Phrenic Cross Innervation of the Hemidiaphragm in the Dog

1958 ◽  
Vol 194 (2) ◽  
pp. 355-358 ◽  
Author(s):  
T. Ogawa ◽  
N. C. Jefferson ◽  
H. Necheles
Keyword(s):  
Phrenic Nerve ◽  
Sympathetic Innervation ◽  
Esophageal Hiatus ◽  
Posterior Branch ◽  
Anterior Branch ◽  
The Right

In acute experiments on mongrel dogs, the innervation of each hemidiaphragm was investigated. In approximately 30% of the animals a division of the posterior branch of the left phrenic nerve was found to cross to the right side, innervating part of the right crus of the diaphragm immediately to the right of the esophageal hiatus. A similar cross innervation from right to left was not found; neither was a cross innervation from an anterior branch of the phrenic nerve found. The physiologic significance of cross innervation in relation to trophic maintenance of the muscle of the diaphragm by sympathetic innervation is discussed.

scholarly journals Morphological assessments on the origin and supplied territory of the artery for the posterior renal segment

2013 ◽  
Vol 19 (1) ◽  
pp. 1-8
Author(s):  
I. Iorga ◽  
O. Azis ◽  
D.M. Iliescu ◽  
P. Bordei
Keyword(s):  
Renal Artery ◽  
Renal Arteries ◽  
Posterior Branch ◽  
Anterior Branch ◽  
The Right ◽  
Superior Pole

Abstract In 105 cases the posterior ramus originated from a renal artery bifurcated into anterior and posterior branches and in 78 cases from trifurcated renal artery. In 12 cases, the posterior ramus originated from a renal artery terminated with four branches. From the aorta, as supernumerary renal artery, the posterior branch originated in 7 cases, 3 cases as double and 4 cases as triple renal arteries. In 86 cases the posterior ramus originated from the anterior branch of the renal artery, superior or inferior or both. The arcade aspect was found in only 134 cases. A particular aspect of the arch is the italic “S” (or inverted italic “S”) or double arch, which we found in 24 cases. This type of posterior branch supplied the entire posterior valve, an aspect found in 11 cases. When the posterior branch was not in arcade, it was arranged transversally and ended by bi or trifurcation. The ending by bifurcation was found in 113 cases and by trifurcation in 17 cases. All of these cases, both the right and the left, supplied the entire posterior valve. In all cases, regardless of any aspect of the posterior branch, it supplied the entire posterior valve in 88 cases. The posterior branch supplied the superior pole in 250 cases, the inferior one in 181 and only the posterior mesorenal part, without participating in the supply of the two poles, in 233 cases.

scholarly journals Bony Canals Along The Course of Middle Meningeal Artery In Dry Skulls

2012 ◽  
Vol 01 (01) ◽  
pp. 019-023 ◽  
Author(s):  
Bindu Aggarwal ◽  
Madhur Gupta ◽  
Harsh Kumar
Keyword(s):  
Middle Cranial Fossa ◽  
Middle Meningeal Artery ◽  
Branching Pattern ◽  
Artery Ligation ◽  
Posterior Branch ◽  
Anterior Branch ◽  
Bony Canal ◽  
Subdural Hemorrhages ◽  
The Right ◽  
Meningeal Artery

Abstract Background : The middle meningeal artery courses in the middle cranial fossa and divides into two or three branches. The branches of the artery are sometimes enclosed within a bony canal. The artery and its branches are likely to get tom in cases of epidural hematomas and may require ligation. Aims: The aim of the study is to report the variations in the branching pattern of middle meningeal artery and incidence of bony canals along the course of these branches. Materials: The study material consisted of 77 bases of dry skulls (154 sides) and the findings were supplemented with dissection of four cadaveric skulls. Results and Conclusions : The length of stem of middle meningeal artery, from foramen spinosum to its division into branches varied from 0.56 to 5.83 mm on the right side and 0.58- 7.53mm on the left. The mean length of the stem was 3.04 on the right side and 3.01 on the left (S D ± 1.4). The middle meningeal artery divided into anterior and posterior branches in all the sides of skull. A middle branch constituting a third branch of middle meningeal artery was observed in 44.15% (68 sides) which arose either from its anterior 35.29% (24 sides) or posterior branch 64.71 % (44 sides). Bony canals were observed in 39.61 % (61 sides). The anterior branch was enclosed in a bony canal in 37.66% (58 sides) and the posterior branch in 1.94% (3 sides). The variations in the course, branching pattern and bony canals along middle meningeal artery are of clinical significance while treating extradural and subdural hemorrhages as due to these variations and presence of bony canal in course of middle meningeal artery, ligation of the vessel may be totally or partially insufficient.

Pericardial mechanoreceptors with phrenic afferents

1993 ◽  
Vol 264 (6) ◽  
pp. H1836-H1846 ◽  
Author(s):  
D. R. Kostreva ◽  
S. P. Pontus
Keyword(s):  
Phrenic Nerve ◽  
Cardiac Rhythm ◽  
Afferent Activity ◽  
Fibrous Layer ◽  
Anesthetized Dogs ◽  
Anatomic Distribution ◽  
Phrenic Nerves ◽  
The Right

Pericardial mechanoreceptors with afferents in the phrenic nerves were studied in anesthetized dogs. The specific aims determined 1) if pericardial receptors with phrenic afferents exist in the dog; 2) the stimuli needed to activate these receptors; 3) the anatomic distribution of these pericardial receptors; and 4) which pericardial layer contains the receptors. Afferent activity was recorded from the phrenic nerves while the pericardium was probed. In 15 of 18 animals, pericardial receptors were found on the right side. In 12 of 18 animals pericardial receptors were located on the left side. Most of the mechanoreceptors were found in a band that paralleled the pericardiophrenic attachment, in the fibrous layer of the pericardium, overlying the atria and atrioventricular grooves. Some receptors had a cardiac rhythm, whereas others were stimulated by the inflating lung. None of the receptors were chemosensitive to capsaicin, bradykinin, or saline. This study is the first to demonstrate that the pericardium of the dog contains mechanosensitive receptors which are innervated by the phrenic nerve.

Low vulnerability of the right phrenic nerve to electroporation ablation

Heart Rhythm ◽  
2015 ◽  
Vol 12 (8) ◽  
pp. 1838-1844 ◽  
Author(s):  
Vincent J.H.M. van Driel ◽  
Kars Neven ◽  
Harry van Wessel ◽  
Aryan Vink ◽  
Pieter A.F.M. Doevendans ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
The Right

Selective parasympathectomy of automatic and conductile tissues of the canine heart

1985 ◽  
Vol 248 (1) ◽  
pp. H61-H68 ◽  
Author(s):  
W. C. Randall ◽  
J. L. Ardell
Keyword(s):  
Vagal Stimulation ◽  
Superior Vena ◽  
Sympathetic Innervation ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Dorsal Surface ◽  
Atrial Pacing ◽  
Canine Heart ◽  
Surgical Interventions ◽  
The Right

From right thoracotomy (T4-T5), the canine heart was suspended in its pericardium to expose its major venous inputs. Vagal and sympathetic trunks were prepared for electrical stimulation (10-20 Hz, 5.0 ms, 3-5 V) before and after each separate denervation procedure. Vagal stimulation was instituted with and without concurrent atrial pacing. The following surgical interventions were performed. 1) The superior vena cava was cleared of connective and nervous tissues from the pericardial reflection caudally to the level of the right pulmonary artery. 2) The azygos vein was cleared, tied, and sectioned. 3) The right pulmonary veins were isolated and cleared intrapericardially. 4) The dorsal surface of the atria was dissected between the right and left pulmonary veins and painted with phenol. Each step in the procedure elicited successive stepwise deletion of parasympathetic influences on sinoatrial tissues of the canine heart with only minor ablation of sympathetic inputs. 5) Dissection of the triangular fat pad at the junction of the inferior vena cava and inferior left atrium eliminated the remaining parasympathetic efferent input to the heart with dramatic deletion of atrioventricular block during either left or right vagal stimulation, again with preservation of most of the sympathetic innervation. These experiments clearly demonstrate differential and selective inputs of parasympathetic pathways to sinoatrial (SAN) and atrioventricular (AVN) regions of the dog heart but relatively little interference with sympathetic distributions.(ABSTRACT TRUNCATED AT 250 WORDS)

Diaphragmatic flutter

2018 ◽  
Vol 18 (3) ◽  
pp. 224-226 ◽  
Author(s):  
Dean Walton ◽  
Michael Bonello ◽  
Malcolm Steiger
Keyword(s):  
Respiratory Distress ◽  
Medical Treatment ◽  
Abdominal Wall ◽  
Phrenic Nerve ◽  
High Frequency ◽  
Rare Disorder ◽  
Nerve Crush ◽  
Irregular Variable ◽  
The Right ◽  
High Index Of Suspicion

A 78-year-old woman presented with involuntary movements of her abdomen, which started after a right hemispheric stroke. She had irregular, variable, hyperkinetic predominantly right-sided abdominal wall movements. MR scan of brain confirmed a recent infarct in the right occipitotemporal lobe and the right cerebellum. Diaphragmatic fluoroscopy confirmed high-frequency flutter as the cause of her abdominal movements and confirmed the diagnosis of van Leeuwenhoek’s disease. Anthonie van Leeuwenhoek first described this condition in 1723 and had the condition himself. He was a Dutch businessman who is often acknowledged as the first microscopist and microbiologist. He disagreed with his physician who attributed his ailment as being of cardiac origin. Diaphragmatic flutter is a rare disorder that requires a high index of suspicion with symptoms including abnormal abdominal wall movements, dyspnoea and respiratory distress. Despite medical treatment, the patient was still highly symptomatic, so she is currently being considered for a phrenic nerve crush.

Isolated internal iliac artery infected pseudoaneurysm occlusion using endovascular coil embolisation

2021 ◽  
Vol 14 (6) ◽  
pp. e239005
Author(s):  
Gorrepati Rohith ◽  
Bachavarahalli Sriramareddy Rajesh ◽  
KM Abdulbasith ◽  
Sathasivam Sureshkumar
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Coil Embolisation ◽  
Incision And Drainage ◽  
Wound Debridement ◽  
Anterior Branch ◽  
Ct Angiogram ◽  
Internal Iliac ◽  
Infected Pseudoaneurysm ◽  
The Right

A 34-year-old man presented with painful swelling in the right gluteal region. The MRI showed right sacroiliitis and adjacent intramuscular abscess. The abscess was drained by a pigtail insertion followed by incision and drainage. The patient developed persistent bleeding from the drainage site. CT angiogram revealed a large pear-shaped pseudoaneurysm arising from the anterior branch of the right internal iliac artery. The patient had Abrus precatorius poisoning previously resulting in methicillin-resistant Staphylococcus aureus septicaemia, which incited above events. Digital subtraction angiography with coil embolisation of the right internal iliac artery was done under the cover of culture-specific antibiotics along with thorough wound debridement following which the patient’s condition improved. Isolated infected pseudoaneurysms of internal iliac arteries, although rare, should be considered in cases of complicated sacroiliitis. Under antibiotic cover, endovascular coil embolisation can be considered as a treatment strategy to treat complicated infected pseudoaneurysms located in difficult anatomical locations.

Abstract 17710: Phrenic Nerve Injury Despite High-Output Pacing in Patients Undergoing Radiofrequency Catheter Ablation of Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Brett Izzo ◽  
Miki Yokokawa ◽  
Krit Jongnarangsin ◽  
Hamid Ghanbari ◽  
Rakesh Latchamsetty ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Phrenic Nerve ◽  
Maximum Output ◽  
Radiographic Findings ◽  
Long Duration ◽  
Mapping System ◽  
3D Mapping System ◽  
Rf Energy ◽  
The Right ◽  
High Output

Introduction: High-output pacing has been advocated as a strategy to avoid injury to the phrenic nerve (PN) during antral pulmonary vein (PV) isolation. We assessed the hypothesis that pacing does not prevent PN injury in patients undergoing radiofrequency (RF) ablation of atrial fibrillation (AF). Methods: The medical records of 198 consecutive patients (age=63±12 years, 129 men, ejection fraction=57±10%, LA=44±6mm, paroxysmal=49%) undergoing their first ablation procedure for AF were reviewed. All patients underwent antral PV isolation using a 3D mapping system (CARTO XP or CARTO 3) and a 3.5 mm irrigated-tip ablation catheter (maximum power, 25 W). Prior to RF energy delivery, high-output pacing (20 mA @ 10 ms, maximum output) was performed to asses for PN capture. Sites that afforded PN capture were avoided and RF energy was delivered at adjacent sites without PN capture. The 3-D maps were reviewed to identify the prevalence and sites of PN capture. Results: High-output pacing along the anterior right antrum resulted in PN capture in 35 patients (18%). The most common site with a positive response was the crux between the upper and lower PVs (60%), followed by the right superior PV (43%), and the right inferior PV (20%). Of the patients with PN capture, 49% had only one site of capture, 20% with two sites, and 31% had 3 or more sites. All PVs were isolated at the end of the procedure. Two patients (1%) developed PN injury (symptom onset on the day after the procedure), which was confirmed on radiography. In neither case was there evidence of PN capture during the procedure. Symptoms resolved in both patients within 3 months, with normalization of radiographic findings. Conclusions: High-output pacing along the anterior right PV antrum yields PN capture in roughly one-fifth of the patients undergoing PV isolation. Despite a negative response to pacing and alteration of the lesion set, PN injury may occur. The reason for this discordance is unknown, but may include the possibility that the capture threshold of the PN exceeds the maximum output of the stimulator, or that RF energy may injure the pericardiophrenic artery, which accompanies the PN. Avoiding high-power or long-duration lesions and high contact force in this region may minimize the risk of PN injury.

Abstract 16831: Provoked PFO Shunt And Posterior Circulation Stroke: An Underrecognized Association

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Muhammad Hamza Saad Shaukat ◽  
Mamoon Ahmed ◽  
Terezia Petraskova ◽  
Alex Georgiev ◽  
Orvar Jonsson
Keyword(s):  
Atrial Fibrillation ◽  
Valsalva Maneuver ◽  
Sympathetic Innervation ◽  
Paradoxical Embolism ◽  
Posterior Circulation ◽  
Saline Injection ◽  
Atrial Size ◽  
Acute Infarct ◽  
History Of ◽  
The Right

Case Presentation: A 50 year old man presented with nausea and weakness. MRI brain showed a small acute infarct in the right pons. CT angiography of the head and neck was unremarkable. No thrombus, vegetation, or inter-atrial communication was seen on transthoracic echocardiogram: LVEF was 55-60% with normal left atrial size. No history of atrial fibrillation, hypertension, diabetes or drug abuse was reported; lower extremity duplex was negative for deep venous thrombosis. TSH was normal. Transesophageal echocardiography showed an aneurysmal atrial septum: agitated saline injection did not demonstrate an inter-atrial communication (figure 1). Repeat saline injection during the same procedure with Valsalva maneuver demonstrated a moderate-sized, provoked right-to-left, patent foramen ovale (PFO) shunt (figure 2). Discussion: Physiologically decreased sympathetic innervation spares posterior cerebral circulation from Valsalva-induced vasoconstriction. The disproportionate increase in posterior cerebral blood flow when venous return/cardiac output increases in the immediate post-strain period explains the association of provoked PFO shunt and paradoxical embolism to posterior circulation. Although the association has been described in literature, it remains underappreciated. Recognition of the association expedited secondary prevention of stroke in this non-elderly patient by circumventing the need to exclude atrial fibrillation on ambulatory rhythm monitoring (3-6 months) before referral for PFO closure.

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