Variations in Course and Branching of Sciatic Nerve and it’s Relation to Pyriformis Syndrome

2021 ◽  
Vol 9 (4) ◽  
pp. 8156-8159
Author(s):  
Patel Dinesh K ◽  
◽  
Shinde Amol A ◽  
Keyword(s):  
Sciatic Nerve ◽  
Hip Replacement ◽  
Popliteal Fossa ◽  
Point Of View ◽  
Lower Limbs ◽  
Type B ◽  
Sacral Plexus ◽  
Type D ◽  
Variant Anatomy ◽  
Anatomy Teaching

Background: Sciatic nerve is a branch of sacral plexus. It passes below the pyriformis and divides in the popliteal fossa. Higher division and relation of sciatic nerve to pyriformis have been documented. Beaton and Anson have classified relation of sciatic nerve to pyriformis. The aim of this study is to find incidence of variant anatomy of sciatic nerve as per Beaton and Anson classification. Materials and methods: 48 formalin embalmed lower limbs used for regular anatomy teaching were used. Branching and course of sciatic nerve was observed in gluteal region,thigh and popliteal fossa. Observations: As per Beaton and Anson classification, we found 81.2% showed type A or normal arrangement. Type B variation was seen in 14.6% while 4.2% showed type D variation. Conclusion: Variations in branching of sciatic nerve and it’s relation to pyriformis muscle are important from point of view of Surgeons and Anaesthetists. Knowledge of these variations will help reducing block failures in cases of sciatica, pyriformis syndrome and hip replacement surgeries. KEY WORDS: Sciatic nerve, Sacral plexus, Pyriformis Syndrome, Hip replacement.

scholarly journals ESTUDIO ANATÓMICO EN FETOS HUMANOS: DIVISIÓN DEL NERVIO CIÁTICO Y SU RELACIÓN CON LA TÉCNICA ANESTÉSICA DE WINNIE A NIVEL GLÚTEO. ANATOMICAL STUDY IN HUMAN FETUSES: SCIATIC NERVE DIVISION RELATED TO WINNIE´S ANAESTHETIC APPROACH AT GLUTEAL LEVEL

2016 ◽  
Vol 2 (1) ◽  
pp. 25-30
Author(s):  
Evangelina Espósito ◽  
Sebastián A, Parisi ◽  
Matías F. Sosa ◽  
Alberto I. Herrando ◽  
Susana N. Biasutto
Keyword(s):  
Sciatic Nerve ◽  
Anatomical Study ◽  
Popliteal Fossa ◽  
Lower Limbs ◽  
Posterior Region ◽  
Gluteal Region ◽  
Formaldehyde Solution ◽  
Human Fetuses ◽  
Lower Side ◽  
Sacral Plexus

Introducción: El nervio ciático nace por la unión de todas las raíces del plexo sacro, sale de la pelvis por la parte inferior de la incisura isquiática mayor, desciende siguiendo la línea media en la región posterior del muslo y se divide en nervios tibial y peroneo, generalmente, a nivel del ángulo superior de la fosa poplítea. No obstante, es posible que se divida en cualquier punto de su recorrido, por lo que los bloqueos anestésicos que se realizan en la región glútea podrían ser insuficientes. Objetivo: Investigar el origen de los nervios tibial y peroneo, sus variantes en el trayecto hacia la región poplítea y su relación con la efectividad de la anestesia mediante el abordaje de Winnie. Material y Método: Se disecaron 50 fetos humanos (88 extremidades inferiores), fijados por inmersión en solución de formol, de entre 10 y 26 semanas de gestación y ambos géneros. Resultados: El nervio ciático se divide en nervios tibial y peroneo del siguiente modo: a) dentro de la fosa poplítea, en el 73,9% de los casos, b)  en la región del muslo posterior, en el 11,4% de los casos, c) en la región glútea, en el 4,5% de los casos, y d) nunca se constituye el nervio ciático, en el 10,2%. Conclusión: El bloqueo anestésico puede ver reducida su eficacia cuando se utiliza el abordaje glúteo como ocurre en la Técnica de Winnie, dado que se podría bloquear solamente uno de los troncos del nervio ciático.Introduction: The sciatic nerve originates by the junction of the sacral plexus roots, leaves the pelvis through the lower side of the greater ischiatic foramen, continues downwards along the medial line of the posterior region of the thigh and divides into tibial and peroneal nerves usually at the upper angle of the popliteal fossa. But that division may happen in upper levels and cause an incomplete anesthetic block in gluteal region. Our objective was to determine the origin of the tibial and peroneal nerves, its variations and the relation with the effectiveness in the anesthetic block by Winnie’s approach. Material and Method: We dissected 50 human fetuses (88 lower limbs), between 10 to 26 weeks of gestation, of both genders and fixed by immersion in formaldehyde solution. Results: The sciatic nerve divides into tibial and peroneal nerves in the following way: a) inside the popliteal fossa, 73.9% of the cases, b) in the posterior region of the thigh, 11.4% of the cases, c) in the gluteal region, 4.5% of the cases, and d) those cases in which there is not a sciatic nerve, in the 10.2%. Conclusion: The anesthetic block may reduce its effectiveness in gluteal approach, as it happens in Winnie’s approach, if only one of the sciatic nerve branches is involved.

scholarly journals Anatomical study on sciatic nerve variations in Andhra Pradesh, India

2019 ◽  
Vol 7 (8) ◽  
pp. 3085
Author(s):  
K. Lakshmi Kumari ◽  
M. Sushma ◽  
A. Raja ◽  
D. Asha Latha
Keyword(s):  
Sciatic Nerve ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Ischial Tuberosity ◽  
Popliteal Fossa ◽  
The Body ◽  
Lower Limbs ◽  
Gluteal Region ◽  
Pelvic Cavity ◽  
Human Cadavers

Background: The sciatic nerve is the largest and widest nerve in the body and is derived from ventral rami of spinal nerves L2 to S3. Sciatic nerve appears in the Gluteal region below Piriformis from Pelvic cavity by passing through Greater Sciatic foramen. In between the Ischial tuberosity and greater trochanter of Femur, it reaches the back of the thigh. At the superior angle of Popliteal fossa, it divides into Tibial and common Peroneal (fibular) nerves. The division varies, and it may occur within the pelvis, Gluteal, upper, mid and lower part of thigh. The anatomical variations of the level at which the Sciatic nerve divides is considered important by Neurosurgeons, Anaesthetists, Orthopaedicians and Surgeons.Methods: This study was conducted on 52 lower limbs to determine the level of sciatic nerve bifurcation and its variations on 26 embalmed human cadavers. The data was analyzed manually using numbers, frequencies and percentages.Results: The findings of this study states that in 2 limbs (3.84%) the nerve divided in the gluteal region; in 4 limbs (7.69%) in the pelvic region; in 10 limbs (19.23%) at the junction between upper and middle thigh. The highest incidence of division occurs in 36 limbs (69.23%) at the superior angle of the popliteal fossa.Conclusions: The findings of this study revealed that the majority of sciatic nerve divisions occur   at the superior angle of popliteal fossa while some divided into other regions such as Pelvis, Gluteal and thigh regions.

scholarly journals The level of the sciatic nerve division and its relations to the piriform muscle

2005 ◽  
Vol 62 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Sladjana Ugrenovic ◽  
Ivan Jovanovic ◽  
Vladislav Krstic ◽  
Vesna Stojanovic ◽  
Ljiljana Vasovic ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Lower Extremities ◽  
Common Peroneal Nerve ◽  
Popliteal Fossa ◽  
Terminal Branch ◽  
Sacral Plexus ◽  
The Common ◽  
Popliteal Block

Background. The sciatic nerve, as the terminal branch of the sacral plexus, leaves the pelvis through the greater sciatic foramen beneath the piriform muscle. Afterwards, it separates into the tibial and the common peroneal nerve, most frequently at the level of the upper angle of the popliteal fossa. Higher level of the sciatic nerve division is a relatively frequent phenomenom and it may be the cause of an incomplete block of the sciatic nerve during the popliteal block anesthesia. There is a possibility of different anatomic relations between the sciatic nerve or its terminal branches and the piriform muscle (piriformis syndrome). The aim of this research was to investigate the level of the sciatic nerve division and its relations to the piriform muscle. It was performed on 100 human fetuses (200 lower extremities) which were in various gestational periods and of various sex, using microdissection method. Characteristic cases were photographed. Results. Sciatic nerve separated into the tibial and common peroneal nerve in popliteal fossa in 72.5% of the cases (bilaterally in the 66% of the cases). In the remainder of the cases the sciatic nerve division was high (27.5% of the cases) in the posteror femoral or in the gluteal region. Sciatic nerve left the pelvis through the infrapiriform foramen in 192 lower extremities (96% of the cases), while in 8 lower extremities (4% of the cases) the variable relations between sciatic nerve and piriform muscle were detected. The common peroneal nerve penetrated the piriform muscle and left the pelvis in 5 lower extremities (2.5% of the cases) and the tibial nerve in those cases left the pelvis through the infrapiriform foramen. In 3 lower extremities (1.5% of the cases) common peroneal nerve left the pelvis through suprapiriform, and the tibial nerve through the infrapiriform foramen. The high terminal division of sciatic nerve (detected in 1/3 of the cases), must be kept in mind during the performing of popliteal block anesthesia. Conclusion. Although very rare, anatomical abnormalities of common peroneal nerve in regard to piriform muscle are still possible.

scholarly journals CTNI-03. IMAGING FEATURES OF LEPTOMENINGEAL METASTASES OF NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER REAL-WORLD STUDY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii41-ii41
Author(s):  
Junjie Zhen ◽  
Lei Wen ◽  
Shaoqun Li ◽  
Mingyao Lai ◽  
Changguo Shan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Type A ◽  
Brain Parenchyma ◽  
Imaging Features ◽  
Type B ◽  
Type D ◽  
Mri Examination ◽  
Mri Features ◽  
Brain And Spinal Cord ◽  
The Brain

Abstract BACKGROUND According to EANO-ESMO clinical practice guidelines, the MRI findings of LM are divided into 4 types, namely linear enhancement (type A), nodular enhancement (type B), linear combined with nodular enhancement (type C), and sign of hydrocephalus (type D). METHODS The MRI features of brain and spinal cord in patients diagnosed with NSCLC-LM in Guangdong Sanjiu Brain Hospital from 2010 until 2019 were investigated, and then were classified into 4 types. The imaging features were analyzed. RESULTS A total of 80 patients were enrolled in the study. The median age of the patients was 53.5 years old, and the median time from the initial diagnosis to the confirmed diagnosis of LM was 11.6 months. The results of enhanced MRI examination of the brain in 79 cases showed that the number of cases with enhancements of type A, B, C and D were 50 (63.3%), 0, 26 (32.9%) and 3 (3.8%), respectively, and that LM with metastases to the brain parenchyma was found in 42 cases (53.2%). The results of enhanced MRI examination of spinal cord in 59 cases showed that there were only enhancements of type A and C in 40 cases (67.8%) and 3 cases (5.0%), and no enhancement sign in the other 16 cases (27.2%). CONCLUSION MRI examination of brain and spinal cord will improve the detection rate of LM. The MRI features of NSCLC-LM in real world are mainly characterized by the linear enhancements of brain and spinal cord, followed by linear combined with nodular enhancement. The enhancements of type B and type D are rare in clinic. Almost half of the patients have LM and metastases to the brain parenchyma. Therefore, the differentiation of tumor metastases is needed to be paid attention to for the early diagnosis and the formulation of reasonable treatment plans.

The Posterior Approach to the Sciatic Nerve in the Popliteal Fossa: A Comparison of Single- Versus Double-Injection Technique

2006 ◽  
Vol 103 (6) ◽  
pp. 1571-1573 ◽  
Author(s):  
Xavier March ◽  
Olga Pineda ◽  
Maria M. Garcia ◽  
Dolores Caram??s ◽  
Antonio Villalonga
Keyword(s):  
Sciatic Nerve ◽  
Posterior Approach ◽  
Popliteal Fossa ◽  
Injection Technique ◽  
Double Injection ◽  
Single Versus

Ultrasound Guidance Improves the Success of Sciatic Nerve Block at the Popliteal Fossa

2008 ◽  
Vol 33 (3) ◽  
pp. 259-265 ◽  
Author(s):  
A PERLAS ◽  
R BRULL ◽  
V CHAN ◽  
C MCCARTNEY ◽  
A NUICA ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Nerve Block ◽  
Ultrasound Guidance ◽  
Popliteal Fossa ◽  
Sciatic Nerve Block

WIGNER MEASURES AND MOLECULAR PROPAGATION THROUGH GENERIC ENERGY LEVEL CROSSINGS

2003 ◽  
Vol 15 (10) ◽  
pp. 1285-1317 ◽  
Author(s):  
CLOTILDE FERMANIAN KAMMERER
Keyword(s):  
Energy Transfer ◽  
Normal Form ◽  
Energy Level ◽  
Point Of View ◽  
Time Dependent ◽  
Type B ◽  
Unified Framework ◽  
Level Crossings ◽  
Normal Form Theorem ◽  
Uniformly Bounded

We study the time-dependent Schrödinger equation with matrix-valued potential presenting a generic crossing of type B, I, J or K in Hagedorn's classification. We use two-scale Wigner measures for describing the Landau–Zener energy transfer which occurs at the crossing. In particular, in the case of multiplicity 2 eigenvalues, we calculate precisely the change of polarization at the crossing. Our method provides a unified framework in which codimension 2, 3 or 5 crossings can be discussed. We recover Hagedorn's result for wave packets, from Wigner measure point of view, and extend them to any data uniformly bounded in L2. The proof is based on a normal form theorem which reduces the problem to an operator-valued Landau–Zener formula.

scholarly journals The effectiveness of TiO2 additions to mortar to maintain initial conditions in terms of its reflectance to solar radiation

2017 ◽  
Vol 17 (3) ◽  
pp. 39-56 ◽  
Author(s):  
Sérgio Roberto Andrade Dantas ◽  
Fulvio Vittorino ◽  
Kai Loh
Keyword(s):  
Solar Radiation ◽  
Ultraviolet Radiation ◽  
Initial Conditions ◽  
Type A ◽  
Just Noticeable Difference ◽  
Type B ◽  
Climate Conditions ◽  
Type D ◽  
Type C ◽  
Over Time

Abstract Contact of facades with degradation agents and direct incidence of ultraviolet radiation on external coatings make them more opaque over time, affecting their colour and reflectance characteristics. This study evaluated the effect of adding different TiO2 contents to mortars applied in concrete substrates in order to verify the reflectance maintenance on surfaces after exposure over time. Mortar with different concentrations of TiO2 (1%, 5%, 10%) were produced in relation to the total dry premix, added as a powder and compared to unpainted mortar without TiO2 (type "A") and painted mortar without TiO2 (type "B"), both used as a reference for colour and reflectance. Exposed over 16 months to climate conditions in São Paulo, regarding the maintenance of reflectance and solar radiation, the results showed that type "B" (0%TiO2) painted mortar presented the best performance. Type "C" (1%TiO2) and type "D" (5%TiO2) unpainted mortar remained more stable. Type "A" (0%TiO2) and type "E" (10%TiO2) unpainted mortar showed greater differences according to the Just Noticeable Difference (JND) range caused by dirt pick up.

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