Neuromuscular Innervation

Neuroanatomy ◽  
2017 ◽  
pp. 59-94
Author(s):  
Adam J Fisch
Keyword(s):  
Brachial Plexus ◽  
Spinal Nerve ◽  
Sensory Innervation ◽  
Lumbosacral Plexus

This chapter focuses on learning the process and components of neuromuscular innervation. Instructions are given on how to draw the brachial plexus, terminal nerves, lumbosacral plexus, peroneal nerves, tibial nerves, and dermatomal maps of spinal nerve sensory innervation. The chapter provides key landmarks along the dermatomal maps of sensory innervation, as well as syndromes associated with the various structures involved in neuromuscular innervation.

Macroanatomical Structure of the Lumbosacral Plexus and its Branches in the Indigenous Duck

2018 ◽  
Vol 52 (1-4) ◽  
pp. 1-9 ◽  
Author(s):  
MT Hussan ◽  
MS Islam ◽  
J Alam
Keyword(s):  
Hind Limb ◽  
Femoral Nerve ◽  
Morphological Structure ◽  
Spinal Nerve ◽  
The Body ◽  
Lumbar Plexus ◽  
Lumbosacral Plexus ◽  
Sacral Plexus ◽  
Spinal Nerves ◽  
Femoral Cutaneous Nerve

The present study was carried out to determine the morphological structure and the branches of the lumbosacral plexus in the indigenous duck (Anas platyrhynchos domesticus). Six mature indigenous ducks were used in this study. After administering an anesthetic to the birds, the body cavities were opened. The nerves of the lumbosacral plexus were dissected separately and photographed. The lumbosacral plexus consisted of lumbar and sacral plexus innervated to the hind limb. The lumbar plexus was formed by the union of three roots of spinal nerves that included last two and first sacral spinal nerve. Among three roots, second (middle) root was the highest in diameter and the last root was least in diameter. We noticed five branches of the lumbar plexus which included obturator, cutaneous femoral, saphenus, cranial coxal, and the femoral nerve. The six roots of spinal nerves, which contributed to form three trunks, formed the sacral plexus of duck. The three trunks united medial to the acetabular foramen and formed a compact, cylindrical bundle, the ischiatic nerve. The principal branches of the sacral plexus were the tibial and fibular nerves that together made up the ischiatic nerve. Other branches were the caudal coxal nerve, the caudal femoral cutaneous nerve and the muscular branches. This study was the first work on the lumbosacral plexus of duck and its results may serve as a basis for further investigation on this subject.

scholarly journals Lumbosacral Plexus Injury and Brachial Plexus Injury Following Prolonged Compression

2006 ◽  
Vol 69 (11) ◽  
pp. 543-548 ◽  
Author(s):  
Chung-Lan Kao ◽  
Chia-Hei Yuan ◽  
Yuan-Yang Cheng ◽  
Rai-Chi Chan
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Lumbosacral Plexus

Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position

2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Rare Complication ◽  
Patient Positioning ◽  
Sensory Innervation ◽  
Plexus Brachialis ◽  
Clinical Anatomy ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Endometriosis Surgery

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.

Brachial Plexus and Spinal Nerve Monitoring

2022 ◽  
pp. 171-186
Author(s):  
Arbaz A. Momin ◽  
Maxwell Y. Lee ◽  
Navkiranjot Kaur ◽  
Michael P. Steinmetz
Keyword(s):  
Brachial Plexus ◽  
Spinal Nerve ◽  
Nerve Monitoring

Anatomical Considerations for Peripheral Nerve Blockade

2010 ◽  
pp. 51-94
Author(s):  
James R. Hebl
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Surface Orientation ◽  
Lumbar Plexus ◽  
Lumbosacral Plexus ◽  
Motor Innervation ◽  
Nerve Blockade ◽  
Peripheral Nerve Blockade

Chapter 5 contains a basic review of terminology used to describe body planes, surface orientation, and movements. The anatomy of major nerve plexuses are also examined: brachial plexus, lumbar plexus, lumbosacral plexus. The chapter concludes with a discussion of peripheral nerve anatomy and sensory and motor innervation, including dermatomes, osteotomes, and myotomes.

Refining a great idea: the consolidation of PECS I, PECS II and serratus blocks into a single thoracic fascial plane block, the SAP block

2019 ◽  
pp. rapm-2019-100745 ◽  
Author(s):  
Carlo D Franco ◽  
Konstantin Inozemtsev
Keyword(s):  
Brachial Plexus ◽  
Chest Wall ◽  
Mechanism Of Action ◽  
Sensory Innervation ◽  
Common Mechanism ◽  
Nerve Blocks ◽  
Intercostal Nerves ◽  
Lateral Branches ◽  
Fascial Plane Block ◽  
Fascial Plane

The popularity of ultrasound-guided nerve blocks has impacted the practice of regional anesthesia in profound ways, improving some techniques and introducing new ones. Some of these new nerve blocks are based on the concept of fascial plane blocks, in which the local anesthetic is injected into a plane instead of around a specific nerve. Pectoralis muscles (PECS) and serratus blocks, most commonly used for post op analgesia after breast surgery, are good examples. Among the nerves targeted by PECS/serratus blocks are different branches of the brachial plexus that traditionally have been considered purely motor nerves. This unsubstantiated claim is a departure from accepted anatomical knowledge and challenges our understanding of the sensory innervation of the chest wall. The objective of this Daring Discourse is to look beyond the ability of PECS/serratus blocks to provide analgesia/anesthesia of the chest wall, to concentrate instead on understanding the mechanism of action of these blocks and, in the process, test the veracity of the claim. After a comprehensive review of the evidence we have concluded that (1) the traditional model of sensory innervation of the chest wall, which derives from the lateral branches of the upper intercostal nerves and does not include branches of the brachial plexus, is correct. (2) PECS/serratus blocks share the same mechanism of action, blocking the lateral branches of the upper intercostal nerves, and so their varied success is tied to their ability to reach them. This common mechanism agrees with the traditional innervation model. (3) A common mechanism of action supports the consolidation of PECS/serratus blocks into a single thoracic fascial plane block with a point of injection closer to the effector site. In a nod to transversus abdominus plane block, the original inspiration for PECS blocks, we propose naming this modified block, the serratus anterior plane block.

Lower-Extremity Sclerotomes

2009 ◽  
Vol 99 (3) ◽  
pp. 232-235 ◽  
Author(s):  
Andrew J. Meyr ◽  
Raymond DiPrimio
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Spinal Nerve ◽  
Sensory Innervation ◽  
Diagnosis And Treatment ◽  
Deep Fascia ◽  
Nerve Blockade ◽  
Anatomical Knowledge ◽  
Peripheral Nerve Blockade

A sclerotome is an anatomical concept that defines an area of bone supplied by a single spinal nerve. Similar to the familiar dermatomes, sclerotomes provide an element of depth to the sensory innervation of the lower extremity based on the deep fascia as an embryologic boundary. Anatomical knowledge of sclerotomes can be used clinically in the diagnosis and treatment of pain and in the perioperative setting. Specifically, a modified version of the classic Mayo block is presented to highlight an active anatomical approach to peripheral nerve blockade. (J Am Podiatr Med Assoc 99(3): 232–235, 2009)

Adult Total Brachial Plexus Injury

2018 ◽  
Author(s):  
Mustafa Nadi ◽  
Rajiv Midha
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
High Energy ◽  
Spinal Nerve ◽  
Adult Males ◽  
Cervical Spine Injuries ◽  
Improved Outcomes ◽  
Timely Fashion ◽  
Microsurgical Techniques

Total brachial plexus injury (BPI) typically results from high-energy vehicular accidents, affects mostly young adult males, and produces a flail, insensate limb. Because of the association of total BPI with head and cervical spine injuries, diagnosis might be delayed. Recognizing patients with total BPI and using electrodiagnostic and imaging tests in a timely fashion are critical. Advances in microsurgical techniques, primary nerve transfer, appropriate nerve graft utilization from a remaining intact (often C5) spinal nerve root, and free muscle transfers have improved outcomes. However, limited recovery even after reconstruction and severe deafferentation pain both remain challenging problems that further advancements will need to overcome.

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