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The Kidney (KI)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Thoracoabdominal nerves (i.e., the ventral rami of the inferior six thoracic nerves): These nerves innervate the anterior abdominal muscles and their overlying skin, as well as the periphery of the diaphragm. T7-T9 provide sensation to the skin superior to the umbilicus; T10 innervates the periumbilical skin; T11 and the subcostal (T12), iliohypogastric (L1) and ilioinguinal (L1) nerves supply the skin inferior, or caudal, to the umbilicus. Entrapment of these nerves within the rectus abdominis muscle causes rectus abdominis syndrome, leading to lower abdominal and pelvic pain that, in female patients, simulates pain from gynecologic conditions. More details about the subcostal, iliohypogastric, and ilioinguinal nerves follow.
Ultrasound guided erector spinae plane block for percutaneous radiofrequency ablation of liver tumors
Published in Egyptian Journal of Anaesthesia, 2020
Shaimaa F. Mostafa, Mona B. El Mourad
The ultrasound-guided erector spinae plane block (ESPB) initially described by Forero et al. [6], is an interfascial plane block with deposition of local anesthetic solution at the tip of the transverse process deep to the erector spinae (ES) muscle [7]. In cadavers, injecting 20-mL solution at the level of the T5 transverse process has been associated with spread of the injectate between the C7 and T8 vertebral levels. ESPB can thus provide thoracic analgesia. Since the ES muscle extends inferiorly to the lumbar spine, performing ESPB at a lower vertebral level (e.g., T7 or T8) should result in local anesthetic spread to the lower thoraco-abdominal nerves that innervate the abdomen [6]. The analgesic efficacy of the ESPB has been proven in various thoracic [8] and abdominal procedures [9,10]. To the best of our knowledge, our study is the first prospective randomized study that assesses the analgesic effect of ESPB during procedures performed under conscious sedation.
Prospective analysis of a surgical algorithm to achieve ventilator weaning in cervical tetraplegia
Published in The Journal of Spinal Cord Medicine, 2022
Matthew R. Kaufman, Thomas Bauer, Stuart Campbell, Kristie Rossi, Andrew Elkwood, Reza Jarrahy
Phrenic nerve reconstruction was performed in the cervical or intra-thoracic regions using an available nerve donor, including: spinal accessory, intercostal, or thoraco-abdominal nerves. The phrenic nerve was exposed and dissected for several centimeters. An adjacent functional (or stimulatable) nerve donor was identified and confirmed using EMG assessment. The nerve donor was transected at its muscular insertion and transposed to the phrenic nerve. A microanastomosis was performed using standard methods. Sural nerve bridging grafts were harvested and coapted between the donor and phrenic nerves as needed when primary nerve transfer was not possible.