Brachial plexus anatomy in the miniature swine as compared to human

2021 ◽  
Author(s):  
Amgad S. Hanna ◽  
Daniel J. Hellenbrand ◽  
Dominic T. Schomberg ◽  
Shahriar M. Salamat ◽  
Megan Loh ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Miniature Swine

Brachial Plexus Anatomy of Miniature Swine Compared to Human

2020 ◽  
Author(s):  
Amgad S Hanna ◽  
Daniel Hellenbrand ◽  
Dominic Schomberg ◽  
Shahriar M Salamat ◽  
Megan Loh ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Gross Anatomy ◽  
Motor Units ◽  
Shoulder Girdle ◽  
Fine Motor ◽  
Human Hand ◽  
Swine Model ◽  
Suitable Model ◽  
Miniature Swine ◽  
Myelinated Axons

Abstract Background: Brachial plexus injury (BPI) occurs when the brachial plexus is compressed, stretched, or avulsed. Although rodents are commonly used to study BPI, these models poorly mimic human BPI due to the discrepancy in size. The objective of this study was to compare the brachial plexus between human and Wisconsin Miniature SwineTM (WMSTM), which are approximately the weight of an average human (68–91 kg), to determine if swine would be a suitable model for studying BPI mechanisms and treatments. Methods: To analyze the gross anatomy, WMS brachial plexi were dissected both anteriorly and posteriorly. For histological analysis, sections from various nerves of human and WMS brachial plexi were fixed in 2.5% glutaraldehyde and then myelinated axons were labeled using 2% osmium tetroxide before being counter-stained with Masson’s Trichrome. Results: Gross anatomy revealed that the separation into 3 trunks and 3 cords is significantly less developed in the swine than in human. In swine, it takes the form of upper, middle, and lower systems with ventral and dorsal components. Histological results showed that despite the similarity in body size between the miniature swine model and humans, there was some discrepancy in nerve size and the number of the myelinated axons. The WMS had significantly fewer myelinated axons than humans in median (p = 0.0009), ulnar (p = 0.0001), and musculocutaneous nerves (p = 0.0451). The higher number of myelinated axons in these nerves for humans is expected, because there is a high demand of fine motor function in the human hand, with more motor units. Due to the stronger shoulder girdle muscles in WMS, the WMS suprascapular nerves were larger than in human. Conclusion: Overall, the WMS brachial plexus is similar in size and origin to human making them an excellent model to study BPI. Future studies analyzing the effects of BPI in WMS should be conducted.

Peripheral Nerve and Brachial Plexus Impairment, AMA Guides, Sixth Edition

2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Complex Regional Pain Syndrome ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Type I ◽  
Sixth Edition ◽  
Nerve Entrapments

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.

Brachial Plexus Injuries

1984 ◽  
Vol 11 (1) ◽  
pp. 121-126
Author(s):  
Hanno Millesi
Keyword(s):  
Brachial Plexus

Top-Ten Tips for Imaging the Brachial Plexus with Ultrasound and MRI

2019 ◽  
Vol 23 (04) ◽  
pp. 405-418 ◽  
Author(s):  
James F. Griffith ◽  
Radhesh Krishna Lalam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Muscle Denervation ◽  
Resonance Imaging ◽  
Neural Injury ◽  
Clinical Indications ◽  
Magnetic Resonance Imaging Mri ◽  
High Level ◽  
Extensive Involvement

AbstractWhen it comes to examining the brachial plexus, ultrasound (US) and magnetic resonance imaging (MRI) are complementary investigations. US is well placed for screening most extraforaminal pathologies, whereas MRI is more sensitive and accurate for specific clinical indications. For example, MRI is probably the preferred technique for assessment of trauma because it enables a thorough evaluation of both the intraspinal and extraspinal elements, although US can depict extraforaminal neural injury with a high level of accuracy. Conversely, US is probably the preferred technique for examination of neurologic amyotrophy because a more extensive involvement beyond the brachial plexus is the norm, although MRI is more sensitive than US for evaluating muscle denervation associated with this entity. With this synergy in mind, this review highlights the tips for examining the brachial plexus with US and MRI.

OUTCOME FOLLOWING EARLY NEUROSURGICAL MANAGEMENT OF BRACHIAL PLEXUS BIRTH INJURIES: AN ANALYSIS OF 100 CONSECUTIVE CASES

2006 ◽  
Vol 37 (S 1) ◽  
Author(s):  
JAI Grossman ◽  
I Yaylali ◽  
LE Ramos ◽  
H Valencia ◽  
P Di Taranto ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Birth Injuries

Brachial Plexus Injuries, Treatment and Neurotization: 45 Cases

2006 ◽  
Vol 22 (04) ◽  
Author(s):  
Harilaos Sakellarides
Keyword(s):  
Brachial Plexus

Comparative Clinical Study Between Racemic Bupivacaine and Levobupivacaine in Supraclavicular Brachial Plexus Block

2011 ◽  
Vol 4 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Jyoti Pushkar Deshpande ◽  
◽  
Poonam S. Ghodaki ◽  
Shalini Sardesai
Keyword(s):  
Clinical Study ◽  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
Comparative Clinical Study ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Our Surgical Strategy for Thoracic Outlet Syndrome

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Yasuhiro Nakajima
Keyword(s):  
Brachial Plexus ◽  
Thoracic Outlet Syndrome ◽  
Vascular Compression ◽  
Compression Tests ◽  
Provocation Tests ◽  
Diagnosis Method ◽  
Tunnel Syndrome ◽  
Electrophysiological Examination ◽  
Sensory Neural ◽  
Plexus Block

Surgical treatment for thoracic outlet syndrome (TOS) is a very controversial surgery because objective diagnosis, such as image and electrophysiological examination, is very difficult. Clinical provocation tests including brachial plexus compression tests, such as Morley and Roos, and vascular compression tests, such as Wright and Eden ,are not high in specificity and are likely to be positive even in healthy persons and patients with carpal tunnel syndrome. We place emphasis on the laterality of latency and amplitude in the sensory neural action potential (SNAP) of the medial antebrachial cutaneous nerve and ulnar nerve. After enough stretching exercises of scapular stabilizers and brachial plexus block, we always select surgery. In this presentation, I would like to show our diagnosis method and treatment strategy including surgery.

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