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Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
When lumbar radiculopathy is due to disc damage, material within the intervertebral disc leaks out, compressing the nerve root. Cervical radiculopathy is marked by nerve compression from herniated disks or arthritic bone spurs. It occurs with pathologies that cause symptoms on the nerve roots such as compression, irritation, traction, and lesions. The pinched nerve may occur in different areas of the thoracic spine. Important structures that are involved in this condition include all of the thoracic vertebrae, the intervertebral discs, the 12 pairs of spinal nerve roots, and the 12 rami. The posterior rami innervate the regional back muscles, while the ventral rami innervate the chest and abdominal skin and muscles.
The Spinal Cord and the Spinal Canal
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
Ventral rami of the trunk divide in a manner similar to dorsal rami, providing metameric innervation to the skin (Figure 1.37) and deep structures. In the cervical, lumbar, and sacral regions, the ventral rami of adjacent spinal nerves unite near their origin and form the cervical (C1 to C4 segments), brachial (C5 to T1), lumbar (L1 to L4), and sacral (L4 to S3) plexuses. Lumbar and sacral plexuses are usually termed the lumbosacral plexus. Such a plexal disposition of nerves has considerable implications for regional anesthesia, and these plexuses are described in Part Two of this book.
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.
Female genito-pelvic reflexes: an overview
Published in Sexual and Relationship Therapy, 2019
Symen K. Spoelstra, Esther R. Nijhuis, Willibrord C. M. Weijmar Schultz, Janniko R. Georgiadis
The main somatic nerve of the perineum is the pudendal nerve, which has somatosensory and somatomotor tributaries, and which divides into three main branches (inferior rectal, perineal, dorsal penile/clitoral) at the level of the levator ani muscle. The muscles that embryonically derive from the cloacal sphincter (external anal and urethral sphincter, superficial transverse perineal muscle, bulbocavernosus muscle and ischiocavernosus muscle) are all innervated by pudendal nerve fibres originating in a specialized sacral motor neuronal pool called Onuf's nucleus (Iwata, Inoue, & Mannen, 1993; Onuf, 1899). As Onuf motoneurons innervate striated muscles but also are known to be relatively unaffected by somatic motoneuron diseases like amyotrophic lateral sclerosis (Mannen, Iwata, Toyokura, & Nagashima, 1977), they have been proposed to be of a mixed somatic/autonomic type (Kihira, Yoshida, Yoshimasu, Wakayama, & Yase, 1997). Interestingly, the pudendal nerve seems less involved in the innervation of the levator ani muscle. A separate nerve, the “levator ani nerve” (Wallner, Maas, Dabhoiwala, Lamers, & De Ruiter, 2010), arising from the ventral ramus of the third and fourth sacral nerves, is held to innervate the pelvic diaphragm. In at least 50% of cadavers studied, the pudendal nerve also contributed to innervation of the levator ani muscle, especially in regards to the medial portions (puborectal and pubococcygeal muscles) (Rock JA, 2003).
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
ESPB is a novel technique that involves local anesthetic injection into the fascial plane deep to the erector spinae muscle. ESPB involves penetration of local anesthetics into the thoracic paravertebral space. It blocks not only the ventral rami of spinal nerves but also the rami communicants that contain sympathetic nerve fibers. The ESPB thus has the potential to provide both somatic and visceral sensory blockade, which would make it an ideal regional anesthetic technique for abdominal surgery [21,22].
Comparison between serratus anterior plane block versus erector spinae plane block for postoperative analgesia after video-assisted thoracoscopic surgery (VATS)
Published in Egyptian Journal of Anaesthesia, 2023
Sameh Salem Hafny Taha, Beshoy Eshak Aziz Hanna, Gamal Eldin Mohammad Ahmed Elewa, Hadil Magdy Abd Elhamid Mohamed, Dalia Fahmy Emam Ali, Mohamed MoienMohamed Elsaid
Erector spinae plane block, which is an inter-fascial plane block, was identified in 2018 by Forero and his colleagues [3]. It can be used for several purposes such as to relieve pain in shoulder, hip, lumbar, thoracic and abdominal areas. This paraspinal block works by focusing on the dorsal and ventral rami to relieve pain in the anterior, lateral and posterior chest walls [4,5]. Erector spinae plane block was proven to greatly reduce surgical discomfort 24 h post operatively [6].