, bilateral camptodactyly, and pulmonary hypoplasia. One child had degeneration of large motor neurons of the thoracolumbosacral spinal cord and irregular atrophy of diaphragm; the other had left microphthalmia, hemiatrophy of the left temporal lobe with calcification of degenerated neurons, and hypoplasia of the cervothoracic spinal cord with decrease and degeneration of neurons. The iliopsoas and intercostal muscles showed focal myofiber atrophy. These findings suggested that some instances of this fetal akinesia syndrome might be due to neuromuscular dysfunction that occurred in utero and may have various causes.

Abnormalities, Multiple↗

PubMed1998

Thoracoscopic microsurgical excision of a thoracic schwannoma. Case report.

A 6-cm-diameter schwannoma located at T-2 was resected completely by using transthoracic microsurgical endoscopy. The partially cystic tumor widened the neural foramen and extended into the apex of the right thoracic cavity but did not extend intradurally. The tumor was accessed by means of three 15-mm incisions made in the intercostal spaces. The operative blood loss was only 200 ml, and there were no complications. The patient was discharged on the 2nd postoperative day and returned to full activity 1 week after surgery. Thoracoscopy provides an excellent alternative to thoracotomy for peripheral thoracic nerve sheath tumors that originate within the neural foramen or more distally along the intercostal nerves within the thorax. An anterior approach is required for intrathoracic tumors but is not suited for intradural tumors. An open posterior or posterolateral approach to the thoracic spine is required for intradural tumors to allow the dura to be closed adequately.

Activities of Daily Living↗

PubMed2000

Changes of bilateral palmar skin temperature in transthoracic endoscopic T-2 sympathectomy.

OBJECT: Transthoracic endoscopic T-2 sympathectomy is currently the treatment of choice for palmar hyperhidrosis (PH). Intraoperative monitoring of palmar skin temperature (PST) is often used to assess the adequacy of sympathetic ablation. The aim of this study was to investigate the time course of PST changes during the operation and to determine factors involved in the sympathetic modulation of the palmar skin blood flow. METHODS: Eighty-one patients with PH underwent bilateral transthoracic endoscopic sympathectomy of T-2 in which continuous intraoperative PST monitoring was used. Palmar skin temperature data, recorded every 30 seconds throughout the operation, were plotted against time, and a graph of two PST curves was obtained in each case. A multiphasic curve pattern of great similarity was observed in nearly 70% of cases. Specific PST readings at different operative stages were collected and averaged for all cases. The trend of PST changes in response to different procedures during the operation was analyzed. It was found that unilateral procedures caused simultaneous bilateral PST alterations. In almost all cases, bilateral PST was dramatically lowered when unilateral skin incision and intercostal muscle dissection were performed. The temperature remained low until the T-2 sympathectomy was finished on one side. In addition, unilateral T-2 sympathectomy induced synchronous elevation of bilateral PST. However, the ipsilateral response was significantly stronger than that on the contralateral side. CONCLUSIONS: Although intraoperative monitoring of PST is a reliable guide for surgeons performing endoscopic transthoracic sympathectomy, it is important to realize that PST fluctuates at different stages during the operation and that surgical procedures themselves can significantly influence PST readings. The PST data recorded at specific time points, therefore, can be misleading in terms of accuracy and the completeness of ablation of the target sympathetic ganglia, especially when the sympathetic trunk or ganglia are anatomically aberrant.

Adolescent↗

PubMed1995

The role of raphe and tractus solitarius neuronal structures in the modulation of respiratory pattern in rabbits.

We studied the effects of MNR stimulation on phrenic (Phr) electroneurogram and external intercostal muscles (EI) electromiogram in spontaneously breathing rabbits. Additionally, experiments were performed before and after lignocaine blockade of nucleus tractus solitarii (NTS) to determine whether the information from MNR is transmitted via NTS neurones. The completeness of the blockade of NTS region was checked by studying the Hering-Breuer reflex. MNR was stimulated at the level 2-7 mm rostral to the obex. Stimulation at the rostral part of this region produced inhibition of phasic inspiratory activity, whereas stimulation in the caudal part elicited tonic activity throughout the respiratory cycle. These effects were more pronounced on EI than Phr. Responses to MNR stimulation were attenuated after lignocaine blockade, suggesting that the neurons located in NTS take part in the transmission of the modulatory information from the MNR to respiratory motoneurones.

Anesthetics, Local↗

PubMed1999

[Two surgical cases of intrathoracic lipoma].

We experienced two cases of intrathoracic lipoma arising from the chest wall. The first case was a 55-year-old male, and another case was a 70-year-old female. In the second case, the computed tomography was highly suggestive of a pleural tumor with almost same density as the subcutaneous adipose tissue. This findings may be diagnostic in assessing intrathoracic chest wall type lipoma. Both cases had thoracotomy to remove the tumors. The tumors were easily resectable, though their capsules were partially unclear. We resected the tumors completely together with pleura, periosteum and intercostal muscle. The diagnosis of intramuscular lipoma was confirmed postoperatively by histopathologic examination in each case. When the capsule of lipoma is not clear, combined resection of the tumor and chest wall should be considered. There have been no recurrence of the tumors in our cases.

Aged↗

PubMed1976

[Thoracophrenotomy as an approach to the adrenal glands].

For 88 operations in 69 patients with different adrenal diseases the author has employed transpleural (in 53 cases) thoracophrenotomy and subpleural (in 35 cases) thoracophrenotomy along the tenth intercostal space. These approaches are recommended evenin one-moment bilateral operation (3 observations). The incidence of complications directly relative to the selected approach is less than in lumbotomy.

Adolescent↗

PubMed1999

[A case of tracheoesophageal fistula cured by surgical therapy after blunt trauma received 38 years ago].

We experienced a case of tracheoesophageal fistula successfully cured by surgical therapy after blunt trauma received 38 years ago. A 71-year-old man was injured blunt trauma at right chest by traffic accident in 1960, and was treated for pneumothorax and ribs fracture. In April, 1998, the patient came to the hospital for hemoptysis. Tracheoesophageal fistula at membranous wall 3 cm upper from the carina was diagnosed and operation was performed. Severe adhesion at 3 cm upper from carina was thought to be fistula. Incision was made at lateral esophageal wall and the fistula was confirmed at the esophageal anterior wall and the esophagus was cut in a circle around the fistula. Trachea was closed 1 layer sutures using esophageal all layers and esophagus was closed with 2 layer sutures. A pedicled 4th intercostal muscle was interposed between the tracheal and esophageal suture lines. Prevention of tracheal stenosis was possible without resection of fistula and closure of trachea using esophageal all layers. This operation was seemed to be effective. This case is supposed to be the longest delay between time of injury and its repair in the world.

Accidents, Traffic↗

PubMed1999

[Controversies in the new TNM staging system].

The latest revision of the International System for Staging Lung Cancer was published in June 1997. We discuss the following 4 major items in the new TNM staging system. 1) The fact that stage I was divided into stage IA (T1N0M0) and IB (T2N0M0) is reasonable, as the survival prospects for the subsets differ significantly. 2) The fact that stage II was divided into stage IIA (T1N1M0) and IIB (T2N1M0) is not appropriate, However, there is no significant survival difference between the T1N1M0 subset and the T2N1M0 subset, because there are fewer T1N1M0 cases. 3) The fact that the T3N0M0 subset was shifted into stage IIB is reasonable. Patients who undergo resection of tumors invading the parietal pleura, neighboring lobe, and main bronchus within 2 cm of the carina in the T3N0M0 group have a good prognosis, but those who undergo resection of tumors invading the rib, intercostal muscle, and diaphragm in the T3N0M0 group have a poor prognosis. 4) The decision to designate satellite lesions within the lobe of the primary tumor as T4 is controversial, because it is very difficult to determine whether satellite lesions are metastases from other lesions or if they are primary synchronous neoplasms.

Humans↗

PubMed1998

[Ultrastructural study on neuromuscular junction of patients with lambert-Eaton myasthenia syndrome or mitochondrial encephalomyopathy].

OBJECTIVE: To study the ultrastructural changes of neuromuscular junction (NMJ) in patients with lambert-Eaton myasthenia syndrome (LEMS) and mitochondrial encephalomyopathy (MEMS). METHODS: The MMJ of internal intercostal muscles from patients with LEMS, MEMS or cardiac disease (control group) was labelled by HRP-BuTx and was quantitatively studied using image analysis system on electron microscopic photo. RESULTS: The ratio of nerve terminal area with postsynaptic membrane of NMJ was less in the MEMS group than controls. Both the length of presynaptic membrane and the ratio of the length of postsynaptic memberane to presynaptic membrane was larger in the LEMS group than in the MEMS group and controls, but the ratio of nerve terminal area with postsynaptic memberane area was less in the LEMS patients than in the MEMS group and controls. CONCLUSION: The areas of nerve terminal in the MEMS patients shrink because of mitochondrial damage. In LEMS patients however, the major change is the elongation of postsynaptic memberane and increasing of Ach receptors.

Adult↗

PubMed2001

[Applied anatomy of the sensate latissimus dorsal muscular flap with the lateral posterior branch of the intercostal nerve].

OBJECTIVE: To provide anatomy basis for a free latissimus dorsal muscular flap with the sensate nerve. METHODS: The structure of back and lateral chest area were dissected and the origin, alignment and distribution of the intercostals nerve within the area of latissimus dorsal muscular flap were observed in 40 adult cadaver specimens. RESULTS: The 5th to 10th lateral posterior branches of the thoracic nerve pierced from respective intercostal area near the axial anterior line and run a long distance in deep fascia. They distributed mainly in lateral latissimus skin outside the scapular line and anastomosed with the lower branch near the scapular line. Among these branchs, the 6th to 8th branches had a longer nerve distribution respectively and the pedicle of nerve and artery was parallel and long. CONCLUSION: It is possible to design a sensate latissimus dorsal muscular flap with the 6th to 8th lateral posterior branch of the intercostal nerve.

Adult↗

PubMed2001

Bronchial stump reinforcement in right pneumonectomy with fascia lata and gelatin resorcin formalin (GRF) glue: case report.

We reinforced the bronchial stump with fascia lata and Gelatin Resorcin Formalin (GRF) glue in a right pneumonectomy. This method was found to be simple and useful. We describe our case and the method herein. A 62-year-old woman had a malignant polypoid lesion which completely occluded the introitus of the right main bronchus and deviated to the introitus of the left main bronchus. Right pneumonectomy was done but materials (pleura, pericardium, intercostal muscle, etc.) obtained from the thoracic cavity were insufficient for bronchial stump reinforcement due to severe adhesion caused by prior tuberculosis. Therefore, we reinforced the bronchial stump using the fascia lata and GRF glue. Fascia lata is a superior material for reinforcement in terms of strength and ease of molding, as well as harvesting. GRF glue is a superior adhesive with rapid and strong fixation. We consider this method of reinforcing the bronchial stump with fascia lata and GRF glue to be feasible, in particular, for pneumonectomy or lobectomy without adequate material in the thoracic cavity because of severe adhesion or lesions.

Drug Combinations↗

PubMed1975

[Role of the somitic mesoderm in the development of the rib cage of bird embryos. I. Origin of the sternal component and conditions for the development of the ribs (author's transl)].

The developmental origin of the sternal component of the ribs and the conditions for the development of the rib cage have been elucidated in bird embryos. Experiments consisted in homo- or heterospecific transplantations of 2-day-old quail or chick embryo somitic mesoderm into chick hosts of the same age in ortho- or heterotopic position along the cephalo-caudal axis. Results show that vertebral halves, ribs (not only their vertebral segment, but also their sternal component when they possess one), the trunk and intercostal muscles, as well as at least part of the scapula originate exclusively from the somitic material, while the sternum, ventral muscles and the other parts of the pectoral girdle are derived from the somatopleural mesoderm. The development of the rib basket is subjected to following rules: -only the somitic mesoderm of the prospective thoracic region (somites 19-26) is able to give rise to ribs. -only the somitic mesoderm of the posterior thoacic region (somites 22-26) is able to develop ribs with a sternal component. -the vertebral component of ribs can develop outside the thoracic region. -contrariwise, the sternal component can form only in the vicinity of the sternal anlage, i.e. within about three somites in front and rear of the normal limits of the thoracic region. It is concluded that the somitic mesoderm is already regionalized at a stage slightly preceding its metamerization and that the somatopleural territory of the sternum plays a morphogenetic role in the development of the sternal component of ribs, although it does not make a cellular contribution to their construction.

Animals↗