The anatomy of the anconeus nerve redefined

2021 ◽  
pp. 175319342110614
Author(s):  
Mauro Maniglio ◽  
Ezequiel E. Zaidenberg ◽  
Ezequiel F. Martinez ◽  
Carlos R. Zaidenberg
Keyword(s):  
Radial Nerve ◽  
Axillary Nerve ◽  
The Other ◽  
Anatomical Landmarks ◽  
Medial Head ◽  
Articular Capsule

The anconeus nerve is the longest branch of the radial nerve and suitable as a donor for the neurotization of the axillary nerve. The aim of this study was to map its topographical course with reference to palpable, anatomical landmarks. The anconeus nerve was followed in 15 cadaveric specimens from its origin to its entry to the anconeus. It runs between the lateral and the medial head of the triceps before entering the medial head and running intramuscularly further distal. Exiting the muscle, it lies on the periosteum and the articular capsule of the elbow, before entering the anconeus muscle. Two types of anconeus nerve in relation to branches innervating triceps were found: nine nerves also innervated the lateral triceps head, while the other six only contributed two branches to its innervation. The course of the anconeus nerve is important for harvesting as a donor nerve and to protect the nerve in surgical elbow approaches.

scholarly journals Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study

2018 ◽  
Vol 10 (03) ◽  
pp. 139-142 ◽  
Author(s):  
Prashant Chaware ◽  
John Santoshi ◽  
Manmohan Patel ◽  
Mohtashim Ahmad ◽  
Bertha Rathinam
Keyword(s):  
Radial Nerve ◽  
Axillary Nerve ◽  
Nerve Supply ◽  
Upper Limbs ◽  
Innervation Pattern ◽  
Medial Head ◽  
Triceps Muscle ◽  
Muscle Transfers ◽  
Long Head ◽  
Lateral Head

AbstractThe innervation pattern of triceps is complex and not fully comprehended. Anomalous innervations of triceps have been described by various authors. We have attempted to delineate the nerve supply of the triceps and documented the anomalous innervations of its different heads. The brachial plexus and its major branches (in the region of the axilla and arm) and triceps were dissected in 36 embalmed cadaver upper limbs. Long head received one branch from radial nerve in 31 (86%) specimens. Four (11%) specimens received two branches including one that had dual innervation from the radial and axillary nerves, and one (3%) specimen had exclusive innervation from a branch of the axillary nerve. Medial head received two branches arising from the radial nerve in 34 (94%) specimens. One (3%) specimen received three branches from the radial nerve whereas one (3%) had dual supply from the radial and ulnar nerves. Lateral head received multiple branches exclusively from the radial nerve, ranging from 2 to 5, in all (100%) specimens. Knowledge of the variations in innervation of the triceps would not only help the surgeon to avoid inadvertent injury to any of the nerve branches but also offers new options for nerve and free functional muscle transfers.

scholarly journals Surgically relevant anatomy of the axillary and radial nerves in relation to the latissimus dorsi tendon in variable shoulder positions: A cadaveric study

2019 ◽  
Vol 12 (1) ◽  
pp. 24-30
Author(s):  
Stephen Gates ◽  
Brian Sager ◽  
Garen Collett ◽  
Avneesh Chhabra ◽  
Michael Khazzam
Keyword(s):  
Internal Rotation ◽  
Nerve Injury ◽  
Radial Nerve ◽  
Latissimus Dorsi ◽  
External Rotation ◽  
Axillary Nerve ◽  
Dynamic Nature ◽  
Iatrogenic Nerve Injury ◽  
Relationship Of ◽  
The Relationship

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.

Nerve Transfer From Triceps Medial Head and Anconeus to Deltoid for Axillary Nerve Palsy

2014 ◽  
Vol 39 (5) ◽  
pp. 940-947 ◽  
Author(s):  
Jayme Augusto Bertelli ◽  
Marcos Flávio Ghizoni
Keyword(s):  
Nerve Palsy ◽  
Nerve Transfer ◽  
Axillary Nerve ◽  
Medial Head

The categorical perception of tactile distance: A difference in acuity at anatomical landmarks?

2012 ◽  
Vol 25 (0) ◽  
pp. 42 ◽  
Author(s):  
Frances Le Cornu Knight ◽  
Matthew Longo ◽  
Andrew J. Bremner
Keyword(s):  
Categorical Perception ◽  
Body Part ◽  
The Body ◽  
The Other ◽  
Anatomical Landmarks ◽  
Body Parts ◽  
Subjective Equality ◽  
Perceptual Distortions ◽  
Distance Judgments

Tactile distance judgments are prone to a number of physiological and perceptual distortions. One such distortion concerns tactile distances over the wrist being perceptually elongated relative to those within the hand or arm. This has been interpreted as a categorical segmentation effect: The wrist implicitly serves as a partition between two body part categories so that stimuli crossing the wrist appear further apart. The effect could alternatively be explained in terms of specialized acuity at anatomical landmarks (i.e., the wrist). To test these opposing explanations we presented participants with two tactile distances sequentially for comparison (one mediolaterally, across the arm, and the other proximodistally, along the arm). Points-of-Subjective-Equality (DV) were compared on the hand, wrist and arm, on dorsal and ventral surfaces between subjects. If the acuity account were true distances would be elongated in both axes at the wrist. If the categorical segmentation account were true there would be a selective perceived increase of the proximodistal distance at the wrist. A previously reported mediolateral bias was found on all body parts but, consistent with the categorical account, at the wrist the magnitude of the bias was either reduced (dorsally) or not found (ventrally) suggesting a selective proximodistal elongation. We found no evidence of increased acuity in the vicinity of the wrist in this task. Therefore we conclude that the segmentation of the body into discrete parts induces categorical perception of tactile distance.

scholarly journals MORPHOLOGICAL ADJUSTMENTS OF THE RADIAL NERVE ARE INTENSITY-DEPENDENT

2017 ◽  
Vol 23 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Patrícia Oliva Carbone ◽  
Walter Krause Neto ◽  
Eliane Florencio Gama ◽  
Wellington de Assis Silva ◽  
Thatiana Lacerda Nobre ◽  
...  
Keyword(s):  
Radial Nerve ◽  
Morphological Analysis ◽  
Morphological Changes ◽  
The Other ◽  
Significance Level ◽  
Training Groups ◽  
Transmission Electron ◽  
Post Hoc ◽  
And Training ◽  
One Way Anova

ABSTRACT Introduction: Peripheral nerve adaptation is critical for strength gains. However, information about intensity effects on nerve morphology is scarce. Objective: To compare the effects of different intensities of resistance training on radial nerve structures. Methods: Rats were divided into three groups: control (GC), training with 50% (GF1) and training 75% (GF2) of the animal’s body weight. The morphological analysis of the nerve was done by light and transmission electron microscopy. One-way ANOVA and the Tukey’s post hoc test were applied and the significance level was set at p≤0.05. Results: Training groups had an increase of strength compared to GC (p≤0.05). All measured nerve components (mean area and diameter of myelin fibers and axons, mean area and thickness of the myelin sheath, and of neurofilaments and microtubules) were higher in GF2 compared to the other (p≤0.05). Conclusion: Results demonstrated greater morphological changes on radial nerve after heavier loads. This can be important for rehabilitation therapies, training, and progression.

The Anterior Approach for Transfer of Radial Nerve Triceps Fascicles to the Axillary Nerve

2019 ◽  
Vol 44 (4) ◽  
pp. 345.e1-345.e6 ◽  
Author(s):  
Andrea S. Bauer ◽  
Remy V. Rabinovich ◽  
Peter M. Waters
Keyword(s):  
Radial Nerve ◽  
Anterior Approach ◽  
Axillary Nerve

scholarly journals Assessment of the Horizontal and Vertical Position of Mental Foramen in Indian Population in Terms of Age and Sex in Dentate Subjects by Pano-ramic Radiographs: A Retrospective Study with Review of Literature

2015 ◽  
Vol 9 (1) ◽  
pp. 297-302 ◽  
Author(s):  
Priyanka Parnami ◽  
Deepak Gupta ◽  
Vishal Arora ◽  
Saurabh Bhalla ◽  
Adarsh Kumar ◽  
...  
Keyword(s):  
Indian Population ◽  
Vertical Plane ◽  
Longitudinal Axis ◽  
Mental Foramen ◽  
The Other ◽  
Vertical Position ◽  
Anatomical Landmarks ◽  
Review Of Literature ◽  
Panoramic Radiographs ◽  
New Criteria

Objective : To familiarize new criteria to access vertical position of mental foramen in panoramic radiographs. Furthermore, to determine and compare the position and symmetry of mental foramen in horizontal as well as in vertical plane in Indian population and to compare the results with those reported for other populations in the literature. Further gender differences in mental foramen position were also accessed to comment on the reliability of panoramic radiographs for sex determination. Methods and Material : Six hundred digital panoramic radiographs were selected and studied regarding the location and symmetry of mental foramen. They were also compared with the other studies in the literature. The method employed is similar to that described by Al Jasser and Nwoku for horizontal position and Fishal et al. for vertical position of mental foramen. Certain modifications were carried out in Fishal’s criteria for vertical position assessment. Results : The commonest position of the mental foramen in horizontal plane was in line with the longitudinal axis of the second premolar (61.0%) while in vertical plane it was found to be located inferior to the apex of second premolar (72.2%). Conclusion : Mental foramen exists in different locations and possesses many variations. Hence, Individual, gender, age, race and assessing technique largely influence these variations. It suggests that the clinicians should carefully identify these anatomical landmarks, by analyzing all influencing factors, prior to their diagnostic or the other dental, surgical and implant operation.

scholarly journals Surgical assessment of the insula. Part 1: surgical anatomy and morphometric analysis of the transsylvian and transcortical approaches to the insula

2016 ◽  
Vol 124 (2) ◽  
pp. 469-481 ◽  
Author(s):  
Arnau Benet ◽  
Shawn L. Hervey-Jumper ◽  
Jose Juan González Sánchez ◽  
Michael T. Lawton ◽  
Mitchel S. Berger
Keyword(s):  
Tumor Resection ◽  
Venous Drainage ◽  
Surgical Anatomy ◽  
Reference Points ◽  
The Other ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Precentral Gyrus ◽  
Bridging Veins ◽  
Zone Ii

OBJECT Transcortical and transsylvian corridors have been previously described as the main surgical approaches to the insula, but there is insufficient evidence to support one approach versus the other. The authors performed a cadaveric comparative study regarding insular exposure, surgical window and freedom, between the transcortical and transsylvian approaches (with and without cutting superficial sylvian bridging veins). Surgical anatomy and skull surface reference points to the different insular regions are also described. METHODS Sixteen cadaveric specimens were embalmed with a customized formula to enhance neurosurgical simulation. Two different blocks were defined in the study: first, transsylvian without (TS) and with the superficial sylvian bridging veins cut (TSVC) and transcortical (TC) approaches to the insula were simulated in all (16) specimens. Insular surface exposure, surgical window and surgical freedom were calculated for each procedure and related to the Berger-Sanai insular glioma classification (Zones I–IV) in 10 specimens. Second, the venous drainage pattern and anatomical landmarks considered critical for surgical planning were studied in all specimens. RESULTS In the insular Zone I (anterior-superior), the TC approach provided the best insular exposure compared with both TS and TSVC. The surgical window obtained with the TC approach was also larger than that obtained with the TS. The TC approach provided 137% more surgical freedom than the TS approach. Only the TC corridor provided complete insular exposure. In Zone II (posterior-superior), results depended on the degree of opercular resection. Without resection of the precentral gyrus in the operculum, insula exposure, surgical windows and surgical freedom were equivalent. If the opercular cortex was resected, the insula exposure and surgical freedom obtained through the TC approach was greater to that of the other groups. In Zone III (posterior-inferior), the TC approach provided better surgical exposure than the TS, yet similar to the TSVC. The TC approach provided the best insular exposure, surgical window, and surgical freedom if components of Heschl’s gyrus were resected. In Zone IV (anterior-inferior), the TC corridor provided better exposure than both the TS and the TSVC. The surgical window was equivalent. Surgical freedom provided by the TC was greater than the TS approach. This zone was completely exposed only with the TC approach. A dominant anterior venous drainage was found in 87% of the specimens. In this group, 50% of the specimens had good alternative venous drainage. The sylvian fissure corresponded to the superior segment of the squamosal suture in 14 of 16 specimens. The foramen of Monro was 1.9 cm anterior and 4.42 cm superior to the external acoustic meatus. The M2 branch over the central sulcus of the insula became the precentral M4 (rolandic) artery in all specimens. CONCLUSIONS Overall, the TC approach to the insula provided better insula exposure and surgical freedom compared with the TS and the TSVC. Cortical and subcortical mapping is critical during the TC approach to the posterior zones (II and III), as the facial motor and somatosensory functions (Zone II) and language areas (Zone III) may be involved. The evidence provided in this study may help the neurosurgeon when approaching insular gliomas to achieve a greater extent of tumor resection via an optimal exposure.

Restoration of Shoulder Abduction after Radial to Axillary Nerve Transfer following Trauma or Shoulder Arthroplasty

2013 ◽  
Vol 3 (1) ◽  
pp. 99-103
Author(s):  
James A Nunley ◽  
Fraser J Leversedge ◽  
Walter H Wray ◽  
J Mack Aldridge
Keyword(s):  
Nerve Injury ◽  
Shoulder Arthroplasty ◽  
Radial Nerve ◽  
Conflicts Of Interest ◽  
Case Series ◽  
Nerve Transfer ◽  
Axillary Nerve ◽  
Shoulder Abduction ◽  
Anterior Branch ◽  
Significant Difference

ABSTRACT Purpose A loss of active shoulder abduction due to axillary nerve dysfunction may be caused by brachial plexus or isolated axillary nerve injury and is often associated with a severe functional deficit. The purpose of this study was to evaluate retrospectively the restoration of deltoid strength and shoulder abduction after transfer of a branch of the radial nerve to the axillary nerve for patients who had sustained an axillary nerve injury. Materials and methods We retrospectively reviewed all patients who underwent transfer of a branch of the radial nerve to the anterior branch of the axillary nerve at our institution, either alone or in combination with other nerve transfers, between 2004 and 2011. We identified, by chart review, 12 patients with an average follow-up of 16.7 months (6-36 months) who met inclusion criteria. Results Active shoulder abduction significantly improved from an average of 9.6° (0-60°) to 84.5° (0-160°) (p < 0.005). Average initial deltoid strength significantly improved from 0.3 (0-2) on the M scale to an average postoperative deltoid strength of 2.8 (0-5) (p < 0.005). Five of 12 (41.7%) achieved at least M4 strength and eight of 12 (66.7%) achieved at least M3 strength. No statistically significant difference was seen when subgroup analysis was performed for isolated nerve transfer vs multiple nerve transfer, mechanism of injury with MVC vs shoulder arthroplasty, age, branch of radial nerve transferred, or time from injury to surgery. No significant change in triceps strength was observed with an average of 4.9 (4-5) strength preoperatively and 4.8 (4-5) postoperatively (p = 0.34). There were three patients who achieved no significant gain in shoulder abduction or deltoid strength for unknown reasons. Conclusion Transfer of a branch of the radial nerve to the anterior branch of the axillary nerve is successful in improving deltoid strength and shoulder abduction in most patients. Our series, the largest North American series to our knowledge, has not shown outcomes as favorable as other series. Larger multicenter trials are needed. Type of study/Level of evidence This is a retrospective case series representing a level IV study. Funding No outside funding was received and the authors have no conflicts of interest to disclose. Wray WH III, Aldridge JM III, Nunley JA II, Ruch DS, Leversedge FJ. Restoration of Shoulder Abduction after Radial to Axillary Nerve Transfer following Trauma or Shoulder Arthroplasty. The Duke Orthop J 2013;3(1):99-103.

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