An equine cadaver study investigating the relationship between cervical flexion, nuchal ligament elongation and pressure at the first and second cervical vertebra

Objectives The aims of this study were to describe the paravertebral brachial plexus (PBP) blockade in cats, and compare the spread of bupivacaine–methylene blue solution (BMS) using two volumes of injection into the PBP. Methods Six cadavers (4.4 ± 1.8 kg) randomly received 0.15 ml/kg (LOW) or 0.2 ml/kg (HIGH) per injection of BMS into the PBP. The first injection was made ventral to the transverse process of the sixth cervical vertebra (nerves C6 and C7) at the emergence of nerve roots. A second injection was performed at the edge of the cranial border of the scapula and directed ventrally towards the first rib (C8 and T1). Cadavers were dissected and the presence of BMS in contact with the nerves (success rate) and length of staining were evaluated for each nerve (C6/C7/C8/T1). Length of target nerves in contact with BMS was measured and <15 mm was considered fair, ⩾15 mm sufficient and >40 mm excessive. Complications (aspiration of blood, staining of pleural space and/or spinal cord) were recorded. Paired t-test, Mann-Whitney U-test and χ2 test were used for statistical analysis when appropriate ( P <0.05). Results Eleven hemilateral brachial plexuses were injected. Aspiration of blood occurred during one injection. Inadvertent pleural or spinal staining was not observed. Success rates (positive nerve staining) in the LOW and HIGH groups, respectively, were as follows: C6: 83% and 80%; C7: 66% and 100%; C8: 66% and 100%; T1: 50% and 60% ( P >0.05). Median (range) length of nerve staining was 22 mm (15–39 mm) for LOW and 21 mm (13–35 mm) for HIGH ( P >0.05). Excessive nerve staining was not recorded. Conclusions and relevance This study describes the PBP blockade in cats with acceptable nerve staining and minimal complications. Success rate and length of nerve staining were not significantly different between the LOW and HIGH groups.

Download Full-text

The relationship between the glenoid track and the range of shoulder motion: A cadaver study

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2017.12.006 ◽

2018 ◽

Vol 104 (6) ◽

pp. 793-796 ◽

Cited By ~ 2

Author(s):

N. Yamamoto ◽

J. Kawakami ◽

H. Nagamoto ◽

Y. Shiota ◽

E. Itoi

Keyword(s):

Cadaver Study ◽

Glenoid Track ◽

Shoulder Motion ◽

The Relationship

Download Full-text

The Relationship Between the Anatomy of the Nuchal Ligament and Postoperative Axial Pain After Cervical Laminoplasty

Spine ◽

10.1097/brs.0b013e318274101b ◽

2012 ◽

Vol 37 (26) ◽

pp. E1607-E1613 ◽

Cited By ~ 9

Author(s):

Atsushi Ono ◽

Yoshikazu Tonosaki ◽

Takuya Numasawa ◽

Kanichiro Wada ◽

Yoshihito Yamasaki ◽

...

Keyword(s):

Cervical Laminoplasty ◽

Axial Pain ◽

Nuchal Ligament ◽

The Relationship

Download Full-text

Anatomy and clinical relevance of sub occipital soft tissue connections with the dura mater in the upper cervical spine

PeerJ ◽

10.7717/peerj.9716 ◽

2020 ◽

Vol 8 ◽

pp. e9716

Author(s):

Rob Sillevis ◽

Russell Hogg

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Cadaver Study ◽

Cervicogenic Headache ◽

Passive Movement ◽

Cervical Region ◽

Upper Cervical Spine ◽

Posterior Aspect ◽

Upper Cervical ◽

Nuchal Ligament

Background The upper cervical region is a complex anatomical structure. Myodural bridges between posterior suboccipital muscles and the dura might be important explaining conditions associated with the upper cervical spine dysfunction such as cervicogenic headache. This cadaver study explored the upper cervical spine and evaluated the myodural bridges along with position of spinal cord in response to passive motion of upper cervical spine. Methods A total of seven adult cadavers were used in this exploratory study. The suboccipital muscles and nuchal ligament were exposed. Connections between the Rectus Capitis Posterior major/minor and the Obliquus Capitis minor, the nuchal ligament, posterior aspect of the cervical spine, flavum ligament and the dura were explored and confirmed with histology. The position of the spinal cord was evaluated with passive motions of the upper cervical spine. Outcomes In all cadavers connective tissues attaching the Rectus Capitis Posterior Major to the posterior atlanto-occipital membrane were identified. In the sagittal dissection we observed connection between the nuchal ligament and the dura. Histology revealed that the connection is collagenous in nature. The spinal cord moves within the spinal canal during passive movement. Discussion The presence of tissue connections between ligament, bone and muscles in the suboccipital region was confirmed. The nuchal ligament was continuous with the menigiovertebral ligament and the dura. Passive upper cervical motion results in spinal cord motion within the canal and possible tensioning of nerve and ligamentous connections.

Download Full-text

The Relationship of Cervical Vertebra Alignment and Dentofacial Morphology.

Nihon Hotetsu Shika Gakkai Zasshi ◽

10.2186/jjps.37.494 ◽

1993 ◽

Vol 37 (3) ◽

pp. 494-498

Author(s):

Tadao Okuda ◽

Mami Iwasa ◽

Takashi Ueda ◽

Taizo Omae ◽

Fumio Takashima ◽

...

Keyword(s):

Cervical Vertebra ◽

Relationship Of ◽

The Relationship

Download Full-text

Vertebra prominence in women: significance in clinical practice and in surface topography

Studies in Health Technology and Informatics - Research into Spinal Deformities 9 ◽

10.3233/shti210441 ◽

2021 ◽

Author(s):

TB Grivas ◽

VA Kechagias ◽

C Mihas

Keyword(s):

Surface Topography ◽

Spinous Process ◽

Cervical Vertebra ◽

Breast Size ◽

Anatomical Structures ◽

Length Relationship ◽

Upper Thoracic ◽

Relationship Of ◽

The Relationship

A sexual dimorphism (SD) of the “vertebra prominens” was found, namely the 7th cervical vertebra (C7) spinous process (SP) is more frequently longer in men and the 1st thoracic (T1) SP in women.[1] We assume that the cause of this SD is the different anatomy of the anterior upper thoracic region (AUTR) between men and women, due to the presence of the breast. One-hundred forty-two women aged 48.1Âś17 years old, who visited the OPD for neck complaints, were studied. Measures included the age, the relationship of C7 and T1 SP length, documented in three types (type 1= [C7>T1], 2 = [C7 = T1], 3 = [C7 < T1]), the breast size, (small, medium and large), the length ratio of C7/T1 SP and the BMI. Breast size and SP length relationship between C7 and T1 was found to be significantly correlated. The results confirm that the cause of the SD of the SP length of C7 and T1 seems to be the different female AUTR anatomy due to the presence of the breast and it is probably the result of the need of the posterior cervical anatomical structures to compensate for the higher torque created by the female AUTR anatomy. These original findings are useful in clinical examination, in breast oncology, for the plastic surgeons, in terms of implantation of the proper breast size implant, after mastectomies for malignancies but also for aesthetic reasons and the software of all surface topography devices should be adjusted accordingly.

Download Full-text

Anatomy of the Nuchal Ligament and Its Surgical Applications

Operative Neurosurgery ◽

10.1227/01.neu.0000303985.65117.ea ◽

2007 ◽

Vol 61 (suppl_5) ◽

pp. ONS301-ONS304 ◽

Cited By ~ 5

Author(s):

Paulo A.S. Kadri ◽

Ossama Al-Mefty

Keyword(s):

Cervical Spine ◽

Blood Loss ◽

Spinous Process ◽

Cervical Vertebra ◽

Trapezius Muscle ◽

Areolar Tissue ◽

Neurosurgical Procedures ◽

Medial Side ◽

Seventh Cervical Vertebra ◽

Nuchal Ligament

Abstract Objective: Although considered a basic maneuver for neurosurgical procedures, dissection of the musculature of the posterior cervical spine can be a source of complications during surgery. These complications include excessive blood loss, a loss of the plane of dissection, and injury to important structures such as the vertebral artery and nerve roots. Inappropriate closing of the muscular plane might also contribute to leakage of spinal fluid and postoperative deformation of the cervical spine. We review the anatomy of the nuchal ligament and describe a technical nuance based on the characteristics of the ligament's components, which can be used to assure the midline for a bloodless and atraumatic dissection. Methods: We set out to determine whether or not the nuchal ligament could be used as a natural plane of dissection for splitting the posterior cervical musculature. We studied the anatomy of the nuchal ligament in five cadavers. Results: The nuchal ligament extends from the external occipital protuberance to the spinous process of the seventh cervical vertebra (C7). It is covered by layers of cervical fascia and the aponeurosis of the trapezius muscle. It is composed of two portions: 1) the lamellar portion, an anterior double-layered portion with fatty areolar tissue interposed between its layers that inserts into the medial side of the bifid spinous process of the cervical vertebra; and 2) the funicular portion, a posterior fibrous portion that corresponds to the fusion of the layers of the lamellar portion. Conclusion: Several steps can assure that the midline plane is respected, thereby decreasing risk and reducing trauma and blood loss during dissection: 1) dissection of the nuchal ligament within the fatty areolar tissue of the lamellar portion, 2) isolation and incision of the funicular portion from inside to outside, and 3) retrograde dissection of the cerviconuchal muscles attached to the occipital bone in a subperiosteal plane.

Download Full-text

Interstellar gas in the central region of the Galaxy

Symposium - International Astronomical Union ◽

10.1017/s0074180900101032 ◽

1967 ◽

Vol 31 ◽

pp. 239-251 ◽

Cited By ~ 3

Author(s):

F. J. Kerr

Keyword(s):

Central Region ◽

Galactic Plane ◽

Neutral Hydrogen ◽

Continuum Emission ◽

Galactic Centre ◽

Interstellar Gas ◽

Hydrogen Recombination ◽

The Galaxy ◽

Centre Region ◽

The Relationship

A review is given of information on the galactic-centre region obtained from recent observations of the 21-cm line from neutral hydrogen, the 18-cm group of OH lines, a hydrogen recombination line at 6 cm wavelength, and the continuum emission from ionized hydrogen.Both inward and outward motions are important in this region, in addition to rotation. Several types of observation indicate the presence of material in features inclined to the galactic plane. The relationship between the H and OH concentrations is not yet clear, but a rough picture of the central region can be proposed.

Download Full-text