Positional Anomaly Between the Brachial Plexus and the Scalene Muscles, Concomitant with an Anomalous Path of the Musculocutaneous Nerve
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Respiratory Function of the Rib Cage Muscles
Copyright @ERS Journals Ltd 1993 Eur Respir J, 1993, 6, 722-728 European Respiratory Journal Printed In UK • all rights reserved ISSN 0903 • 1936 REVIEW Respiratory function of the rib cage muscles J.N. Han, G. Gayan-Ramirez, A. Dekhuijzen, M. Decramer Respiratory function of the rib cage muscles. J.N. Han, G. Gayan-Ramirez, R. Respiratory Muscle Research Unit, Labo Dekhuijzen, M. Decramer. ©ERS Journals Ltd 1993. ratory of Pneumology, Respiratory ABSTRACT: Elevation of the ribs and expansion of the rib cage result from the Division, Katholieke Universiteit Leuven, co-ordinated action of the rib cage muscles. We wished to review the action and Belgium. interaction of the rib cage muscles during ventilation. Correspondence: M. Decramer The parasternal intercostal muscles appear to play a predominant role during Respiratory Division quiet breathing, both in humans and in anaesthetized dogs. In humans, the para University Hospital sternal intercostals act in concert with the scalene muscles to expand the upper rib Weligerveld 1 cage, and/or to prevent it from being drawn inward by the action of the diaphragm. B-3212 Pellenberg The external intercostal muscles are considered to be active mainly during inspira Leuven tion, and the internal intercostal muscles during expiration. Belgium The respiratory activity of the external intercostals is minimal during quiet breathing both in man and in dogs, but increases with increasing ventilation. In Keywords: Chest wall mechanics contractile properties spiratory activity in the external intercostals can be enhanced in anaesthetized ani rib cage muscles mals and humans by inspiratory mechanical loading and by col stimulation, rib displacement suggesting that the external intercostals may constitute a reserve system, that may be recruited when the desired expansion of the rib cage is increased. -
6. the Pharynx the Pharynx, Which Forms the Upper Part of the Digestive Tract, Consists of Three Parts: the Nasopharynx, the Oropharynx and the Laryngopharynx
6. The Pharynx The pharynx, which forms the upper part of the digestive tract, consists of three parts: the nasopharynx, the oropharynx and the laryngopharynx. The principle object of this dissection is to observe the pharyngeal constrictors that form the back wall of the vocal tract. Because the cadaver is lying face down, we will consider these muscles from the back. Figure 6.1 shows their location. stylopharyngeus suuperior phayngeal constrictor mandible medial hyoid bone phayngeal constrictor inferior phayngeal constrictor Figure 6.1. Posterior view of the muscles of the pharynx. Each of the three pharyngeal constrictors has a left and right part that interdigitate (join in fingerlike branches) in the midline, forming a raphe, or union. This raphe forms the back wall of the pharynx. The superior pharyngeal constrictor is largely in the nasopharynx. It has several origins (some texts regard it as more than one muscle) one of which is the medial pterygoid plate. It assists in the constriction of the nasopharynx, but has little role in speech production other than helping form a site against which the velum may be pulled when forming a velic closure. The medial pharyngeal constrictor, which originates on the greater horn of the hyoid bone, also has little function in speech. To some extent it can be considered as an elevator of the hyoid bone, but its most important role for speech is simply as the back wall of the vocal tract. The inferior pharyngeal constrictor also performs this function, but plays a more important role constricting the pharynx in the formation of pharyngeal consonants. -
Relation of Roots and Trunks of Brachial Plexus to Scalenus Anterior Muscle and Its Clinical Significance
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 11, Issue 4 (Nov.- Dec. 2013), PP 03-05 www.iosrjournals.org Relation of roots and trunks of brachial plexus to scalenus anterior muscle and its clinical significance Yogesh1, Viveka S2, Sudha M J3, Santosh Kumar S.C4, Sanjay Revankar5 1Assistant Professor, Department of Anatomy, Shridevi Institute of Medical Sciences & Research Hospital, Tumkur 2Assistant Professor, Department of Anatomy, Azeezia Institute of Medical Sciences, Kollam 3Assistant Professor, Department of Pharmacology, Azeezia Institute of Medical Sciences, Kollam 4 Department of Pharmacology, Shridevi Institute of Medical Sciences & Research Hospital, Tumkur 5Post graduate, Department of Anatomy, A J Institute of Medical Sciences, Mangalore. Abstract: Variations in the structures at the root of neck are important in understanding many clinical and surgical conditions. Scalenus anterior, the key muscle in the neck, usually related to the roots of brachial plexus in its posterior aspect. This study was designed to evaluate the relations of roots of brachial plexus to the scalene muscles. Posterior triangles of neck on both sides were studied in 24 cadavers. In two cases C5 and C6 pierced scalenus anterior muscle and emerged from its anterior surface. In other specimen roots of C5, C6 and C7 entered scalenus muscle and exited anterolateraly in a sequential manner. Knowledge of such variations is important for anaesthetists and surgeons. Key words: Scalenus anterior; Scalenus medius; roots of brachial plexus; variations I. Introduction Brachial plexus is formed by union of ventral rami of lower four cervical nerves and first thoracic nerve. -
Hyperfunctional Laryngeal Conditions: Muscle Tension
Karen Drake MA, CCC-SLP Linda Bryans MA, CCC-SLP Jana Childes MS, CCC-SLP Identify disorders that can be classified as hyperfunctional laryngeal conditions Describe how laryngeal hyperfunction can contribute to dysphonia, chronic cough and paradoxical vocal fold motion (PVFM) Describe how treatment may be modified to better address these interrelationships 2 3 “MTD can be described as the pathological condition in which an excessive tension of the (para)laryngeal musculature, caused by a diverse number of etiological factors, leads to a disturbed voice.” ◦ Van Houtte, Van Lierde & Claeys (2011) Descriptive label Multiple etiological factors Diagnosed by specific findings on videostroboscopy Voice therapy is the treatment of choice – supported by a joint statement of the AAO and ASHA in 2005 Hoarseness Poor vocal quality Vocal fatigue Increase voicing effort/strain Difficulty with projection Inability to be understood over background noise or the telephone Voice breaks Periods of voice loss Sore throat Globus sensation Throat clearing Pressure, tightness or tension Tenderness Difficulty getting a full breath Running out of air with speaking Difficulty swallowing secretions Disturbed Altered tension of Changed position inclination of extrinsic muscles of larynx in neck cartilaginous structures Tension of intrinsic Voice disturbance musculature Van Houtte, Van Lierde & Claeys (2011) Excess jaw tension Lingual posture and/or tension Altered resonance focus Breath holding Poor coordination of breath and voice Pharyngeal -
Muscular and Skeletal Changes in Cervical Dysphonic in Women
Original Article Muscular and Skeletal Changes in Cervical Dysphonic in Women Alterações Musculares e Esqueléticas Cervicais em Mulheres Disfônicas Laiza Carine Maia Menoncin*, Ari Leon Jurkiewicz**, Kelly Cristina A. Silvério***, Paulo Monteiro Camargo****, Nathália Martii Monti Wolff*****. * Master in Communication Disorders at the University Tuiuti. Physiotherapist. ** PhD, UNIFESP. Professor of the Masters Program in Communication Disorders at the University Tuiuti. *** Doctor Unicamp. Professor, Master’s and Doctoral Program in Communication Disorders at the University Tuiuti. **** PhD in Clinical - Surgical UFPR. Head of the Department of Laryngology of the Hospital Angelina Caron. ***** Medical. ENT resident. Institution: University of Tuiuti Curitiba. Curitiba / PR - Brazil. Mail Address: Nathan Wolff Monti Martini - Sector Master Program in Communication Disorders - Rua Sydnei A. Rangel Santos, 238 - Curitiba / PR - Brazil - Zip code: 82010-330 - Telephone: (+55 41) 3331-7700 - E-mail: [email protected] Article received on June 14, 2010. Approved on 1 October 2010. SUMMARY Introduction: The vocal and neck are associated with the presence of tension and cervical muscle contraction. These disorders compromise the vocal tract and musculoskeletal cervical region and, thus, can cause muscle shortening, pain and fatigue in the neck and shoulder girdle. Objective: To evaluate and identify cervical abnormalities in women with vocal disorders, and neck pains comparing them to women without vocal complaints independent of the neck. Method: This prospective study of 32 subjects studied in the dysphonic group and 18 subjects in the control group, aged between 25 and 55 year old female. The subjects underwent assessments, ENT, orthopedic, physical therapy and voice recording. Results: At Rx cervical region more patients in the control group had this normal, however, with regard to the reduction of spaces interdiscal dysphonic patients prevailed. -
Levator Scapulae Muscle Asymmetry Presenting As a Palpable Neck Mass: CT Evaluation
Levator Scapulae Muscle Asymmetry Presenting as a Palpable Neck Mass: CT Evaluation Barry A. Shpizner1 and Roy A . Hollida/ PURPOSE: To define the normal CT anatomy of the levator scapulae muscle and to report on a series of five patients who presented with a palpable mass in the posterior triangle due to asymmetry of the levator scapulae muscles. PATIENTS AND METHODS: The contrast-enhanced CT examinations of the neck in 25 patients without palpable masses were reviewed to es tablish the normal CT appearance of the levator scapulae muscle. We retrospectively reviewed the contrast-enhanced CT examinations of the neck in five patients who presented with a palpable mass secondary to asymmetric levator scapulae muscles . RESULTS: In three patients who had undergone unilateral radical neck dissection, hypertrophy of the ipsi lateral levator scapulae muscle was found. In one patient, the normal levator scapulae muscle produced a fa ctitious "mass" due to atrophy of the contralateral levator scapulae muscle. One patient had an intramuscular neoplasm of the levator scapulae. CONCLUSION: Asymmetry of the levator scapulae muscles , an unusual cause of a posterior triangle mass, can be diagnosed using CT. Index terms: Neck, muscles; Neck, computed tomography AJNR 14:461-464, Mar/ Apr 1993 The levator scapulae muscle can be identified between January 1987 and March 1991 were reviewed. A ll readily on axial images by its characteristic ap patients presented with a palpable mass in the posterior pearance and its relationship to the other muscles triangle of the infrahyoid neck. The patients, three men forming the boundaries of the posterior triangle. -
Prevertebral Muscles (A, B) Scalene Muscles (A, B)
80 Trunk Prevertebral Muscles (A, B) lift the first two pairs of ribs and thus the superior part of the thorax. Their action is The prevertebral muscles include the rec- increased when the head is bent backward. tus capitis anterior, longus capitis, and lon- Unilateral contraction tilts the cervical gus colli. column to one side. Occasionally there is a The rectus capitis anterior (1) extends scalenus minimus which arises from the from the lateral mass of the atlas (2) to the seventh cervical vertebra and joins the basal part of the occipital bone (3). It helps scalenus medius. It is attached to the apex to flex the head. of the pleura. Nerve supply: cervical plexus (C1). The scalenus anterior (17) arises from the The longus capitis (4) arises from the ante- anterior tubercles of the transverse Trunk rior tubercles of the transverse processes of processes of the (third) fourth to sixth cervi- the third to sixth cervical vertebrae (5). It cal vertebrae (18) and is inserted on the runs upward and is attached to the basal anterior scalene tubercle (19) of the first rib. part of the occipital bone (6). The two longi Nerve supply: brachial plexus (C5 –C7). capitis muscles bend the head forward. The scalenus medius (20) arises from the pos- Unilateral action of the muscle helps to tilt terior tubercles of the transverse processes the head sideways. of the (first) second to seventh cervical Nerve supply: cervical plexus (C1 –C4). vertebrae (21). It is inserted into the 1st rib The longus colli (7) is roughly triangular in behind the subclavian artery groove and shape because it consists of three groups of into the external intercostal membrane of fibers. -
Levator Claviculae: a Case Report and Review of the Literature
Folia Morphol. Vol. 67, No. 4, pp. 307–310 Copyright © 2008 Via Medica C A S E R E P O R T ISSN 0015–5659 www.fm.viamedica.pl Levator claviculae: a case report and review of the literature M. Loukas1, A. Sullivan1, R.S. Tubbs2, M.M. Shoja3 1Department of Anatomical Sciences, School of Medicine, St. George’s University, Grenada, West Indies 2Section of Pediatric Neurosurgery, Children’s Hospital, Birmingham, AL, USA 3Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran [Received 3 April 2008; Accepted 29 August 2008] The levator claviculae is an uncommon anatomical variant found in the poste- rior cervical triangle. In this report we present a 78-year-old man with this muscular variation, which was found during gross anatomical dissection. While sites of insertion and origin have been variable, in the present case the muscle originated from the left transverse processes of C3 and C4, and inserted onto the lateral third of the ipsilateral clavicle. Clinical considerations of this variant anatomy are of interest, as they may present in patients as a supraclavicular mass and may also mimic pathology on cross-sectional imaging. (Folia Morphol 2008; 67: 307–310) Key words: anatomy, neck, cervical, clavicle INTRODUCTION reports have been documented as well, although The levator claviculae is a very rare variation of these are much less common [3, 14]. The nerve sup- the cervical musculature, although it is observed reg- ply of the levator claviculae has been described as ularly in certain mammalian species [7, 14, 17]. It arising from a branch of the fourth cervical nerve lies in the posterior cervical triangle of the neck, usually and its blood supply as stemming from the ascend- arising from the transverse processes of the upper ing cervical artery [8, 11]. -
Shifteh Retropharyngeal Danger and Paraspinal Spaces ASHNR 2016
Acknowledgment • Illustrations Courtesy Amirsys, Inc. Retropharyngeal, Danger, and Paraspinal Spaces Keivan Shifteh, M.D. Professor of Clinical Radiology Director of Head & Neck Imaging Program Director, Neuroradiology Fellowship Montefiore Medical Center Albert Einstein College of Medicine Bronx, New York Retropharyngeal, Danger, and Retropharyngeal Space (RPS) Paraspinal Spaces • It is a potential space traversing supra- & infrahyoid neck. • Although diseases affecting these spaces are relatively uncommon, they can result in significant morbidity. • Because of the deep location of these spaces within the neck, lesions arising from these locations are often inaccessible to clinical examination but they are readily demonstrated on CT and MRI. • Therefore, cross-sectional imaging plays an important role in the evaluation of these spaces. Retropharyngeal Space (RPS) Retropharyngeal Space (RPS) • It is seen as a thin line of fat between the pharyngeal • It is bounded anteriorly by the MLDCF (buccopharyngeal constrictor muscles anteriorly and the prevertebral fascia), posteriorly by the DLDCF (prevertebral fascia), and muscles posteriorly. laterally by sagittaly oriented slips of DLDCF (cloison sagittale). Alar fascia (AF) Retropharyngeal Space • Coronally oriented slip of DLDCF (alar fascia) extends from • The anterior compartment is true or proper RPS and the the medial border of the carotid space on either side and posterior compartment is danger space. divides the RPS into 2 compartments: Scali F et al. Annal Otol Rhinol Laryngol. 2015 May 19. Retropharyngeal Space Danger Space (DS) • The true RPS extends from the clivus inferiorly to a variable • The danger space extends further inferiorly into the posterior level between the T1 and T6 vertebrae where the alar fascia mediastinum just above the diaphragm. -
Seventh Cervical Nerve Perforating the Middle Scalene Muscle: a Possible Clinical and Surgical Application
Original article http://dx.doi.org/10.4322/jms.ao041013 Seventh cervical nerve perforating the middle scalene muscle: a possible clinical and surgical application SILVA, A. T.1*, GAMA, H. V. P.1, SIQUEIRA, S. L.2, SALES, M. C.3, FRANCO, A. G.1 and CASAGRANDE, M. M.3 1Acadêmico do 5º ano de Medicina da Faculdade de Ciências Médicas de Minas Gerais, Monitor da disciplina de Anatomia, Departamento de Anatomia, Faculdade de Ciências Médicas de Minas Gerais – FCMMG, Alameda Ezequiel Dias, 275, Santa Efigênia, CEP 30130-110, Belo Horizonte, MG, Brazil 2Pós-doutor em Ciências e Técnicas Nucleares pela Universidade Federal de Minas Gerais – UFMG, Mestre e Doutor em Cirurgia pela UFMG, Professor Assistente da Disciplina de Anatomia da Faculdade de Ciências Médicas de Minas Gerais – FCMMG, Professor Adjunto de Cirurgia da Universidade Federal de Ouro Preto – UFOP, Departamento de Anatomia, Faculdade de Ciências Médicas de Minas Gerais – FCMMG, Alameda Ezequiel Dias, 275, Santa Efigênia, CEP 30130-110, Belo Horizonte, MG, Brazil 3Acadêmico do 4º ano de Medicina da Faculdade de Ciências Médicas de Minas Gerais, Monitor da disciplina de Anatomia, Departamento de Anatomia, Faculdade de Ciências Médicas de Minas Gerais – FCMMG, Alameda Ezequiel Dias, 275, Santa Efigênia, CEP 30130-110, Belo Horizonte, MG, Brazil *E-mail: [email protected] Abstract Introduction: In most of cases, the emergency of the nervous roots of the brachial plexus in the posterior cervical triangle occur between the anterior and middle scalene muscles. However, anatomic variations in the brachial plexus are not rare. Methods: In the laboratory of Human Anatomy of the “Faculdade de Ciências Médicas de Minas Gerais” 106 cadavers were dissected. -
Fascia and Spaces on the Neck: Myths and Reality Fascije I Prostori Vrata: Mit I Stvarnost
Review/Pregledni članak Fascia and spaces on the neck: myths and reality Fascije i prostori vrata: mit i stvarnost Georg Feigl* Institute of Anatomy, Medical University of Graz, Graz, Austria Abstract. The ongoing discussion concerning the interpretation of existing or not existing fas- ciae on the neck needs a clarification and a valid terminology. Based on the dissection experi- ence of the last four decades and therefore of about 1000 cadavers, we investigated the fas- cias and spaces on the neck and compared it to the existing internationally used terminology and interpretations of textbooks and publications. All findings were documented by photog- raphy and the dissections performed on cadavers embalmed with Thiel´s method. Neglected fascias, such as the intercarotid fascia located between both carotid sheaths and passing be- hind the visceras or the Fascia cervicalis media as a fascia between the two omohyoid mus- cles, were dissected on each cadaver. The ”Danger space” therefore was limited by fibrous walls on four sides at level of the carotid triangle. Ventrally there was the intercarotid fascia, laterally the alar fascia, and dorsally the prevertebral fascia. The intercarotid fascia is a clear fibrous wall between the Danger Space and the ventrally located retropharyngeal space. Lat- ter space has a continuation to the pretracheal space which is ventrally limited by the middle cervical fascia. The existence of an intercarotid fascia is crucial for a correct interpretation of any bleeding or inflammation processes, because it changes the topography of the existing spaces such as the retropharyngeal or “Danger space” as well. As a consequence, the existing terminology should be discussed and needs to be adapted. -
Suprahyoid and Infrahyoid Neck Overview
Suprahyoid and Infrahyoid Neck Overview Imaging Approaches & Indications by space, the skull base interactions above and IHN extension below are apparent. Neither CT nor MR is a perfect modality for imaging the • PPS has bland triangular skull base abutment without extracranial H&N. MR is most useful in the suprahyoid neck critical foramen involved; it empties inferiorly into (SHN) because it is less affected by oral cavity dental amalgam submandibular space (SMS) artifact. The SHN tissue is less affected by motion compared • PMS touches posterior basisphenoid and anterior with the infrahyoid neck (IHN); therefore, the MR image basiocciput, including foramen lacerum; PMS includes quality is not degraded by movement seen in the IHN. Axial nasopharyngeal, oropharyngeal, and hypopharyngeal and coronal T1 fat-saturated enhanced MR is superior to CECT mucosal surfaces in defining soft tissue extent of tumor, perineural tumor • MS superior skull base interaction includes zygomatic spread, and dural/intracranial spread. When MR is combined with CT of the facial bones and skull base, a clinician can obtain arch, condylar fossa, skull base, including foramen ovale (CNV3), and foramen spinosum (middle meningeal precise mapping of SHN lesions. Suprahyoid and Infrahyoid Neck artery); MS ends at inferior surface of body of mandible CECT is the modality of choice when IHN and mediastinum are • PS abuts floor of external auditory canal, mastoid tip, imaged. Swallowing, coughing, and breathing makes this area including stylomastoid foramen (CNVII); parotid tail a "moving target" for the imager. MR image quality is often extends inferiorly into posterior SMS degraded as a result. Multislice CT with multiplanar • CS meets jugular foramen (CNIX-XI) floor, hypoglossal reformations now permits exquisite images of the IHN canal (CNXII), and petrous internal carotid artery canal; unaffected by movement.