The Experts below are selected from a list of 36 Experts worldwide ranked by ideXlab platform
Mark D Stringer - One of the best experts on this subject based on the ideXlab platform.
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Redefining the Coccygeal Plexus
Clinical Anatomy, 2013Co-Authors: Jason T. K. Woon, Mark D StringerAbstract:The Coccygeal Plexus is variably described in anatomy texts and has rarely been studied despite the idiopathic nature of coccydynia in up to one-third of affected patients. The Plexus was therefore investigated using a combination of microdissection and histology. The distal sacrum and coccyx in continuity with ischiococcygeus were removed en bloc from 16 embalmed cadavers (mean age 78 ± 10 years, 7 females) with no local disease. Ten specimens underwent microdissection of the Coccygeal Plexus and the remaining six were examined histologically after staining with hematoxylin and eosin and S100 immunohistochemistry to demonstrate nerve fibers. The Coccygeal Plexus is formed within ischiococcygeus from the ventral rami of S4, S5, and Co1 with a contribution (gray rami communicantes) from the sacral sympathetic trunk. It gives rise to anoCoccygeal nerves which pierce ischiococcygeus and the sacrospinous ligament to supply the subcutaneous tissue on the dorsal aspect of the coccyx. Some branches from the Plexus pass medially anterior to the coccyx. The coccycgeal Plexus is formed within ischiococcygeus rather than on its pelvic surface and appears to supply skin in the anoCoccygeal region. It probably also contributes to the innervation of ischiococcygeus, the sacrospinous ligament, Coccygeal ligaments, and periosteum. It deserves to be considered as a potential pain generator that may be implicated in some patients with coccydynia. Clin. Anat. 27:254–260, 2014. © 2013 Wiley Periodicals, Inc.
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Clinical anatomy of the coccyx: A systematic review.
Clinical Anatomy, 2011Co-Authors: Jason T. K. Woon, Mark D StringerAbstract:The coccyx has been relatively neglected in anatomical research which is surprising given the population prevalence of coccydynia and our inadequate understanding of its etiology. This systematic review analyzes available information on the clinical anatomy of the coccyx. A literature search using five electronic databases and standard anatomy reference texts was conducted yielding 61 primary and 7 secondary English-language sources. This was supplemented by a manual search of selected historical foreign language articles. The Coccygeal vertebrae, associated joints, ligaments and muscles, Coccygeal movements, nerves, and blood supply were analyzed in detail. Although the musculoskeletal aspects of the coccyx are reasonably well described, the precise anatomy of the Coccygeal Plexus and its distribution, the function of the Coccygeal body, and the anatomy of the sacroCoccygeal zygapophyseal joints are poorly documented. Further research into the anatomy of the coccyx may clarify the etiopathogenesis of coccydynia which remains uncertain in one-third of affected patients.
Jason T. K. Woon - One of the best experts on this subject based on the ideXlab platform.
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Redefining the Coccygeal Plexus
Clinical Anatomy, 2013Co-Authors: Jason T. K. Woon, Mark D StringerAbstract:The Coccygeal Plexus is variably described in anatomy texts and has rarely been studied despite the idiopathic nature of coccydynia in up to one-third of affected patients. The Plexus was therefore investigated using a combination of microdissection and histology. The distal sacrum and coccyx in continuity with ischiococcygeus were removed en bloc from 16 embalmed cadavers (mean age 78 ± 10 years, 7 females) with no local disease. Ten specimens underwent microdissection of the Coccygeal Plexus and the remaining six were examined histologically after staining with hematoxylin and eosin and S100 immunohistochemistry to demonstrate nerve fibers. The Coccygeal Plexus is formed within ischiococcygeus from the ventral rami of S4, S5, and Co1 with a contribution (gray rami communicantes) from the sacral sympathetic trunk. It gives rise to anoCoccygeal nerves which pierce ischiococcygeus and the sacrospinous ligament to supply the subcutaneous tissue on the dorsal aspect of the coccyx. Some branches from the Plexus pass medially anterior to the coccyx. The coccycgeal Plexus is formed within ischiococcygeus rather than on its pelvic surface and appears to supply skin in the anoCoccygeal region. It probably also contributes to the innervation of ischiococcygeus, the sacrospinous ligament, Coccygeal ligaments, and periosteum. It deserves to be considered as a potential pain generator that may be implicated in some patients with coccydynia. Clin. Anat. 27:254–260, 2014. © 2013 Wiley Periodicals, Inc.
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Clinical anatomy of the coccyx: A systematic review.
Clinical Anatomy, 2011Co-Authors: Jason T. K. Woon, Mark D StringerAbstract:The coccyx has been relatively neglected in anatomical research which is surprising given the population prevalence of coccydynia and our inadequate understanding of its etiology. This systematic review analyzes available information on the clinical anatomy of the coccyx. A literature search using five electronic databases and standard anatomy reference texts was conducted yielding 61 primary and 7 secondary English-language sources. This was supplemented by a manual search of selected historical foreign language articles. The Coccygeal vertebrae, associated joints, ligaments and muscles, Coccygeal movements, nerves, and blood supply were analyzed in detail. Although the musculoskeletal aspects of the coccyx are reasonably well described, the precise anatomy of the Coccygeal Plexus and its distribution, the function of the Coccygeal body, and the anatomy of the sacroCoccygeal zygapophyseal joints are poorly documented. Further research into the anatomy of the coccyx may clarify the etiopathogenesis of coccydynia which remains uncertain in one-third of affected patients.
Candace Wooten - One of the best experts on this subject based on the ideXlab platform.
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Anatomy of the Coccygeal Plexus
Nerves and Nerve Injuries, 2015Co-Authors: Candace WootenAbstract:The Coccygeal Plexus is formed in the pelvis by three nerve roots: the fourth and fifth sacral nerves and the first Coccygeal nerve. From this position it branches into the anoCoccygeal nerves, which supply cutaneous innervation to the anoCoccygeal region.
Woon, Jason Tai King - One of the best experts on this subject based on the ideXlab platform.
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Clinical anatomy of the coccyx and associated structures
'University of Otago Library', 2013Co-Authors: Woon, Jason Tai KingAbstract:The coccyx and associated structures are poorly described in standard anatomy texts. This is surprising given that localised Coccygeal pain (coccydynia) is not uncommon and its cause is unknown in up to one-third of patients. There has been no systematic study of the Coccygeal Plexus or the sacroCoccygeal (SC) cornual region. Both structures are potential sources of pain. Lack of morphometric data on the normal adult coccyx hampers current understanding of radiological abnormalities in coccydynia. This thesis aimed to study: 1) the Coccygeal Plexus; 2) the bony anatomy of the coccyx in normal individuals and patients with coccydynia; and 3) the SC cornual region. In the first study, the Coccygeal Plexus was investigated in 16 embalmed cadaver specimens (mean age 78 years, 7 females) with no known pelvic disease. Ten specimens underwent microdissection and the remaining six were examined by serial histology. The second study consisted of a retrospective case-control analysis of computed tomography (CT) scans of the SC region in 112 normal adults (mean age 63 years, 50 males) and comparable magnetic resonance scans from 107 adults with coccydynia (mean age 43 years; 84 females). The following parameters were evaluated: Coccygeal segmentation; intervertebral joint fusion; bony spicule formation, interCoccygeal subluxation; and sacral and Coccygeal angles and curvatures. In the third study, the bony anatomy of the SC cornual region was analysed in: 33 high-resolution CT scans (mean age 64 years, 17 males); seven microCT scans of cadaver specimens (mean age 77 years, 3 males); and an archival collection of 105 Asian Indian adult skeletons. Soft tissues and innervation were also examined histologically in five cadaver specimens. The Coccygeal Plexus was found to be formed within ischiococcygeus from the ventral rami of S4, S5 and Co1. It gave rise to branches to ischiococcygeus and terminated as anoCoccygeal nerves which pierced ischiococcygeus and the sacrospinous ligament to supply skin overlying the Coccygeal region. The normal adult coccyx has the following features: usually consists of four segments (76%); shows SC joint fusion (57%); interCoccygeal joint fusion is increasingly common caudally; a bony spicule on the terminal segment in 23%; and is significantly longer in men than women (P
John E. Skandalakis - One of the best experts on this subject based on the ideXlab platform.
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Surgical anatomy of the retroperitoneal spaces, Part IV: retroperitoneal nerves.
American Surgeon, 2010Co-Authors: Petros Mirilas, John E. SkandalakisAbstract:We present surgicoanatomical topographic relations of nerves and Plexuses in the retroperitoneal space: 1) six named parietal nerves, branches of the lumbar Plexus: iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, femoral. 2) The sacral Plexus is formed by the lumbosacral trunk, ventral rami of S1―S3, and part of S4; the remainder of S4 joining the Coccygeal Plexus. From this Plexus originate the superior gluteal nerve, which passes backward through the greater sciatic foramen above the piriformis muscle; the inferior gluteal nerve also courses through the greater sciatic foramen, but below the piriformis; 3) sympathetic trunks: right and left lumbar sympathetic trunks, which comprise four interconnected ganglia, and the pelvic chains; 4) greater, lesser, and least thoracic splanchnic nerves (sympathetic), which pass the diaphragm and join celiac ganglia; 5) four lumbar splanchnic nerves (sympathetic), which arise from lumbar sympathetic ganglia; 6) pelvic splanchnic nerves (nervi erigentes), providing parasympathetic innervation to the descending colon and pelvic splanchna; and 7) autonomic (pre-vertebral) Plexuses, formed by the vagus nerves, splanchnic nerves, and ganglia (celiac, superior mesenteric, aorticorenal). They include sympathetic, parasympathetic, and sensory (mainly pain) fibers. The autonomic Plexuses comprise named parts: aortic, superior mesenteric, inferior mesenteric, superior hypogastric, and inferior hypogastric (hypogastric nerves).