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Maciej Henneberg - One of the best experts on this subject based on the ideXlab platform.
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Surgical anatomy of the sural and Superficial Fibular Nerves with an emphasis on the approach to the lateral malleolus.
Journal of Anatomy, 2001Co-Authors: Lucian B. Solomon, L. Ferris, R. Tedman, Maciej HennebergAbstract:The aim of this study was to investigate the risk and to analyse the significance of laceration of the sural and Superficial Fibular Nerves during the surgical approach to the lateral malleolus. The sural and the Superficial Fibular Nerves, and their branches were dissected under ×3 magnifying lenses in 68 embalmed leg-ankle-foot specimens. The specimens were measured, drawn and photographed. In 35% of specimens the Superficial Fibular Nerve branched before piercing the crural fascia, and in all these specimens the medial dorsal cutaneous Nerve of the foot was located in the anterior compartment while the intermediate dorsal cutaneous Nerve of the foot was located in the lateral compartment. In 35% of specimens the intermediate dorsal cutaneous Nerve of the foot was absent or did not innervate any toe. The deep part of the Superficial Fibular Nerve was in contact with the intermuscular septum. Its Superficial part was parallel with the lateral malleolus when the Nerve pierced the fascia more proximally and oblique to the lateral malleolus when the Nerve pierced the fascia distally. In one case the intermediate dorsal cutaneous Nerve of the foot was in danger of laceration during a subcutaneous incision to the lateral malleolus. In 7 cases (10%) the sural Nerve overlapped or was tangent to the tip of the malleolus. Malleolar Nerve branches were identified in 76% of the cases (in 28% from both sources). The sural Nerve supplies the lateral 5 dorsal digital Nerves in 40% of cases. Our study indicates that during the approach to the lateral malleolus there is a high risk of laceration of malleolar branches from both the sural and the Superficial Fibular Nerves. There is less risk of damage to the main trunk of these Nerves, but the 10% chance of laceration of sural Nerve at the tip of the malleolus is significant. As the sural Nerve supplies the Superficial innervation to the lateral half of the foot and toes in 40% of cases, the risk of its laceration is even more important than indicated by the common anatomical teaching.
Lucian B. Solomon - One of the best experts on this subject based on the ideXlab platform.
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Surgical anatomy of the sural and Superficial Fibular Nerves with an emphasis on the approach to the lateral malleolus.
Journal of Anatomy, 2001Co-Authors: Lucian B. Solomon, L. Ferris, R. Tedman, Maciej HennebergAbstract:The aim of this study was to investigate the risk and to analyse the significance of laceration of the sural and Superficial Fibular Nerves during the surgical approach to the lateral malleolus. The sural and the Superficial Fibular Nerves, and their branches were dissected under ×3 magnifying lenses in 68 embalmed leg-ankle-foot specimens. The specimens were measured, drawn and photographed. In 35% of specimens the Superficial Fibular Nerve branched before piercing the crural fascia, and in all these specimens the medial dorsal cutaneous Nerve of the foot was located in the anterior compartment while the intermediate dorsal cutaneous Nerve of the foot was located in the lateral compartment. In 35% of specimens the intermediate dorsal cutaneous Nerve of the foot was absent or did not innervate any toe. The deep part of the Superficial Fibular Nerve was in contact with the intermuscular septum. Its Superficial part was parallel with the lateral malleolus when the Nerve pierced the fascia more proximally and oblique to the lateral malleolus when the Nerve pierced the fascia distally. In one case the intermediate dorsal cutaneous Nerve of the foot was in danger of laceration during a subcutaneous incision to the lateral malleolus. In 7 cases (10%) the sural Nerve overlapped or was tangent to the tip of the malleolus. Malleolar Nerve branches were identified in 76% of the cases (in 28% from both sources). The sural Nerve supplies the lateral 5 dorsal digital Nerves in 40% of cases. Our study indicates that during the approach to the lateral malleolus there is a high risk of laceration of malleolar branches from both the sural and the Superficial Fibular Nerves. There is less risk of damage to the main trunk of these Nerves, but the 10% chance of laceration of sural Nerve at the tip of the malleolus is significant. As the sural Nerve supplies the Superficial innervation to the lateral half of the foot and toes in 40% of cases, the risk of its laceration is even more important than indicated by the common anatomical teaching.
Etienne Allart - One of the best experts on this subject based on the ideXlab platform.
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Distribution of the branches of common and Superficial Fibular Nerves to peronei longus et brevis muscles. Use in the treatment of spasticity of Fibular muscles.
Annals of Physical and Rehabilitation Medicine, 2016Co-Authors: Christian Fontaine, Jean-christophe Porchet, Aurélien Aumar, M.y. Grauwin, Nadine Nachef, Etienne AllartAbstract:Objective Beside the posterior leg compartment, spasticity of the hemiplegic patient can involve other muscle groups in the leg. Spasticity of the lateral compartment is responsible of a vertical clonus that may be confused with the clonus of the triceps surae (long Fibular) or a transverse clonus (short Fibular), and by the liveliness of the tendon reflex when striking their tendon. Beside recurrent botulinum toxin injections, this spasticity may be treated by a hyponeurotisation by partial section of the branches of the Superficial Fibular Nerve to the muscle(s) concerned. Its technique has never been described. Material/patients and methods Twelve legs of formalin corpses have been dissected. The number of branches to PL and PB, their level of emergence from the common and deep Fibular Nerves, and their entry point into the muscle have been measured from the lateral femoral-tibial articular space (LTF). Results There was always a common trunk to the EDL and the EHL, arisen on average at 10.3 cm (8.2–13.6) from the LTF line. Six times out of 10 in addition to this common one (3), two (2) or three (1) additional branches to the EDL, arisen between 4.6 and 12 cm downstream the LTF line. Six times out of 10 in addition to this common trunk existed one (4) or two (2) additional branches to the EHL, arisen between 13 and 26 cm downstream the LTF line. Discussion–conclusion This first study allow establishing the surgical technique of the hyponeurotisation of PL and PB muscles. The first results are presented.
Santos, Lázaro Antonio Dos - One of the best experts on this subject based on the ideXlab platform.
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Origem e distribuição do plexo lombossacral de javali (Sus scrofa - Linnaeus, 1758)
Universidade Federal de Uberlândia, 2016Co-Authors: Santos, Lázaro Antonio DosAbstract:Objetivou-se estudar a origem e distribuição do plexo lombossacral de Sus scrofa. Foram utilizados 30 exemplares, sendo 13 fêmeas e 17 machos, após serem fixados em solução aquosa de formaldeído a 10%. Os javalis possuem cinco ou seis vértebras lombares e quatro sacrais. O plexo lombossacral origina-se dos segmentos medulares de L2 a S4. O nervo cutâneo femoral lateral de L2 a L4 ramifica-se nos músculos psoas maior e menor, oblíquo interno do abdome, linfonodos subilíacos e pele da região da articulação do joelho. O nervo femoral de L3 a L6 supre os músculos psoas maior, psoas menor, ilíaco, quadríceps femoral, pectíneo, emite nervo safeno que inerva o músculo sartório e fáscia e pele das articulações do joelho e tarso. O nervo obturatório de L3 a L6 distribui-se para os músculos obturador externo, pectíneo, grácil e adutor. Nervo glúteo cranial de L4 a S1 inerva os músculos glúteo médio e piriforme. Nervo glúteo caudal de L6 a S2 emite ramos para o músculo glúteo Superficial. Nervo isquiático de L4 a S2 inerva os músculos tensor da fáscia lata, glúteo médio, glúteo profundo, glúteo acessório, gêmeos, quadrado femoral, semitendíneo, semimbranáceo, bíceps femoral. O nervo tibial supre os músculos gastrocnêmico, sóleo, poplíteo e flexores profundos dos dedos na região plantar divide-se em nervos plantares medial e lateral, os quais ramificam em digitais plantares. O nervo Fibular comum divide-se em nervos Fibular Superficial e Fibular profundo. O Fibular profundo emite ramos para os músculos tibial cranial, Fibular terceiro, extensor longos dos dedos, Fibular longo, extensor lateral dos dedos e interósseo. O nervo Fibular Superficial supre a fáscia da articulação do tarso continua como nervos digitais dorsais. O nervo pudendo de S2 a S4 distribui-se para músculos, esfíncter externos do ânus, levantador do ânus, constritor da vulva, isquiocavernoso e bulboesponjoso, emite os ramos dorsal do clitóris e mamários que inervam clitóris e pele da região vulvar respectivamente, o ramo dorsal do pênis distribui-se na glande pênis, prepúcio e escroto. O nervo retal caudal de S2 a S4 distribui-se para os músculos levantadores do ânus, coccígeo e esfíncter externo do ânus. A formação do plexo lombossacral, assim como origens e distribuições dos nervos que o compõem são similares aos descritos na literatura alusiva aos animais domésticos.It aimed to study the origin and distribution of the lumbosacral plexus of Sus scrofa. 30 specimens were used, with 13 females and 17 males, after being fixed in an aqueous 10% formaldehyde. Boars have five or six lumbar vertebrae and four sacral vertebrae. The lumbosacral plexus originates from the spinal cord segments from L2 to S4. The lateral femoral cutaneous Nerve from L2 to L4 branches off to the psoas major and minor muscles, internal oblique of the abdomen, sub-iliac lymph nodes and the knee joint region skin. The femoral Nerve L3 to L6 supplies the major psoas muscle, iliac minor psoas, femoral quadriceps, pectineus, emits saphenous Nerve that innervates the sartorius muscle and fascia and skin of the knee and tarsus joints. The obturator Nerve from L3 to L6 is distributed to the external obturator muscles, pectineus, gracilis and adductor. The gluteal cranial Nerve from L4 to S1 innervates the gluteus medius and piriformis muscles. The gluteal caudal Nerve from L6 to S2 emits branches to the Superficial gluteal muscle. The sciatic Nerve from L4 to S2 innervates the tensor muscles of the fascia lata, gluteus medius, deep gluteus, gluteus accessory, twins, femoral square, semitendinosus, semimembranosus, biceps femoris. The tibial Nerve supplies the gastrocnemius, soleus, popliteal and the deep finger flexors in the plantar region that is divided into medial and lateral plantar Nerves which branch off into digital plantar. The common Fibular Nerve is divided into Superficial Nerves and deep Fibular. The deep Fibular Nerve emits branches to the cranial tibial, third Fibular, long extensor of fingers, peroneus longus, lateral extensor digitorum and interosseous muscles. The Superficial Fibular Nerve supplies the fascia joint of the tarsos, which continues as dorsal digital Nerves. The pudendal Nerve from S2 to S4 is distributed to muscles, external anal sphincter, levator ani, constrictor of the vulva, ischiocavernosus and bulbospongiosus, emits the dorsal branches of the clitoris and of the breast, that innervate the clitoris and skin of the vulvar region, respectively. The dorsal branch of the penis is distributed in the glans penis, prepuce and scrotum. The rectal caudal Nerve from S2 to S4 is distributed to the levator ani, coccyx and external anal sphincter. The formation of the lumbosacral plexus, as well as sources and distributions of the Nerves that form it, are similar to those described in the literature alluding to domestic animals
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Origem e distribuição do plexo lombossacral de javali (Sus scrofa - Linnaeus, 1758)
'EDUFU - Editora da Universidade Federal de Uberlandia', 2016Co-Authors: Santos, Lázaro Antonio DosAbstract:It aimed to study the origin and distribution of the lumbosacral plexus of Sus scrofa. 30 specimens were used, with 13 females and 17 males, after being fixed in an aqueous 10% formaldehyde. Boars have five or six lumbar vertebrae and four sacral vertebrae. The lumbosacral plexus originates from the spinal cord segments from L2 to S4. The lateral femoral cutaneous Nerve from L2 to L4 branches off to the psoas major and minor muscles, internal oblique of the abdomen, sub-iliac lymph nodes and the knee joint region skin. The femoral Nerve L3 to L6 supplies the major psoas muscle, iliac minor psoas, femoral quadriceps, pectineus, emits saphenous Nerve that innervates the sartorius muscle and fascia and skin of the knee and tarsus joints. The obturator Nerve from L3 to L6 is distributed to the external obturator muscles, pectineus, gracilis and adductor. The gluteal cranial Nerve from L4 to S1 innervates the gluteus medius and piriformis muscles. The gluteal caudal Nerve from L6 to S2 emits branches to the Superficial gluteal muscle. The sciatic Nerve from L4 to S2 innervates the tensor muscles of the fascia lata, gluteus medius, deep gluteus, gluteus accessory, twins, femoral square, semitendinosus, semimembranosus, biceps femoris. The tibial Nerve supplies the gastrocnemius, soleus, popliteal and the deep finger flexors in the plantar region that is divided into medial and lateral plantar Nerves which branch off into digital plantar. The common Fibular Nerve is divided into Superficial Nerves and deep Fibular. The deep Fibular Nerve emits branches to the cranial tibial, third Fibular, long extensor of fingers, peroneus longus, lateral extensor digitorum and interosseous muscles. The Superficial Fibular Nerve supplies the fascia joint of the tarsos, which continues as dorsal digital Nerves. The pudendal Nerve from S2 to S4 is distributed to muscles, external anal sphincter, levator ani, constrictor of the vulva, ischiocavernosus and bulbospongiosus, emits the dorsal branches of the clitoris and of the breast, that innervate the clitoris and skin of the vulvar region, respectively. The dorsal branch of the penis is distributed in the glans penis, prepuce and scrotum. The rectal caudal Nerve from S2 to S4 is distributed to the levator ani, coccyx and external anal sphincter. The formation of the lumbosacral plexus, as well as sources and distributions of the Nerves that form it, are similar to those described in the literature alluding to domestic animals.Tese (Doutorado)Objetivou-se estudar a origem e distribuição do plexo lombossacral de Sus scrofa. Foram utilizados 30 exemplares, sendo 13 fêmeas e 17 machos, após serem fixados em solução aquosa de formaldeído a 10%. Os javalis possuem cinco ou seis vértebras lombares e quatro sacrais. O plexo lombossacral origina-se dos segmentos medulares de L2 a S4. O nervo cutâneo femoral lateral de L2 a L4 ramifica-se nos músculos psoas maior e menor, oblíquo interno do abdome, linfonodos subilíacos e pele da região da articulação do joelho. O nervo femoral de L3 a L6 supre os músculos psoas maior, psoas menor, ilíaco, quadríceps femoral, pectíneo, emite nervo safeno que inerva o músculo sartório e fáscia e pele das articulações do joelho e tarso. O nervo obturatório de L3 a L6 distribui-se para os músculos obturador externo, pectíneo, grácil e adutor. Nervo glúteo cranial de L4 a S1 inerva os músculos glúteo médio e piriforme. Nervo glúteo caudal de L6 a S2 emite ramos para o músculo glúteo Superficial. Nervo isquiático de L4 a S2 inerva os músculos tensor da fáscia lata, glúteo médio, glúteo profundo, glúteo acessório, gêmeos, quadrado femoral, semitendíneo, semimbranáceo, bíceps femoral. O nervo tibial supre os músculos gastrocnêmico, sóleo, poplíteo e flexores profundos dos dedos na região plantar divide-se em nervos plantares medial e lateral, os quais ramificam em digitais plantares. O nervo Fibular comum divide-se em nervos Fibular Superficial e Fibular profundo. O Fibular profundo emite ramos para os músculos tibial cranial, Fibular terceiro, extensor longos dos dedos, Fibular longo, extensor lateral dos dedos e interósseo. O nervo Fibular Superficial supre a fáscia da articulação do tarso continua como nervos digitais dorsais. O nervo pudendo de S2 a S4 distribui-se para músculos, esfíncter externos do ânus, levantador do ânus, constritor da vulva, isquiocavernoso e bulboesponjoso, emite os ramos dorsal do clitóris e mamários que inervam clitóris e pele da região vulvar respectivamente, o ramo dorsal do pênis distribui-se na glande pênis, prepúcio e escroto. O nervo retal caudal de S2 a S4 distribui-se para os músculos levantadores do ânus, coccígeo e esfíncter externo do ânus. A formação do plexo lombossacral, assim como origens e distribuições dos nervos que o compõem são similares aos descritos na literatura alusiva aos animais domésticos
C R Slater - One of the best experts on this subject based on the ideXlab platform.
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Release and synthesis of acetylcholine at ectopic neuromuscular junctions in the rat.
The Journal of Physiology, 1994Co-Authors: G. T. H. Van Kempen, Peter C. M. Molenaar, C R SlaterAbstract:1. The ability of axons in the Superficial Fibular Nerve to synthesize and release acetylcholine (ACh) has been studied before and after the formation of ectopic neuromuscular junctions (NMJs) with denervated soleus muscles of adult rats. 2. The central end of the severed Fibular Nerve was transplanted to the surface of the soleus muscle. After 3.5-5 weeks the soleus muscle was denervated in one group of rats by cutting the tibial Nerve, allowing the formation of functional ectopic NMJs within a few days. In other rats the tibial Nerve remained intact, preventing the formation of functional ectopic NMJs. 3. A month later the content of ACh, the levels of activity of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE), and the amount of ACh released by depolarization by exposure to 50 mM KCl were measured in segments of isolated muscles that (i) contained normal or ectopic NMJs, (ii) were free of Nerve or (iii) contained Nerve that had not made NMJs. 4. Regions of muscles with ectopic Nerve growth in which new NMJs had not formed contained substantial amounts of ACh and ChAT but no AChE. No detectable release of ACh could be evoked from these regions. 5. In muscles in which ectopic NMJs had formed after cutting the tibial Nerve, the amounts of ACh and ChAT were about one-fifth of those in the regions of innervation of control muscles. ACh release could be evoked from the region of ectopic Nerve growth in amounts nearly as great as those released from NMJs in normal and contralateral control muscles. 6. We conclude that the ability of the terminal parts of mature motor axons to synthesize and store ACh is largely independent of functional contact with muscle fibres. By contrast, the ability to release ACh in substantial amounts only develops when NMJs are formed. The possible significance of this situation for the development of synapses is discussed.