The lamination of the masseter muscle in the Japanese serow (Capricornis crispus)

The lamination of the masseter muscle in 21 Japanese serows of different sexes and ages was studied by the method of Yoshikawa et al. who proposed a lamination theory for this muscle. The masseter muscle in the Japanese serow was found to be composed of I) the proper masseter muscle which included 1) the first superficial, 2) the second superficial, 3) the intermediate and 4) the deep masseter muscles, in which the deep masseter muscle could be subdivided into a pars anterior and pars posterior and II) the improper masseter muscle which included 5) the maxillomandibular and 6) the zygomaticomandibular muscles, in which the maxillomandibular muscle was further divided into first and second layers. These findings indicate that the lamination of the masseter muscle in the Japanese serow is the same as that in the goat and sheep.     

The lumbosacral plexus of the Japanese serows, Capricornis crispus

The lumbosacral plexus of the Japanese serow was grossly investigated on 30 fresh specimens. 28 of 30 showed 6 lumbar vertebrae and 2 of the remaining had 5. The communicating pattern among segmental origins from L3 to S5 revealed a variability of the plexus in both types of 5 and 6 lumbar vertebrae. The ratio of prefixed, median fixed and postfixed plexuses in 6 lumbar vertebral type was nearly 2:6:1. The serow's plexus was basically similar to that of domestic ruminants.     

The bronchial tree and blood vessels of the Japanese serow lung

The right lung is constituted of the bilobed upper, middle, accessory and lower lobes. The left lung consists of the bilobed middle and lower lobes. The bronchial ramification and lobular divisions are similar to those of the goat lung.     

The efficacy of end-to-end and end-to-side nerve repair (neurorrhaphy) in the rat brachial plexus

Proximal nerve injury often requires nerve transfer to restore function. Here we evaluated the efficacy of end-to-end and end-to-side neurorrhaphy of rat musculocutaneous nerve, the recipient, to ulnar nerve, the donor. The donor was transected for end-to-end, while an epineurial window was exposed for end-to-side neurorrhaphy. Retrograde tracing showed that 70% donor motor and sensory neurons grew into the recipient 3 months following end-to-end neurorrhaphy compared to 40–50% at 6 months following end-to-side neurorrhaphy. In end-to-end neurorrhaphy, regenerating axons appeared as thick fibers which regained diameters comparable to those of controls in 3–4 months. However, end-to-side neurorrhaphy induced slow sprouting fibers of mostly thin collaterals that barely approached control diameters by 6 months. The motor end plates regained their control density at 4 months following end-to-end but remained low 6 months following end-to-side neurorrhaphy. The short-latency compound muscle action potential, typical of that of control, was readily restored following end-to-end neurorrhaphy. End-to-side neurorrhaphy had low amplitude and wide-ranging latency at 4 months and failed to regain control sizes by 6 months. Grooming test recovered successfully at 3 and 6 months following end-to-end and end-to-side neurorrhaphy, respectively, suggesting that powerful muscle was not required. In short, both neurorrhaphies resulted in functional recovery but end-to-end neurorrhaphy was quicker and better, albeit at the expense of donor function. End-to-side neurorrhaphy supplemented with factors to overcome the slow collateral sprouting and weak motor recovery may warrant further exploration.     

Anatomical variations of the brachial plexus

Important variations exist in the brachial plexus (Kaufmann, Cunningham, Kerr, Lee). Perivascular techniques of brachial plexus block used sometimes use important quantities of anaesthesia product. It seems that certain surgical treatment failures of brachial plexus lesions are related to the brachial plexus variations (Bonnel). Our aim is to study the brachial plexus variations and its relations from the cervical region to brachial region. We dissected twenty-three brachial plexus (13 women and 10 men, fresh or injected by formalin). We studied the brachial plexus anatomic variations and its relations. We found the anatomic variations at the level of different parts of brachial plexus: Trunk: 8 cases (34.8%); Terminal branch: 8 cases (34.8%); brachial plexus tract: 1 case (4.3%); collateral branch: 1 case (4.3%); in 5 cases we didn't find any abnormalities. Some studies show the frequency of 4th cervical root (C4) participation in brachial plexus. Kerr found 65.9%. It was 30.4% of C4 participation in brachial plexus in our series. Among the 8 cases of terminal branch variations in our series, two (8.7%) musculocutaneous was low source. The brachial plexus variations could fail the brachial plexus loco-regional anaesthesia. In the surgical treatment of brachial plexus lesions, the surgeon must know brachial plexus anatomical variations perfectly.     

Two rare anomalies of the brachial plexus

Morphological variations of the brachial plexus and variants in the distribution of the anterior division of the middle trunk are relatively frequent. Two of the rarest anomalies occurred in the left brachial plexus of a 62-y-old Japanese male, 1 of 104 plexuses dissected between 1996 and 1997 at Kanazawa University Faculty of Medicine. The superior trunk of the brachial plexus was formed by the anterior primary division of C5 and C6 and a thin branch (0.5 mm in diameter) from C4, the middle trunk by the C7, and the inferior trunk by C8 and T1 (Fig.). We could not determine whether there was a branch derived from T2 to T1, since the subject had died of lung carcinoma. The entire anterior division of the middle trunk crossed the axillary artery and joined the medial root of the median nerve which was the continuation of the medial cord after the cord branched off the ulnar nerve. The lateral cord pierced coracobrachialis and divided into the musculocutaneous nerve and the lateral root of the median nerve just after emerging from the muscle, finally joining the medial root of the median nerve superficial to the brachial artery ∼115 mm distal to the lower border of latissimus dorsi to form the median nerve. The musculocutaneous nerve gave rise to the nerves to biceps brachii, brachialis, and the long head of biceps brachii and finally continued as the lateral cutaneous nerve of the forearm. The branch to coracobrachialis had already been cut and its course could not be traced.     

On the morphology of the brachial plexus of the platypus (Ornithorhynchus anatinus) and the echidna (Tachyglossus aculeatus)

Four forelimbs of 3 platypuses and 3 forelimbs of 2 echidnas were examined to study the precise form of the brachial plexus and to clarify the structural characteristics of the brachial plexus in phylogeny. The spinal components contributing to the plexus (C4–T2) and the formation patterns of the 3 trunks of the plexus were the same as those generally observed in mammals. In the cranial half of the brachial plexus from C4, 5 and 6 in monotremes, division into the ventral bundle (lateral cord) and dorsal bundle (axillary nerve) is clear, as in other mammals. However, for monotremes, in the caudal half of the plexus from C7 and T1 (+T2) and the nerves arising from the caudal plexus there is no definite division into the ventral and dorsal bundles, which distribute to the flexor and extensor parts of the forelimbs, respectively. The lower trunk of the monotreme brachial plexus forms a cord which contains both ventral and dorsal components. This characteristic diverges from the generally accepted idea that the tetrapod limb plexus is divided clearly into 2 layers: a dorsal layer for extensors and a ventral layer for flexors of the limb. Considering the incomplete dorsoventral division of forelimb nerves in some reptiles and urodeles, the caudal half of the monotreme brachial plexus has characteristics in common with those of lower tetrapods.     

腋窝顶定位穿刺锁骨下位点阻滞麻醉用于创伤性臂丛损伤手术

目的　探讨腋窝顶定位穿刺锁骨下位点阻滞麻醉用于创伤性臂丛损伤手术的可行性。 方法　60例患者随机均分为3组,A组：腋窝顶定位穿刺锁骨下位点阻滞麻醉;B组：插管全麻;C组：腋窝顶定位穿刺锁骨下位点阻滞复合插管全麻,术后用PCIA泵镇痛和VAS评价镇痛程度。评估术中除共同项目外,麻醉技术、耗材和药品所产生的医疗费用。 结果　3组患者一般情况比较差异无统计学意义（P>0.05）;术中全麻丙泊酚和瑞芬太尼每小时应用剂量、术后唤醒和拔管定向力恢复时间,B组显著多或长于C组（P<0.01）;麻醉前准备、操作完成时间A组相似文献   

臂神经丛联合阻滞的应用

目的总结＂四针法＂臂丛神经联合阻滞的经验,指导神经刺激仪的合理应用。方法回顾性分析臂神经丛阻滞356例,根据阻滞方法分为联合组（n=148）,联合组同时实施肌间沟阻滞加腋路阻滞加肋间臂神经阻滞;传统组（n=208）,传统组只实施肌间沟阻滞（n=176）,或腋路阻滞（n=32）,不行肋间臂神经阻滞。结果联合组麻醉效果优占97.3%,穿刺异感占47.3%;传统组优占87.0%,穿刺异感占69.7%。联合组与传统组比较,具有显著差异（P〈0.01）。结论 ＂四针法＂臂神经丛联合阻滞可提高臂神经丛阻滞的成功率。     

Systematic evaluation of brachial plexus injuries

Brachial plexus injuries offer a unique challenge to the athletic trainer because of their relatively high frequency rate in contact sports and because of the complexity of the neuroanatomy in the cervical area. During a game, athletic trainers must make a fast, accurate decision regarding a player's return to competition. It is imperative that the athletic trainer be able to quickly differentiate between minor injuries and more serious injuries warranting removal from the game and/or physician referral. A systematic approach to the evaluation of a brachial plexus injury is essential to ensure proper treatment. This paper will present a structured approach to an on-the-field assessment of brachial plexus injuries.     

新生儿臂丛损伤发生机制研究进展

新生儿臂从损伤(neonatal brachial plexus injury,NBPP),主要是指在胎儿发育和分娩过程中,受到各种力的因素影响导致胎儿一侧或双侧臂丛损伤,临床主要表现为伤侧上肢功能障碍,也严重影响了患者的心理发育健康,给社会及家庭带来沉重负担.NBPP的发病率各国报道为0.16‰～4‰ [1],通常认为发展中国家的发生率更高 [2],Jaggi等 [3]提出NBPP发生率有增加趋势.揭示NBPP发生机制,为有效预防或降低NBPP发生提供理论依据.本文就NBPP发生机制的研究进展进行综述,提高对NBPP发生规律的认识.     

臂丛及其有关血管的研究

目的 为了获得臂丛的解剖学资料,并为手术提供定位数据。方法 对３２具尸体的臂丛进行调查和测量。结果 将６４例臂丛的类型,位置,变异等情况进行分析归类并与临床的关系进行探讨。结论本研究结果对臂丛神经根损伤的诊治具有积极的指导意义。     

Macro- and microanatomical characterization of the cat brachial plexus

The anatomy of the cat brachial plexus is poorly documented despite its importance for reparative surgery. The present work aims to study the anatomy of the brachial plexus of 20 European cats and to analyze the radicular constituents of 10 of them using histological techniques. The plexus radicular constitution is very homogeneous and is mainly composed of the ventral rami (also called ventral branches) arising from C6, C7, C8 and T1 spinal nerves. The fascicular and axonal structure is more variable. C8 is the ventral ramus that contains the largest number of axons (16,673 +/- 3,307), and is composed of 6.7 +/- 3.5 fascicles. The radial nerve is the peripheral nerve that contains the largest number of axons (11,245 +/- 2,217), and is composed of 7.3 +/- 3.8 fascicles. The number of nervous fibers does not differ proportionally to the weight of the cat, or between the right or the left side. Our data could help neurotization and entubulation repair after brachial plexus injury.