Normal and sonographic anatomy of selected peripheral nerves. Part I: Sonohistology and general principles of examination, following the example of the median nerve
Ultrasonography is an established method for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. It enables the identification of post-traumatic changes of nerves, neuropathies secondary to compression syndromes, inflammat...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Sciendo
2012-06-01
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| Series: | Journal of Ultrasonography |
| Subjects: | |
| Online Access: | http://jultrason.pl/index.php/issues/volume-12-no-49/normal-and-sonographic-anatomy-of-selected-peripheral-nerves-part-i-sonohistology-and-general-principles-of-examination-following-the-example-of-the-median-nerve?aid=2 |
| Summary: | Ultrasonography is an established method for imaging peripheral nerves. It serves to supplement
the physical examination, electromyography, and magnetic resonance imaging.
It enables the identification of post-traumatic changes of nerves, neuropathies secondary
to compression syndromes, inflammatory or neoplastic nerve lesions as well as the evaluation
of postoperative complications. In certain situations, this technique is the imaging
method of choice. It is increasingly used in anesthesiology for regional anesthesia. As in
the case of other ultrasound imaging studies, the examination of peripheral nerves is
non-invasive, well-tolerated by patients, and relatively inexpensive. This article presents
the histological structure of peripheral nerves and their appearance in ultrasonography.
It also presents the examination technique, following the example of the median nerve,
and includes a series of diagrams and ultrasound images. The interpretation of the shape,
echogenicity, thickness and vascularity of nerves is described, as well as their relation
to the surrounding tissues. The “elevator technique”, which consists of locating a set
nerve at a characteristic anatomic point, and following it proximally or distally, has been
explained. The undisputed benefits of the ultrasound examination have been presented,
including its advantages over other diagnostic methods. These advantages include the
dynamic component of the ultrasound examination and the possibility of correlating
the patient’s symptoms with the ultrasound images. As an example, the proper anatomy
and the ultrasonographic appearance of the median nerve were described. This nerve’s
course is presented, its divisions, and characteristic reference points, so as to facilitate
its location and identification, and enable subsequent use of the aforementioned “elevator
technique”. This article opens a series of publications concerning anatomy, technique of
examination and pathologies of peripheral nerves. |
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| ISSN: | 2084-8404 2451-070X |