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Peripheral Nerve Examination
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Mohammed Tahir Ansari, Santanu Kar, Devansh Goyal, Dyuti Deepta Rano, Rajesh Malhotra
The innervations of the triceps muscle vary significantly. The branches to the long head, medial head and lateral head about 7.1, 9.5 and 10.1 cm respectively, below the tip of acromion. Another branch to the medial head arises about 11.2 cm below the tip of the acromion [1]. These branches to the triceps usually remain between the heads of the triceps muscle and the main stem remains very close to the bone (shaft of humerus) leading to stretching of the nerve by the shaft of the humerus fracture but minimal stretching of the triceps innervating collaterals [2]. Hence the triceps are usually spared in the shaft of humerus fractures but they can be compressed in axilla against the latissimus dorsi and teres major muscles or in the triangular interval where the nerve is against the humeral shaft and two muscles (long head of triceps and teres major) [2]. Hence, compression in the axilla leading to total paralysis including triceps comprising of “very high” radial nerve palsy and compression/stretching around/below the spiral groove but above the elbow leads to sparing of the triceps (hence elbow extension is normal) leading to “high radial” nerve palsy. The nerve to the brachioradialis (BR) and extensor carpi radialis longus (ECRL) is almost always supplied by branches above or at the level of the lateral epicondyle [2]. Hence wrist extension is spared in lesions below the elbow designating “low” radial nerve palsy.
Isokinetics
Published in Paul Grimshaw, Michael Cole, Adrian Burden, Neil Fowler, Instant Notes in Sport and Exercise Biomechanics, 2019
Isokinetic devices can be set up to examine almost any joint within the human body. Figure G6.2 shows an application on the shoulder during a flexion and extension movement. The machine, in this case, would assess the agonist and antagonist shoulder muscle function. The agonist muscle is defined as the muscle that contracts while another muscle resists or counteracts its motion. The antagonist muscle is defined as the muscle that offers a resistance during the action of the agonist muscle. This muscle contraction can be in the form of both a concentric and an eccentric type of contraction. Concentric contraction is defined as when muscle tension is developed to accelerate a lever arm or limb. In this case, the muscle contracts concentrically and the fibres of the muscle shorten (i.e. origin and insertion are drawn together). An eccentric contraction is when muscle tension is developed to decelerate a lever arm or limb. As the muscle contracts eccentrically, its fibres lengthen and the origin and insertion points are drawn apart. During the shoulder movement portrayed in Figure G6.2, the machine would assess the torque/strength possessed by both the flexor (pectoralis major and deltoid) and the extensor (latissimus dorsi and teres major) muscles of the shoulder joint.
Vascular access for percutaneous interventionsand angiography
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
Nay Htyte, Christopher J. White
Anatomically, the axillary artery transitions into the brachial artery distal to the inferior border of the teres major muscle. It lies medial to the humerus and biceps tendon and its point of maximal pulsation can be palpated proximal to the antecubital fossa before reaching the neck of the radius where the radial and ulnar artery bifurcation occurs (Figure 8.6). Some variations in vascular anatomy include high location of this bifurcation or anomalous branching of these arteries from the axillary or high brachial artery.44
Anatomical feasibility study of the infraspinatus muscle neurotization by lower subscapular nerve
Published in Neurological Research, 2023
Aneta Krajcová, Michal Makel, Gautham Ullas, Veronika Němcová, Radek Kaiser
The teres major muscle, innervated by the LSN, is an internal rotator of the shoulder, while the infraspinatus muscle innervated by the IB-SSN rotates the shoulder externally. Although post-operative rehabilitation would be easier when donor and recipient nerves had a synergistic action, several neurotization techniques with antagonistic nerves have been described with good results [29]. The mean diameter of the LSN stumps found in our study is similar to the previously published results [9]. We proved that the mean diameters of both nerve stumps are very similar (LSN to IB-SSN ratio 90%). This fact contributes to the expected good applicability of this technique, especially in patients with scapular fracture suffering from palsy of the external rotation of the shoulder. However, the efficacy of the proposed technique can only be confirmed with a clinical study. Since the LSN originates from the C5 – C7 roots, this technique would not be feasible in most adult patients with an upper or complete brachial plexus injuries. Its use can only be considered in very selected casesfor example, a very distal suprascapular nerve rupture.
Superficial location of the brachial plexus and axillary artery in relation to pectoralis minor: a case report
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
The axillary artery is a continuation of the subclavian artery once it has passed over the first rib. The pectoralis minor muscle is located superficial to the axillary artery and it is this relationship that is used to divide the artery into three parts. The first part of the axillary artery is situated between the first rib and the superior border of pectoralis minor, the second part is deep to pectoralis minor, and the third part is located between the inferior borders of pectoralis minor and teres major muscles, after which it is known as the brachial artery.5 The axillary artery is accompanied by the axillary vein, a continuation of the brachial vein at the inferior border of teres major. The axillary vein is superficial to the axillary artery and becomes the subclavian vein as it crosses over the outer border of rib one.6
Adaptive threshold method for peak detection of surface electromyography signal from around shoulder muscles
Published in Journal of Applied Statistics, 2018
Amanpreet Kaur, Ravinder Agarwal, Amod Kumar
The SEMG data were collected from the different positions of around shoulder primary muscles point combinations with teres major muscle (I sensor 5,6) trapezius (T sensor 1,2) and pectoralis major (P sensor 3,4), as shown in Figure 1. The subjects were asked to perform the four sets of action of the shoulder as resting without any activation of muscles, elevation with lifting the shoulder towards ear and then loosening, protraction with rolling the shoulder forward and squeezing the shoulder blades at the chest and retraction with rolling the shoulder in backward and squeezing the shoulder blades at the back [9,24] as shown in Figure 2. The amputee participants performed the same with their residual limb. Each movement was randomly repeated 4 times and recorded for 5 seconds. The raw SEMG signals were filtered by the IIR band-pass Butterworth filter with a frequency range of 20–500 Hz. The signal amplitude changes with respect to the movement of shoulder, as shown in Figure 2 [17].