##erve Resonance, Influence And Nerve Importance

The patient was an active participant in both contact as well as non-contact athletic activities. The patient reported occurrence of different symptoms that included; pain, weakness, instability, paresthesia, crepitus, as well as instability of the shoulder during sleep. Sulculus sign was conducted to assess the rotator interval and load and shift test for determination of the patient’s posterior stability. The doctor diagnosed positive for multidirectional instability. The patient’s multidirectional instability was not caused by a traumatic event. The patient had not exercised the joint over a long period of time, hence he had a weak shoulder joint, particularly the rotator cuff. The doctor recommended that the patient should be treated for the pain and inflammation of the shoulder caused by the multidirectional instability and then placed on physical therapy aimed for one year aimed at helping in the strengthening of the muscles of the patient that support the scapula (shoulder blade) and the rotator cuff (shoulder joint) so as to help the patient in returning to normal physical activity and also prevent an injury at the same place

MRI of the right shoulder report dated 03/04/14 revealed tear of the supraspinatus/infraspinatus tendon and subscapularis tendon. There is tendinosis of the teres minor. Abnormal signal is noted within the biceps tendon concerning for tear. Degenerative changes involving humeral head are seen. Bone marrow edema is noted involving the superior lateral aspect of the humeral head and the glenoid bone. Degenerative changes at the glenohumeral joint and the acromioclavicular joint are noted. There is edema and sclerosis of the posterior glenoid. Abnormal cortex of the posterior glenoid is demonstrated

Evaluation of the prognosis of recovery of the nerve injury should be first established before management could be done conservatively or using a surgical approach.

The shoulder is the most complex joint in the body. It is capable of moving in more than 16,000 positions. Many of its ailments, including the most common ones, involve biomechanical mechanisms that are unique to the shoulder. The most common shoulder problem for which professional help is sought out for is shoulder impingement (Haig 1996). Shoulder impingement is primarily an overuse injury that involves a mechanical compression of the supraspinatus tendon, subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch (Prentice 2001). Impingement has been described as a continuum during which repetitive compression eventually leads to irritation and inflammation that progresses to

Therefore, numerous spectrums of instability types and associated lesions affecting capsuloabral, ligamentous, and osseous structures can be identified (Stayner et al., 2000). The pathophysiology of an anterior shoulder dislocation involves violent external rotation in abduction levers causing the humerus to be dislodged from the glenoid socket, tearing the shoulder capsule and detaching the labrum from the glenoid (the Bankart lesion) (Farber et al., 2006). Additionally, the posterior part of the humeral head exits the joint, colliding with the anterior rim of the glenoid, producing a bony depression at the back of the humeral head (the Hill Sachs lesion) (Farber et al., 2006). Furthermore, anterior dislocation can occur when people fall with a combination of abduction, extension, and a force directed posteriorly on the arm; this is a common mechanism in the elderly (Stayner et al. 2000). A fracture of the humeral head, neck or greater tuberosity can occur with a dislocation (Stayner et al., 2000). In contrast, a posteriorly dislocated shoulder is less common. It is commonly caused by external forces acting on the shoulder when the shoulder is held in internal rotation and adduction caused by direct trauma experienced during sporting activities (Hegedus et al., 2008). Additionally, it may be result from an epileptic fit,

Typical symptoms consist of pain in the front of the shoulder, which often radiates to the side of the upper arm. There is increased pain with lifting, reaching, and overhead activities. Swelling and tenderness are usually present over the front of the shoulder. As the shoulder impingement progresses, the pain may start at night also, and loss of ROM may occur.

The shoulder girdle is an intricate anatomic structure representation to maximize three-dimensional motion of the hand and opposing thumb, and although the shoulder is often thought of as synonymous with the glenohumeral joint, it is in fact possessed of four separate joints, (acromioclavicular, sternoclavicular, glenohumeral and scapulothoracic), as well as numerous muscles and ligaments that follow synergistically to limit gesture of the upper extremity. Make headway in cross-sectional imaging over the past decade have insurrection imaging of the shoulder girdle, mainly with deem to the soft-tissue structures. Trauma to the shoulder is common. Usually injuries range from a separated shoulder resulting from a fall onto the shoulder

Recently, Ehler et al in Czech Republic have reported mean normative value of ulnar nerve MNCSs for FDI and ADM above and below elbow among 227 healthy volunteers according to the recommendation of American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM).The results of their study showed that ulnar nerve MNCV recorded from FDI and ADM at forearm were 60.4(5.2) and 59.7(4.7)m/s, respectively .Reported ulnar nerve MNCV from FDI and ADM across the elbow were 57.1(5.9) and 56.5(5.7),respectively. Mean differences of MNCV at forearm –across the elbow recorded from FDI and ADM were 3.3(6.6) and 3.2(6.4),

Superior Anterior-Posterior lesions (SLAP) of the labrum is a condition which can be considered to be spread in the male population between the ages 20 to 50. Furthermore, as mentioned by Zhang et al. it has been reported more than 4000 cases in a year. Additionally, based on medical reports, surgeons are reporting more surgeries of this type of injury every year. Moreover, it the fastest growing procedure considering all other surgeries in the outpatient setting. The lesion can be considered of a complex and comprehensive etiology. Most of the time, the mechanism of injury has been reported to be an extreme and repetitive movement of the shoulder, also maximum loading on the bicep in an eccentric position. When considering a number of

Slide the probe slightly lateral and identify the bright hyperechoic fascial plane between the superficial biceps muscle and the deeper coracobrachialis muscle. The musculocutaneous nerve appears as an oval or triangular structure in this fascial place with a bright hyperechoic surrounding epineurium and a dark center. If exact nerves are unable to be identified, an injection

Magnetic Resonance Imaging is an important technology of neuromechanic imaging as it allows for the generation of images of the body used for diagnostic purpose. MRI’s are able to do so through the usage of radio waves and strong magnetic waves to create images that include all aspects of the body. MRI’s are more effective in diagnosing issues in the central nervous system than CT scans as they generate images with higher resolution for examining tissues, display images in more than one plane, exclude excess images of the bones, and more (Edelman et all., 1993). MRI’s ability to view soft tissue and organs has allowed for this method of technology to be used most prominently when dealing with issues involving the central nervous system and

With the patient in the proper position for blocking sciatic nerve by anterior approach, the doppler curved probe (SonoScape®, SSI-6000, China) was placed 10 cm distal to the inguinal crease so as to identify the sciatic nerve. After standard skin preparation, subcutaneous anesthesia was done at the puncture site with lidocaine 1% 1 ml. A 22-gauge, 150-mm insulated b-bevel needle (Stimuplex; B-Braun, Boulogne-Billancourt, France) connected to the nerve stimulator was inserted and directed posteriorly and laterally with a 10°–15° angle relative to the vertical plane. At a depth of 5 cm, the nerve stimulator was set to deliver a current of 5.0 mA. Within a depth of 10–15 cm, the sciatic nerve was identified via stimulation and muscular responses of one of its two components: plantar flexion or inversion of the foot for the tibial nerve (TN) and dorsiflexion or eversion of the foot for the common peroneal nerve (CPN).If no muscular response was obtained at a depth of 15 cm or if the needle

After a review of the clinical information provided by Dr. Yelena Lindenbaum, the Medical Director has determined that Electromyography (a diagnostic test that records the electrical activity of muscles), Nerve Conduction Study (measure how well and how fast the nerves can send electrical signals) is not medically necessary. The information presented is limited and consists only of symptoms and/or diagnoses and proposed services. There is no clinical information provided to support the medical necessity for electromyography/nerve conduction studies for evaluation. There is no physical examination or imaging study results. There is no history of medical or physical therapy. Therefore, we must deny the requested services as not medically

In all patients, neuromuscular disease, biceps or labral lesions, shoulder instability, acromioclavicular joint arthritis, humeral head arthritis, adhesive capsulitis, calcific tendinitis, rotator cuff full thickness tear, previous surgery on the affected shoulder, and suspected cervical lesions were ruled out by clinical examination and radiologic findings with X - ray radiography and MRI.

In comparison, those who were diagnosed early (less one month post injury) and who followed a period of prolonged rest fared better. For patients with persistent symptoms in this series, surgery consisted an ORIF for a fracture displaced more than three centimeters as well as posterior femoral fasciotomy. Eight other patients had surgery for persistent symptoms, five consisting of debridement of scar tissue around the sciatic nerve and biceps tendon, and two excisions of bone fragments. Neurolysis of sciatic nerve following chronic symptoms was also described by other authors' as an adjunct procedure. Neurolysis of the sciatic nerve at the area of the proximal hamstrings for symptoms consistent with hamstring syndrome has been more frequently described in the literature , but not in the adolescent population.