China
Africa
Explore chapters and articles related to this topic
Complications of upper extremity bypass grafting for occlusive and aneurysmal disease
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
As the axillary artery becomes the brachial artery, the median and ulnar nerve are the most adjacent neurologic structures. The median nerve changes its relative location to the brachial artery, switching from a lateral position in the upper arm to a medial position as both pass through the bicipital aponeurosis. In the forearm, the surgeon must be cognizant of the ulnar nerve as it becomes more intimately associated with the ulnar artery. Injuries to the ulnar nerve are divided into low and high categories. If the nerve is injured distal to the motor branch of the flexor carpi ulnaris muscle, it is considered a low injury and the patient loses sensation in the ulnar portion of the palm. If the injury is high, there is loss in the function of the intrinsic muscles of the hand that results in the “claw” hand where the fourth and fifth fingers have hyperextension at the metacarpal joints and flexion at the intra-phalangial joints.20 The median nerve innervates the pronator teres, palmaris longus and flexors carpi radialis and digitorum superficialis, so injury leads to an inability to oppose the thumb and a weak grip. The patient may also experience numbness of the forearm, palm, thumb, digits 2, 3 and half of 4. Finally, a radial nerve injury will manifest as wrist weakness and loss of finger extension.
Distal Conduction Blocks
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The ulnar nerve runs along the medial side of the forearm, upon the flexor digitorum profundus muscle. In the distal part of the forearm, it lies on the lateral side of the flexor carpi ulnaris muscle, close to the medial side of the ulnar artery (Figures 1.31C and 1.64). After passing behind the volar carpal ligament, it divides into dorsal and volar terminal branches. The dorsal branch emerges a few centimeters above the wrist and reaches the medial side of the back of the wrist and hand, where it gives rise to two or three dorsal digital nerves (Figure 1.65). The volar branch reaches the palm and divides into two palmar digital nerves, one of which supplies the medial side of the little finger (Figure 1.66). The other one gives at least three branches; one unites with the median nerve, the others supply the lateral side of the little finger and the medial side of the ring finger.
The Antebrachium
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
The flexor carpi ulnaris muscle lies upon the ulnar border of the forearm, taking much of its origin from the subcutaneous border of the ulna. Distally, it inserts partially into the pisiform bone and other adjacent bones and ligamentous elements. The pisiform bone is one of the smaller bones of the wrist (carpus). You can palpate the pisiform bone as the hard little structure at the medial border of the wrist, just beyond the distal flexor crease of your wrist.
Deep versus moderate neuromuscular block in laparoscopic bariatric surgeries: effect on surgical conditions and pulmonary complications
Published in Egyptian Journal of Anaesthesia, 2019
Mohamed M. Abu Yazed, Sameh Abdelkhalik Ahmed
Quantitative neuromuscular function was monitored using an acceleromyograph (TOF-watch-SX, MSD BV, Oss, Netherlands) that measures the adductor pollicis muscle response. Two electrodes were placed over the course of the ulnar at the radial side of the flexor carpi ulnaris muscle 1 cm proximal to the wrist joint. The contractions of the ipsilateral adductor pollicis muscle (causing adduction of the thumb) were detected by attaching a sensor to the tip of the thumb and placing it in a flexible adaptor to generate preload. TOF-watch-SX was calibrated and stabilized after induction of general anesthesia and before rocuronium administration, according to manufacturer specifications. Neuromuscular block was assessed after endotracheal intubation at 15-second intervals.
Comparison of vecuronium or rocuronium for rapid sequence induction in morbidly obese patients: a randomized study
Published in Egyptian Journal of Anaesthesia, 2020
Mohamed M. Abu Yazed, Sameh Abdelkhalik Ahmed
The neuromuscular functions were monitored by acceleromyography (TOF-watch-SX, MSD BV, Oss, The Netherlands); the response of the adductor pollicis muscle was detected by two electrodes placed over the path of the ulnar nerve: the first was placed over the lateral side of the flexor carpi ulnaris muscle, and the second was placed 1 cm proximal to the wrist joint. A sensor was placed on the tip of the thumb to detect the contractions of the ipsilateral adductor pollicis muscle. The thumb was placed in a flexible adapter to generate preload while the rest of the hand was fixed. Calibration of the train-of-four monitor was carried out after the induction of anesthesia but before the injection of the muscle relaxants.
Quality of life and satisfaction in patients surgically treated for cubital tunnel syndrome
Published in Neurological Research, 2023
María Elena Córdoba-Mosqueda, Lukas Rasulić, Andrija Savić, Jovan Grujić, Filip Vitošević, Milan Lepić, Aleksa Mićić, Stefan Radojević, Stefan Mandić-Rajčević, Ivana Jovanović, Carlos Alberto Rodríguez-Aceves
Decompression of the ulnar nerve was performed under local anesthesia on an in- or outpatient basis. The incision was made anterior to the medial condyle (Figure 2-A). The ulnar nerve was identified proximally (Figure 2-B) to the sulcus and dissected 5 cm distally toward the condyle (Figure 2-C). To achieve this, the Osborne ligament was divided. If the arcade of Struthers was found, it was also released (Figure 2-D). The ulnar nerve was explored between the two heads of the flexor carpi ulnaris muscle and the submuscular membranes (Figure 2-E); and other constrictive tissues around the nerve were released (Figure 2-F)[10]