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Anatomical and clinical study of the subscapular nerves
Menezes, CC; Cricenti, SV; Mendes, FMP; Souza, EM; Maia-Filho, EM.
  • Menezes, CC; Federal University of Piaui (PICOS). Picos. BR
  • Cricenti, SV; Federal University of São Paulo. Department of Morphology. Post-graduation Section. São Paulo. BR
  • Mendes, FMP; Federal University of Maranhão. Department of Morphology. Post-graduation Section. São Luís. BR
  • Souza, EM; University Center of Maranhão. Post-graduation Section. São Luis. BR
  • Maia-Filho, EM; University Center of Maranhão. Post-graduation Section. São Luis. BR
Braz. j. morphol. sci ; 27(2): 74-76, Apr.-June 2010. ilus
Article in English | LILACS | ID: lil-644219
ABSTRACT
Introduction: Painful shoulder on hemiplegic patients has been associated to subscapular muscle spasticity.An alternative for treatment is based on subscapular nerve block using phenol. However, there is lack ofinformation on anatomical references for subscapular nerves blockage technique. The aim of this study wasto determine mean values and confidence intervals for maximum penetration points in order to facilitateblockage during anesthetic procedure of subscapular nerves. Material and methods: Using 30 dissected adultcadaver limbs, the medial edge of scapula and a horizontal plan to the lower edge of the bone spine wereidentified. The maximal and minimal angles of the penetration points of the subscapular nerve both above andbelow the horizontal plan were measured, as well as the minimal and maximal distances from the medial edgeof scapula. Superior and inferior bisector angles and the mean horizontal distance (in mm) were calculatedfor descriptive analysis. Kolmogorov-Smirnov normality test indicated the normal distribution of the data(p > 0.05). Results: Mean superior angle was 6.63° (confidence interval 4.52-8.75), mean inferior angle was11.30° (confidence interval 8.73-13.86) and mean horizontal distance was 72.53 mm (confidence interval69.25-75.80). Conclusions: According to this data, for maximum points blocking after solution injection, theneedle should be introduced horizontally at the scapula spine level under its medial edge to a mean depth of72.53 mm. Then, the needle must be driven upwards in a 6.63° angle and later, driven downwards to form a11.30° angle with the horizontal plan. Those mean values represent 95% of the distribution.
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Index: LILACS (Americas) Main subject: Shoulder Limits: Adult / Female / Humans / Male Language: English Journal: Braz. j. morphol. sci Journal subject: Anatomy Year: 2011 Type: Article Affiliation country: Brazil Institution/Affiliation country: Federal University of Maranhão/BR / Federal University of Piaui (PICOS)/BR / Federal University of São Paulo/BR / University Center of Maranhão/BR

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Index: LILACS (Americas) Main subject: Shoulder Limits: Adult / Female / Humans / Male Language: English Journal: Braz. j. morphol. sci Journal subject: Anatomy Year: 2011 Type: Article Affiliation country: Brazil Institution/Affiliation country: Federal University of Maranhão/BR / Federal University of Piaui (PICOS)/BR / Federal University of São Paulo/BR / University Center of Maranhão/BR