Stereotactic Topography of the Greater and Third Occipital Nerves and Its
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Gross Anatomy
www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY www.BookOfLinks.com Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the infor- mation contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY David A. Morton, PhD Associate Professor Anatomy Director Department of Neurobiology and Anatomy University of Utah School of Medicine Salt Lake City, Utah K. Bo Foreman, PhD, PT Assistant Professor Anatomy Director University of Utah College of Health Salt Lake City, Utah Kurt H. -
Comparing the Injectate Spread and Nerve
Journal name: Journal of Pain Research Article Designation: Original Research Year: 2018 Volume: 11 Journal of Pain Research Dovepress Running head verso: Baek et al Running head recto: Ultrasound-guided GON block open access to scientific and medical research DOI: http://dx.doi.org/10.2147/JPR.S17269 Open Access Full Text Article ORIGINAL RESEARCH Comparing the injectate spread and nerve involvement between different injectate volumes for ultrasound-guided greater occipital nerve block at the C2 level: a cadaveric evaluation In Chan Baek1 Purpose: The spread patterns between different injectate volumes have not yet been investigated Kyungeun Park1 in ultrasound-guided greater occipital nerve (GON) block at the C2 level. This cadaveric study Tae Lim Kim1 was undertaken to compare the spread pattern and nerve involvements of different volumes of Jehoon O2 dye using this technique. Hun-Mu Yang2,* Materials and methods: After randomization, ultrasound-guided GON blocks with 1 or 5 mL dye solution were performed at the C2 level on the right or left side of five fresh cadavers. The Shin Hyung Kim1,* suboccipital regions were dissected, and nerve involvement was investigated. 1 Department of Anesthesiology and Results: Ten injections were successfully completed. In all cases of 5 mL dye, we observed the Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University deeply stained posterior neck muscles, including the suboccipital triangle space. The suboccipital College of Medicine, Seoul, Republic and third occipital nerves, in addition to GONs, were consistently stained when 5-mL dye was 2 of Korea; Department of Anatomy, used in all injections (100%). Although all GONs were successfully stained in the 1-mL dye Yonsei University College of Medicine, Seoul, Republic of Korea cases, three of five injections (60%) concomitantly stained the third occipital nerves. -
Shoulder Anatomy & Clinical Exam
MSK Ultrasound - Spine - Incheon Terminal Orthopedic Private Clinic Yong-Hyun, Yoon C,T-spine Basic Advanced • Medial branch block • C-spine transforaminal block • Facet joint block • Thoracic paravertebral block • C-spine intra-discal injection • Superficial cervical plexus block • Vagus nerve block • Greater occipital nerve block(GON) • Third occipital nerve block(TON) • Hydrodissection • Brachial plexus(1st rib level) • Suboccipital nerve • Stellate ganglion block(SGB) • C1, C2 nerve root, C2 nerve • Brachial plexus block(interscalene) • Recurrent laryngeal nerve • Serratus anterior plane • Cervical nerve root Cervical facet joint Anatomy Diagnosis Cervical facet joint injection C-arm Ultrasound Cervical medial branch Anatomy Nerve innervation • Medial branch • Same level facet joint • Inferior level facet joint • Facet joint • Dual nerve innervation Cervical medial branch C-arm Ultrasound Cervical nerve root Anatomy Diagnosis • Motor • Sensory • Dermatome, myotome, fasciatome Cervical nerve root block C-arm Ultrasound Stallete ganglion block Anatomy Injection Vagus nerve Anatomy Injection L,S-spine Basic Advanced • Medial branch block • Lumbar sympathetic block • Facet joint block • Lumbar plexus block • Superior, inferior hypogastric nerve block • Caudal block • Transverse abdominal plane(TAP) block • Sacral plexus block • Epidural block • Hydrodissection • Interlaminal • Pudendal nerve • Transforaminal injection • Genitofemoral nerve • Superior, inferior cluneal nerve • Rectus abdominal sheath • Erector spinae plane Lumbar facet -
The Neuroanatomy of Female Pelvic Pain
Chapter 2 The Neuroanatomy of Female Pelvic Pain Frank H. Willard and Mark D. Schuenke Introduction The female pelvis is innervated through primary afferent fi bers that course in nerves related to both the somatic and autonomic nervous systems. The somatic pelvis includes the bony pelvis, its ligaments, and its surrounding skeletal muscle of the urogenital and anal triangles, whereas the visceral pelvis includes the endopelvic fascial lining of the levator ani and the organ systems that it surrounds such as the rectum, reproductive organs, and urinary bladder. Uncovering the origin of pelvic pain patterns created by the convergence of these two separate primary afferent fi ber systems – somatic and visceral – on common neuronal circuitry in the sacral and thoracolumbar spinal cord can be a very dif fi cult process. Diagnosing these blended somatovisceral pelvic pain patterns in the female is further complicated by the strong descending signals from the cerebrum and brainstem to the dorsal horn neurons that can signi fi cantly modulate the perception of pain. These descending systems are themselves signi fi cantly in fl uenced by both the physiological (such as hormonal) and psychological (such as emotional) states of the individual further distorting the intensity, quality, and localization of pain from the pelvis. The interpretation of pelvic pain patterns requires a sound knowledge of the innervation of somatic and visceral pelvic structures coupled with an understand- ing of the interactions occurring in the dorsal horn of the lower spinal cord as well as in the brainstem and forebrain. This review will examine the somatic and vis- ceral innervation of the major structures and organ systems in and around the female pelvis. -
Complications Associated with Clavicular Fracture
NOR200061.qxd 9/11/09 1:23 PM Page 217 Complications Associated With Clavicular Fracture George Mouzopoulos ▼ Emmanuil Morakis ▼ Michalis Stamatakos ▼ Mathaios Tzurbakis The objective of our literature review was to inform or- subclavian vein, due to its stable connection with the thopaedic nurses about the complications of clavicular frac- clavicle via the cervical fascia, can also be subjected to ture, which are easily misdiagnosed. For this purpose, we injuries (Casbas et al., 2005). Damage to the internal searched MEDLINE (1965–2005) using the key words clavicle, jugular vein, the suprascapular artery, the axillary, and fracture, and complications. Fractures of the clavicle are usu- carotid artery after a clavicular fracture has also been ally thought to be easily managed by symptomatic treatment reported (Katras et al., 2001). About 50% of injuries to the subclavian arteries are in a broad arm sling. However, it is well recognized that not due to fractures of the clavicle because the proximal all clavicular fractures have a good outcome. Displaced or part is dislocated superiorly by the sternocleidomas- comminuted clavicle fractures are associated with complica- toid, causing damage to the vessel (Sodhi, Arora, & tions such as subclavian vessels injury, hemopneumothorax, Khandelwal, 2007). If no injury happens during the ini- brachial plexus paresis, nonunion, malunion, posttraumatic tial displacement of the fractured part, then it is un- arthritis, refracture, and other complications related to os- likely to happen later, because the distal segment is dis- teosynthesis. Herein, we describe what the orthopaedic nurse placed downward and forward due to shoulder weight, should know about the complications of clavicular fractures. -
A Case Report of an Enlarged Suboccipital Nerve with Cutaneous Branch
Open Access Case Report DOI: 10.7759/cureus.2933 A Case Report of an Enlarged Suboccipital Nerve with Cutaneous Branch Sasha Lake 1 , Joe Iwanaga 2 , Rod J. Oskouian 3 , Marios Loukas 4 , R. Shane Tubbs 5 1. Anatomical Studies, St. George's, St. George, GRD 2. Medical Education and Simulation, Seattle Science Foundation, Seattle, USA 3. Neurosurgery, Swedish Neuroscience Institute, Seattle, USA 4. Anatomical Sciences, St. George's University, St. George's, GRD 5. Neurosurgery, Seattle Science Foundation, Seattle, USA Corresponding author: Joe Iwanaga, [email protected] Abstract Variations of the suboccipital nerve are infrequently reported. This nerve derived from the C1 spinal nerve is usually a small branch that primarily innervates the short suboccipital muscles. During the routine dissection of the occipital region in an adult cadaver, a vastly enlarged left-sided suboccipital nerve was identified. The nerve innervated the short suboccipital muscles and overlying semispinalis capitis in normal fashion. However, it continued cranially to end in the overlying skin of the occiput. Although not normally thought to have a cutaneous branch, recalcitrant occipital neuralgia might be due to such a variant branch. Future studies are necessary to further elucidate this proposed pathomechanism. Categories: Neurology, Pathology Keywords: suboccipital nerve, c1 nerve, occiput cutaneous innervation, sensory suboccipital nerve Introduction The suboccipital nerve is the dorsal ramus of C1. This nerve is found between the skull and atlas and within the suboccipital triangle. Here, it is positioned between the posterior arch of the atlas and vertebral artery bordering the nerve inferiorly and superiorly, respectively [1]. The suboccipital nerve innervates the rectus capitis posterior major and minor, obliquus capitis superior, obliquus capitis inferior, and semispinalis capitis. -
Comparing the Injectate Spread and Nerve
Journal name: Journal of Pain Research Article Designation: Original Research Year: 2018 Volume: 11 Journal of Pain Research Dovepress Running head verso: Baek et al Running head recto: Ultrasound-guided GON block open access to scientific and medical research DOI: http://dx.doi.org/10.2147/JPR.S17269 Open Access Full Text Article ORIGINAL RESEARCH Comparing the injectate spread and nerve involvement between different injectate volumes for ultrasound-guided greater occipital nerve block at the C2 level: a cadaveric evaluation In Chan Baek1 Purpose: The spread patterns between different injectate volumes have not yet been investigated Kyungeun Park1 in ultrasound-guided greater occipital nerve (GON) block at the C2 level. This cadaveric study Tae Lim Kim1 was undertaken to compare the spread pattern and nerve involvements of different volumes of Jehoon O2 dye using this technique. Hun-Mu Yang2,* Materials and methods: After randomization, ultrasound-guided GON blocks with 1 or 5 mL dye solution were performed at the C2 level on the right or left side of five fresh cadavers. The Shin Hyung Kim1,* suboccipital regions were dissected, and nerve involvement was investigated. 1Department of Anesthesiology and For personal use only. Results: Ten injections were successfully completed. In all cases of 5 mL dye, we observed the Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University deeply stained posterior neck muscles, including the suboccipital triangle space. The suboccipital College of Medicine, Seoul, Republic and third occipital nerves, in addition to GONs, were consistently stained when 5-mL dye was 2 of Korea; Department of Anatomy, used in all injections (100%). -
SŁOWNIK ANATOMICZNY (ANGIELSKO–Łacinsłownik Anatomiczny (Angielsko-Łacińsko-Polski)´ SKO–POLSKI)
ANATOMY WORDS (ENGLISH–LATIN–POLISH) SŁOWNIK ANATOMICZNY (ANGIELSKO–ŁACINSłownik anatomiczny (angielsko-łacińsko-polski)´ SKO–POLSKI) English – Je˛zyk angielski Latin – Łacina Polish – Je˛zyk polski Arteries – Te˛tnice accessory obturator artery arteria obturatoria accessoria tętnica zasłonowa dodatkowa acetabular branch ramus acetabularis gałąź panewkowa anterior basal segmental artery arteria segmentalis basalis anterior pulmonis tętnica segmentowa podstawna przednia (dextri et sinistri) płuca (prawego i lewego) anterior cecal artery arteria caecalis anterior tętnica kątnicza przednia anterior cerebral artery arteria cerebri anterior tętnica przednia mózgu anterior choroidal artery arteria choroidea anterior tętnica naczyniówkowa przednia anterior ciliary arteries arteriae ciliares anteriores tętnice rzęskowe przednie anterior circumflex humeral artery arteria circumflexa humeri anterior tętnica okalająca ramię przednia anterior communicating artery arteria communicans anterior tętnica łącząca przednia anterior conjunctival artery arteria conjunctivalis anterior tętnica spojówkowa przednia anterior ethmoidal artery arteria ethmoidalis anterior tętnica sitowa przednia anterior inferior cerebellar artery arteria anterior inferior cerebelli tętnica dolna przednia móżdżku anterior interosseous artery arteria interossea anterior tętnica międzykostna przednia anterior labial branches of deep external rami labiales anteriores arteriae pudendae gałęzie wargowe przednie tętnicy sromowej pudendal artery externae profundae zewnętrznej głębokiej -
Integrated Care Management Guideline
Back and Nerve Pain Procedures-Radiofrequency Ablation, Facet and Other Injections Medical Policy Service: Back and Nerve Pain Procedures - Radiofrequency Ablation, Facet and Other Injections PUM 250-0035-1706 Medical Policy Committee Approval 05/27/2021 Effective Date 09/01/2021 Prior Authorization Needed Yes Related Medical Policies: • Back Pain Procedures-Epidural Injections • Back Pain Procedures-Sacroiliac Joint and Coccydynia Treatments • Non-covered Services and Procedures • BOTOX (onabotulinum toxin a) requests are reviewed by our specialty vendor partners – refer to the Drug Prior authorization list Pain injection services are subject to medical necessity review. If a limit is not specified in the member’s health plan, the maximum follows the medical necessity guidelines in this policy. If a year is not described in the member health plan (e.g. per calendar year), a year is defined as the 12-month period starting from the date of service of the first approved injection. Description: A facet joint injection is the injection of a local anesthetic with or without steroid into one or more of the facet joints of the spine. A medial branch nerve block is an injection of a local anesthetic near the medial branch nerves that innervate the facet joint. Both the diagnostic facet joint injection and the diagnostic medial branch nerve block are performed to determine whether the facet joint is the source of the pain symptoms, in order to guide future treatment such as neuroablation. This policy addresses diagnosis of facet joint pain using diagnostic facet and medial branch block injections in preparation for treatment of non-radicular* spine pain using neuroablation. -
Abdominal Wall and Cavity
Abdominal Wall and Cavity Dr. ALSHIKH YOUSSEF Haiyan BOUNDARIES Bony Landmarks around Abdomen Iliac crest • Anterior superior iliac • spine (ASIS) Pubic crest • Inguinal ligament • Costal margin • Xiphoid process • Body Cavities Abdominopelvic Cavity Abdominal Cavity – Pelvic Cavity – P242-fig.4.21 Abdominal wall Muscle Aponeurosis DIVISIONS Abdominal Quadrants Applied Anatomy Abdomen is divided into 9 regions via four • planes: Two horizontal [sub-costal (10th) and trans – tubercules plane] (L5). Two vertical (midclavicular planes). – They help in localization of abdominal signs • and symptoms Abdomen Boundaries 9 regions hypochondrium epigastric region subcostal plane flank umbilical region transtubercular plane groin pubic region midclavicular line P243-fig.4.23 Abdominal wall Anterolateral abdominal wall Posterior abdominal wall Anterolateral abdominal wall Layers ( from superficial to deep) Skin • Superficial fascia • Anterolateral muscles • Transverse fascia • Extraperitoneal fascia • Parietal peritoneum • Superficial fascia Camper’s fascia • Scarpa's fascia • Anterolateral abdominal wall Superficial fascia : -division below umbilicus = Fatty layer (Camper’s fascia) continuous • with the superficial fascia over the rest of the ) Thigh –thorax (body. = Membranous layer (Scarpa’s fascia) • passes over the inguinal ligament to fuse the deep fascia of the thigh (fascia lata) approximately one fingerbreadth below the inguinal ligament. In the midline, it is not attached to the pubis but instead from a tubular sheath for the penis (clitoris). In the perineum, it is attaches on each side to the margins of the pubic arch and is know as Colles’ fascia. deep fascia : thin layer covering abdominal • musceles . Arteries 5 intercostal arteries • subcostal arteries • 4 lumbar arteries • Superior epigastric artery— • internal thoracic artery Inferior epigastric artery - • external iliac artery Deep iliac circumflex artery- • external iliac artery SUPERFICIAL ARTERIES Lateral • Posterior intercostal a. -
Redalyc.Headaches and Pain Referred to the Teeth: Frequency And
RSBO Revista Sul-Brasileira de Odontologia ISSN: 1806-7727 [email protected] Universidade da Região de Joinville Brasil Franklin Molina, Omar; Huber Simião, Bruno Ricardo; Yukio Hassumi, Marcio; Iuata Rank, Rise Consolação; da Silva Junior, Fausto Félix; Alves de Carvalho, Adilson Headaches and pain referred to the teeth: frequency and potential neurophysiologic mechanisms RSBO Revista Sul-Brasileira de Odontologia, vol. 12, núm. 2, abril-junio, 2015, pp. 151- 159 Universidade da Região de Joinville Joinville, Brasil Available in: http://www.redalyc.org/articulo.oa?id=153041505002 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ISSN: Electronic version: 1984-5685 RSBO. 2015 Apr-Jun;12(2):151-9 Original Research Article Headaches and pain referred to the teeth: frequency and potential neurophysiologic mechanisms Omar Franklin Molina1 Bruno Ricardo Huber Simião2 Marcio Yukio Hassumi3 Rise Consolação Iuata Rank4 Fausto Félix da Silva Junior5 Adilson Alves de Carvalho6 Corresponding author: Omar Franklin Molina Avenida Pará, 1.544 – Faculdade de Odontologia CEP 77400-000 – Gurupi – TO – Brasil E-mail: [email protected] 1 School of Dentistry (Orofacial Pain), UNIRG University Center – Gurupi – TO – Brazil. 2 School of Dentistry (Prosthodontics), UNIRG University Center – Gurupi – TO – Brazil. 3 School of Dentistry (Periodontics), UNIRG University Center – Gurupi – TO – Brazil. 4 School of Dentistry (Pedodontics), UNIRG University Center – Gurupi – TO – Brazil 5 School of Dentistry (Preventive Dentistry), UNIRG University Center – Gurupi – TO – Brazil 6 Private Practice – Goiânia – GO – Brazil. -
Bilateral Variation of the Suboccipital Region Musculature
S Journal of O p s e s n Acce Anatomy and Physiological Studies CASE REPORT Bilateral Variation of the Suboccipital Region Musculature AR Dickerson*, CL Fisher PhD Center for Anatomical Sciences, University of North Texas Health Science Center, Fort Worth, Texas, USA Abstract Dissection of the posterior cervical and suboccipital regions of an embalmed 81-year-old male cadaver revealed bilateral variations in the muscular anatomy, including two accessory muscles lying deep to the semispinalis capitis on each side, as well as a bilateral doubling of the rectus capitis posterior major muscle. These two sets of anatomical variations have little to no previous documentation in the literature. The accessory muscle bands were observed to have unique relationships with the greater occipital nerve on each side. This case report describes the findings in detail and examines their precedent in the literature. The suboccipital region has been implicated in the etiology of cervicogenic pain, headaches, and occipital neuralgia. Variations in the muscular anatomy have the potential to create structural interactions with vascular and neurologic structures in the area. Anatomic variations like those reported here should be considered in the diagnosis and treatment of pain and other conditions of the suboccipital region. Keywords: Anatomic Variation, Suboccipital, Accessory Muscle, Greater Occipital Nerve, Rectus capitis posterior major muscle Background leading us to believe that we had encountered accessory muscles that had been previously unreported. The muscles This case report describes variation of the musculature in the were delicate and located in a region often removed to expose suboccipital region observed during dissection of an embalmed the suboccipital region just beneath, so we postulate that the 81-year-old male cadaver.