Inervación del músculo extensor radial corto del carpo en individuos brasileños: biometría de su origen y distribución / Innervation of the extensor carpi radialis brevis muscle in Brazilian individuals: biometry of its origin and distribution

El ramo de inervación para el músculo extensor radial corto del carpo (MERCC) ha sido utilizado para restablecer funciones de la musculatura del miembro superior en pacientes con lesiones medulares, del plexo braquial o de sus ramos terminales. El origen del nervio para el MERCC es variable, pudiendo originarse desde el tronco del nervio radial (NR), del ramo profundo de este nervio (RPNR) o del ramo superficial del mismo (RSNR). Con el propósito de complementar la anatomía sobre el origen y distribución del ramo para el MERCC, se utilizaron 30 miembros superiores, formolizados, de cadáveres de individuos Brasileños, localizados en los laboratorios de Anatomía de la Universidad Estadual de Ciencias da Saude, Maceió, Brasil. A través de disección se localizó el músculo y su inervación, determinando su origen, así como su distribución. Para efectuar la biometría, se consideró como referencia una línea transversal que pasaba entre las partes más prominentes de los epicóndilos lateral y medial del húmero (LBE), registrando la distancia entre esta línea y el punto de origen de este ramo muscular, así como la distancia entre la LBE y los puntos motores. El nervio para el MERCC se originó del RPNR en 50 % de los casos; desde el tronco principal del NR en 26, 7 % y desde el RSNR en 23, 3 %. La distancia entre el origen del ramo en estudio y la LBE fue en promedio de 23 ± 12 mm; la distancia entre el 1º, 2º y 3º punto motor respecto a la LBE fue de 55 ± 17 mm, 66 ± 17 mm y 79 ± 11 mm, respectivamente. La distribución de la inervación fue clasificada en 4 tipos en relación a sus puntos motores. Los resultados obtenidos son un importante aporte al conocimiento anatómico, así como a la neurocirugía en las transferencias nerviosas con propósitos de restauración de las funciones de músculos lesionados en el miembro superior.

The branch of the innervation for the extensor carpi radialis brevis muscle (ECRBm), has been used to reestablish muscle functions in the upper limbs of patients who have spinal cord injury, of the brachial plexus or its terminal branches. The origin of the ECRBm varies, and can originate from the trunk of the radial nerve (RN), from the deep branch of the radial nerve (DBRN), or from the superficial branch of the radial nerve (SBRN). In order to further complement the anatomy related to the origin and distribution of the ECRBm branch, 30 formolized upper limbs from Brazilian individuals, from the Universidad Estadual de Ciencias da Saude, Maiceió, Brazil were used. Through dissection, the muscle and its innervations was located, determining the origin of the branch as well as distribution. To determine biometry, a transversal reference line, which passed through the most prominent areas of the epicondyles of the humerus (BEL) was considered. The nerve for ECRBm originated from DBRN in 50 % of cases; from the main trunk of RN in 26.7 % and from SBRN in 23.3 %. The distance from the origin of the branch studied and the BEL was an average of 23 ± 12 mm; the distance from the first, second and third motor point to the BEL was 55 ± 17 mm, 66 ± 17 mm and 79±11 mm, respectively. The distribution of the innervation was classified in four types in relation to the motor points. The results are an important contribution to anatomical knowledge, as well as neurosurgery during nerve transfers to restore functions of damaged muscles in the upper limb.

Unraveling a masticatory - oculomotor neural pathway in rat: Implications for a pathophysiological neural circuit in human?

Anterograde tracers were injected into the mesencephalic trigeminal nucleus (Vme) in pons, labeled axons and terminals were observed in ipsilateral oculomotor (III) and trochlear (IV) nuclei, as well as in interstitial nucleus of Cajar and Darkschewitsch nucleus (INC/DN), the well-known premotor nuclei to the III/IV, but not in abducens nucleus and central mesencephalic and paramedian pontine reticular formation (CMRF/PPRF). Retrogradely labeled INC/DN neurons do ensue from injection of tracers into the III. Confocal microscopy revealed labeled Vme axonal terminals contact with labeled pre-oculomotor neurons in the INC/DN. In response to electrical stimulation of trigeminal nerve root (TR) jaw muscle branches, which contains peripheral processes of the jaw muscle spindle, extracellular unit discharges were recorded in the ipsilateral III/IV and INC/DN. Electromyography (EMG) was also recorded from superior rectus (SR) and levator palpebrae (LP) following electrical stimulation of the TR. Moreover, stimulation of the TR induced Fos expression in the INC/DN pre-oculomotor neurons, but not in CMRF/PPRF that harbors horizontal eye moving premotor neurons. By injection of retrograde tracers into the III combined with Fos immunostain, double labeled pre-oculomotor neurons were observed in the INC/DN. About 80% of retrogradely labeled III premotor neurons express Fos. These results suggest a neural pathway from the masticatory Vme neurons to the oculomotor system that is probably involved exclusively in vertical and torsional eye movement as well as eyelid retraction. The potential relationship between this pathway and Marcus Gunn Syndrome (MGS), a congenital jaw-winking syndrome, was discussed.