The Relationship of the Radial Nerve With the “Apex of Triceps Aponeurosis”

2013 ◽  
Vol 27 (5) ◽  
pp. e125-e126 ◽  
Author(s):  
Sumit Arora ◽  
Aman Goyal
2019 ◽  
Vol 12 (1) ◽  
pp. 24-30
Author(s):  
Stephen Gates ◽  
Brian Sager ◽  
Garen Collett ◽  
Avneesh Chhabra ◽  
Michael Khazzam

Background The purpose of this study was to define the relationship of the axillary and radial nerves, particularly how these are affected with changing arm position. Methods Twenty cadaveric shoulders were dissected, identifying the axillary and radial nerves. Distances between the latissimus dorsi tendon and these nerves were recorded in different shoulder positions. Positions included adduction/neutral rotation, abduction/neutral rotation for the axillary nerve, adduction/internal rotation, adduction/neutral rotation, adduction/external rotation, and abduction/external rotation for the radial nerve. Results Width of the latissimus tendon at its humeral insertion was 29.3 ± 5.7 mm. Mean distance from the latissimus insertion to the axillary nerve in adduction/neutral rotation was 24.2 ± 7.1 mm, the distance increased to 41.1 ± 9.8 mm in abduction/neutral rotation. Mean distance from the latissimus insertion to the radial nerve was 15.3 ± 5.5 mm with adduction/internal rotation, 25.8 ± 6.9 mm in adduction/neutral rotation, and 39.5 ± 6.8 mm in adduction/external rotation. Mean distance increased with abduction/external rotated 51.1 ± 7.4 mm. Conclusions Knowing the axillary and radial nerve locations relative to the latissimus dorsi tendon decreases the risk of iatrogenic nerve injury. Understanding the dynamic nature of these nerves related to different shoulder positions is critical to avoid complications.


2014 ◽  
Vol 39 (3) ◽  
pp. 480-483 ◽  
Author(s):  
Ilke Ali Gurses ◽  
Osman Coskun ◽  
Ozcan Gayretli ◽  
Aysin Kale ◽  
Adnan Ozturk

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 53-58 ◽  
Author(s):  
P. A. McCann ◽  
G. C. S. Smith ◽  
D. Clark ◽  
R. Amirfeyz

This study aims to identify the relationship of the radial nerve as it descends across the humerus with reference to a reliable soft tissue landmark, the tricipital aponeurosis. Following cadaveric dissection of 10 adult humerii, the radial nerve was located as it crossed the lateral midsagittal point of the humeral diaphysis. A horizontal line was then subtended medially from this point to another line subtended vertically from the lateral border of the tricipital aponeurosis. The vertical distance from this intersection to the lateral apex of the aponeurosis was recorded in three positions (full flexion, 90° of flexion and full extension). The location of the radial nerve on the posterior aspect of the humeral diaphysis to the medial apex of the tricipital aponeurosis was also noted. In 90° of flexion the radial nerve at the lateral midsagittal point of the humerus was 0.9 mm proximal to the lateral apex of the tricipital aponeurosis. Flexion and extension of the elbow changed the interval to 16.3 mm (nerve proximal) in full flexion and 7.1 mm in full extension (nerve distal). On the posterior aspect of the humerus the radial nerve was 21.8 mm proximal to the medial aspect of the tricipital aponeurosis. The aponeurosis provides a reference point from which the nerve can be easily located on the lateral aspect of the humerus intraoperatively in a range of positions, whilst the medial apex provides a guide to the location of the nerve on the posterior aspect of the arm.


2020 ◽  
Author(s):  
José García Martínez ◽  
Gerard Alvarez ◽  
Albert Perez-Bellmunt ◽  
Maribel Miguel ◽  
Ginés Viscor

Abstract Background: Radial nerve (RN) compression most commonly occurs at the level of the supinator arch (SA), also called arcade of Fröhse, but other sites of entrapment along the course of the nerve are possible. This study aimed to perform an ultrasound and anatomical examination of these entrapment sites, to provide a solid anatomical base for the differential diagnosis of lateral arm pain, to allow a more precise manual therapy approach. Methods: Nineteen fresh-frozen cadavers were examined, first on ultrasound then on anatomical dissection. Two points of possible RN entrapment were injected with dye under ultrasound guidance: where the RN crosses the lateral intermuscular septum (LIMS) and at the SA. Dissection confirmed the location of the dye at these points and allowed us to describe the relationship of the RN with the adjacent structures; the distances from each of these two points to the lateral epicondyle and the diameter of the RN were also measured. Results: The dye was observed in the correct place in all specimens. We observed a close relationship of the RN with the lateral head of triceps brachialis (LHTB) muscle and the LIMS as it passed through these structures. In both structures, longitudinal aponeurotic extensions were observed. In the anterior compartment of the arm, where the RN glides between the brachialis (B) and brachioradialis (BR) muscles, we observed varying relationships between these three structures (5% had vascular unions, 79% had union of the epimysium, and 16% muscular unions). Finally, in the forearm, just before reaching the SA, we observed a septum that compartmentalize the forearm musculature and created an aponeurotic arch through which the motor branch of the RN passed. Conclusions: Ultrasound study helps correctly identify the RN; the two points identified on US and dissection correlated well. The anatomical findings on the relationship of the RN with its surrounding structures may explain its entrapment.


Paleobiology ◽  
1980 ◽  
Vol 6 (02) ◽  
pp. 146-160 ◽  
Author(s):  
William A. Oliver

The Mesozoic-Cenozoic coral Order Scleractinia has been suggested to have originated or evolved (1) by direct descent from the Paleozoic Order Rugosa or (2) by the development of a skeleton in members of one of the anemone groups that probably have existed throughout Phanerozoic time. In spite of much work on the subject, advocates of the direct descent hypothesis have failed to find convincing evidence of this relationship. Critical points are:(1) Rugosan septal insertion is serial; Scleractinian insertion is cyclic; no intermediate stages have been demonstrated. Apparent intermediates are Scleractinia having bilateral cyclic insertion or teratological Rugosa.(2) There is convincing evidence that the skeletons of many Rugosa were calcitic and none are known to be or to have been aragonitic. In contrast, the skeletons of all living Scleractinia are aragonitic and there is evidence that fossil Scleractinia were aragonitic also. The mineralogic difference is almost certainly due to intrinsic biologic factors.(3) No early Triassic corals of either group are known. This fact is not compelling (by itself) but is important in connection with points 1 and 2, because, given direct descent, both changes took place during this only stage in the history of the two groups in which there are no known corals.


Author(s):  
D. F. Blake ◽  
L. F. Allard ◽  
D. R. Peacor

Echinodermata is a phylum of marine invertebrates which has been extant since Cambrian time (c.a. 500 m.y. before the present). Modern examples of echinoderms include sea urchins, sea stars, and sea lilies (crinoids). The endoskeletons of echinoderms are composed of plates or ossicles (Fig. 1) which are with few exceptions, porous, single crystals of high-magnesian calcite. Despite their single crystal nature, fracture surfaces do not exhibit the near-perfect {10.4} cleavage characteristic of inorganic calcite. This paradoxical mix of biogenic and inorganic features has prompted much recent work on echinoderm skeletal crystallography. Furthermore, fossil echinoderm hard parts comprise a volumetrically significant portion of some marine limestones sequences. The ultrastructural and microchemical characterization of modern skeletal material should lend insight into: 1). The nature of the biogenic processes involved, for example, the relationship of Mg heterogeneity to morphological and structural features in modern echinoderm material, and 2). The nature of the diagenetic changes undergone by their ancient, fossilized counterparts. In this study, high resolution TEM (HRTEM), high voltage TEM (HVTEM), and STEM microanalysis are used to characterize tha ultrastructural and microchemical composition of skeletal elements of the modern crinoid Neocrinus blakei.


Author(s):  
Leon Dmochowski

Electron microscopy has proved to be an invaluable discipline in studies on the relationship of viruses to the origin of leukemia, sarcoma, and other types of tumors in animals and man. The successful cell-free transmission of leukemia and sarcoma in mice, rats, hamsters, and cats, interpreted as due to a virus or viruses, was proved to be due to a virus on the basis of electron microscope studies. These studies demonstrated that all the types of neoplasia in animals of the species examined are produced by a virus of certain characteristic morphological properties similar, if not identical, in the mode of development in all types of neoplasia in animals, as shown in Fig. 1.


Author(s):  
J.R. Pfeiffer ◽  
J.C. Seagrave ◽  
C. Wofsy ◽  
J.M. Oliver

In RBL-2H3 rat leukemic mast cells, crosslinking IgE-receptor complexes with anti-IgE antibody leads to degranulation. Receptor crosslinking also stimulates the redistribution of receptors on the cell surface, a process that can be observed by labeling the anti-IgE with 15 nm protein A-gold particles as described in Stump et al. (1989), followed by back-scattered electron imaging (BEI) in the scanning electron microscope. We report that anti-IgE binding stimulates the redistribution of IgE-receptor complexes at 37“C from a dispersed topography (singlets and doublets; S/D) to distributions dominated sequentially by short chains, small clusters and large aggregates of crosslinked receptors. These patterns can be observed (Figure 1), quantified (Figure 2) and analyzed statistically. Cells incubated with 1 μg/ml anti-IgE, a concentration that stimulates maximum net secretion, redistribute receptors as far as chains and small clusters during a 15 min incubation period. At 3 and 10 μg/ml anti-IgE, net secretion is reduced and the majority of receptors redistribute rapidly into clusters and large aggregates.


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