scholarly journals Neurofibrom-Schwannom Hybrid Tumor In The Chest Wall

2020 ◽  
Vol 6 (3) ◽  
pp. 1-4
Author(s):  
Cakmak Muharrem ◽  
Keyword(s):  
Chest Wall ◽  
Spinal Nerve ◽  
Hybrid Tumor ◽  
Intercostal Nerves

Schwannoma originates from the roots of spinal nerve. Chest wall shwannoma originating from intercostal nerves is very rare. In this study, we aimed to share a schawannoma-neurofibroma hybrid tumor located in the chest wall.

Chest Pain

PEDIATRICS ◽  
1986 ◽  
Vol 77 (4) ◽  
pp. 618-618
Author(s):  
STEVEN M. SELBST
Keyword(s):  
Chest Pain ◽  
Chest Wall ◽  
Clinical Entity ◽  
Distinct Clinical Entity ◽  
Intercostal Nerves

In Reply.— Dr Rogers describes brief anterior chest pain, worse with inspiration, which he has labeled "benign pleuralgia." The etiology of this pain, as with most chest pain, is uncertain. Perhaps, the pain arises in the pain-sensitive pleura and then travels through the intercostal nerves in the chest wall. If such pain is not reproducible with palpation, and not related to recent exercise, I would not consider this to be of musculoskeletal origin. Although some may prefer to consider this a distinct clinical entity, I would "lump" such vague, unexplainable pain in the idiopathic category.

Refining a great idea: the consolidation of PECS I, PECS II and serratus blocks into a single thoracic fascial plane block, the SAP block

2019 ◽  
pp. rapm-2019-100745 ◽  
Author(s):  
Carlo D Franco ◽  
Konstantin Inozemtsev
Keyword(s):  
Brachial Plexus ◽  
Chest Wall ◽  
Mechanism Of Action ◽  
Sensory Innervation ◽  
Common Mechanism ◽  
Nerve Blocks ◽  
Intercostal Nerves ◽  
Lateral Branches ◽  
Fascial Plane Block ◽  
Fascial Plane

The popularity of ultrasound-guided nerve blocks has impacted the practice of regional anesthesia in profound ways, improving some techniques and introducing new ones. Some of these new nerve blocks are based on the concept of fascial plane blocks, in which the local anesthetic is injected into a plane instead of around a specific nerve. Pectoralis muscles (PECS) and serratus blocks, most commonly used for post op analgesia after breast surgery, are good examples. Among the nerves targeted by PECS/serratus blocks are different branches of the brachial plexus that traditionally have been considered purely motor nerves. This unsubstantiated claim is a departure from accepted anatomical knowledge and challenges our understanding of the sensory innervation of the chest wall. The objective of this Daring Discourse is to look beyond the ability of PECS/serratus blocks to provide analgesia/anesthesia of the chest wall, to concentrate instead on understanding the mechanism of action of these blocks and, in the process, test the veracity of the claim. After a comprehensive review of the evidence we have concluded that (1) the traditional model of sensory innervation of the chest wall, which derives from the lateral branches of the upper intercostal nerves and does not include branches of the brachial plexus, is correct. (2) PECS/serratus blocks share the same mechanism of action, blocking the lateral branches of the upper intercostal nerves, and so their varied success is tied to their ability to reach them. This common mechanism agrees with the traditional innervation model. (3) A common mechanism of action supports the consolidation of PECS/serratus blocks into a single thoracic fascial plane block with a point of injection closer to the effector site. In a nod to transversus abdominus plane block, the original inspiration for PECS blocks, we propose naming this modified block, the serratus anterior plane block.

scholarly journals Pain in mesothelioma: feasibility study of percutaneous image-guided radiofrequency ablation of chest wall lesions

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
M. Belletti ◽  
S. Barbero ◽  
S. Crivellari ◽  
G. Gallizzi ◽  
A. Roveta ◽  
...  
Keyword(s):  
Chest Pain ◽  
Chest Wall ◽  
Tumor Invasion ◽  
Asbestos Exposure ◽  
Disease Onset ◽  
Pleural Mesothelioma ◽  
Tumor Infiltration ◽  
Nerve Roots ◽  
Image Guided ◽  
Intercostal Nerves

Malignant pleural mesothelioma (MPM) is a rare tumor that originates in the lung pleura; it commonly results from previous asbestos exposure that occurred between 20 and 50 years prior to disease onset, and its incidence is increasing worldwide. Symptoms commonly related to MPM include chest pain. The causes of the pain are multifactorial: it may be due to tumor infiltration of the ribs of the nerve roots, intercostal nerves, chest wall, or, in some cases, from tumor invasion of the neurovascular bundle. Treatment of chest pain makes use of medical therapy, surgical and radiotherapy approaches.

scholarly journals Utility of Intercostal Nerve Conventional Thermal Radiofrequency Ablations in the Injured Worker after Blunt Trauma

2012 ◽  
Vol 5;15 (5;9) ◽  
pp. E711-E718 ◽  
Author(s):  
Andrew J. Engel
Keyword(s):  
Case Report ◽  
Pain Relief ◽  
Blunt Trauma ◽  
Chest Wall ◽  
Intercostal Nerve ◽  
Chest Wall Trauma ◽  
Intercostal Neuralgia ◽  
Intercostal Nerves

Background: Intercostal nerve blocks offer short-term therapeutic relief and serve as a diagnostic test for intercostal neuralgia. This original case report demonstrates the efficacy of radiofrequency ablations for long-term pain relief of intercostal neuralgia. To date, there have been no studies that demonstrate the efficacy of thermal conventional intercostal nerve radiofrequency ablations for intercostal neuralgia. Objective: Describe the use of conventional thermal radiofrequency ablations of the intercostal nerves to treat blunt chest wall trauma. Study Design: Case report. Setting: Clinical practice. Methods: Six patients suffering from work-related injuries to the chest wall whose treatment focused on conventional thermal radiofrequency ablations of the intercostal nerves. Results: Four of the 6 patients were pain free by their final visit. The remaining 2 patients experienced pain relief until one began wearing a brace after an L5-S1 fusion; the other required repeat treatment after 5.5 months. Limitations: Case series. There was limited follow-up as patients were either discharged after receiving potentially curative care or were lost to follow-up. Conclusions: Following conventional thermal radiofrequency ablations of the intercostal nerves, 5 of the 6 patients experienced either long-term pain relief or required no additional care. The treatment has potential efficacy for injuries, including rib fractures or intercostal neuralgia, stemming from blunt trauma to the chest wall. In addition, there may be a potential for this treatment to help patients suffering from postthoracotomy pain. Key Words: Radiofrequency ablation, intercostal neuralgia, rib fracture, blunt trauma, workers’ compensation.

scholarly journals ACUTE PANCREATITIS AS AN INITIAL SYNDROME OF ZOSTER

2019 ◽  
pp. 112-115
Author(s):  
I. D. Duzhyi ◽  
A. Ya. Navras ◽  
A. V. Yurchenko ◽  
Yu. Yu. Shevchenko ◽  
I. A. Hnatenko
Keyword(s):  
Infectious Disease ◽  
Acute Pancreatitis ◽  
Abdominal Wall ◽  
Chest Wall ◽  
Pleural Cavity ◽  
Clinical Signs ◽  
Underlying Disease ◽  
Internal Organs ◽  
Intercostal Nerves

Summary. Zoster is referred to as an infectious disease that, affecting the nerve ganglia, can manifest itself in a different clinic, depending on the nerves involved in the process. Since, in addition to the chest wall and pleural cavity, the lower intercostal nerves innervate the abdominal wall, peritoneum and give branches to the internal organs, the disease may manifest itself with clinical signs of diseases of the chest or abdominal cavities. The authors share the observation of zoster, which manifested signs of acute pancreatitis, and only after 7 days did the symptoms of the underlying disease — zoster appear.

Vascular changes in the chest wall after unilateral resection of the intercostal nerves in the growing rabbit

1990 ◽  
Vol 8 (2) ◽  
pp. 283-290 ◽  
Author(s):  
M. Agadir ◽  
B. Sevastik ◽  
F. P. Reinholt ◽  
L. Perbeck ◽  
J. Sevastik
Keyword(s):  
Chest Wall ◽  
Vascular Changes ◽  
Intercostal Nerves

Rating Spinal Nerve Extremity Impairment Using the Sixth Edition

2009 ◽  
Vol 14 (4) ◽  
pp. 1-6
Author(s):  
Christopher R. Brigham
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Nerve Injuries ◽  
Sixth Edition ◽  
Federal Employee ◽  
Nerve Root Injury ◽  
Root Injury ◽  
Rating Process

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, does not provide a separate mechanism for rating spinal nerve injuries as extremity impairment; radiculopathy was reflected in the spinal rating process in Chapter 17, The Spine and Pelvis. Certain jurisdictions, such as the Federal Employee Compensation Act (FECA), rate nerve root injury as impairment involving the extremities rather than as part of the spine. This article presents an approach to rate spinal nerve impairments consistent with the AMA Guides, Sixth Edition, methodology. This approach should be used only when a jurisdiction requires ratings for extremities and precludes rating for the spine. A table in this article compares sensory and motor deficits according to the AMA Guides, Sixth and Fifth Editions; evaluators should be aware of changes between editions in methodology used to assign the final impairment. The authors present two tables regarding spinal nerve impairment: one for the upper extremities and one for the lower extremities. Both tables were developed using the methodology defined in the sixth edition. Using these tables and the process defined in the AMA Guides, Sixth Edition, evaluators can rate spinal nerve impairments for jurisdictions that do not permit rating for the spine and require rating for radiculopathy as an extremity impairment.

Questions and Answers

2000 ◽  
Vol 5 (2) ◽  
pp. 3-3
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Spinal Nerve ◽  
Sensory Loss ◽  
Residual Symptoms ◽  
Additional Information ◽  
Questions And Answers ◽  
Motor Nerves ◽  
Symptoms And Signs ◽  
Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

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