Evaluation of High-Volume Injections Using a Modified Dorsal Quadratus Lumborum Block Approach in Canine Cadavers

The quadratus lumborum (QL) block targets the fascial plane surrounding the QL muscle providing abdominal somatic and visceral analgesia. The extension of its analgesic effects is a subject of research, as it could not cover areas of the cranial abdomen in dogs. This study assesses in eight thawed canine cadavers, the distribution of high-volume injections (0.6 mL kg−1 of a mixture of methylene blue and iopromide) injected between the psoas minor muscle and the vertebral body of L1. Anatomical features of the area of interest were studied in two cadavers. In another six dogs, QL blocks were performed bilaterally under ultrasound-guidance. The distribution of contrast was evaluated by computed tomography (CT). Hypaxial abdominal muscles were dissected to visualize the dye spread (spinal nerves and sympathetic trunk) in 5 cadavers. The remaining cadaver was refrozen and cross-sectioned. CT studies showed a maximum distribution of contrast from T10 to L7. The methylene blue stained T13 (10%), L1 (100%), L2 (100%), L3 (100%), L4 (60%) and the sympathetic trunk T10 (10%), T11 (20%), T12 (30%), T13 (70%), L1 (80%), L2 (80%), L3 (60%) and L4 (30%). These findings may suggest that despite the high volume of injectate administered, this modified QL block could not produce somatic analgesia of the cranial abdomen, although it could provide visceral analgesia in dogs.

A study of psoas minor muscle morphology

Psoas minor is long, slender skeletal muscle it lies anterior to psoas major. It is an inconstant muscle. It was absent in 40-70% of subjects. To determine the frequency and morphometry of psoas minor muscle.: 20 cadavers were dissected during routine dissection for undergraduate students at Ayaan institute of medical sciences, Moinabad, Hyderabad and Government medical college, Mahabubnagar. Bilateral variations were observed in one specimen, unilateral variations were observed in two specimens.: Out of forty specimens Psoas minor was present in three specimens. In one specimen bilateral variations observed, other two specimens unilateral. If it is present, clinical importance to radiologists, surgeons and physiotherapists as it can mimic certain abdominal emergencies.

Nerve Transfers to Recover External Rotation of the Shoulder after Brachial Plexus Injuries in Adults

Restoration of external rotation of the shoulder in adults with partial brachial plexus palsies is challenging. While nerve grafts are possible, nerve transfers are currently the most use method for satisfactory restoration of function. Numerous nerve transfers have been described, although the transfer of the spinal accessory nerve to the suprascapular nerve remains the gold standard. The suprascapular nerve and the nerve to the teres minor muscle are the two preferred targets to restore external rotation of the shoulder. There are numerous nerve donors, but their use obviously depends on the initial injury. The most common donors are the spinal accessory nerve, the rhomboid nerve, branches of the radial nerve, the C7 root fascicle or the ulnar nerve. The choice for the transfer depends on the available nerves and first of all on chosen approach, whether it be cervical or scapular. It also depends on the other associated reconstruction procedures, grafts, or nerve transfers for the recovery of other functions, specifically, elevation of the shoulder and flexion of the elbow. The objective of this chapter is to present the main nerve transfers and to propose a therapeutic strategy.

Giant Lipoma of The Breast: Special Clinical Finding

Lipomas are the most common benign tumors of mesenchymal origin.Lipoma of breast is somewhat difficult to diagnose clinically because of fattyconsistency of breast. Giant lipoma is the mass of lipoma that exceeds atleast 10 cm in one dimension or weighs a minimum of 1000 gr.Only veryfew case reports giant lipoma of the breast available in literature becauserarity in size and location. Due to the fatty composition of the breast,difficulties in diagnosis, threatment, and reconstruction are oftenencountered.Presently, we have reported a case of this rare entity in 49years old female with giant tumor of the left breast that most of its mass,causing breast asymmetry and feel heavy. The operative finding: looks likelipoma between pectoralis major muscle and pectoralis minor muscle witha diameter of 31 cm and weighs 3.1 kg. After excision the tumor we need tomammoplasty.Pathology anatomy examination showed a lipoma.