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Trunk Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Rowan Sherwood
Labranche et al. (2017) note that somatic dysfunction of spinalis capitis can contribute to compressive neuropathy of the dorsal rami of the cervical spinal nerves. Asymmetry of spinalis capitis may unilaterally strain the ligamentum nuchae and lead to the development of cervicogenic headaches or occipital headaches (Labranche et al. 2017).
Trunk
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The spinal nerves divide into ventral rami and dorsal rami. The ventral rami form the intercostal nerves (T1–T12) in the thoracic region, as well as the cervical plexus, brachial plexus, lumbar plexus, and sacral plexus, thereby supplying the muscles and skin of the upper and lower limbs and part of the trunk. The lumbar plexus, sacral plexus, and pudendal plexus form the lumbosacral plexus. Intercostal nerves T1 to T11 lie together with the intercostal veins and intercostal arteries in the 11 intercostal spaces, while T12 is a subcostal nerve that courses below the 12th rib. The anterior end of an intercostal space is supplied by the anterior intercostal branches of the internal thoracic artery. The intercostal nerves supply the serratus posterior superior and serratus posterior inferior and the external intercostal muscle, internal intercostal muscle, and innermost intercostal muscle. The intercostal nerves also have cutaneous branches at the anterior (ventral) and lateral surfaces of the thoracic wall. The dorsal rami supply the paravertebral muscles (paraspinal muscles) and skin near the midline of the back.
Percutaneous spinal interventions and pain management
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Joint injections: Cervical or lumbar facet joint pain has been shown to be the source of pain in 15%–40% of patients. Controversy regarding the efficacy of certain forms of physical therapy alone, in combination with intraarticular injections, medial branch blocks, or radiofrequency rhizotomy of medial branch/dorsal rami nerves has not been resolved in the literature. Clinical consultation with an interventional spine specialist (physiatry, anesthesia, or radiology) is an option. Additional injections after the first injection should be contingent upon >50% improvement sustained more than 4 weeks, with concomitant improvement in functional/work status, or complete elimination of pain symptoms for a minimum of 1 week following single joint injection.
Influence of ultrasound-guided erector spinae plane block on post-operative pain and diaphragmatic dysfunction in obese patients undergoing repair of Epigastric Hernia
Published in Egyptian Journal of Anaesthesia, 2023
Asmaa Ragab Eid, Mona Blough El Mourad, Salah Eldeen Ibrahim Al Sherief, Shaimaa Waheed Zahra
It is unclear how local anesthetics work or how far they go in an ESP block. In a research using cadavers, Forero et al. [4] injected all samples using US guidance for all interventional operations. By blocking the spinal nerve roots and the branches communicating with the sympathetic ganglia, they showed that local anesthetics infiltrate the thoracic paravertebral region anteriorly through connective tissues and ligaments. Regarding imaging studies, the widespread sensory block found after a single application at T5 TPs propagated craniocaudally in-between C7 and T8, perhaps because of the columnar architecture of the ESM and its retinaculum. This also suggests that the dissemination to the lower thoracic nerves feeding the belly should occur after injection at levels caudal to T5 [2]. In contrast, Ivanusic et al.’s [16] cadaveric research showed that the vertebral column muscles are firmly attached to the TPs, preventing any anterior spread of dye toward the paravertebral space. This would have affected the thoracic spinal nerves. Dorsal ramus blockage was suspected to have occurred behind the costotransverse foramen, with the lateral cutaneous branches of the intercostal nerves likely being involved.
Effectiveness of Ultrasound Guided Erector Spinae Plane Block Compared to Ultrasound Guided Modified Pectoral Nerves Block in Modified Radical Mastectomy: A Randomized Single Blinded Study
Published in Egyptian Journal of Anaesthesia, 2022
Mohamed Elsaid Abdel Fattah, Osama Sayed Ibrahim, Nevine Mahmoud Gouda, Mohamed Mohamed Abdel-Hak
The ultrasound (US)-guided erector spinae plane block (ESPB) was primarily mentioned in 2016, and it has since been used to manage acute and chronic thoracic pain. In a para spinal facial plane block, a local anesthetic administered the erector spinae muscle deep while the thoracic transverse processes are superficial. There are few contraindications in doing the ESPB because the injection site is far from the pleura, main blood arteries, and spinal cord. The injected local anesthetic medicine blocks the ventral and dorsal rami of spinal nerves in the paravertebral area [7].
Erector spinae plane block combined with general anaesthesia versus conventional general anaesthesia in lumbar spine surgery
Published in Egyptian Journal of Anaesthesia, 2020
Ezzzt M. Siam, Doaa M. Abo Aliaa, Sally Elmedany, Mohamed E. Abdelaa
The erector spine plane block targeting the dorsal rami thus can be used as a perioperative pain control technique in lumbar spine surgeries [7]. It is applied preoperatively before skin incision as a preemptive analgesia so it suppresses chronic sensitization process. In addition, it may abolish the neuroendocrine stress response by decreasing release of the counter-regulatory hormones like catecholamines the mechanism by which it may augment controlled hypotensive anaesthesia [8]