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Radial Nerve (radial + nerve)

Distribution by Scientific Domains

Medical Sciences	50%
Life Sciences	50%

Selected Abstracts

Single stimulation of the posterior cord is superior to dual nerve stimulation in a coracoid block

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010
J. RODRÍGUEZ
Background: Both multiple injection and single posterior cord injection techniques are associated with extensive anesthesia of the upper limb after an infraclavicular coracoid block (ICB). The main objective of this study was to directly compare the efficacy of both techniques in terms of the rates of completely anesthetizing cutaneous nerves below the elbow. Methods: Seventy patients undergoing surgery at or below the elbow were randomly assigned to receive an ICB after the elicitation of either a single radial nerve-type response (Radial group) or of two different main nerve-type responses of the upper limb, except for the radial nerve (Dual group). Forty milliliters of 1.5% mepivacaine was given in a single or a dual dose, according to group assignment. The sensory block was assessed in each of the cutaneous nerves at 10, 20 and 30 min. Block performance times and the rates of complete anesthesia below the elbow were also noted. Results: Higher rates of sensory block of the radial nerve were found in the Radial group at 10, 20 and 30 min (P<0.05). The rates of sensory block of the ulnar nerve at 30 min were 97% and 75% in the Radial and in the Dual groups, respectively (P<0.05). The rate of complete anesthesia below the elbow was also higher in the Radial group at 30 min (P<0.05). Conclusions: Injection of a local anesthetic after a single stimulation of the radial nerve fibers produced more extensive anesthesia than using a dual stimulation technique under the conditions of our study. [source]

Incidence and morphology of the brachioradialis accessorius muscle

JOURNAL OF ANATOMY, Issue 3 2001
M. RODRÍGUEZ-NIEDENFÜHR
A separate supernumerary muscle in the lateral cubital fossa originating from the humerus or brachioradialis and inserting into the radius, pronator teres or supinator muscle has been considered as a variation of the brachioradialis muscle (Dawson, 1822; Meckel, 1823; Lauth, 1830; Halbertsma, 1864; Gruber, 1868b; Testut, 1884; LeDouble, 1897; Spinner & Spinner, 1996). However, a similar description was used to report additional heads of the brachialis or biceps brachii muscles (Gruber, 1848; Wood, 1864, 1868; Macalister, 1864,66, 1966,69, 1875; Gruber, 1868a; Wolff-Heidegger, 1937). The innervation of these variant muscles would be a good tool to assign each variation to its associated muscle. Consequently, innervation by the radial nerve would indicate that it is a derivative of the humero,radialis group of muscles, while innervation by the musculocutaneous nerve would support it as a derivative of the anterior musculature of the arm (Rolleston, 1887; Lewis, 1989). However, no references to the innervation were found in the available literature. Therefore this study set out to establish the phylogenetic origin of the brachioradialis accessorius muscle and, with the help of its innervation, to determine its incidence and unreported detailed morphology. [source]

Anatomy and quantitation of the subscapular nerves

CLINICAL ANATOMY, Issue 6 2007
R. Shane Tubbs
Abstract Information regarding branches of the brachial plexus can be of utility to the surgeon for neurotization procedures following injury. Sixty-two adult cadaveric upper extremities were dissected and the subscapular nerves identified and measured. The upper subscapular nerve originated from the posterior cord in 97% of the cases and in 3% of the cases directly from the axillary nerve. The upper subscapular nerve originated as a single nerve in 90.3% of the cases, as two independent nerve trunks in 8% of the cases and as three independent nerve trunks in 1.6% of the cases. The thoracodorsal nerve originated from the posterior cord in 98.5% of the cases and in 1.5% of the cases directly from the proximal segment of the radial nerve. The thoracodorsal nerve always originated as a single nerve from the brachial plexus. The lower subscapular nerve originated from the posterior cord in 79% of the cases and in 21% of the cases directly from the proximal segment of the axillary nerve. The lower subscapular nerve originated as a single nerve in 93.6% of the cases and as two independent nerve trunks in 6.4% of the cases. The mean length of the lower subscapular nerve from its origin until it provided its branch into the subscapularis muscle was 3.5 cm and the mean distance from this branch until its termination into the teres major muscle was 6 cm. The mean diameter of this nerve was 1.9 mm. The mean length of the upper subscapular nerve from its origin to its termination into the subscapularis muscle was 5cm and the mean diameter of the nerve was 2.3 mm. The mean length of the thoracodorsal nerve from its origin to its termination into the latissimus dorsi muscle was 13.7 cm. The mean diameter of this nerve was 2.6 mm. Our hopes are that these data will prove useful to the surgeon in surgical planning for potential neurotization procedures of the brachial plexus. Clin. Anat. 20:656,659, 2007. © 2007 Wiley-Liss, Inc. [source]

Nerve supply of the brachioradialis muscle: Surgically relevant variations of the extramuscular branches of the radial nerve

CLINICAL ANATOMY, Issue 7 2005
Maria D. Latev
Abstract The brachioradialis muscle is utilized in tendon-transfer operations, carried out for a variety of purposes. The extramuscular branches of the radial nerve to the brachioradialis were dissected and studied in 43 embalmed cadaveric specimens. The number of primary and secondary branches and the spatial locations of their origins and muscle-entry points was determined for each specimen. All distances were measured relative to the lateral epicondyle. A wide anatomic variation was observed in both the nerve branching pattern as well as the number and locations of muscle-entry points. A single primary nerve branch was found in 20 specimens, or 46.5% of the cases. On an average, single primary nerve branches arose from the radial nerve 30 mm proximal to the lateral epicondyle. In 16 of these cases, the primary branch splits into two to four secondary branches, and in four cases there was only one branch entering the muscle. Seventeen specimens had two primary branches whose origin points were separated by 5 to 40 mm with an average of 15 mm. In seven of these seventeen cases one or both of the primary branches split into secondary branches. Six specimens had three primary branches; the origin points of the most proximal and the most distal branch were separated by up to 30 mm with an average of 13 mm. Excluding the four cases with extensive fanning into multiple thin branches, the number of muscle-entry points ranged from 1 to 4 (mean 2.7). The locations of the muscle-entry points for all specimens were widespread ranging from 50 mm proximal and 40 mm distal to the lateral epicondyle with an average at 6 mm proximal to the lateral epicondyle. The greatest distance between muscle-entry points was 50 mm in a single specimen. In surgical procedures involving dissection of the brachioradialis muscle more proximal than 50 mm distal to the elbow, the extramuscular branch(es) of the radial nerve branches to the brachioradialis may be at risk. Clin. Anat. 18:488,492, 2005. © 2005 Wiley-Liss, Inc. [source]

Single vs. double stimulation during a lateral sagittal infraclavicular block

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2009
E. AKY
Background: The objective of this study was to evaluate the influence of single vs. dual control during an ultrasound-guided lateral sagittal infraclavicular block on the efficacy of sensory block and the time of block onset. Methods: In a prospective manner, 60 adult patients scheduled for distal upper limb surgery were randomly allocated to single (Group S) or double stimulation (Group D) groups. A local anesthetic (LA) mixture of 20 ml of levobupivacaine 5 mg/ml and 20 ml of lidocaine 20 mg/ml with 5 ,g/ml epinephrine (total 40 ml) was administered in both groups. In the Group S following a median, an ulnar or a radial nerve response, the entire LA was administered at a single site. In Group D 10 ml of LA was administered following the electrolocation of the musculocutaneous nerve and 30 ml LA was injected following median, ulnar or radial nerves. A successful block was defined as analgesia or anesthesia of all five nerves distal to the elbow. Sensory and motor blocks were tested at 5-min intervals for 30 min. Results: The block was successful in 27 patients in Group S and 28 patients in Group D. The time from starting the block until satisfactory anesthesia was significantly shorter in Group D than in Group S (19.3 vs. 23.2 min) (P<0.05). Total sensory scores were significantly higher in the double stimulation group at 20 and 30 min after the block performance (P<0.05). Conclusions: Although the block performance time was longer in the double stimulation group, block onset time and extent of anesthesia were more favorable in the double stimulation group. [source]

Endoscopic Versus Conventional Radial Artery Harvest,Is Smaller Better?

JOURNAL OF CARDIAC SURGERY, Issue 4 2006
Oz M. Shapira M.D.
Methods: Data were prospectively collected on 108 consecutive patients undergoing isolated CABG with ERH, and compared to 120 patients having conventional harvest (CH). Follow-up was achieved in 227 patients (99%). At the time of follow-up the severity of motor and sensory symptoms, as well as cosmetic result in the harvest forearm, were subjectively graded using a 5-point scale. Grade 1,high intensity deficits, poor cosmetic result. Grade 5,no deficits, excellent cosmetic result. Results: Hospital mortality, myocardial infarction, and stroke rates were similar between the groups. Follow-up mortality, reintervention rate, and average angina class were also similar. Harvest time was longer in the ERH group (61 ± 24 min vs. 45 ± 11 min, p < 0.001). Three patients in the ERH group were converted to CH and one radial artery was discarded. There were no vascular complications of the hand in either group. Average score of motor (ERH 4.4 ± 0.9, CH 4.2 ± 1.0) or sensory symptoms (ERH 3.7 ± 1.1, CH 3.8 ± 1.2) were similar. In the CH group sensory deficits were observed in the distribution of both the lateral antebrachial cutaneous and the superficial radial nerves (SRN). In contrast, sensory deficits in the ERH group were limited to the distribution of the SRN. Cosmetic result score was higher in the ERH group (ERH 4.2 ± 1.0, CH 3.1 ± 1.4, p < 0.0001). Conclusions: ERH is safe. It is technically demanding with a significant learning curve. Motor and sensory symptoms are not completely eliminated by using a smaller incision, but cosmetic results are clearly superior. [source]

Medial dorsal superficial peroneal nerve studies in patients with polyneuropathy and normal sural responses

MUSCLE AND NERVE, Issue 3 2005
Mark Kushnir MD
Abstract We studied medial dorsal superficial peroneal (MDSP) nerves in 52 patients with clinical evidence of mild chronic sensorimotor polyneuropathy and normal sural nerve responses, in order to assess the diagnostic sensitivity and usefulness of MDSP nerve testing in electrodiagnostic practice. To determine the effect of age on MDSP nerve parameters, 98 normal subjects were also examined. Electrodiagnostic evaluation involved studies of motor nerve conduction in tibial, peroneal, and median nerves; sensory nerve conduction in sural, MDSP, median, and radial nerves; tibial and peroneal nerve F waves; H reflexes from the soleus muscles; and needle electromyography of gastrocnemius and abductor hallucis muscles. Among the patients, 49% had low-amplitude sensory responses in MDSP nerves and 57% had either slowing of sensory conduction velocity or no sensory responses on proximal stimulation. MDSP nerve amplitude, tibial nerve motor velocity, and H reflexes were the most sensitive for detection of mild chronic symmetrical axonal sensorimotor polyneuropathy. MDSP nerve testing should be included in the routine electrodiagnostic evaluation of patients with suspected polyneuropathy and normal sural nerve responses. Muscle Nerve, 2005 [source]