The relationship between the saphenopopliteal junction and the common peroneal nerve: a cada-veric study

2009 ◽  
Vol 24 (2) ◽  
pp. 67-73 ◽  
Author(s):  
R Balasubramaniam ◽  
R Rai ◽  
D C Berridge ◽  
D J A Scott ◽  
R W Soames
Keyword(s):  
Peroneal Nerve ◽  
Anatomic Variation ◽  
Common Peroneal Nerve ◽  
Joint Space ◽  
Anatomical Landmarks ◽  
Fibula Head ◽  
Increased Risk ◽  
The Common ◽  
Relationship Of ◽  
The Relationship

Objectives The variable anatomy of the short saphenous vein (SSV) and the potential failure to identify the saphenopopliteal junction (SPJ) contribute to an increased risk of damage to the common peroneal nerve (CPN) during surgical exploration. The aim of the present study was to determine the variation of the SPJ, its relationship to the CPN, and the relationship of both SPJ and CPN to defined anatomical landmarks. Methods Measurements of the distance between the SPJ and CPN, and the defined anatomical landmarks (fibula head, lateral joint space, lateral femoral epicondyle), were undertaken on 30 cadaveric limbs following careful dissection of the popliteal fossa. Results The level of SPJ termination was classified as low (below), normal (within 100 mm above) and high (more than 100 mm above), the lateral femoral epicondyle. Of the 30 limbs dissected, 70% of SPJs were normal, 23% low and 7% high. Direct measurement from the SPJ to anatomical landmarks showed a higher interquartile range (IQR) in low compared with normal terminations; however, the vertical distance from the SPJ to the fibula head showed an increase in IQR from low to normal terminations (7.1–14.2). The mean distances between the SPJ and CPN in low and normal terminations were 23.3 and 16.7 mm, respectively. Comparison of the IQR showed values very similar to low terminations having a slightly higher IQR compared with normal terminations (7.15–6.0). Conclusion Significant anatomic variation was observed in the termination of the SSV, with 67% located within 66 mm above the lateral femoral epicondyle. The risk of damaging the CPN during saphenopopliteal ligation may be higher for SPJs located above the lateral femoral epicondyle because of the proximity of the two structures and variability of SPJ.

scholarly journals VARIANT RELATION OF THE SCIATIC NERVE TO THE PIRIFORMIS MUSCLE: A CADAVERIC STUDY FROM NORTH INDIA. Variaciones en la relación del nervio ciático con el músculo piriforme: Un estudio cadavérico en India del Norte

2016 ◽  
Vol 8 (1) ◽  
pp. 38-42
Author(s):  
Virendra Budhiraja ◽  
Rakhi Rastogi ◽  
Sanjeev K Jain ◽  
Nidhi Sharma ◽  
Rohin Garg ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Clinical Outcomes ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Common Peroneal Nerve ◽  
North India ◽  
Piriformis Muscle ◽  
The Common ◽  
Long Course ◽  
Relationship Of

El nervio ciático sale de la pelvis y entra en la  región glútea debajo del  músculo piriforme como un único tronco. Tiene dos componentes: el nervio peroneo común y el  nervio tibial. La relación variable del nervio ciático con el músculo piriforme y su longitud hace que el nervio sea vulnerable a las lesiones. Estudiamos la relación variable del nervio ciático en sesenta extremidades inferiores de treinta cadáveres y encontramos el nervio ciático emergiendo indiviso por debajo del músculo piriforme en el 68,33% de los casos, pero en el 31,66% el nervio ciático estaba dividido arriba en la pelvis. En el 18,33% de los casos el componente peroneo común emergió arriba y en el 13,33% de los casos emergió a través del  músculo piriforme. Pensamos que tener un conocimiento adecuado sobre la anatomía del  nervio ciático es bueno para los resultados clínicos.  Sciatic nerve leaves the pelvis and enters the gluteal region below the piriformis muscle as single trunk. It has two components common peroneal nerve and the tibial nerve. The variable relationship of sciatic nerve with the piriformis muscle and its long course makes the nerve vulnerable to injury. We studied sciatic nerve variable relation in sixty lower extremities of thirty cadavers and found the sciatic nerve emerging undivided below the piriformis muscle in 68.33% of cases but in 31.66% the sciatic nerve divided high in the pelvis. In 18.33% cases the common peroneal component emerged above and in 13.33% of cases it emerged through the piriformis muscle. We think proper knowledge of the anatomy of the sciatic nerve is good for clinical outcomes

Relationship of the common peroneal nerve and its branches to the head and neck of the fibula

2003 ◽  
Vol 16 (6) ◽  
pp. 501-505 ◽  
Author(s):  
William Ryan ◽  
Nick Mahony ◽  
Maire Delaney ◽  
Moira O'Brien ◽  
Paraic Murray
Keyword(s):  
Head And Neck ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
The Common ◽  
Relationship Of

Branchial Cleft Cyst Posterior to the Carotid Vessels

1995 ◽  
Vol 74 (11) ◽  
pp. 774-776 ◽  
Author(s):  
David J. Halvorson ◽  
Edward S. Porubsky
Keyword(s):  
Anatomical Landmarks ◽  
Branchial Cleft Cyst ◽  
Branchial Arches ◽  
Branchial Cleft Anomalies ◽  
Second Branchial Cleft Cyst ◽  
Branchial Cleft ◽  
The Common ◽  
Carotid Vessels ◽  
Relationship Of ◽  
The Relationship

Branchial cleft anomalies may appear as a sinus fistula or cyst. An understanding of the developmental embryology and anatomy can predict branchial cleft anomalies by the relationship of the corresponding branchial arches that form at the time of development. The second branchial cleft anomalies are the most common and may be found along a tract from the anterior border of the sternocleidomastoid muscle anterior to the carotid vessels and IX and XII. A cyst may form anywhere along this tract but most commonly is just lateral to the internal jugular vein anterior to the carotid vessels. We describe a patient with a second branchial cleft cyst that was posterior to the carotid vessels documented by computed tomography. The cyst was found intraoperatively to be clearly posterior to the common carotid artery. This case demonstrates the need for an understanding of developmental embryology, anatomical landmarks and variations.

scholarly journals Level options for the formation and branching of the common peroneal nerve

2019 ◽  
Vol 21 (2) ◽  
pp. 160-165
Author(s):  
D M Isaev ◽  
A I Gaivoronsky ◽  
I V Gaivoronsky ◽  
I A Goryacheva
Keyword(s):  
Clinical Picture ◽  
Peroneal Nerve ◽  
Common Peroneal Nerve ◽  
Average Value ◽  
Fibula Head ◽  
Examination Techniques ◽  
Surface Location ◽  
The Common ◽  
Lateral Cutaneous Nerve ◽  
Variant Anatomy

The study of topographic and anatomical features of the common peroneal nerve and its main branches was performed on 72 lower extremities of adult corpses. Morphoscopic and morphometric established that the higher the level of development of the common peroneal nerve, the greater the diameter, it has held more distance to the branch of the lateral cutaneous nerve of the calf. The average value of the diameter of the common peroneal nerve at the place of formation is10,1±2,8 mm. Differences in the level of development of the common peroneal nerve play an important role in the evaluation of the clinical picture of his injuries. In the «high» version of the formation, the probability of isolated damage to the common peroneal nerve is higher with trauma to the upper and middle third of the thigh. In this embodiment, the formation between the tibial and the common peroneal nerve revealed «anastomoses». Their presence helps to explain the possible dissonance between the clinical picture and the anatomical substrate of the lesion. It is shown that the lower the level of nerve formation, the greater the angle at which the nerve departs. The loose type of branching of the common peroneal nerve at the level of the head of the fibula does not allow adequate mobilization of the nerve in this area. This, in turn, does not allow intraoperatively overcome diastasis with nerve injury at the level of the fibula head. The surface location of the nerve, as well as its immobility in this place cause a high risk of compression-ischemic neuropathy. These features of the formation and variant anatomy of the common peroneal nerve explain a small percentage of favorable outcomes of surgical treatment of lesions of the common peroneal nerve and its main branches. The obtained morphometric data should be used as an indicator of the range of anatomical norms in the conduct of neuroimaging examination techniques (ultrasound, magnetic resonance) in the diagnosis of damage to the common peroneal nerve.

scholarly journals A Cadaveric Study of the Distal Biceps Femoris Muscle in relation to the Normal and Variant Course of the Common Peroneal Nerve: A Possible Cause of Common Peroneal Entrapment Neuropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jeong-Hyun Park ◽  
Jinseo Yang ◽  
Kwang-Rak Park ◽  
Tae Woo Kim ◽  
Taeyeong Kim ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Gastrocnemius Muscle ◽  
Common Peroneal Nerve ◽  
Biceps Femoris ◽  
Biceps Femoris Muscle ◽  
Distal Biceps ◽  
The Common ◽  
The Relationship ◽  
Femoris Muscle ◽  
Lateral Head

The most frequent mononeuropathy in the lower extremity has been reported as the common peroneal nerve entrapment neuropathy (CPNe) around the head and neck of the fibula, although the mechanism of the neuropathy in this area cannot be fully explained. Therefore, the aim of this cadaveric study was to evaluate the relationship between morphologic variations of the distal biceps femoris muscle (BFM) and the course of the common peroneal nerve (CPN) and to investigate the incidence and morphological characteristics of anatomical variations in the BFM associated with CPNe. The popliteal region and the thigh were dissected in 115 formalin-fixed lower limbs. We evaluated consensus for (1) normal anatomy of the distal BFM, (2) anatomic variations of this muscle, and (3) the relationship of the muscle to the CPN. Measurements of the distal extents of the short and long heads of the BFM from insertion (fibular head) were performed. Two anatomic patterns were seen. First, in 93 knees (80.8%), the CPN ran obliquely along the lateral side of the BFM and then superficial to the lateral head of the gastrocnemius muscle. Second, in 22 cases (19.2%), the CPN coursed within a tunnel between the biceps femoris and lateral head of the gastrocnemius muscle (LGCM). There was a positive correlation between the distal extents of the short heads of the biceps femoris muscle (SHBFM) and the presence of the tunnel. The “popliteal intermuscular tunnel” in which the CPN travels can be produced between the more distal extension variant of the SHBFM and the LGCM. This anatomical variation of BFM may have a clinical significance as an entrapment area of the CPN in the patients in which the mechanism of CPNe around the fibula head and neck is not understood.

scholarly journals Fibular epiphyseal transfer: the peroneal vessels revisited

2018 ◽  
Vol 1 (2) ◽  
pp. 100-102
Author(s):  
Adrian D Murphy ◽  
Christopher J Coombs
Keyword(s):  
Rotator Cuff ◽  
Peroneal Nerve ◽  
Proximal Humerus ◽  
Common Peroneal Nerve ◽  
Lateral Approach ◽  
Peroneal Artery ◽  
Fibula Head ◽  
Vascularized Fibula ◽  
Pedicle Length ◽  
The Common

The case of a seven-year-old boy with a Ewing’s sarcoma of the humerus diaphysis extending into the epiphysis proximally. He underwent chemotherapy followed by 12 cm resection of the proximal humerus with preservation of rotator cuff. Reconstruction was performed using a 15 cm vascularized fibula epiphyseal transfer raised using a postero-lateral approach based on the peroneal artery and its venae commitans. The common peroneal nerve was protected proximally and all motor branches were preserved. The pedicle length was 7cm. When isolated on the peroneal artery, bleeding was seen at the level of the epiphysis and periosteum of the fibula head.

scholarly journals Electrical Stimulation of the Common Peroneal Nerve and Its Effects on the Relationship Between Corticomuscular Coherence and Motor Control in Healthy Adults

2021 ◽  
Author(s):  
Tadaki Koseki ◽  
Daisuke Kudo ◽  
Natsuki Katagiri ◽  
Shigehiro Nanba ◽  
Mitsuhiro Nito ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Performance ◽  
Peroneal Nerve ◽  
Sensory Input ◽  
Common Peroneal Nerve ◽  
Healthy Adults ◽  
Ankle Dorsiflexion ◽  
Beta Band ◽  
The Common ◽  
The Relationship

Abstract Background: Sensory input via neuromuscular electrical stimulation (NMES) may contribute to synchronization between motor cortex and spinal motor neurons and motor performance improvement in healthy adults and stroke patients. However, the optimal NMES parameters used to enhance physiological activity and motor performance remain unclear. In this study, we focused on sensory feedback induced by a beta-band frequency NMES (β-NMES) based on corticomuscular coherence (CMC) and investigated the effects of β-NMES on CMC and steady-state of isometric ankle dorsiflexion in healthy volunteers. Twenty-four participants received β-NMES at the peak beta-band CMC or fixed NMES (f-NMES) at 100 Hz on different days. NMES was applied to the right part of the common peroneal nerve for 20 min. The stimulation intensity was 95% of the motor threshold with a pulse width of 1 ms. The beta-band CMC and the coefficient of variation of force (Force CV) were assessed during isometric ankle dorsiflexion for 2 min. In the complementary experiment, we applied β-NMES to 14 participants and assessed beta-band CMC and motor evoked potentials (MEPs) with transcranial magnetic stimulation.Results: No significant changes in the means of beta-band CMC, Force CV, and MEPs were observed before and after NMES conditions. Changes in beta-band CMC were correlated to a) changes in Force CV immediately, at 10 min, and at 20 min after β-NMES (all cases, p < 0.05) and b) changes in MEPs immediately after β-NMES (p = 0.01). No correlations were found after f-NMES.Conclusions: Our results suggest that the sensory input via NMES was inadequate to change the beta-band CMC, corticospinal excitability, and voluntary motor output. Whereas, the β-NMES affects the relationship between changes in beta-band CMC, Force CV, and MEPs. These findings may provide the information to develop NMES parameters for neurorehabilitation in patients with motor dysfunction.

scholarly journals Electrical stimulation of the common peroneal nerve and its effects on the relationship between corticomuscular coherence and motor control in healthy adults

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tadaki Koseki ◽  
Daisuke Kudo ◽  
Natsuki Katagiri ◽  
Shigehiro Nanba ◽  
Mitsuhiro Nito ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Performance ◽  
Peroneal Nerve ◽  
Sensory Input ◽  
Common Peroneal Nerve ◽  
Healthy Adults ◽  
Ankle Dorsiflexion ◽  
Beta Band ◽  
The Common ◽  
The Relationship

Abstract Background Sensory input via neuromuscular electrical stimulation (NMES) may contribute to synchronization between motor cortex and spinal motor neurons and motor performance improvement in healthy adults and stroke patients. However, the optimal NMES parameters used to enhance physiological activity and motor performance remain unclear. In this study, we focused on sensory feedback induced by a beta-band frequency NMES (β-NMES) based on corticomuscular coherence (CMC) and investigated the effects of β-NMES on CMC and steady-state of isometric ankle dorsiflexion in healthy volunteers. Twenty-four participants received β-NMES at the peak beta-band CMC or fixed NMES (f-NMES) at 100 Hz on different days. NMES was applied to the right part of the common peroneal nerve for 20 min. The stimulation intensity was 95% of the motor threshold with a pulse width of 1 ms. The beta-band CMC and the coefficient of variation of force (Force CV) were assessed during isometric ankle dorsiflexion for 2 min. In the complementary experiment, we applied β-NMES to 14 participants and assessed beta-band CMC and motor evoked potentials (MEPs) with transcranial magnetic stimulation. Results No significant changes in the means of beta-band CMC, Force CV, and MEPs were observed before and after NMES conditions. Changes in beta-band CMC were correlated to (a) changes in Force CV immediately, at 10 min, and at 20 min after β-NMES (all cases, p < 0.05) and (b) changes in MEPs immediately after β-NMES (p = 0.01). No correlations were found after f-NMES. Conclusions Our results suggest that the sensory input via NMES was inadequate to change the beta-band CMC, corticospinal excitability, and voluntary motor output. Whereas, the β-NMES affects the relationship between changes in beta-band CMC, Force CV, and MEPs. These findings may provide the information to develop NMES parameters for neurorehabilitation in patients with motor dysfunction.

Pensare Dio. Spunti di riflessione in dialogo con Anca Vasiliu

Elenchos ◽  
2020 ◽  
Vol 41 (1) ◽  
pp. 181-194
Author(s):  
Angela Longo
Keyword(s):  
Late Antiquity ◽  
Human Being ◽  
Common Thread ◽  
Critical Issues ◽  
Relevant Topic ◽  
The Common ◽  
The One ◽  
Relationship Of ◽  
The Relationship ◽  
The Trinity

AbstractThe following work features elements to ponder and an in-depth explanation taken on the Anca Vasiliu’s study about the possibilities and ways of thinking of God by a rational entity, such as the human being. This is an ever relevant topic that, however, takes place in relation to Platonic authors and texts, especially in Late Antiquity. The common thread is that the human being is a God’s creature who resembles him and who is image of. Nevertheless, this also applies within the Christian Trinity according to which, not without problems, the Son is the image of the Father. Lastly, also the relationship of the Spirit with the Father and the Son, always within the Trinity, can be considered as a relationship of similarity, but again not without critical issues between the similarity of attributes, on the one hand, and the identity of nature, on the other.

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