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Pesquisa : A08.800.800.720.450.250 [Categoria DeCS]
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Id: lil-755538
Autor: Neri, Letícia Oliveira; de Amorim, Milena Menezes; Campos, Stella Andrade Rodrigues; Sanada, Luciana Sayuri; Fazan, Valéria Paula Sassoli.
Título: Hind limb sensory innervation in rats: comparison between sural and saphenous nerve morphometry / Inervación sensorial de los miembros posteriores en ratas: comparación morfométrica entre los nervios sural y safeno
Fonte: Int. j. morphol;33(2):743-750, jun. 2015. ilus.
Idioma: en.
Projeto: Fundação de Amparo à Pesquisa do Estado de São Paulo; . Conselho Nacional de Pesquisa e Tecnologia.
Resumo: Although numerous studies investigate sensory recovery of the hind paw of the rat after nerve damage, still no comprehensive overview of its normal innervation is present in the literature. We investigated the morphometry of myelinated fibers in the sural and saphenous nerves and analyzed their size distributions in young rats. Six 30-day-old female Wistar rats were perfused with 2.5% glutaraldehyde and their right and left sural and saphenous nerves were prepared for light microscopy and morphometry. Morphometric data were compared between segments (proximal versus distal) and sides (right versus left) for the same nerves. Also, segments from right or left sides were compared between nerves (sural versus saphenous). Both, the sural and saphenous nerves, exhibited proximal to distal symmetry on both sides as well as left-right symmetry. Histograms of the diameter of the myelinated fibers were unimodal in both nerves, regardless of segments or sides with the peaks of the fibers size occurring between 2.5 and 4.0 µm. The axon distributions reflected the myelinated fiber distributions, with the sural and saphenous nerves peaking between 1.5 and 2.0 µm. The G ratio (the ratio between the axon and fiber diameters) distributions were also unimodal, with peaks at 0.6 for both nerves. This study contributes to the literature with information on the myelinated fibers morphometry from the two sensory nerves responsible for the rat hind limb innervation. This information is valuable for a better understanding of the possible contribution of collateral sprouting from the sural or saphenous nerves on the paw sensory territory recovery observed after one of these nerves is damaged.

Aunque numerosos estudios investigan la recuperación sensorial del miembro pélvico o posterior de la rata después del daño en los nervios, aún no existe en la literatura una visión global de su inervación normal. Investigamos la morfometría de fibras mielínicas de los nervios sural y safeno y analizamos sus distribuciones de tamaño en ratas jóvenes. Seis ratas Wistar de 30 días de edad fueron perfundidas con 2,5% de glutaraldehído, se prepararon los nervios sural y safeno derecho e izquierdo para microscopía de luz y morfometría. Datos morfométricos fueron comparados entre los segmentos (proximal vs distal) y laterales (derecho vs izquierdo) para los mismos nervios. Además, los segmentos de los lados derecho e izquierdo se compararon entre los nervios (sural vs safeno). Ambos nervios sural y safeno exhibieron una simetría proximal a distal en ambos lados, así como una simetría izquierda-derecha. Histogramas del diámetro de las fibras mielinizadas eran unimodales en ambos nervios, independientemente de los segmentos o de los lados, siendo los peaks del tamaño de las fibras entre 2,5 y 4,0 micras. Las distribuciones de los axones reflejan las distribuciones de fibras mielinizadas, de los nervios sural y safeno que alcanzaban entre 1,5 and 2,0 µm. La relación de G (relación entre los diámetros de los axones y de fibra) eran también unimodales, alcanzando 0,6 para ambos nervios. Este estudio contribuye a la literatura con los datos de la morfometría de fibras mielinizadas de ambos nervios sensoriales responsables de la inervación de la extremidad pélvica de la rata. Esta información es valiosa para una mejor comprensión de los nervios sural y safeno en la recuperación sensorial del miembro después de que uno de estos nervios ha sido dañado.
Descritores: Nervo Sural/anatomia & histologia
Nervo Femoral/anatomia & histologia
Membro Posterior/inervação
Fibras Nervosas Mielinizadas
-Ratos Wistar
Limites: Animais
Feminino
Ratos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1002282
Autor: Alveal-Mellado, D; Sousa-Rodrigues, C. F; Olave, E.
Título: Ramos de inervación y distribución del nervio femoral en el músculo cuádriceps femoral de individuos brasileños / Innervation branches and distribution of the femoral nerve in the quadriceps femoral muscle in Brazilian individuals
Fonte: Int. j. morphol;37(2):712-718, June 2019. tab, graf.
Idioma: es.
Resumo: El nervio femoral (NF) se describe originándose desde el plexo lumbar (L2, L3 y L4) y en su recorrido emite ramos destinados a cada una de las porciones del músculo cuádriceps femoral (mCF), los cuales nacen de forma aislada o bien, a partir de troncos comunes. El detalle de la distribución del NF en el mCF, permite disminuir riesgos asociados a diferentes intervenciones quirúrgicas llevadas a cabo en la zona anterior del muslo. Con el propósito describir la distribución del NF en los componentes del mCf. Se utilizaron 15 miembros inferiores formolizados, 10 del lado izquierdo y 5 del lado derecho, de individuos adultos, Brasileños, localizados en los Laboratorios de Anatomía de la Universidade Estadual de Ciências da Saúde de Alagoas (UNCISAL), Maceió, Brasil. El NF se clasificó en cuatro tipos de acuerdo a su ramificación y distribución. El Tipo II se subdividió en 3 subtipos y se presentó en 60 % de las muestras y el tipo III en 20 %. El NF se dividió de medial a lateral hasta en 5 ramos (R1,R2,R3,R4,R5), donde el R1 fue el más medial. El R1 dio origen en promedio a 2,47 ramos secundarios (Rs) y a 2,58 ramos terciarios (Rt), en 13,3 % el R1 no emitió Rs. En 73,3 % inervó a sólo a un componente del mCF; el R2 dio origen en promedio a 3,93 Rs y a 3,58 Rt. En 26,7 % inervó a sólo a un componente del mCF; el R3 dio origen en promedio a 3,33 Rs y a 2,0 Rt. En 80 % inervó a sólo a un componente del mCF. La distribución de R4 y R5 se muestran en el texto. Resultados biométricos de origen, diámetro y longitud de los ramos mencionados son mostrados en tablas. Los datos obtenidos en esta investigación complementan el conocimiento de la anatomía regional, pudiendo ser utilizados por la clínica quirúrgica y para efectuar tratamientos que mejoren trastornos neurológicos que afectan a la región.

The femoral nerve (FN) is described as originating from the lumbar plexus (L2, L3 and L4) and in its course it emits branches destined to each one of the quadriceps femoral muscle (QFm), which are originated in an isolated way or, from common trunks. The detail of the distribution of the FN in the QFm, allows to diminish risks associated with different surgical interventions carried out in the anterior thigh area. With the purpose of describing the distribution of FN in the QFm components. Fifteen formalized lower limbs were used, 10 on the left side and 5 on the right side of adult individuals, Brazilians, located in the Anatomy Laboratories of the State University of Ciências da Saúde de Alagoas (UNCISAL) , Maceió, Brazil. The FN was classified into four types according to its branch and distribution. Type II was subdivided into 3 subtypes and presented in 60 % of the samples and type III in 20 %. The FN was divided from medial to lateral in 5 branches (B1, B2, B3, B4, B5), where B1 was the most medial. The B1 gave rise to an average of 2.47 secondary branches (sB) and to 2.58 tertiary branches (tB), in 13.3 % the B1 did not emit sB. In 73.3 %, only one component of the QFm was invested; B2 gave rise to an average of 3.93 sB and 3.58 tB. In 26.7 %, it invested only one component of the QFm; B3 gave rise to an average of 3.33 sB and 2.0 tB. In 80 %, it invested only one component of the QFm. The distribution of B4 and B5 are shown in the text. Biometric results of origin, diameter and length of the mentioned branches are shown in tables. The data obtained in this research complements the knowledge of the regional anatomy, being able to be used by the surgical clinic and to carry out treatments that improve neurological disorders that affect the region.
Descritores: Músculo Quadríceps/inervação
Nervo Femoral/anatomia & histologia
-Brasil
Limites: Seres Humanos
Masculino
Feminino
Adulto
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-914608
Autor: Gomes, Andréa Regina Abrantes; Silva, Frederico Ozanam Carneiro e; Iglesias, Luciana Pedrosa; Ribeiro, Lucas Assis; Souza, Tharlianne Alici Martins de; Furlan, Nicole Latanza.
Título: Origens e ramificações do nervo femoral em javalis (Sus scrofa scrofa Linnaeu, 1758) / Origins and ramifications of the femoral nerve in wild boars (Sus scrofa scrofa Linnaeu, 1758)
Fonte: Biosci. j. (Online);29(3):727-731, may/june 2013. ilus, tab.
Idioma: pt.
Resumo: Neste estudo foram analisadas a origem e distribuição dos nervos femorais em 25 fetos de javalis (Sus scrofa scrofa). A fixação destes animais em solução aquosa de formaldeído a 10% ocorreu mediante diferentes pontos de injeções subcutâneas, intramusculares e intracavitárias, bem como por imersão dos referidos exemplares em recipientes com a mesma solução por um período mínimo de 48 horas, a fim de preparar o material para posterior dissecação. Foi observado que a origem das raízes do nervo originaram-se de L3 a S1. No tocante a quantidade de vértebras lombar, variou de cinco a sete, sendo cinco em oito casos (32%), seis em 12 exemplares (48%) e sete em cinco animais (20%). Com relação a sua distribuição, os nervos femorais emitiram de dois a cinco ramos para os músculos ilíacos direito e de dois a quatro para o esquerdo, o psoas maior direito recebeu de dois a cinco, e seu antimero esquerdo, de dois a sete, o sartório direito, por sua vez, foi inervado por dois ramos em um caso e o quadríceps femoral apresentou variação de sete a 16, em ambos os antímeros.

We analyzed the origin and distribution of the femoral nerve in 25 fetuses of wild boar (Sus scrofa scrofa). The introduction of these animals in aqueous formaldehyde 10% was by different points of subcutaneous, intramuscular and intracavitary injections, as well as by immersion of those specimens, in containers of the same solution for a minimum of 48 hours, to prepare the material for further dissection. It was observed that the origin of the nerve roots were derived from S1 to L3. Regarding the amount of lumbar vertebrae varied from five to seven, five in eight cases (32%), six in twelve specimens (48%) and seven in five animals (20%). In relation to their distribution, the femoral nerves emitted 2-5 branches to the right iliac muscle and 2-4 to the left, the right psoas major received 2-5, and its left antimer, 2-7, the right sartorius was innervated by two branches and in 1 case and the femoral quadriceps presented variation of 7-16 branches, in both antimers.
Descritores: Nervo Femoral
Neuroanatomia
Sus scrofa
Plexo Lombossacral
Responsável: BR396.4


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Texto completo SciELO Uruguai
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Id: biblio-949974
Autor: Moreno, L González; Ramos, G; Prestes, I; Bouchacort, JP; Kohn, E; Riva, J.
Título: Anestesia regional periférica para revascularización arterial de miembros inferiores. Revisión bibliográfica y casos clínicos / Peripheral regional anesthesia for arterial revascularization of lower limbs. Bibliographical review and clinical cases
Fonte: Anest. analg. reanim;29(2):45-69, dic. 2016. ilus.
Idioma: es.
Resumo: Introducción: La tendencia actual es diferir la cirugía de revascularización de miembros inferiores hasta etapas avanzadas, lo que explica que sean pacientes de mayor complejidad con alta morbimortalidad cardíaca y respiratoria. Los mayores avances para reducirlas, se han desarrollado en la preparación de los pacientes y en las técnicas quirúrgicas. La elección de la técnica anestésica no ha sido considerada un factor determinante. Los bloqueos regionales presentan potenciales ventajas, como mayor estabilidad hemodinámica y respiratoria. Objetivo: Realizar una revisión bibliográfica y presentación de casos clínicos sobre la utilidad de los bloqueos periféricos para anestesia en la cirugía de revascularización de miembros inferiores. Material y métodos: La búsqueda se realizó a través de la base de datos Medline, LILACS y SciELO. Se incluyeron estudios donde los bloqueos periféricos se utilizaron para anestesia. Se describen dos casos clínicos. Resultados: Se seleccionaron 4 artículos originales, 3 de ellos eran estudios descriptivos de la técnica y el cuarto una comparación con anestesia general inhalatoria. 2más correspondieron a casos clínicos. Conclusiones: No existe evidencia suficiente que permita concluir que reducen la mortalidad o la morbilidad cuando se la compara con las demás técnicas anestésicas. Esto puede ser debido al diseño metodológico de los estudios, a la no utilización de la ecografía como guía y la no sistematización de los bloqueos. El análisis de los casos clínicos sugiere que en situaciones específicas como pacientes de alto riesgo cardíaco y respiratorio, bajo tratamiento con anticoagulantes y antiagregantes estos presentan ventajas sobre las otras técnicas.

Background: The current trend is to defer revascularization surgery from lower limbs to advanced stages, which explains why they are more complex patients with high cardiac and respiratory mortality. The choice of anesthetic technique remains controversial. Regional blockades have potential advantages, such as hemodynamic and respiratory stability. Our primary objective was a bibliographic review to assess the peripheral blockages for anesthesia in lower limb revascularization surgery. Our secondary objective was report two clinical cases. Material and methods: The search was performed through the Medline, LILACS and SciELO database. We included studies where peripheral blocks were used for anesthesia. Two clinical cases are described. Results: Four original articles were selected, 3 of which were descriptive studies of the technique and the fourth a comparison with general inhalation anesthesia. 2 more corresponded to clinical cases. Conclusions: There is insufficient evidence to conclude that peripheral nerve block reduce mortality or morbidity when compared with other anesthetic techniques. This may be due to the methodological design of the studies, to the non-use of echocardiography as a guide and the non-systematization of the blocks. The analysis of the clinical cases suggests that this technique is a good option in specific situations as patients with high cardiac and respiratory risk, under treatment with anticoagulants and antiplatelets drugs.
Descritores: Nervo Isquiático
Nervo Femoral
Anestesia por Condução
-Extremidade Inferior/cirurgia
Revascularização Miocárdica
Limites: Seres Humanos
Masculino
Responsável: UY1.1 - BINAME - Biblioteca Nacional de Medicina


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Id: biblio-835760
Autor: Barousse, Rafael.
Título: Utilidad de la neurografía por IRM en el diagnóstico de la meralgia parestésica / Usefulness of MRI neurography in the diagnosis of meralgia paresthetica
Fonte: Rev. argent. neurocir;30(2):77-80, jun. 2016. ilus.
Idioma: es.
Resumo: Objetivo: Evidenciar cómo la Imagen Resonancia magnética (IRM) con equipo de 3 Tesla, utilizando secuencias neurográficas específicas y uso de contraste endovenoso permite ubicar el área de lesión nerviosa. Caso clínico: Mujer de 17 años con hipoestesia y parestesias en la región anterior y lateral del muslo izquierdo, se le realiza un estudio de Resonancia Magnética (RM) en equipo Philips Achieva 3 T, usando protocolo neurográfico y contraste endovenoso, demostrando engrosamiento y cambios de señal del nervio y realce post-contraste característico de la neuropraxia. Conclusión: el caso presentado demuestra el valor actual de los estudios de IRM con técnica neurográfica en la evaluación de la patología de los nervios periféricos. Es fundamental utilizar secuencias adecuadas, realizar un estudio comparativo bilateral y en lo posible usar medios de contraste endovenoso para aumentar la sensibilidad. Estos hallazgos resultan de gran importancia a la hora de planificar la estrategia quirúrgica.

Objective: Demonstrate the usefulness of Magnetic Resonance Imaging (MRI) with equipment 3 Tesla using neurographics specific sequences and use of intravenous contrast can locate the area of nerve injury.Clinical case: 17 year old woman with hypoesthesia and paresthesia in the anterior and lateral region of the left thigh, the study of Magnetic Resonance Imaging (MRI) equipment Philips Achieva 3 T, using neurographic protocol and intravenous contrast, showing thickening and changes signal nerve and post-contrast enhancement characteristic in neuropraxia.Conclusión: the case presented shows the current value of MRI studies with neurographics technique in assessing the pathology of peripheral nerves. It is essential to use appropriate sequences, make a bilateral comparative study and possible use of intravenous contrast media to increase sensitivity. These findings are of great importance when planning the surgical strategy.
Descritores: Nervo Femoral
Imagem por Ressonância Magnética
Mononeuropatias
Limites: Seres Humanos
Responsável: AR423.1 - Biblioteca


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Id: lil-795858
Autor: Calvo, Rafael; Figueroa, David; Arellano, Sergio; Schmidt-Hebbel, Andrés; Ramos, Miguel; Riquelme, Amanda.
Título: Bloqueo de nervio femoral único vs. continuo en reconstrucción de ligamento cruzado anterior; un estudio clínico aleatorizado / Femoral nerve block in anterior cruciate ligament surgery; a prospective randomised trial
Fonte: Rev. chil. ortop. traumatol;57(1):14-19, ene.-abr.2016. ilus, tab.
Idioma: es.
Resumo: En cirugía de reconstrucción del ligamento cruzado anterior (LCA) es fundamental la rehabilitación precoz y, para ello, la analgesia. El bloqueo de nervio femoral (BNF) es un procedimiento frecuentemente utilizado en cirugía artroscópica y protésica de rodilla, sin embargo, se debate aún cómo debe ser aplicado para mejorar la analgesia sin afectar una rehabilitación precoz. Objetivo: Comparar analgesia mediante BNF con punción única versus infusión continua en las primeras 48h de reconstrucción del LCA. Metodología:Cuarenta y tres pacientes >18 años, ASA 1-2, sometidos a cirugía artroscópica de LCA (autoinjerto) con mismo equipo quirúrgico. Se crearon aleatoriamente 2 grupos: grupo 1 (G1) bloqueo femoral único con bupivacaína más solución fisiológica; grupo 2 (G2) bloqueo femoral+catéter femoral con infusión continua de bupivacaína con adrenalina 1:300.000 por 48h. Se evaluó dolor de reposo y al mover la extremidad, hipoestesia de muslo y necesidad de analgesia adicional a las 6, 12, 24 y 48h. Resultados: El BNF fue exitoso en todos los pacientes, logrando hipoestesia en la totalidad del G2 vs solo 17 por ciento del G1 a las 24h y 74 por ciento vs 0 por ciento a las 48h, respectivamente. El dolor postoperatorio fue bajo y sin diferencias entre los grupos, con requerimiento de analgesia extra de 33 por ciento G1 vs 0 por ciento G2. Conclusión: El BNF es una técnica analgésica eficaz para controlar el dolor postoperatorio en cirugía de LCA. No se observaron diferencias significativas entre las técnicas investigadas. Nivel de evidencia tipo ii...

Early rehabilitation is essential after anterior cruciate ligament (ACL) surgery. Femoral nerve block (FNB) is a frequently used method to control post-operative pain in arthroscopic and reconstructive knee surgery; however, it is still unknown how to apply this procedure to improve analgesia without affecting early rehabilitation. Objective:To compare the effectiveness of pain management after a single dose of FNB vs a continuous FNB infusion during the first 48hours after ACL surgery. Methodology: Forty-three patients older than 18 years, ASA I-II, underwent ACL reconstruction with an autograft. Patients were prospectively randomised into two separate groups: Group 1 (G1) received a single dose of FNB with bupivacaine diluted in 10mL saline solution. Group 2 (G2) received continuous FNB infusion with bupivacaine and epinephrine (1:300.000) for 48hours. Pain was assessed at rest and with controlled passive motion of the knee. Thigh hypo-aesthesia and the need for additional analgesia were evaluated at 6, 12, 24, and 48hours. Statistical analysis was performed with Fisher's exact test (percent) and Mann-Whitney's test (VAS). Statistical significance with P<.05. Results: FNB was successful in all patients, and thigh hypo-aesthesia was present in 100 percent of G2 vs. 17 percent in G1 at 24hours, declining to 74 percent vs. 0 percent at 48hours, respectively. Post-operative pain scores were low, and did not differ between the two groups. Additional analgesia was required in 33 percent of patients in G1 vs. 0 percent in G2. Conclusion: FNB is a successful method for controlling pain after ACL reconstruction. No statistical significance differences were found in pain control between techniques investigated. Level of Evidence type II...
Descritores: Bloqueio Nervoso/métodos
Bupivacaína/administração & dosagem
Nervo Femoral
Reconstrução do Ligamento Cruzado Anterior/métodos
-Anestésicos Locais/administração & dosagem
Dor Pós-Operatória/prevenção & controle
Medição da Dor
Limites: Seres Humanos
Masculino
Adulto
Feminino
Adulto Jovem
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Chile
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Id: lil-787037
Autor: Singh, Rajani; Tubbs, Shane; Singla, Mukesh.
Título: Classification and fascicular analysis of variant branching pattern of femoral nerve for microsurgical intervention: a series of thirteen cadavers / Clasificación y análisis fascicular de las variantes en el patrón de ramificación del nervio femoral en intervenciones microquirúrgicas: una serie de 13 cadáveres
Fonte: Int. j. morphol;34(2):561-569, June 2016. ilus.
Idioma: en.
Resumo: Femoral neuropathy associated with lower limb is treated by surgical intervention through activation/regeneration/grafting of nerve fibers by a nerve cuff electrode implant or neuro-prosthesis. These procedures require detailed and precise knowledge of neuro-anatomical variants of the femoral nerve and its fascicular anatomy so that the nerve injury can be investigated and treated more efficiently. The aim of the study is to uncover the variations both in the femoral nerve and its branches, to classify them and to bring out corresponding fascicular anatomy using a hypothesis based on the principle of consistency, continuity and traceability of fascicles. The study was carried out in the Department of Anatomy AIIMS Rishikesh using 13 matched lower limbs (26 femoral nerves) from 13 cadavers. The femoral nerve was exposed in the femoral triangle and traced to the posterior abdominal wall. Variations in the shape, size and course of the femoral nerve and its branches were analyzed. The fascicular arrangement was also conceptualized based on the hypothesis. Seven classes, high division, trunk anomaly, semi-scattered, scattered branching pattern, pectocutaneous, lateral cutaneous nerve of thigh and nerve to sartorius anomalies were detected. The corresponding fascicular organizations were modeled. The seven classes along with corresponding fascicular pattern will be very useful for neurosurgeons, radiologists, anesthetists and anatomists in diagnosis and treatment of femoral neuropathy.

La neuropatía femoral asociada con el miembro inferior es tratada por intervención quirúrgica a través de activación, regeneración e injerto de fibras nerviosas mediante un implante de electrodo de manguito de nervios o neuro-prótesis. Estos procedimientos requieren un conocimiento detallado y preciso de las variantes neuro-anatómicas del nervio femoral y su anatomía fascicular de modo que la lesión del nervio pueda ser investigada y tratada de manera más eficiente. El objetivo del estudio fue descubrir las variaciones tanto en el nervio femoral y sus ramas y clasificarlos a partir de la anatomía fascicular utilizando una hipótesis basada en el principio de la continuidad y trazabilidad de los fascículos correspondientes. El estudio se llevó a cabo en el Departamento de Anatomía AIIMS Rishikesh utilizando 13 miembros inferiores pareados (26 nervios femorales) de 13 cadáveres. El nervio femoral se expuso en el triángulo femoral y fue trazado en la pared abdominal posterior. Se analizaron las variaciones en la forma, tamaño y trayecto del nervio femoral y sus ramas. El patrón fascicular fue conceptulizado de acuerdo a la hipótesis planteada. Se detectaron anomalías clasificadas en: siete clases, división alta, anomalías de tronco, semi-dispersos, patrón de ramificación dispersa, pectocutáneo, nervio cutáneo lateral y nervio del músculo sartorio. Las clasificaciones junto con el patrón fascicular correspondientes serán de gran utilidad para los neurocirujanos, radiólogos, anestesistas y anatomistas en el diagnóstico y tratamiento de la neuropatía femoral.
Descritores: Nervo Femoral/anormalidades
Extremidade Inferior/inervação
-Variação Anatômica
Cadáver
Nervo Femoral/anatomia & histologia
Plexo Lombossacral/anatomia & histologia
Limites: Seres Humanos
Masculino
Feminino
Idoso
Idoso de 80 Anos ou mais
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Brasil
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Id: lil-759290
Autor: Mei, ShuYa; Jin, ShuQing; Chen, ZhiXia; Ding, XiBing; Zhao, Xiang; Li, Quan.
Título: Analgesia for total knee arthroplasty: a meta-analysis comparing local infiltration and femoral nerve block
Fonte: Clinics;70(9):648-653, Sept. 2015. tab, ilus.
Idioma: en.
Resumo: Patients frequently experience postoperative pain after a total knee arthroplasty; such pain is always challenging to treat and may delay the patient’s recovery. It is unclear whether local infiltration or a femoral nerve block offers a better analgesic effect after total knee arthroplasty.We performed a systematic review and meta-analysis of randomized controlled trials to compare local infiltration with a femoral nerve block in patients who underwent a primary unilateral total knee arthroplasty. We searched Pubmed, EMBASE, and the Cochrane Library through December 2014. Two reviewers scanned abstracts and extracted data. The data collected included numeric rating scale values for pain at rest and pain upon movement and opioid consumption in the first 24 hours. Mean differences with 95% confidence intervals were calculated for each end point. A sensitivity analysis was conducted to evaluate potential sources of heterogeneity.While the numeric rating scale values for pain upon movement (MD-0.62; 95%CI: -1.13 to -0.12; p=0.02) in the first 24 hours differed significantly between the patients who received local infiltration and those who received a femoral nerve block, there were no differences in the numeric rating scale results for pain at rest (MD-0.42; 95%CI:-1.32 to 0.47; p=0.35) or opioid consumption (MD 2.92; 95%CI:-1.32 to 7.16; p=0.18) in the first 24 hours.Local infiltration and femoral nerve block showed no significant differences in pain intensity at rest or opioid consumption after total knee arthroplasty, but the femoral nerve block was associated with reduced pain upon movement.
Descritores: Artroplastia do Joelho
Analgesia/métodos
Anestesia Local
Nervo Femoral
Bloqueio Nervoso
-Anestésicos Locais
Medição da Dor
Ensaios Clínicos Controlados Aleatórios como Assunto
Limites: Seres Humanos
Tipo de Publ: Estudo Comparativo
Metanálise
Research Support, Non-U.S. Gov't
Revisão
Responsável: BR1.1 - BIREME


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Id: lil-755521
Autor: Medeiros-do-Nascimento, Renata; Alves-Pereira, Jorge Luiz; Rocha-Barbosa, Oscar; Abidu- Figueiredo, Marcelo.
Título: Origin and antimeric distribution of the femoral nerves in New Zealand rabbits / Origen y distribución antimérica del nervio femoral en conejos Nueva Zelanda
Fonte: Int. j. morphol;33(2):632-637, jun. 2015. ilus.
Idioma: en.
Resumo: The origin and distribution of the femoral nerves in both antimeres were studied in 30 New Zealand rabbits (15 males and 15 females). The specimens were collected after natural death and fixed with 10% formaldehyde solution. In males, the femoral nerve originated from the ventral branches of the fourth, sixth and seventh lumbar spinal nerves in seven animals (46.67%), in two animals (13.33%) from the ventral branches of the fifth and sixth lumbar spinal nerves, in one animal (6.67%) from the ventral branch of the fifth lumbar spinal nerve, in three animals (20%) from the ventral branches of the fifth, sixth and seventh lumbar spinal nerves, in one animal (6.67%) from the ventral branches of the fourth and fifth lumbar spinal nerves, and in one animal (6.67%) from the ventral branches of the fifth and seventh lumbar spinal nerves. In females, the femoral nerve originated from the ventral branches of the fourth, sixth and seventh lumbar spinal nerves in four animals (26.67%), in two cases (13.33%) from the ventral branches of the fifth and sixth lumbar spinal nerves, in one animal (6.67%) from the ventral branch of the fifth lumbar spinal nerve, in three animals (20%) from the ventral branches of the sixth and seventh lumbar spinal nerves, in four animals (26.67%) from the ventral branches of the fifth, sixth and seventh lumbar spinal nerves and in one animal (6.67%) from the ventral branches of the fourth and seventhlumbar spinal nerves. In all animals the femoral nerves were distributed in different branches to the major and minor psoas, femoral quadriceps, sartorius and pectinius muscles.

Se estudió el origen y distribución del nervio femoral de ambos antímeros en 30 conejos neozelandeses, 15 machos y 15 hembras. Los animales fueron recolectados después de su muerte natural y se fijaron en formaldehído al 10%. En los machos, el nervio femoral se originó a partir de los ramos ventrales del cuarto, sexto y séptimo nervios espinales lumbares en siete casos (46,67%); en tres casos (20%) desde los ramos ventrales del quinto, sexto y séptimo nervios espinales lumbares; en dos casos (13,33%) desde los ramos ventrales del quinto y sexto nervios espinales lumbares, mientras que en tres animales (n=1 respectivamente), desde los ramos ventrales del quinto nervio espinal lumbar (6,67%), los ramos ventrales del cuarto y quinto nervios lumbares espinales (6,67%) y desde los ramos ventrales del quinto y séptimo nervios espinales lumbares. En las hembras, el nervio femoral se originó a partir de los ramos ventrales del cuarto, sexto y séptimo nervios espinales en cuatro casos (26,67%); en otros cuatro casos (26,67%) desde los ramos ventrales del quinto, sexto y séptimo nervios espinales lumbar, en tres casos (20%) desde los ramos ventrales del sexto y séptimo nervios espinales lumbares, en dos casos (13,33%) desde los ramos ventrales del quinto y sexto nervios espinales, y en dos animales (n=1, respectivamente) procedían desde los ramos ventrales del quinto nervio espinal lumbar (6,67%) y de los ramos ventrales del cuarto y séptimo nervios espinales lumbares (6,67%). Los nervios femorales en todos los animales estaban distribuidos en diversos ramos de los músculos psoas mayor y menor, cuádriceps femoral sartorios y pectinatos.
Descritores: Nervo Femoral/anatomia & histologia
Coelhos/anatomia & histologia
Limites: Animais
Masculino
Feminino
Responsável: CL1.1 - Biblioteca Central


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Id: lil-721377
Autor: Jaeger, Marcos Ricardo de Oliveira; Silva, Jefferson Luis Braga; Bain, James; Ely, Pedro Bins; Pires, Jefferson André; Ferreira, Lydia Masako.
Título: A gastrocnemius heterotopical transplant model with end-to-side neurorraphy
Fonte: Acta cir. bras;29(supl.2):50-54, 2014. graf.
Idioma: en.
Resumo: PURPOSE: To present an animal model to assess the effects of end-to-side innervation in the heterotopically transplanted model with reduced chances of neural contamination. METHODS: The medial portion of the gastrocnemius muscle in wistar male rats was isolated and its pedicle dissected and performed a flap in the abdominal portion. To prevent neural contamination in the abdominal region, the muscle was wrapped with a Goretex(r) sheet. The specimens were divided into 2 groups (G). In G1 was performed an end-to-end suture between tibial nerve of the gastrocnemius and femoral motor nerve and between the saphenous sensory nerve and the motor nerve. In G2 was performed a end-to-side suture between the tibial nerve and the motor femoral and between the tibial nerve and saphenous motor nerve. The specimens were evaluated 60 days later to check the structure of the neurorraphy. Sections were obtained proximal and distal to the coaptation site. RESULTS: The medial gastrocnemius muscle had the advantage of maintaining visible mass after 60 days. No disruption of the coaptation site was found. No major injury to the donor nerve was seen in group 2. CONCLUSION: The proposed model is simple, reproduciple and prevent the neural contamination in the flap in end-to-side suture. .
Descritores: Modelos Animais
Músculo Esquelético/inervação
Músculo Esquelético/transplante
Transferência de Nervo/métodos
Técnicas de Sutura
Transplante Heterotópico/métodos
-Nervo Femoral/transplante
Microscopia Eletrônica
Microcirurgia/métodos
Ratos Wistar
Reprodutibilidade dos Testes
Procedimentos Cirúrgicos Reconstrutivos/métodos
Retalhos Cirúrgicos
Fatores de Tempo
Nervo Tibial/transplante
Limites: Animais
Masculino
Responsável: BR1.1 - BIREME



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