MyMedR

Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications.

Matched MeSH terms: Foot/innervation*; Leg/innervation*; Muscle, Skeletal/innervation*

Fulltext Gracilis muscle as neoanal sphincter for faecal incontinence

Zailani MH, Azmi MN, Deen KI

Med J Malaysia, 2010 Mar;65(1):66-7.

PMID: 21265253 MyJurnal

Faecal incontinence is a debilitating chronic clinical condition which may affect the patient and care givers. Modality of treatment is based on severity of the symptoms as well as the anatomical defect itself, availability of resources and expertise. We describe a modified technique of dynamic graciloplasty as neoanal sphincter for the treatment severe faecal incontinence who has failed previous over lapping sphincteroplasty. In our modified version, instead of using implanted intramuscular electrodes and subcutaneous neurostimulator to provide continuous stimulation, the patient will undergo an external stimulation on the nerve of transplanted gracilis periodically and concurrent biofeedback therapy. We believe the technique is relatively easy to learn and very cost effective without any electrodes or neurostimulator related complications.

Matched MeSH terms: Muscle, Skeletal/innervation

An unusual case of additional branches of median nerve innervating the corachobrachialis muscle and its clinical implications

Das S, Maatoq Sulaiman I, Hussan F, Haji Suhaimi F, Latiff AA, Othman F

Clin Ter, 2009;160(1):25-7.

PMID: 19290409

The flexor compartment muscles of the arm comprising of biceps brachii, brachialis and the coracobrachialis are innervated by the musculocutaneous nerve arising from the lateral cord of the brachial plexus. In the present study, we report a case of anomalous innervation of the corachobrachialis muscle on the left side of a 45-year-old male cadaver. The musculocutaneous nerve originated from the lateral cord, as usual and pierced the corachobrachialis muscle. The median nerve was formed by a contribution from both lateral and medial roots, both of which took origin from the lateral and medial cords, respectively. In addition to the usual musculocutaneous nerve which pierced the corachobrachialis muscle and innervated it, two more anomalous branches from the median nerve were observed to innervate the corachobrachialis. The anatomical knowledge of the variations of the innervations of the corachobrachialis muscle may be important not only for surgeons performing coracoid transfer but also for clinicians diagnosing nerve lesions.

Matched MeSH terms: Pectoralis Muscles/innervation*

Role of renal sympathetic nervous system in the control of renal potassium handling

Salman IM, Sattar MA, Abdullah NA, Ameer OZ, Basri F, Hussain NM, et al.

J Nephrol, 2010 May-Jun;23(3):291-6.

PMID: 20349424

It is well established that renal sympathetic nerves are primarily involved in renal sodium and water regulation. However, the relationship between renal sympathetic nerve activity (RSNA) and renal potassium handling is not extensively known. The present study was performed to investigate the role of the renal sympathetic nervous system in the regulation of tubular potassium reabsorption and secretion.

Matched MeSH terms: Kidney/innervation*

A method for evaluating the results of tendon transfers for foot drop

Yeap JS, Singh D, Birch R

Clin Orthop Relat Res, 2001 Feb.

PMID: 11210956

A system for assessing the results of tibialis posterior tendon transfers in the treatment of foot drop secondary to nerve palsy is proposed. There are seven sections to this scoring system: pain, need for orthosis, ability to wear normal shoes, activity level, muscle power of ankle dorsiflexion, degree of active ankle dorsiflexion, and foot posture. The total score is 100. The results are classified as excellent for scores between 85 and 100, good between 70 and 84, fair between 55 and 69, and poor for scores below 55. The results of 18 patients (mean followup, 64.6 months) who had a tibialis posterior tendon transfer were assessed using this method. Four patients (22.2%) had an excellent result, seven (38.8%) had a good result, two (11.1%) had a fair result, and five (27.7%) had a poor result. The average score was 67.2, suggesting an overall fair result for this operation. In nine patients, there was correlation between the outcome when assessed with this method and with patient rating. In two patients, the outcomes were better when assessed with this method than with patient rating, whereas the reverse was true in seven other patients. Thus, this system may provide a more objective and critical evaluation of tibialis posterior transfers for foot drop.

Matched MeSH terms: Foot/innervation*

Fulltext Renal Denervation in Asia: Consensus Statement of the Asia Renal Denervation Consortium

Kario K, Kim BK, Aoki J, Wong AY, Lee YH, Wongpraparut N, et al.

Hypertension, 2020 Mar;75(3):590-602.

PMID: 32008432 DOI: 10.1161/HYPERTENSIONAHA.119.13671

The Asia Renal Denervation Consortium consensus conference of Asian physicians actively performing renal denervation (RDN) was recently convened to share up-to-date information and regional perspectives, with the goal of consensus on RDN in Asia. First- and second-generation trials of RDN have demonstrated the efficacy and safety of this treatment modality for lowering blood pressure in patients with resistant hypertension. Considering the ethnic differences of the hypertension profile and demographics of cardiovascular disease demonstrated in the SYMPLICITY HTN (Renal Denervation in Patients With Uncontrolled Hypertension)-Japan study and Global SYMPLICITY registry data from Korea and Taiwan, RDN might be an effective hypertension management strategy in Asia. Patient preference for device-based therapy should be considered as part of a shared patient-physician decision process. A practical population for RDN treatment could consist of Asian patients with uncontrolled essential hypertension, including resistant hypertension. Opportunities to refine the procedure, expand the therapy to other sympathetically mediated diseases, and explore the specific effects on nocturnal and morning hypertension offer a promising future for RDN. Based on available evidence, RDN should not be considered a therapy of last resort but as an initial therapy option that may be applied alone or as a complementary therapy to antihypertensive medication.

Matched MeSH terms: Kidney/innervation*

Renal functional & haemodynamic changes following acute unilateral renal denervation in Sprague Dawley rats

Salman IM, Sattar MA, Abdullah NA, Ameer OZ, Hussain FB, Hye Khan MA, et al.

Indian J Med Res, 2010 Jan;131:76-82.

PMID: 20167977

Regulation of renal function and haemodynamics are under a direct control from the renal sympathetic nerves and renal denervation produces overt diuresis and natriuresis in several mammalian species. However, the inter-related series of changes in renal function and haemodynamics following acute renal denervation (ARD) is not fully understood. Thus, we aimed to investigate and relate the changes in renal function and haemodynamics following acute unilateral renal denervation in anaesthetized Sprague Dawley (SD) rats.

Matched MeSH terms: Kidney/innervation*

The axillary arch - morphological and histological study with clinical importance

Omar N, Abidin FZ, Das S, Abd Ghafar N, Haji Suhaimi F, Abd Latiff A, et al.

Morphologie, 2010 May;94(305):36-9.

PMID: 20359930 DOI: 10.1016/j.morpho.2010.03.001

The latissimus dorsi is a muscle of the back which forms the posterior fold of the axilla and its tendon twists to insert into the floor of the intertubercular sulcus of the humerus. Occasionally, the muscle has a muscular slip which crosses the axilla to insert into the pectoralis major. This muscular slip is often termed as "axillary arch." In the present study, we report bilateral axillary arch detected in a 45-year-old male cadaver. The average vertical length of the axillary arch measured 7 cm. The average maximum width of the uppermost, middle and lower part of the arch measured 2, 3.5 and 3.2 cm, respectively. The presence of the axillary arch is an uncommon finding in humans, considering the fact that it is solely found in the animals who prefer to hang on the trees. A histological study of the axillary arch was also performed and it showed skeletal muscle fibres which was uniformly arranged. The presence of the axillary arch may assist in the adduction of the shoulder. It may also compress the axillary vessels and nerves thereby causing resultant symptoms. Prior anatomical knowledge of the presence of axillary arch may be helpful for surgeons performing radical dissection of the axillary lymph nodes and ligation of axillary vessels, clinicians diagnosing abduction syndromes and interventional radiologists interpreting axillary mass in day to day clinical practice.

Matched MeSH terms: Axilla/innervation; Muscle, Skeletal/innervation

Partial anterior interosseous nerve palsy: isolated neuropraxia of the branch to flexor pollicis longus

Haflah NH, Rashid AH, Sapuan J

Hand Surg, 2010;15(3):221-3.

PMID: 21089198

Anterior interosseous nerve palsy is rare. Isolated neuropraxia of its branch to the flexor pollicis longus is even rarer. We present a case of a 24-year-old man who presented with weakness of his left thumb flexion after sustaining closed fracture of the proximal third of his left radius. On exploration, the anterior interosseous nerve and its branches was found to be intact as was the flexor pollicis longus. Electrophysiological studies demonstrated acute left anterior interosseous nerve neuropathy. Electromyography showed discrete motor unit at the flexor pollicis longus. Two months later the patient had full recovery of the flexor pollicis longus. We would like to highlight this rare occurrence and present a detailed history of this case to increase awareness amongst clinicians regarding this condition.

Matched MeSH terms: Thumb/innervation*; Muscle, Skeletal/innervation*

Normal motor nerve conduction studies using surface electrode recording from the supraspinatus, infraspinatus, deltoid, and biceps

Buschbacher RM, Weir SK, Bentley JG, Cottrell E

PM R, 2009 Feb;1(2):101-6.

PMID: 19627883 DOI: 10.1016/j.pmrj.2008.08.002

Proximal peripheral nerve conduction studies can provide useful information to the clinician. The difficulty of measuring the length of the proximal nerve as well as a frequent inability to stimulate at 2 points along the nerve adds a challenge to the use of electrodiagnosis for this purpose. The purpose of this article is to present normal values for the suprascapular, axillary, and musculocutaneous nerves using surface electrodes while accounting for side-to-side variability.

Matched MeSH terms: Muscle, Skeletal/innervation*; Upper Extremity/innervation*

A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups

Ngeow WC, Dionysius DD, Ishak H, Nambiar P

J Oral Sci, 2009 Jun;51(2):231-7.

PMID: 19550091

The anterior loop is defined as where the mental neurovascular bundle crosses anterior to the mental foramen then doubles back to exit the mental foramen. It cannot be seen clinically but can be detected in 11-60% of panoramic radiographs. As this anatomical structure is important in determining the placement position of endosseous implants in the mandibular premolar region, a pilot study was undertaken to determine its visibility on dental panoramic radiographs in dentate subjects of various age groups. One or more anterior loops were visible in 39 (40.2%) radiographs encompassing 66 sites (34.4%). Interestingly, anterior loops were most commonly observed bilaterally, followed by on the right side of the mandible only. An anterior loop on the left side only was observed in just 1 radiograph. Visibility of anterior loops reduced as the age of subjects increased. More than half (58.1%) of subjects aged 20-29 years exhibited at least one anterior loop; this gradually reduced to only 15 percent of subjects aged 50 and older. There was no association between visualization of the anterior loop and subject gender.

Matched MeSH terms: Chin/innervation; Mandible/innervation*

Contralateral Obturator Nerve to Femoral Nerve Transfer for Restoration of Knee Extension After Acute Flaccid Myelitis: A Case Report

Doi K, Sem SH, Hattori Y, Sakamoto S, Hayashi K, Maruyama A

JBJS Case Connect, 2019 Dec;9(4):e0073.

PMID: 31850914 DOI: 10.2106/JBJS.CC.19.00073

CASE: A 7-year-old boy presented with left femoral and obturator nerves (ONs) palsy after an asthmatic attack with a viral prodrome, and his right lower limb was unaffected. He was diagnosed with acute flaccid myelitis (AFM) after positive spinal magnetic resonance imaging findings. After contralateral ON to femoral nerve transfer (CONFNT), his left quadriceps was reinnervated at 5.5 months, full knee extension was recovered at 14 months, and good functional outcomes were achieved at 31 months.

CONCLUSIONS: This first clinical report on CONFNT demonstrated a feasible good alternative in treating young patients with AFM with unilateral L2-L4 palsy and short duration of deficit.

Matched MeSH terms: Lower Extremity/innervation; Quadriceps Muscle/innervation

Numbness of the ear following inferior alveolar nerve block: the forgotten complication

Ngeow WC, Chai WL

Br Dent J, 2009 Jul 11;207(1):19-21.

PMID: 19590550 DOI: 10.1038/sj.bdj.2009.559

This article presents a distant complication in the auricle following the administration of a standard inferior alveolar nerve block. The patient experienced profound numbness of the auricle on the ipsilateral side of the injection that lasted for about an hour following unintended injection to the auriculotemporal nerve.

Matched MeSH terms: Temporomandibular Joint/innervation; Ear Auricle/innervation*

The sternalis muscle in cadavers: anatomical facts and clinical significance

Rahman NA, Das S, Maatoq Sulaiman I, Hlaing KP, Haji Suhaimi F, Latiff AA, et al.

Clin Ter, 2009;160(2):129-31.

PMID: 19452102

The sternalis is an anomalous muscle located in the anterior wall of thorax and several past reports have described its presence with clinical implications. The sternalis muscle may be incidentally detected during routine cadaveric dissections and autopsies. We observed the presence of anomalous sternalis muscle on both sides of the anterior chest wall in 25 cadavers (n = 50), over a span of three years. Out of a 50 cases, we observed a single case of sternalis on the right side of the 55-year-old male cadaver (2%). The sternalis was found to be absent in the rest 49 cases (98%). The sternalis muscle displayed an oblique course in the anterior wall of the thorax. The muscle originated near the seventh costal cartilage extending obliquely upwards to insert into the second costal cartilage close to the sternum. The originating portion of the muscle was located at a distance of 3.5 cm lateral to the mid-sternal plane. The vertical length and the maximum width of the anomalous sternalis muscle measured 9 cm and 1.9 cm, respectively. The fibers of the muscle vertically ascended upwards. No other associated anomalies were observed in the same cadaver. The presence of sternalis muscle is considered to be a rare variation with no earlier studies being performed in the Malaysian population. The anomalous sternalis muscle may be important for reconstructive surgeons performing mastectomy and radiologists interpreting mammograms. Thus, the sternalis muscle may be academically, anthropologically and surgically important.

Matched MeSH terms: Pectoralis Muscles/innervation; Muscle, Skeletal/innervation

Non-Hodgkin's lymphoma with left suprascapular neuropathy on magnetic resonance imaging

Faridah Y, Abdullah BJ

Hong Kong Med J, 2003 Apr;9(2):134-6.

PMID: 12668827

Magnetic resonance imaging is gaining importance in the diagnosis of nerve and muscular disorders. The ability of magnetic resonance imaging to delineate the different muscles and the nerve in any plane has made the differentiation between the changes of neuropathy, denervation, and nerve entrapment possible. Although findings on magnetic resonance imaging are non-specific, their use, coupled with clinical symptoms and electromyographic findings, allow an accurate diagnosis to be made without resorting to invasive biopsies.

Matched MeSH terms: Scapula/innervation*; Muscle, Skeletal/innervation*

Fulltext Perivascular Adipose Tissue: the Sixth Man of the Cardiovascular System

Cheng CK, Bakar HA, Gollasch M, Huang Y

Cardiovasc Drugs Ther, 2018 10;32(5):481-502.

PMID: 30171461 DOI: 10.1007/s10557-018-6820-z

Perivascular adipose tissue (PVAT) refers to the local aggregate of adipose tissue surrounding the vascular tree, exhibiting phenotypes from white to brown and beige adipocytes. Although PVAT has long been regarded as simply a structural unit providing mechanical support to vasculature, it is now gaining reputation as an integral endocrine/paracrine component, in addition to the well-established modulator endothelium, in regulating vascular tone. Since the discovery of anti-contractile effect of PVAT in 1991, the use of multiple rodent models of reduced amounts of PVAT has revealed its regulatory role in vascular remodeling and cardiovascular implications, including atherosclerosis. PVAT does not only release PVAT-derived relaxing factors (PVRFs) to activate multiple subsets of endothelial and vascular smooth muscle potassium channels and anti-inflammatory signals in the vasculature, but it does also provide an interface for neuron-adipocyte interactions in the vascular wall to regulate arterial vascular tone. In this review, we outline our current understanding towards PVAT and attempt to provide hints about future studies that can sharpen the therapeutic potential of PVAT against cardiovascular diseases and their complications.

Matched MeSH terms: Adipose Tissue/innervation; Blood Vessels/innervation

Analysis of crosstalk in the mechanomyographic signals generated by forearm muscles during different wrist postures

Islam A, Sundaraj K, Ahmad RB, Sundaraj S, Ahamed NU, Ali MA

Muscle Nerve, 2015 Jun;51(6):899-906.

PMID: 25204740 DOI: 10.1002/mus.24454

In this study, we analyzed the crosstalk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles of the forearm during wrist flexion (WF) and extension (WE) and radial (RD) and ulnar (UD) deviations.

Matched MeSH terms: Wrist/innervation*

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