What about Brachial Plexuses

Wikipedia gives a great explanation to what Brachial Plexuses is check it out at http://en.wikipedia.org/wiki/Brachial_plexus

Now Brachial Plexus can be in simple terms be called SHOULDER PAIN... I know I know doctors and the medical industry like to give fancy names to medical conditions so they can charge more on your medical bill seriously LOL

More on Brachial Plexus over the next coming days as I am about to really update this blog ... thanks for your patience guys

brachial plexus block and surgery

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brachial plexus block and surgery

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Brachial Plexus Stretch Test

gcatep | February 01, 2011 | 0 likes, 0 dislikes New Project 6

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Contralateral C7 Transfer Video 2

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brachial plexus block and surgery

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brachial plexus block and surgery

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brachial plexus block and surgery

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Radial nerve palsy rehabilitation using HandTutor system

MediTouch Ltd. manufactures innovative rehabilitation systems that consist of...

MediTouch Ltd. manufactures innovative rehabilitation systems that consist of wearable motion capture devices and dedicated rehabilitation software. For hand and arm rehabilitation, the company offers the HandTutor™ an ergonomic glove and the ArmTutor™, an ergonomic elbow brace and shoulder 3D position system. For leg rehabilitation the company offers the LegTutor™ an ergonomic knee brace and hip 3D position system. Together with dedicated rehabilitation software MediTouch rehabilitation systems allow patients with upper and or lower extremity movement dysfunction to practice intensive virtual functional task training of single and multi joints. In this way our systems implement impairment oriented training (IOT) with augmented motion feedback to give a tailored arm or leg exercise rehabilitation program that allows the patient to achieve better functional recovery.
It is widely accepted that a combination of impairment oriented training with task specific training is essential for enhancing functional recovery. MediTouch provides dedicated rehabilitation systems for upper and lower extremity limb based on impairment oriented evaluation and training. The HandTutor is an ergonomic glove with dedicated windows based rehabilitation software that allows a therapist to evaluate kinematics hand movement parameters (range of motion (ROM), speed and accuracy of movement). The interactive program is customized to the patient's motor sensory and cognitive ability and allows for documented tele-rehabilitation with sessions being conducted over the internet. The HandTutor system provides objective and quantitative kinematic finger and writs movement measurements and customization of exercise tasks to the patients' condition. All the data is documented and saved to the patients electronic file within the system. The system is used for hand rehabilitation by physical and occupational therapy in hospital and community rehabilitation centers as well as through tele-rehabilitation with the patient in their own home. HandTutor is indicated for hand rehabilitation following neurological and orthopedic injuries such as Stroke, Spinal Cord Injury, Traumatic Brain Injury, Cerebral Palsy, Hand Surgery, Brachial Plexus Injuries, Radial and Ulnar nerve injuries, Complex Regional Pain Syndrome (CRPS), Development Co-ordination Syndrome, ADD, and ADHD. The system is safe and reliable, affordable, user friendly, FDA and CE certified.
www.meditouch.co.il

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shiatsu chair massage: with thai techniques included

This customer is receiving a sports massage on her levator scapula and brachi...

This customer is receiving a sports massage on her levator scapula and brachial plexus due to tightness.
Sports stretching is also included

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brachial plexus block and surgery(ORIF)

MrPada420 | January 29, 2011 | 0 likes, 0 dislikes Patient with multiple fractures of humerus radius and ulna. Patient was opera...

MrPada420 | January 29, 2011 | 0 likes, 0 dislikes Patient with multiple fractures of humerus radius and ulna. Patient was operated(ORIF) humerus month ago under regional anesthesia (bp block sup.clavicle approach) now in this video he was operated (ORIF)ulna and ulna under bp block(mixed inter scalene and supra clavicle approach) .----anesthetic given bupivaquine0.5% 30ml for basic block and 2.5 ml and 5 ml bupivacaine0.25% for patchy block for ulnar and musculocutaneus nerve respectively. 10 mg nalbupine i/v given at the start of bone mnipulation .block was performed without any sedation and anesthesia. parasthesia was achieved after 10 min. Full dense bp block (moter and sensory) achieved in 30 min. monitored used Pao2 ,pulse ,manual bp

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הנדטיוטר (HandTutor ) לשיקום יד לאחר פגיעה בעצב הרדיאלי

????? HandTutor™ ???? ????? ?????? ?????? ?????? ??? ??? ?????? ????????. ???...

????? HandTutor™ ???? ????? ?????? ?????? ?????? ??? ??? ?????? ????????. ?????? ????? ???? ????????? ?????? ??????? ??????. ?????? ?????? ????? ?????? ?? ????? ??? ?????? ??????? ?????? ???????? ?????? ???????? ?????? ??????. ?????? ???????? ?????? ?? ??????? ??????? ????????? ????? ????? ?????? ???????? ?? ?????? ?????? ??????. ?????? ?????? ????? ?????? ???? ???? ?????? ?????? ?????, ????? ?????? ???? ??????????, ?????? ????????? ????? ??????? ?????? ????? ?????. ?????? ????? ?????? ???? ???? ???? ???? ?"? ???? ?????? ????? ?????? ??????? ??????? ?????? ?"?FDA ,CE ????? ??????? ???????.
?????????? ????????

1.??? ????
2.????? ???
3.Brachial Plexus Injuries
4. ???? ?????
5.????????
6.?????? CRPS
7.????? ???? ?????? ?? ??? ???? ????? ?????
8.????? ????? ???? ????? CP))
9.????? ?? ?????? ????????? ????? (DCD)
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www.meditouch.co.il

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Noncatastrophic Cervical Spine Injuries

Please call + (65) 6471 2694 (round) for urgent matters
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Jadon's Journey: Preparations

There are just four weeks until we leave for Philadelphia Jadon's shoulder/late surgery.  I have not really bought a variety of shirts yet.  Just does not seem to decide which size will fit best.  A friend of mine has given me a box of 4T shirts to use during this time.  Originally thought that I will need to change shirts to get them to fit over the votes but I read that a mother, I could just stretch shirts that was about 3-4 sizes larger than the child usually wore over color casts.  I hope it works!  It would be nice to be able to use these clothes later when Jadon is actually this size.

Another thing we understand we will need before we provide is a new car seat.  I do not think it currently used will work because the pages curve in toward Jadon.  With his arm in a cast out this his page, we need a site that allows.  We are going to go check out car seats next weekend hopefully!

Grandmother Cindy will travel with us on your next trip.  She remarked that she would go, and more that Matt and I thought the more we liked the idea of having a few more hands to help us.  Especially after surgery.

Before we even go for the surgery, we have another great event.  Jadon turns two this month!  I do not know when the time comes.  He is growing so fast!  We look forward to this birthday party and hope he can really have fun on this.  Last year, he had one of their pain episodes right before the party started and was either asleep or miserable for the rest of the party.  A few months later, we finally figure out what is causing the 4-6 hour pain episodes ..... double inguinal bråcks!!  Poor old Cutie!!

Jadon has done really well in therapy.  His right Benik splint finally arrived and it really helps him with his hand function.  His therapist, it also creates a new splint on his elbow.  We would like to see more elbow extension and this splint placed in that position and gives him a few more functions while he wears it.  Therapist is very satisfied with the results she sees so far.

Here are some pictures from one of Jadons most recent therapy sessions where he had to use Righty to play Lucky ducks!

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Different learning curves for Axillary <b>Brachial Plexus</b> Block <b>...</b>

Little is known about learning the skills needed to perform ultrasonic or nerve stimulator-guided peripheral nerve block. The aim of this study was to compare learning curves of people trained in ultrasound guidance versus residents are trained in nerve stimulation for Brachial plexus block axillary. Ten people with no previous experience with ultrasonic received ultrasonic training and another ten people with no previous experience with nerve stimulation was nervous stimulation education. Beginner learning curves were generated by retrospective data analysis of our electronic anesthesia database. Individual achievement awards was the pool and institutional learning curve was calculated by taking a bootstrapping technology in combination with a procedure to Monte Carlo simulation. The skills required to carry out successful ultrasound-guided Brachial plexus block axillary can more quickly learn and lead to a higher final success compared to nerve stimulator-guided Brachial plexus block axillary.

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Radiation Induced-Brachial Plexopathy and lymphedema «Lymphedema Blog

By Joachim Zuther, on the 28th January 2011

Today I would like to deal with the important and often neglected issue of radiation induced brachial plexopathy (RIBP), and how it relates to Lymphedema. This first part covers the causes and symptoms of this condition, the next blog post will discuss the treatment of RIBP with special reference to the existence Lymphedema of.

Radiation-Induced Brachial Plexopathy caused by radiation damage to Brachial plexus, a bundle of nerves near the neck and shoulder. Brachial plexus nerves that make up has its origins in the spinal cord in the neck and is responsible for sensory and muscular innervation of the entire upper extremity.

The positive effects of radiation therapy in breast cancer and other malignant diseases are well known and documented. This life-saving therapy, however, potentially adverse effects on a number of organ systems, which are exposed to the rays during treatment – such as skin, nerves, and internal organs.

In breast cancer administered radiation therapy to the breast, axillary, or neck. Radiation damage to this network of nerves can lead

Brachial Plexus

sensory or motor impairments, with or without accompanying pain in Brachial plexus distribution in the arm. Symptoms may include Paresthesia (numbness, tingling, pricking), dysesthesia (abnormal sense of touch, as burning, itching, sensation of an electric current, "pins and needles", pain), decreased sensitivity, partial loss of mobility (muscle weakness and difficulty to perform simple tasks like opening pots or containers, objects), complete arm paralysis, muscular atrophy, dexterity and partial dislocation of the shoulder joint.

The exact mechanism of RIBP is not yet fully understood. Research shows that the damage to Brachial plexus results from a combination of direct nerve cell damage from ionizing radiation and more progressive damage through the development of scar tissue (fibrosis radiation) and peripheral nerves, combined with damage to nearby vessels supplying these nerves with oxygen and nutrients. Radiation of nervous tissue causing nerve cells to shrink, which resulted in a decrease of elasticity in nerve fibers, which further exacerbates the situation. The extent of the damage associated with the radiation dose and technology and the simultaneous use of chemotherapy.

The progressive damage to vessels and the development of scar tissue continues to evolve significantly in some, and gradually in other patients [3] after the initial radiation therapy, which explains why some patients develop RIBP symptoms many years after radiation treatment. Most patients develop symptoms within the first three years. average interval between the last dose of radiation and the emergence of RIBP symptoms reported in the literature vary much (range between six months and 20 years [1, 2]). Prevalence of RIBP is reported to be between 1.8% and 4.9% [1]; RIBP is more common after radiation in combination with chemotherapy and nervous tissue of younger patients seems to be more vulnerable [4].

Relationship between RIBP and lymphedema

Persons who have had surgery and radiation for breast cancer and do not constitute even after mastectomy/lumpectomy-Lymphedema is considered in a latency stage and always runs the risk of developing lymphedema. Any additional stress to the lymphatic system, such as trauma, loss of mobility or pain may cause the appearance of the upper extremity lymphedema.

The presence of RIBP, especially in the case of wholly or partly of mobility is one of those triggering factors. Lymph tissue fluid to return from the upper extremity depends in part on the pumping action muscles exert on the outside of the lymph vessels. Stillness of these muscles in pain, paralysis, in whole or in part, has a harmful effect to the return of lymph tissue and causes the lymph fluid to stagnate in the end. In combination with the negative effects of gravity, it may trigger the emergence of lymphedema.

The people who have already RIBP and develop Lymphedema may experience an increase in pain and swelling at the partial or total loss of motor function.

Stay tuned for the next blog post that covers the treatment of RIBP with special reference to the existence Lymphedema of.Tweet

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Muscles and <b>Plexus Brachialis muscle</b>-Lab Exam 1

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Surgical <b>Brachial plexus</b> injury ...

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Surgical procedure for brachial plexus injury... Home The Physio Shop The Physio Directory Physiotherapy Jobs Physiotherapy Courses Physiotherapy PI Insurance Welcome to the Online Physio Forum. Login: Remember Me? Home Forum Today's Posts FAQ Calendar Community Groups Forum Actions Mark Forums Read Quick Links View Site Leaders Blogs Physio Links What's New? Advanced Search Forum Physiotherapy Discussion Areas, News and General Interest Neuro Physiotherapy Surgical procedure for brachial plexus injury... + Reply to Thread Results 1 to 2 of 2 Thread: Surgical procedure for brachial plexus injury... LinkBack LinkBack URL About LinkBacks   Bookmark & Share Digg this Thread!Add Thread to del.icio.usBookmark in TechnoratiTweet this Thread! Thread Tools Show Printable Version Email this Page… Subscribe to this Thread… Search Thread   Advanced Search Display Linear Mode Switch to Hybrid Mode Switch to Threaded Mode 27-01-2011 10:15 AM #1 aishah Forum Member Join Date Jan 2011 Location malaysia Age 19 Posts 1 Rep Power 0 Surgical procedure for brachial plexus injury...

anyone know about surgical procedure for brachial plexus injury?? i need it for my assignment..thank you.

Reply With Quote 28-01-2011 03:15 AM #2 Jerram Forum Member Join Date Oct 2009 Location Ohio, USA Posts 5 Rep Power 0 Re: Surgical procedure for brachial plexus injury...

I can't say I know much about it...but I do know a therapist that worked a the Mayo clinic and I know they specialized in this type of surgery. Here is a link to their website with some basic info on brachial plexus injury and surgical options. There are some
specific references on the site that you could look into as well
for more journal based information....


Brachial plexus injury - MayoClinic.com

good luck...

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Pesquisa Veterinária Brasileira-Anatomy <b>Brachial plexus</b> <b>...</b>

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MORFOFISIOLOGIA

Anatomia do plexo braquial de macaco-barrigudo (Lagothrix lagothricha)

Anatomy of the brachial plexus of the Woolly-Monkey (Lagothrix lagothricha.)

Gessica Ariane M. CruzI; Marta AdamiII

ICurso de Medicina Veterinária, Escola de Medicina Veterinária, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil. E-mail: aririvet@gmail.com
IIDepartamento de Anatomia dos Animais Domésticos, Escola de Medicina Veterinária, UFBA, Avenida Adhemar de Barros 500, Campus Universitário de Ondina, Salvador, BA 40170-110. E-mail: madami@ufba.br

ABSTRACT

The woolly-monkey (Lagothrix lagothricha) is an antropoid belonging to the Atelidae Family which includes the largest neotropical primates. A female cadaver woolly-monkey was fixed in a 10% formaldehyde solution and dissected using a stereoscopic magnifying glass and photodocumented. The brachial plexus originated from the spinal nerves C5 to C8 and T1, forming the cranial, medium, and caudal stems, from which derived the peripheral nerves; those nerves had similar origin and innervation area when compared to plexuses from other primates, with the exception of the musculocutaneous nerve that crossed the coracobraquial muscle. Data from studies with brachial plexus from primates allow the access to valuable information regarding the morphology of those animals, and could also assist in the establishment of anatomical parameters among species, which could then contribute to anesthetic procedures and injury treatments.

INDEX TERMS: Nervous plexus, nervous system, Lagothrix lagothricha.

RESUMO

O macaco-barrigudo (Lagothrix lagothricha) é um antropóide pertencente à Família Atelidae que possui os maiores primatas neotropicais. Um cadáver fêmea de macaco-barrigudo foi fixado com solução de formaldeído a 10%, posteriormente dissecado com o auxílio de lupa estereoscópica e fotodocumentado. O plexo braquial originou-se dos nervos espinhais C5 a C8 e T1, formando os troncos cranial, médio e caudal, dos quais derivaram os nervos periféricos que se assemelharam na origem e no território de inervação com os plexos de outros primatas, com exceção do nervo musculocutâneo que atravessou o músculo coracobraquial. Pesquisas sobre o plexo braquial de primatas fornecem dados que disponibilizam o acesso a informações valiosas sobre a morfologia destes animais e auxiliam no estabelecimento de parâmetros anatômicos entre as espécies, contribuindo também no tratamento de injúrias e procedimentos anestésicos.

TERMOS DE INDEXAÇÃO: Plexo braquial, sistema nervoso, Lagothrix lagothricha.

Introdução

O macaco-barrigudo (Lagothrix lagothricha Humboldt, 1812) encontra-se distribuído desde o Brasil até a Colômbia (Napier & Napier 1967, Chiarelli 1972, Hill 1972, Auricchio 1995, Reis et al. 2006). Vivem em grupos com indivíduos do mesmo gênero ou associados a outros primatas em florestas primárias com até 3.000m de altitude, possuem habilidade de semibraquiação relacionada com sua dieta basicamente frugívora (Napier & Napier 1967, Auricchio 1995, Reis et al. 2006). Atualmente sua situação é de "baixo risco" pela IUCN (International Union for Conservation of Nature and Natural Resources), porém até 1994 seu estado era vulnerável (Rylands 2007).

O plexo braquial de primatas tem sido amplamente estudado em espécies de Macaca em analogia com o plexo braquial do homem (Brooks 1883, Sugiyama 1965), em gorila (Gorilla sp.), chimpanzé (Pan sp.), orangotango (Pongo sp.) e gibão (Hylobates sp.) (Hepburn 1892, Oliveira 2003), Gessica Ariane M. Cruz e Marta Adami gálagos (Galago senegalensis senegalensis) (Kanagasuntheram & Mahran 1960), macaco-de-cheiro (Saimiri sciureus) (Mizuno 1969a), macaco-prego-de-cara-branca (Cebus capucinus) (Mizuno 1969b), chimpanzés e micos (Troglotydes niger e Cynocephalus anubis) (Champneys 1975), babuínos (Papio ursinus) (Booth et al. 1997), macaco-prego (Cebus apella) (Ribeiro 2002).

Dados sobre as características morfológicas de macaco-barrigudo ainda são escassos e destacam-se estudos sobre análises funcionais de estruturas relacionadas à postura e locomoção (Ziemer 1978, Johnson & Shapiro 1998, Youlatos 2000). Hill (1972) descreveu sobre o esqueleto, trato digestório e órgão dos sentidos.

Objetivou-se descrever o plexo braquial de Lagothrix lagothricha em sua origem, composição, nervos derivados e território de inervação, ressaltando a importância do conhecimento anatômico como base para o estabelecimento de parâmetros anatômicos entre as espécies e também contribuir no tratamento de injúrias e nos procedimentos anestésicos.

Material e métodos

O macaco-barrigudo (Lagothrix lagothricha) é um primata pertencente à Infraordem Platyrrhini, que abrange os macacos do novo mundo e faz parte da Família Atelidae que possui os maiores primatas neotropicais e Gênero Lagothrix (Napier & Napier 1967, Chiarelli 1972). Um exemplar fêmea que veio a óbito por causas naturais, foi cedido pelo Planeta Zoo, situado no município de Lauro de Freitas, Bahia, para o Departamento de Anatomia dos Animais Domésticos da Escola de Medicina Veterinária, Universidade Federal da Bahia (UFBA). A pesquisa foi autorizada pelo Sistema de Autorização e Informação em Biodiversidade (SISBIO) do Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis (IBAMA) com o nº 17907-1 em 18.11.2008. O animal foi fixado com solução de formaldeído a 10% injetada via artéria carótida comum e posteriormente, os dois antímeros foram dissecados com o auxílio de lupa estereoscópica (PZO-Labimex) e fotodocumentados. A terminologia adotada foi baseada no International Committee on Veterinary Gross Anatomical Nomenclature (2005).

Resultados

O macaco-barrigudo apresentou sete vértebras cervicais, com a emergência do primeiro par de nervos espinhais entre o occipital e o atlas. O plexo braquial originou-se a partir do quinto, sexto, sétimo e oitavo segmentos medulares cervicais e primeiro segmento medular torácico, que corresponderam às vértebras cervicais 5º, 6º, 7º e 8º e à 1a vértebra torácica. Os nervos espinhais C5 a C8 e T1 formaram três troncos: cranial (C5 e C6), médio (C7) e caudal (C8 e T1).

Em ambos os antímeros observou-se a alça axilar formada pela artéria axilar e o nervo mediano. Os troncos cranial e médio originaram sete nervos cada um e o tronco caudal seis. Foram eles: tronco cranial: nervo supraescapular, nervo subescapular, nervo musculocutâneo, nervo mediano, nervo radial, nervo axilar e nervo toracodorsal, sendo dois exclusivos do tronco: nervo supraescapular e nervo musculocutâneo. Tronco médio: nervo subescapular, nervo peitoral, nervo mediano, nervo radial, nervo axilar, nervo torácico longo, nervo toracodorsal e apenas um restrito ao tronco: nervo torácico longo. Tronco caudal: nervo mediano, nervo ulnar, nervo radial, nervo toracodorsal, nervo cutâneo medial do antebraço e dois exclusivos do tronco: nervo ulnar e nervo cutâneo medial do antebraço.

Ramos comunicantes entre os nervos foram observados entre os nervos musculocutâneo e mediano. O NMC emitiu um ramo comunicante para o NM no terço proximal do braço, o que implicou a contribuição do tronco cranial na formação do NM. No terço distal do mesmo segmento o NMC recebeu um ramo comunicante do NM. (Quadro 1, Fig.1 e Fig.2)

Discussão

A origem e formação do plexo do macaco-barrigudo assemelharam-se com grande parte dos primatas já estudados. Brooks (1883) observou em espécies de Macaca a participação do 5º, 6º, 7º e 8º nervos cervicais e o 1º nervo torácico, podendo receber contribuição considerável de C4. Em Lagothrix sp. o plexo braquial é formado pelas divisões dos três últimos nervos cervicais e o primeiro nervo torácico (Hill 1972), difereciando-se da maioria dos primatas que apresenta contribuição, mesmo que pequena, de C4 e/ou T2. Em macaco-de-cheiro (Saimiri sciureus) (Mizuno 1969a) e babuínos (Papio ursinus) foram observadas formações do plexo semelhantes ao macaco-barrigudo, podendo ocorrer contribuição de T2 (Booth et al. 1997). Kawashima et al. (2007) observaram na dissecação do plexo braquial de um orangotango (Pongo sp.) a participação de C5 a T1, podendo ocorrer também de C4.

A formação da alça axilar e a composição dos troncos corresponderam com o encontrado em macaco-prego-da-cara-branca e babuínos (Mizuno 1969b, Booth et al. 1997) enquanto em Macaca, orangotango e gorila, a participação de C4 no tronco cranial e de T2 no tronco caudal (Sugiyama 1965, Koizumi & Sakai 1995), diferiram do observado em macaco-barrigudo.

O tronco cranial formado por C5 e C6 assemelhou-se com o gálago (Galago senegalensis) (Kanagasuntheram & Mahran 1960) e babuíno (Papio ursinus) (Booth et al. 1997), enquanto o tronco médio composto somente por C7, também foi observado em guenon (Cercopithecus) (Hill 1966); macaca (Macacus cyclopsis) (Sugiyama 1965); macaco-de-cheiro (Saimiri scirieus) (Mizuno 1969a); orangotango (Pongo sp.) e gorila (Gorilla sp.) (Koizumi & Sakai 1995).

O tronco caudal assemelhou-se ao de macaca (Macacus cyclopsis) e macaco-prego (Cebus apella), porém nestes animais a presença de T2 na formação do plexo foi frequente (Sugiyama 1965, Ribeiro 2002).

A formação do plexo braquial de Lagothrix lagothricha equivaleu à mesma do macaco-prego-de-cara-branca (Cebus capucinus) (Mizuno 1969b). De acordo com Parada et al. (1989), durante o processo evolutivo a origem do plexo braquial deslocou-se cranialmente, alcançando C4 nos macacos e C3 em humanos. O plexo braquial recebe contribuição principal dos três últimos nervos espinhais cervicais e do primeiro torácico nos animais domésticos. A participação de ramos mais craniais, como C5 e C4, caracteriza um plexo pré-fixado como o observado em macacos do novo mundo e em Lagothrix que tem contribuição de C5 (Sugiyama 1965, Hill 1972).

No macaco-barrigudo a contribuição dos troncos para a formação dos nervos ocorreu em diferentes arranjos. Alguns nervos originaram-se exclusivamente de um tronco: os nervos supraescapular e o musculocutâneo a partir do tronco cranial; o nervo torácico longo do tronco médio e os nervos ulnar e o cutâneo medial do antebraço do tronco caudal. Em babuínos (Papio ursinus) o NSP e o NU também se originaram exclusivamente de um tronco, cranial e caudal, respectivamente, porém o NMC e o NTL não rece
beram contribuições exclusivas na sua formação (Booth et al. 1997). Em macaca (Macacus cyclopsis), o NSP, o NCMA e o NU surgiram de apenas um dos troncos (Sugiyama 1965), da mesma forma que Lagothrix lagothricha, enquanto todos os outros nervos derivados do plexo receberam contribuição de mais de um tronco.

Em chimpanzé (Pan sp.), orangotango (Pongo sp.) (Hepburn 1892), gálago (Galago senegalensis) (Kanagasuntheram & Mahran 1960) e babuíno (Papio ursinus) (Booth et al. 1997), a origem e o território de inervação do nervo supraescapular foram iguais a de Lagothrix lagothricha. Hill (1972) relatou somente a contribuição de C6 em Macaca e, em L. lagothricha, principalmente por C6, podendo ser formado pelo tronco cranial (C5 e C6).

Em babuínos (Papio ursinus) a origem e o número de nervos subescapulares foram iguais aos de Lagothrix lagothricha, porém com inervação restrita ao músculo subescapular (Booth et al. 1997). Em gorila (Hepburn 1892) o número variou de 3 a 5, com território de inervação semelhante ao do macaco-barrigudo.

Os nervos peitorais, em chimpanzé (Pan sp.), orangotango (Pongo sp.), gibão (Hylobates sp.) e gorila (Gorilla sp.), originaram-se dos troncos cranial e médio e seguiram para os músculos peitorais maior e menor (Champneys 1975, Hepburn 1982), diferindo da origem em Lagothrix lagothricha, porém com o mesmo território de inervação. Em babuínos (Papio ursinus) sua origem foi do tronco médio com contribuição do NTL, direcionando-se para os músculos subclávio, peitorais maior e menor (Booth et al. 1997).

A origem do nervo musculocutâneo a partir tronco cranial assemelhou-se ao observado em guenon (Cercopithecus mona)(Hill 1966) e babuíno (Papio ursinus) (Booth et al. 1997). Em relação ao seu trajeto houve variação em relação a alguns primatas, a exemplo, macaco-prego (Cebus apella) (Ribeiro 2002), babuínos (Papio ursinus) (Booth et al. 1997) e orangotango (Pongo sp.) (Kawashima et al. 2007). Todos diferiram de Lagothrix lagothricha que, semelhante ao homem (Chitra 2007) e ao chimpanzé (Pan sp.) (Champneys 1975, Koizumi & Sakai 1995), o nervo musculocutâneo atravessou o músculo coracobraquial. Em gibão (Hylobates sp) o NMC após suprir o coracobraquial emitiu ramos para o bíceps e continuou seu curso no músculo braquial (Hepburn, 1892), corroborando com nossos achados. Em chimpanzé (Pan sp.), gibão (Hylobates sp.), macaco-aranha (Ateles sp), muriqui (Brachyteles) (Hill 1972), e macaco-prego (Cebus apella) (Aversi-Ferreira et al. 2005) os músculos inervados pelo NMC foram o coracobraquial, bíceps braquial e braquial à semelhança do macaco-barrigudo.

O nervo mediano apresentou um ramo comunicante com o NMC em diversas espécies de primatas condizente ao que foi observado em Lagothrix lagothricha no qual este ramo foi responsável pela contribuição do tronco cranial para a formação de nervo e da alça axilar. Em babuínos (Papio ursinus) o NM, o NU e o NCMA apresentaram origem de um tronco comum recebendo fibras de C8, T1 e T2 e o NMC, que se originou de C5, C6 e C7, uniu-se ao NM de maneira que os troncos cranial e médio também contribuíram para a formação deste nervo além do tronco caudal, semelhante ao observado no macaco-barrigudo (Booth et al. 1997).

O nervo ulnar em gálago (Kanagasuntheram & Mahran 1960) apresentou origem e composição iguais às de Lagothrix lagothricha. Em babuínos (Papio ursinus) o NU originou-se de um tronco comum com o NM e o NCMA recebendo fibras de C8, T1 e T2 (Booth et al. 1997). Mizuno (1969) afirmou que, em macaco-prego-de-cara-branca (Cebus capucinus), o NU e o NM não se separaram até se aproximarem da articulação do cotovelo.

O nervo radial originou-se de C6, tronco médio e C8 em gálago (Galago senegalensis) (Kanagasuntheram & Mahran 1960) e em alguns espécimes de macaco-prego (Cebus apella) (Ribeiro 2002), diferente do encontrado em macaco-barrigudo. Em babuínos (Papio ursinus) todos os nervos espinhais do plexo braquial contribuíram diretamente na origem deste nervo (Booth et al. 1997), indo ao encontro do observado neste trabalho. Hill (1966) descreveu em Cercopithecus a inervação do músculo tríceps braquial e em muriqui (Brachyteles) houve a emissão de ramos cutâneos para o músculo deltóide.

O nervo axilar, em alguns primatas, derivou dos troncos cranial e médio e contribuiu para a formação do NR (Hill 1972, Ribeiro 2002). Em chimpanzé (Troglotydes niger), anubis (Cynocephalus anubis) (Champneys 1975) e em babuínos (Papio ursinus) (Booth et al. 1997) houve contribuição dos troncos cranial e médio, com território de inervação semelhante ao do Lagothrix lagothricha.

O nervo torácico longo em gorila (Gorilla sp.), orangotango (Pongo sp.) e chimpanzé (Pan sp.) originou-se do tronco cranial (Hepburn 1892, Champneys 1975), em anubis (Cynocephalus anubis) de C6, tronco médio e, ocasionalmente, C8 (Champneys 1975)e em Cercopithecus houve a contribuição de C6, podendo receber de C5 e do tronco médio (Hill 1966). Em macaco-prego (Cebus apella), Ribeiro (2002) observou a participação dos troncos cranial e médio. No Lagothrix lagothricha a origem do NTL diferiu dos outros primatas estudados, pois se originou de apenas um dos troncos e seu território de inervação supriu o músculo serrátil ventral, conforme descrito na maioria dos primatas (Hill 1972, Hepburn 1982, Booth et al. 1997, Ribeiro 2002).

O nervo toracodorsal, conforme descrito por Hill (1972), em Lagothrix sp., dirigiu-se para o músculo grande dorsal, com origem apenas do oitavo nervo cervical. Em babuínos (Papio ursinus) (Booth et al. 1997) sua origem foi descrita a partir do tronco comum com o NR, recebendo contribuição de todos os nervos espinhais que formaram o plexo braquial e o território de inervação correspondeu ao músculo grande dorsal, semelhante ao encontrado em Lagothrix lagothricha.

A origem do nervo cutâneo medial do antebraço em macaco-barrigudo correspondeu à mesma origem descrita no macaco-prego (Cebus apella) por Hill (1972), contudo,
em Cercopithecus este nervo originou-se somente de C8 (Hill 1966), apresentando, porém, o mesmo território de inervação. Em babuínos (Papio ursinus) a origem foi a partir do tronco comum do NM e NU e o território de inervação equivaleu à porção medial da pele (Booth et al. 1997), diferindo do Lagothrix lagothricha.

Conclusões

O plexo braquial de Lagothrix lagothricha originou-se dos nervos espinhais C5 a T1 constituindo os troncos cranial, médio e caudal.

Os nervos periféricos derivados dos troncos assemelharam na origem, trajeto e no território de inervação com os plexos de outros primatas, com exceção do nervo musculocutâneo que atravessou o músculo coracobraquial.

Na formação dos nervos do plexo houve a participação de um, dois ou dos três troncos nervosos.

Referências

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Aversi-Ferreira T., Silva M.S.L., Paula J.P., Silva L.G. & Silva N.P. 2005. Anatomia comparativa dos nervos do braço de Cebus apella: descrição do músculo dorsoepitroclear. Acta Sci. Biol. Sci. 27(3):291-296.         [ Links ]

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Champneys F. 1975. On the muscles and nerve of a Chimpanzee (Troglodytes niger) and Cynocephalus anubis. J. Anat. Phys. 6(1):176-211.         [ Links ]

Chiarelli A.B. 1972. Taxonomic Atlas of Living Primates. Academic Press, London. 63p.         [ Links ]

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Recebido em 1 der março de 2010.
Aceito para publicação em 5 de agosto de 2010.

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Infraclavicular <b>Brachial Plexus</b>-NYSORA

2011-01-21 23: 55: 00

Ultrasonic transducer position to slide view infraclavicular Brachial plexus transverse

Click on the images below for a high-resolution version.

Ultrasonic transducer position to slide view infraclavicular Brachial plexus transverse

Ultrasound image of the lateral and posterior Brachial plexus laces in the transverse

Ultrasound image of the named lateral and rear cords of the Brachial plexus transverse

Cross the cross sectional areas of Anatomy infraclavicular Brachial plexus

Key:
PMaM Pectoralis Major muscle-
LC-lateral cord
PC-cable
AA-Axillary artery
By-Axillary vein
CV-Cephalic vein
MC-Medial cord
PMiM-Pectoralis Minor muscle
CI-clavicle

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<b>Brachial plexus</b> traction injury?

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Brachial plexus traction injury? Home The Physio Shop The Physio Directory Physiotherapy Jobs Physiotherapy Courses Physiotherapy PI Insurance Welcome to the Online Physio Forum. Login: Remember Me? Home Forum Today's Posts FAQ Calendar Community Groups Forum Actions Mark Forums Read Quick Links View Site Leaders Blogs Physio Links What's New? Advanced Search Forum Physiotherapy Discussion Areas, News and General Interest Musculoskeletal/Outpatients Brachial plexus traction injury? + Reply to Thread Results 1 to 3 of 3 Thread: Brachial plexus traction injury? LinkBack LinkBack URL About LinkBacks   Bookmark & Share Digg this Thread!Add Thread to del.icio.usBookmark in TechnoratiTweet this Thread! Thread Tools Show Printable Version Email this Page… Subscribe to this Thread… Search Thread   Advanced Search Display Linear Mode Switch to Hybrid Mode Switch to Threaded Mode 21-01-2011 12:40 PM #1 alfiePT Forum Member Join Date Dec 2010 Location Australia Posts 1 Rep Power 0 Brachial plexus traction injury?

Would like to hear some other opinions on a client I have started seeing recently. Two months ago she sustained an injury unlocking a heavy mechanism on a caravan (this is the best description she can give me) which should have had two people operating it. She felt a "pop" and then had pain which steadily got worse over the top of her left shoulder. She saw a PT a couple of times who did some needling which helped a little bit, and has now started at my clinic two months post injury. She describes burning over her upper shoulder area, and tingling in her whole arm, and says it feels heavy. The symptoms seem glove-like over the whole arm and hand. Her reflexes appear intact and she has decent strength but it is a bit weaker generally, possibly from pain inhibition however. She has normal neck range of motion now (this is what we worked on at first). Her CT says narrowing at C5/6 foramen on the same side but she also has a history of a whiplash injury. I can give her some relief by taping the shoulder into elevation from its dropped position but everything else either doesn't help or makes it feel worse (needling, attempts at postural exercises). She is in tears from the pain when she tries to work (nursing) and is only on Mobic. Any ideas???

Reply With Quote 23-01-2011 10:42 AM #2 bobo Forum Member Join Date Jan 2008 Location Far away Posts 20 Rep Power 9 Re: Brachial plexus traction injury?

I had a patient with a brachial plexus injury that happened when she fell backwards and grabbed onto something infront of her - pulling the arm and stretching the plexus. She was in agony to be honest and from my (allbeit limited) experience of dealing with them, recovery can take a long time and its important the patient knows that. Like you, i taped the shoulder into elevation to offer some relief but it only lasted a while before that position became painful too. Recovery was spontaneous but I left that place of work and don't know how she got on after the first few sessions.

I did an inservice presentation on them, its a powerpoint and might give you a few ideas but from my reading for it the jist of the principles of management were education and psychosocial support (as its a nasty long term injury), ROM exercises to prevent secondary injuries and pain management. For that you could try things like TENS, massage (might be an idea to start distally as massaging the shoulder could be pretty painful - whatever works best i guess), hydrotherapy and trigger pointing. Happy to send presentation to you if you PM me an email.

Reply With Quote 24-01-2011 09:16 AM #3 pudding_bowl Forum Member Join Date Sep 2009 Location NZ Posts 276 Rep Power 30 Re: Brachial plexus traction injury?

Hey there,

sounds interesting. Please assess the thoracic spine if you haven't already and see if there is any change with manual therapy to the area. Worth a shot if you haven't already. If it is a brachial plexus injury then it'll be slow like bobo said and you should be offering symptom relief as best you can. Did the CT cover the shoulder and thoracic spine? or just the Cx?

bit of food for thought there. Would love to hear how it all goes

Puddin

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