Neuroanatomy overview
Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni in Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
The radial nerve travels in the arm by going through the triangular space along with the profunda brachii vessels (space bounded by the long head of triceps medially, humerus laterally, and teres major superiorly). The nerve crosses the medial head of the triceps to wind up in the spiral groove deep to the lateral head of the triceps. It travels sinuously in the spiral groove around the posterior aspect of the arm between the medial and lateral heads of the triceps, which it supplies. Supply to the anconeus is also given off here. In the spiral groove, the nerve is reduced to the least number of fascicles in its entire course (4–5). Prior to piercing the lateral intermuscular septum, two small cutaneous nerves are given off—the inferior lateral cutaneous nerve and the posterior antebrachial cutaneous nerve. It then pierces the lateral intermuscular septum to wind up in the anterior compartment of the arm. Here, it is separated from bone by brachialis, and descends into the intermuscular slit between brachialis and brachioradialis. It can be identified here by splitting these two muscles. A branch is given off to the brachioradialis and to extensor carpi radialis longus about 2–3 cm proximal to the elbow.
Humeral shaft fractures
Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou in Orthopaedic Trauma, 2014
The proximal end of the humerus comprises the head, which articulates with the glenoid fossa of the scapula to form the glenohumeral joint. The greater and lesser tuberosities, which are intimately related to the humeral head, receive the tendons of the rotator cuff. The pectoralis major tendon inserts at the level of the bicipital groove, which contains the long head of biceps tendon. Injuries proximal to the humeral metaphysis are covered in Chapter 8. Distal to the proximal metaphysis, the humerus becomes cylindrical, with attachment of the deltoid into its groove laterally. The radial nerve originates from the posterior cord of the brachial plexus (C5–T1) and passes through the triangular space between the long head of triceps and the humerus, beneath the teres major. In the upper arm the nerve spirals around the humerus from medial to lateral, closely related to the periosteum of the spiral groove that lies approximately 13 cm above the trochlea (Fig. 9.1). The nerve then pierces the lateral intermuscular septum approximately 8 cm proximal to the trochlea, to enter the anterior compartment of the upper arm, before descending between the brachialis and brachioradialis muscles.
Thoracic outlet syndromes
Larry R. Kaiser, Sarah K. Thompson, Glyn G. Jamieson in Operative Thoracic Surgery, 2017
Anatomically, there are three locations within the thoracic outlet region that are responsible for the development of compression of the neurovascular structures: (1) the interscalene triangular space; (2) the costoclavicular space; and, less commonly, (3) the subpectoralis minor space (see Figure 5.4).
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
Complex scapular fractures are operated via the Judet posterior approach in which the skin incision is made along the scapular spine and curved caudally along the medial edge of the scapular body. Then, the infraspinatus muscle is detached from the floor of the infraspinous fossa [11,23]. Therefore, we used the same approach in our study. The circumflex scapular artery, a branch of the subscapular artery, is the only structure (with accompanying veins) passing through the triangular space [12]. It then runs on the ventral surface of the infraspinatus muscle. After the mobilization of the IB-SSN, this vessel can be therefore used as a guiding structure for dissecting the ‘tunnel’ from the infraspinous fossa into the triangular space [12] (formed by teres minor and major muscles and long head of the triceps). For approaching this space, it is recommended to cut the skin between the teres muscles. Therefore, we propose to make a U-shaped skin incision for LSN – IB-SSN nerve transfer (Figure 7). In revision cases after previous orthopaedic procedure for scapular fracture performed via the Judet approach, the incision should follow the primary cut and then be prolonged caudo-laterally parallel to the scapular spine.
Contemporary review of management techniques for cephalic arch stenosis in hemodialysis
Published in Renal Failure, 2023
Gift Echefu, Shivangi Shivangi, Ramanath Dukkipati, Jon Schellack, Damodar Kumbala
The Cephalic vein is part of the upper extremity’s superficial venous system. It originates in the anatomical snuffbox from the radial aspect of the superficial venous network of the dorsum of the hand. Coursing along the anterolateral forearm to the elbow, it communicates with the basilic veins via median ante-cubital veins. It then courses along the lateral aspect of the biceps toward the pectoralis major muscle as it enters the deltopectoral groove (a triangular space formed by the adjacent borders of the deltoid and pectoralis major muscles Figure 2). It then passes under the clavicle, turning sharply to pierce the clavipectoral fascia terminating as the axillary vein. The cephalic arch refers to the final arch of the cephalic vein before it drains into the first part of the axillary vein.
Adam Politzer (1835-1920) and the cochlear nucleus
Published in Journal of the History of the Neurosciences, 2021
Albert Mudry, John Riddington Young
In the last edition of his textbook, Buck eventually mentioned the nucleus: The cochlear division as its oblongata entry lies caudad and dorsad of the other (i.e. vestibular). It courses round the convex face of the restiform column and enters into direct connection with a nidus of nerve elements, filling out the triangular space between the cochlear entry dorsad, the vestibular entry ventrad, and the the restiform column mesad. It is also connected (probably indirectly, and after interruption by the nidus cochlearis) with the tuberculum acusticum. … The nidus cochlearis is regarded as the homologue of a spinal ganglion for the cochlear nerve, which has become included in the oblongata. (Buck 1889, 184)
Related Knowledge Centers
- Circumflex Scapular Artery
- Quadrangular Space
- Subscapularis Muscle
- Teres Major Muscle
- Axillary Space
- Triangular Interval
- Triceps
- Teres Minor Muscle