Branches Of Cervical Nerves Research Articles

An exploratory study on the presence of sensory nerves in the caudal part of the trapezius

Intramuscular onabotulinumtoxinA (BTX) injections and nerve decompression surgery both aim to release compressed sensory nerves and are used in the treatment of migraine/headaches. Although for many BTX injection sites, sensory nerves and their potential entrapment sites have been established, for the trapezius this information is incomplete. A macro- and microscopic cadaveric study was performed in which the suprascapular part of the trapezius was explored for the presence of piercing or penetrating nerves and whether these nerves contained sensory nerve fibers. One side of six human cadavers were dissected to reveal trapezius-associated nerves in its suprascapular part. Schematic overview drawings were made of nerves either piercing or penetrating the trapezius in this region. Piercing or penetrating cervical nerves were resected and microscopically studied for the presence of sensory nerve fibers. For this suprascapular region, correlating potential entrapment sites of the supraclavicular nerves were detected. In all specimens, plexuslike connections between the accessory nerve and branches of the cervical plexus, varying between CII-CV, were observed to innervate the trapezius at locations that showed overlap with BTX injection sites. Moreover, all these nerves contained sensory nerve fibers as confirmed by immunohistochemical staining with the sensory nerve marker CGRP. The presence of potential entrapment sites for supraclavicular nerves and other cervical nerve branches might explain why BTX injection in the suprascapular part of the trapezius show therapeutic effectivity in the treatment of migraine/headaches

Thyrohyoideus muscle innervation in the horse.

To describe the innervation of the thyrohyoideus (TH) muscle and to confirm our findings with stimulation of first cervical (C1) nerve branches. Ex vivo phase 1 and clinical phase 2. Fourteen head and neck specimens and 17 client-owned horses. In phase 1, the cranial nerve (CN) XII and the C1 nerve were dissected with their branches in 20 dissections were performed on 14 specimens (6 left and right side and 8 only left or right) Anatomy was noted. Samples of nerve bifurcations were collected for histological confirmation of anatomical findings. First cervical nerve branches were stimulated in horses undergoing cervical nerve graft to treat laryngeal hemiplegia. The nerve innervating the TH muscle arose directly from the C1 nerve in 17 of 20 dissections, from an anastomotic branch between CN XII and the C1 nerve in two of 20 dissections, and from the C1 nerve and the anastomotic branch in one of 20 dissections. No direct connection between the TH muscle and CN XII was found. Histological examination revealed that the anastomosis was composed of C1 nerve fibers passing over to CN XII. First cervical stimulation resulted in TH muscle contraction in 16 of 17 horses. The innervation of the TH muscle originated from the C1 nerve according to dissection, histological, and conduction studies, with variation in the branching pattern. Care should be taken to preserve the C1 nerve during prosthetic laryngoplasty. The surgical technique for C1 nerve grafts should be reconsidered in light of these findings, along with new options to treat dorsal displacement of the soft palate..

Two mammalian species in which the intercostal nerves innervate the serratus anterior or scalenus muscles together with the cervical nerves: an important clue to clarify the homology of cervico-thoracic trunk muscles in mammals.

The levator scapulae, rhomboideus, and serratus anterior muscles (as a group referred to the dorsal shoulder girdle muscles) and the scalenus muscles in mammals are usually innervated by cervical nerves. However, in koalas, the serratus anterior is additionally innervated by the lateral cutaneous branch of the first intercostal nerve. In cats, as in some other mammalian species, a part of the scalenus muscle (scalenus longus muscle) is innervated by the lateral cutaneous branches of the intercostal nerves. A precise comparison of the innervating nerves at the same segment in these two cases could clarify the homological relationship between the cervical and thoracic trunk muscles. In this context, the aim of this study was to follow the nerve fibers included in the nerves supplying the dorsal shoulder girdle and scalenus muscles up to the level of the spinal nerve roots in two koalas and two cats. The resultant observations revealed that both of the nerves to the serratus anterior in koalas and to the scalenus muscles in cats from the lateral cutaneous branch of the intercostal nerve occupy the same position in the spinal roots as the cervical nerve branches to the dorsal shoulder girdle muscles and the thoracic nerve branches to the external intercostal muscle. Based on these results, the axial trunk muscles in the cervico-thoracic region could be classified as follows: the scalenus and dorsal shoulder girdle muscles belong to the same lateral axial trunk muscle group as the external intercostal muscle, and are clearly distinguished from the medial group, such as the internal and innermost intercostal muscle.

RETRACTED: Blocking of multiple posterior branches of cervical nerves using an erector spinae plane block

RETRACTED: Blocking of multiple posterior branches of cervical nerves using an erector spinae plane block

RETRACTED: Blocking of multiple posterior branches of cervical nerves using a cervical interfascial plane block

RETRACTED: Blocking of multiple posterior branches of cervical nerves using a cervical interfascial plane block

Paroxysmal Stabbing Headache in The Multiple Dermatomes of The Head and Neck: A Variant of Primary Stabbing Headache or Occipital Neuralgia?

A paroxysmal stabbing or icepick-like headache in the multiple nerve dermatomes, especially involving both trigeminal and cervical nerves, has not been fully explained or classified by the International Classification of Headache Disorder, 2(nd) Edition (ICHD-II). Of patients with acute-onset paroxysmal stabbing headache who had visited the Hallym University Medical Center during the last four years, 28 subjects with a repeated stabbing headache involving multiple dermatomes at the initial presentation or during the course were prospectively enrolled. All patients were neurologically and otologically symptom free. A coincidental involvement of both trigeminal and cervical nerve dermatomes included seven cases. Six cases involved initially the trigeminal and then cervical nerve dermatomes. Five cases showed an involvement of the cervical and then trigeminal nerve dermatomes. The remaining patients involved multiple cervical nerve branches (the lesser occipital, greater occipital and greater auricular). Pain lasted very shortly and a previous history of headache with the same nature was reported in 13 cases. Preceding symptom of an infection and physical and/or mental stress were manifested in seven and six subjects, respectively. All patients showed a self-limited benign course and completely recovered within a few hours to 30 days. Interestingly, a seasonal gradient in occurrence of a stabbing headache was found in this study. A paroxysmal stabbing headache manifested on multiple dermatomes can be explained by the characteristics of pain referral, and may be considered to be a variant of primary stabbing headache or occipital neuralgia.

Fiber arrangements of cutaneous and muscular rami in cervical nerves of the rat--regarding conception of the spinal nerve stratum-structure.

Fluorescence tracers DiO and DiI were applied to compare fiber arrangements of cutaneous and muscular rami in the proximal region of anterior and posterior branches of cervical nerves. Results show that a ventrodorsal relationship of cervical nerves is observed in gross level; however, fiber arrangements of cutaneous and muscular rami differ in anterior branches according to distance from the anterior root and dorsal root ganglia. That is, the fibers have a scattering course (no ventrodorsal relationship) in distal regions. Moreover, just before entering anterior roots, the motor fibers of muscular ramus run through the ventral part and sensory fibers of muscles and fibers of cutaneous ramus run through the dorsal part and intersect with motor fibers of the posterior muscular ramus. In contrast with the anterior one, in posterior branches of cervical nerves, cutaneous and muscular rami fibers are very regularly arranged in the distal and proximal region. Based on these results, the ventrodorsal relationship of fiber arrangements could exist in posterior branches and proximal region of anterior branches. Present results differ with those of the spinal nerve stratum-structure; therefore, they are insufficient to elucidate the relationship of peripheral nerves by conception of spinal nerve stratum-structure.

The early development of the parotid gland around the facial nerve and its branches in man.

AbstractThe manner in which the parotid gland forms around the related facial nerve branches was studied with the aid of reconstructions in 15 human embryos and fetuses 18 to 80 mm, crown‐rump length, 7+ to 13.5 weeks (w), menstrual age. Peripheral branches of the nerve terminate in the cervicomandibular region at 18 mm (7+w), when the unbranched parotid bud is farther rostral. By 22 mm (8w), a small nerve branch approaches the buccal region superficial to the bud that extends toward the preauricular region. At 26 mm (8.5w), several nerve branches course superficial to the parotid primordium which has first order ductules and is adjacent to the masseter muscle. Second order ductules form quickly (27 mm, 8.5w) as the primordium approaches the superficial aspect of the lower buccal, marginal mandibular and cervical nerve branches. The primordium enters the parotid space by 32 mm (9w) as third order ductules develop. At 37 mm (10w), it has fourth order ductules and the buccal nerve branches are superficial to the main duct. Nerve branches of the temporofacial ramus (temporal, zygomatic and upper buccal) occupy a superficial position in the primordium whereas branches of the cervicofacial ramus (lower buccal, marginal mandibular and cervical) are deeper. A similar arrangement is evident at 56–80 mm (11.5–13.5w) when the complex primordium has connections with its superficial and deep portions between many nerve branches.