No abstract available.
Thoracic Nerves*

The 213 first ribs Koreans were measured and morphologically studied. The results were as follows. 1. On average, the internal straight length of the first rib was 53.7mm (male), 49.9mm (female) ; the external straight length was 79.7mm (male), 75.4mm (female), the maximum straight length was 87.4mm (male), 81.2mm (female) ; the breadth was 15.2mm (male), 14.4mm (female) ; and the thickness was 5.5mm (male), 5.4mm (female). 2. The proportion of the scalene tubercle to the costal breadth was 0% to 90% (average 37%). 3. The incidence of the presence of the groove for the first thoracic nerve was 7.5%. 4. The common shapes of the articular surface of the head were ball-shape(41%), cylinder-shape (25%) and plane-shape (25%) ; and those of the tubercle were cylinder-shape (44%), saddle-shape (31%) and socket-shape (14%).
Head ; Incidence ; Ribs* ; Thoracic Nerves

The brachial plexus may be visualized simply as beginning with five nerves and terminating in five nerves. It begins with the anterior rami of C5, C6, C7, C8, and the first thoracic nerve. It terminates with the formation of the musculocutaneous, median, ulnar, axillary, and radial nerves. The anatomy of the brachial plexus can be confusing, especially because of frequent variations in the length and the caliber of each of its components. The most common type of injury is one involving a motorcycle or bicycle crash in which a forceful impact on the shoulder depresses the entire shoulder girdle and avules a portion of the plexus. The injuried area is usually the upper trunk althrough the lower trunk can be involved either in addition to or as the main site of injury. Our case involves brachial plexus injury due to physical restraint that had been used to avoid using a pharmachologic restraint.
Brachial Plexus* ; Motorcycles ; Radial Nerve ; Restraint, Physical* ; Shoulder ; Thoracic Nerves

This study was carried out to evaluate the quantity of the nerve fiber of the terminal branches of the typical brachial plexus in the 6 sides of the Korean adults. The dorsal scapular nerve, which is derived from ramus of the brachial plexus, was comprised of C5 and participating nerve fiber was 355+/-180. The long thoracic nerve was composed of C5, C6 and C7, and was mainly originated from C6, and participating nerve fiber was 743+/-346. The nerves, which are branched out from trunk, nerve to subclavius muscle was composed of C5 and participating quantity was 242+/-71. The suprascapular nerve was comprised of C5 and C6, and the nerve fiber was mainly derived from C5 (1,942+/-505). The nerve, which is originated from proximal portion of the cord, the lateral pectoral nerve was constituted of C5, C6 and C7. The main component was C7 as the 2,917+/-785 nerve fiber. The medial pectoral nerve was made with C8 and T1. The main component was C8 as the 964+/-430 nerve fiber. The upper subscapular nerve was derived from C5 and C6. The nerve fiber was 1,179+/-92 in C5, mainly participated. The Lower subscapular nerve was constituted of C5, C6 and C7. C6 was the main component and contributing nerve fiber was 1,070+/-390 in C6, principal component. The thoracodorsal nerve was formed by C6, C7 and C8. The chief component was C7, contributed of 2,335+/-324. The nerves, which are came out from the distal portion of the cord, musculocutaneous nerve was derived from the C5, C6 and C7. The C6 was principal component, and was joined with 4,009+/-1,883. The median nerve was contributed from C5 to T1. The chief component was C7 added with 9,651+/-2,663. The ulnar nerve was composed of C7, C8 and T1. The C8 was the main component comprised of 10,075+/-1,473. The medial brachial and antebrachial cutaneous nerves was constituted of C8 and T1. In the both nerves, the main component was T1 participated with 1,752+/-390, 3,080+/-1,140 respectively. The radial nerve was composed of C5 to T1. The C7 was principal component added with 7,958+/-2,333. The axillary nerve was made up C5 and C6. In the nerve, the both spinal segments were similarly participated to the nerve. This results could be applied for the injuries and neurotization procedure of the terminal nerves of the brachial plexus.
Brachial Plexus ; Median Nerve ; Muscles ; Musculocutaneous Nerve ; Nerve Fibers ; Nerve Transfer ; Porphyrins ; Radial Nerve ; Spinal Nerves ; Thoracic Nerves ; Ulnar Nerve

Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve. The authors successfully performed a modified Pecs II block and PIFB without complications in a parturient who refused general anesthesia for breast surgery.
Anesthesia, Conduction ; Anesthesia, General ; Breast* ; Female ; Humans ; Intercostal Nerves ; Methods ; Nerve Block* ; Pregnant Women* ; Thoracic Nerves ; Thorax

Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve. The authors successfully performed a modified Pecs II block and PIFB without complications in a parturient who refused general anesthesia for breast surgery.
Anesthesia, Conduction ; Anesthesia, General ; Breast* ; Female ; Humans ; Intercostal Nerves ; Methods ; Nerve Block* ; Pregnant Women* ; Thoracic Nerves ; Thorax

Although several cases of a dumbbell tumor of thoracic nerve roots have been reported, reports on the surgical procedures for a dumbbell tumor of the first thoracic (T1) nerve root are rare. Surgeons should be cautious, especially when performing a surgical procedure for a dumbbell tumor of the T1 nerve root because the tumor is anatomically located adjacent to important organs and because the T1 nerve root composes the lower trunk of the brachial plexus with the eighth cervical nerve root. We present cases with dumbbell tumors of the T1 nerve root that were treated with combined surgical treatment to remove the tumor. We first performed video-assisted thoracic surgery (VATS) to release the organs anteriorly and then performed posterior spinal surgery in the prone position. The combined VATS and posterior spinal surgery may become a standard surgical procedure for the treatment of dumbbell tumors of the T1 nerve root.
Brachial Plexus ; Prone Position ; Spinal Cord Neoplasms ; Surgical Procedures, Minimally Invasive ; Thoracic Nerves* ; Thoracic Surgery, Video-Assisted*

We studied the variations in the ventral rami of 152 brachial plexuses in 77 Korean adults. Brachial plexus were composed mostly of the fifth, sixth, seventh and eighth cervical nerves and the first thoracic nerve (77.0%). In 21.7% of the cases examined, the fourth, fifth, sixth, seventh and eighth cervical and the first thoracic nerves contributed to the plexus. A plexus composed of the fourth, fifth, sixth, seventh and eighth cervical and the first and second thoracic nerves, and a plexus composed of the fifth, sixth, seventh eighth cervical nerves were also observed. The plexuses were classified into three groups according to cephalic limitation, and the plexus of group 2 in which the whole fifth cervical nerve enters the plexus, were observed the most frequent. The average diameter of the sixth and the seventh cervical ventral rami of the plexus was greatest and that of the fifth cervical was smallest. The largest nerve entering the plexus was the sixth or the seventh cervical nerve in about 79% of cases. The dorsal scapular nerve originated from the fifth cervical ventral ramus in 110 cases (75.8%). The long thoracic nerve was formed by joining of roots from the fifth, sixth, and seventh cervical nerves in 76.0% of cases. Also, a branch to the phrenic nerve, the suprascapular nerve, a nerve to the pectoralis major muscle and a nerve to the subscapular muscle arising from the ventral rami of the plexus were observed.
Brachial Plexus/*anatomy & histology ; Cervical Plexus/anatomy & histology ; Female ; Humans ; Male ; Thoracic Nerves/*anatomy & histology

During routine dissection of the upper extremity of an adult male cadaver, multiple variations in branches of medial and lateral cords of brachial plexus were encountered. Three unique findings were observed. First, intercordal neural communications between the lateral and medial cords were observed. Second, two lateral pectoral nerves and one medial pectoral nerve were seen to arise from the lateral and medial cord respectively. The musculocutaneous nerve did not pierce the coracobrachialis. Finally, the ulnar nerve arose by two roots from the medial cord. Knowledge of such variations is of interest to anatomists, radiologists, neurologists, anesthesiologists, and surgeons. The aim of our study is to provide additional information about abnormal brachial plexus and its clinical implications.
Adult ; Anatomists ; Brachial Plexus* ; Cadaver ; Humans ; Male ; Musculocutaneous Nerve ; Thoracic Nerves ; Ulnar Nerve ; Upper Extremity

Pain of intraabdominal organ is transduced through splanchnic and sympathetic nerve. Mallet- Guy et al introduced the method of splanchnicectomy and lumbar sympathectomy for control of pain of pancreatitis and pancreatic cancer. It has been considered as an out-dated procedure because of the long surgical incisions and the development of celiac plexus block with long needles. However, as VATS was recently applied to many thoracic surgical fields, splanchnicotomy assisted by a thoracoscope is considered as a good method for intractable abdominal pain.
Abdominal Pain* ; Celiac Plexus ; Needles ; Pancreatic Neoplasms ; Pancreatitis ; Splanchnic Nerves ; Sympathectomy ; Thoracic Surgery, Video-Assisted ; Thoracoscopes