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Ganglion Anatomy

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181. Non-Small Cell Lung Cancer

mortality in the United States.[ ] The 5-year relative survival rate from 1995 to 2001 for patients with lung cancer was 15.7%. The 5-year relative survival rate for patients with local-stage (49%), regional-stage (16%), and distant-stage (2%) disease varies markedly, depending on the stage at diagnosis.[ ] Anatomy NSCLC arises from the epithelial cells of the lung of the central bronchi to terminal alveoli. The histological type of NSCLC correlates with site of origin, reflecting the variation (...) in respiratory tract epithelium of the bronchi to alveoli. Squamous cell carcinoma usually starts near a central bronchus. Adenocarcinoma and bronchioloalveolar carcinoma usually originate in peripheral lung tissue. Anatomy of the respiratory system. Pathogenesis Smoking-related lung carcinogenesis is a multistep process. Squamous cell carcinoma and adenocarcinoma have defined premalignant precursor lesions. Before becoming invasive, lung epithelium may undergo morphological changes that include

2012 PDQ - NCI's Comprehensive Cancer Database

182. Neuroblastoma, Childhood

or other exposures have not been unequivocally associated with increased or decreased incidences of neuroblastoma.[ ] Anatomy Neuroblastoma originates in the adrenal medulla and paraspinal or periaortic regions where sympathetic nervous system tissue is present (refer to ). Figure 1. Neuroblastoma may be found in the adrenal glands and paraspinal nerve tissue from the neck to the pelvis. Genetic Predisposition and Familial Neuroblastoma Studies analyzing constitutional DNA in rare cohorts of familial (...) lymphangiectasia.[ ] Vasoactive intestinal peptide secretion may also occur with chemotherapeutic treatment, and tumor resection reduces vasoactive intestinal peptide secretion.[ ] Presence of Horner syndrome: Horner syndrome is characterized by miosis, ptosis, and anhidrosis. It may be caused by neuroblastoma in the stellate ganglion, and children with Horner syndrome without other apparent cause are also examined for neuroblastoma and other tumors.[ ] Subcutaneous skin nodules: Subcutaneous metastases

2012 PDQ - NCI's Comprehensive Cancer Database

183. Germ Cell Tumors, Childhood Central Nervous System

of the classification of CNS tumors and a link to the corresponding treatment summary for each type of brain tumor, refer to the PDQ summary on . Incidence In Western countries, GCTs represent 3% to 4% of primary brain tumors in children; however, series from Japan and Asia report the incidence of CNS GCTs as approximately 15% of pediatric CNS tumors.[ , - ] The genetic or environmental reasons for these differences remain unknown. Anatomy CNS GCTs usually arise in the pineal and/or suprasellar regions of the brain (...) do females, with males having a preponderance of pineal-region primary tumors. Other areas that may be involved, though rare, include the basal ganglia, ventricles, thalamus, cerebral hemispheres, and medulla.[ , ] Figure 1. Anatomy of the inside of the brain. The supratentorium contains the cerebrum, ventricles (with cerebrospinal fluid shown in blue), choroid plexus, hypothalamus, pineal gland, pituitary gland, and optic nerve. The infratentorium contains the cerebellum and brain stem

2012 PDQ - NCI's Comprehensive Cancer Database

184. Embryonal Tumors, Central Nervous System, Childhood

subtype of the medulloblastoma and possibly other factors, such as extent of dissemination at time of diagnosis and degree of resection. Children who survive for 5 years are considered cured of their tumor. Survival rates for other embryonal tumors are generally poorer, ranging from less than 5% to 50%; specifics are discussed within each subgroup in the summary.[ - ] Figure 1. Anatomy of the inside of the brain, showing the pineal and pituitary glands, optic nerve, ventricles (with cerebrospinal (...) of the tumor, is as follows: ETMR, C19MC -altered. ETMR, not otherwise specified (NOS). Medulloepithelioma. CNS neuroblastoma. CNS ganglioneuroblastoma. CNS embryonal tumor, NOS. Atypical teratoid/rhabdoid tumor. CNS embryonal tumor with rhabdoid features. CNS embryonal tumors that demonstrate distinct areas of neuronal differentiation are termed cerebral neuroblastomas and, if ganglion cells are present, ganglioneuroblastomas . Likewise, medulloepitheliomas have a specific histologic pattern and remain

2012 PDQ - NCI's Comprehensive Cancer Database

185. Neuro-ophthalmic Manifestations of Vascular Eye Diseases (Overview)

Neuro-ophthalmic Manifestations of Vascular Eye Diseases (Overview) Neuro-ophthalmic Manifestations of Vascular Eye Diseases: Vascular Anatomy, Ischemic Optic Neuropathy, Retinal Artery Occlusion Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2MjkxNi1vdmVydmlldw== processing > Neuro-ophthalmic Manifestations of Vascular Eye Diseases Updated: Jan 24, 2019 Author: Robert A Egan, MD; Chief Editor: Helmi L Lutsep, MD Share Email Print Feedback Close Sections Sections Neuro-ophthalmic Manifestations of Vascular Eye Diseases Vascular Anatomy The ophthalmic artery originates from the distal end of the internal carotid artery (ICA). After several microscopic branches emerge from the ICA in the petrous region, the ophthalmic artery proceeds toward the globe

2014 eMedicine.com

186. Neurogenic Bladder (Overview)

. Acute management of autonomic dysreflexia is to decompress the rectum or bladder. Decompression usually will reverse the effects of unopposed sympathetic outflow. If additional measures are required, parenteral ganglionic or adrenergic blocking agents, such as chlorpromazine, may be used. Oral blocking agents, including terazosin, may be used for prophylaxjis in patients with autonomic dysreflexia. Alternatively, spinal anesthesia may be used as a prophylactic measure whenever bladder (...) . Videourodynamics combines the radiographic findings of voiding cystourethrogram (VCUG) and multichannel urodynamics. Videourodynamics enables documentation of lower urinary tract anatomy, such as vesicoureteral reflux and bladder diverticulum, as well as the functional pressure-flow relationship between the bladder and the urethra. Previous Next: Treatment & Management Medical Care Treatment of urinary incontinence varies by type, as follows: Stress incontinence may be treated with surgical and some non

2014 eMedicine.com

187. Neonatal Brachial Plexus Palsies (Overview)

trunk nerve injury, attributing the findings to traction on the upper trunk, now called Erb's palsy (or Duchenne-Erb's palsy). [ ] In 1885, Klumpke described injury to the C8-T1 nerve roots and the nearby stellate ganglion that now bears her name. Many cases of BPP are transient, with the child recovering full function in the first week of life. A smaller percentage of children continue to have weakness leading to long-term disability from the injury. The mainstay of treatment for these children (...) of the variability in presentation, treatment options, and outcome measures, a multidisciplinary approach to the care of the infant with BPP is recommended. Next: Pathophysiology To understand the clinical presentation of brachial plexus palsy (BPP) and provide anticipatory guidance for families affected by the condition, the clinician must first know basic anatomy. As seen in the image below, the brachial plexus consists of nerves (the ventral rami) from C5-T1. Brachial Plexus. Image courtesy of Michael Brown

2014 eMedicine.com

188. Penile Prosthesis Implantation (Overview)

chain ganglia. They synapse onto sacral and caudal lumbar ganglion cells. These cells then send postganglionic axons via gray rami to diverge into the pelvic, cavernous, and pudendal nerves that serve the urogenital tract. Somatic pathways are important for penile sensation and ejaculation. Sensory afferents from the pudendal nerve become the dorsal nerve of the penis, which enters the urogenital diaphragm to innervate the penile skin, prepuce, and glans. The input from these sensory fibers helps (...) . Previous Next: Relevant Anatomy To understand the relevant anatomy of erectile function is to understand the tunica albuginea. It is the tough covering of the corpora cavernosa and consists of inner circular layers with intracavernosal pillars that help tether the corporal bodies from overexpansion. Outer longitudinally arranged fibers run from the glans penis to the proximal crura at the base of the penis. The tunica albuginea is made of elastic tissue with embedded collagen fiber that offers

2014 eMedicine.com

189. Esophageal Motility Disorders (Overview)

observed in a patient with manometry confirmed findings of diffuse esophageal spasm (DES). Image courtesy of Andrew Taylor, MD, Professor, Abdominal Imaging, Department of Radiology, University of Wisconsin Medical School, Madison. Response to amyl nitrate, with disappearance of the spasm on esophagram. Image courtesy of Andrew Taylor, MD, Professor, Abdominal Imaging, Department of Radiology, University of Wisconsin Medical School, Madison. Anatomy The tubular esophagus is a muscular organ (...) Achalasia is the best defined primary motility disorder and the only one with an established pathology. The predominant neuropathologic process of achalasia involves the loss of ganglion cells from the wall of the esophagus, starting at the LES and developing proximally. The degree of ganglion cell loss parallels the disease duration such that, at 10 years, ganglion cells are likely completely absent. At the LES, the loss of inhibitory nerves is demonstrated by loss of nitric oxide synthase

2014 eMedicine.com

190. Epidural Steroid Injections (Overview)

and dorsal root ganglion, they often travel a distance superiorly and laterally in the lateral epidural space to join the anterior spinal artery supplying the anterior two thirds of the spinal cord. Additionally, in about 63% of cases of cadaver studies, there is a posterior branch of the radicular medullary artery going to the dorsal aspect of the cauda equina. It is conceivable that the epidural needle in the interlaminar lumbar epidural steroid injection will very likely encounter the radicular (...) paresis, and respiratory depression, are generally thought to be reversible and an additional indicator of possible vascular uptake. Additionally, avoidance of heavy sedation during procedures has been recommended to decrease adverse effects. Lumbar transforaminal ESI The artery of Adamkiewicz, a critical radiculomedullary artery that supplies the anterior spinal artery, is known to be localized in the superior and anterior aspect of dorsal root ganglion and the exiting nerve root in the lumbar

2014 eMedicine.com

191. Ulnar Neuropathy (Diagnosis)

Ulnar Neuropathy (Diagnosis) Ulnar Neuropathy: Background, Anatomy, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0MTUxNS1vdmVydmlldw== processing > Ulnar Neuropathy Updated: Jun 08, 2018 (...) to be satisfactory. Next: Anatomy Course of ulnar nerve The ulnar nerve is the terminal branch of the medial cord of the brachial plexus and contains fibers from C8, T1, and, occasionally, C7. [ , ] It enters the arm with the axillary artery and passes posterior and medial to the brachial artery, traveling between the brachial artery and the brachial vein. At the level of the insertion of the coracobrachialis in the middle third of the arm, the ulnar nerve pierces the medial intermuscular septum to enter

2014 eMedicine.com

192. Trigeminal Neuralgia (Diagnosis)

and accurate detail in his 1912 book The Principles and Practice of Medicine . [ ] In 1900, in a landmark article, Cushing reported a method of total ablation of the gasserian ganglion to treat trigeminal neuralgia. See also . Previous Next: Anatomy The trigeminal nerve is the largest of all the cranial nerves. It exits laterally at the mid-pons level and has 2 divisions—a smaller motor root (portion minor) and a larger sensory root (portion major). The motor root supplies the temporalis, pterygoid, tensor (...) Trigeminal Neuralgia (Diagnosis) Trigeminal Neuralgia: Practice Essentials, Background, Anatomy Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0NTE0NC1vdmVydmlldw== processing > Trigeminal Neuralgia Updated

2014 eMedicine.com

193. Trigeminal Neuralgia (Diagnosis)

the cranial nerves. It exits laterally at the midpons level and has 2 divisions—a smaller motor root (portion minor) and a larger sensory root (portion major). The motor root supplies the temporalis, pterygoid, tensor tympani, tensor palati, and mylohyoid muscles, as well as the anterior belly of the digastrics muscle. The motor root also contains sensory nerve fibers that particularly mediate pain sensation. The gasserian ganglion is located in the trigeminal fossa (Meckel cave) of the petrous bone (...) in the middle cranial fossa. It contains the first-order general somatic sensory fibers that carry pain, temperature, and touch. The peripheral processes of neurons in the ganglion form the 3 divisions of the trigeminal nerve: ophthalmic, maxillary, and mandibular (see the image below). The ophthalmic division exits the cranium via the superior orbital fissure; the maxillary and mandibular divisions exit via the foramen rotundum and foramen ovale, respectively. The ophthalmic and maxillary nerves are purely

2014 eMedicine.com

194. Radial Nerve Entrapment (Follow-up)

. Counsel the patient about this risk. In exploring the posterior interosseous nerve, a large ganglion or lipoma may be seen encompassing the nerve, and during dissection, the nerve may be severed or severely stretched. Another complication is failure of the patient to seek medical help until the affected muscles have atrophied or fibrosed. Although nerve decompression should still be strongly considered, the possibility of a satisfactory outcome from neurolysis alone is slim, and tendon transfers may (...) Operative Orthopaedics . 13th ed. Philadelphia: Elsevier; 2017. Vol 4: 3162-225. Ritts GD, Wood MB, Linscheid RL. Radial tunnel syndrome. A ten-year surgical experience. Clin Orthop Relat Res . 1987 Jun. (219):201-5. . Sunderland S. Nerves and Nerve Injuries . 2nd ed. New York: Churchill Livingstone; 1978. 127. Robson AJ, See MS, Ellis H. Applied anatomy of the superficial branch of the radial nerve. Clin Anat . 2008 Jan. 21(1):38-45. . Thomsen NO, Dahlin LB. Injury to the radial nerve caused

2014 eMedicine Surgery

195. Peroneal Tendon Pathology (Follow-up)

rupture. Previous Next: Surgical Therapy Surgical treatment is best considered in the context of the specific pathology being addressed. [ ] With any procedure, it is important to remove abnormal-appearing synovium or tenosynovium, which can cause persistent pain if not removed. This can be accomplished easily with the use of a rongeur. (See the images below.) Peroneus brevis degeneration forming ganglion-type mass. Peroneus brevis above after resection of degenerative mass and peroneus longus below (...) . Partial repair of peroneal tendon sheath. Repaired peroneal tendon sheath. Skin closed over peroneal tendon repair. Torn or degenerated tendons or ganglia removed from peroneal tendons can show a myxoid pattern of degeneration (see the images below). Cystic mass (ganglion) on right arising from peroneal tendon (×40). Ganglion with myxoid degeneration and connective tissue with myxoid material pools with cystic change (×400). Tenosynovitis Tenosynovitis may be treated surgically with simple division

2014 eMedicine Surgery

196. Cystic Lesions About the Knee (Follow-up)

tears can also favorably affect results. Previous Next: Future and Controversies The etiology of some knee cysts (eg, meniscal cysts, cruciate ganglion cysts) remains controversial. As further reports and histologic studies continue, the origins of such cysts will become clearer. Previous References Goss CM, ed. Gray's Anatomy of the Human Body. 29th ed. Philadelphia, Pa: Lea and Febiger. 1974: 353-4. Crema MD, Roemer FW, Marra MD, Niu J, Lynch JA, Felson DT, et al. Contrast-enhanced MRI (...) (5):409-14. . Jobe CM, Wright M. Anatomy of the knee. In: Fu FH, Harner CD, Vince KG, eds. Knee Surgery. Baltimore, Md: Lippincott Williams and Wilkins. 1994: 48-9. Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature. BMC Musculoskelet Disord . 2012 Aug 3. 13:137. . . Hayashi D, Xu L, Roemer FW, Hunter DJ, Li L, Katur AM, et al. Detection of osteophytes and subchondral cysts in the knee with use of tomosynthesis. Radiology . 2012 Apr

2014 eMedicine Surgery

197. Cubital Tunnel Syndrome (Diagnosis)

Cubital Tunnel Syndrome (Diagnosis) Ulnar Neuropathy: Background, Anatomy, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0MTUxNS1vdmVydmlldw== processing > Ulnar Neuropathy Updated: Jun 08 (...) appear to be satisfactory. Next: Anatomy Course of ulnar nerve The ulnar nerve is the terminal branch of the medial cord of the brachial plexus and contains fibers from C8, T1, and, occasionally, C7. [ , ] It enters the arm with the axillary artery and passes posterior and medial to the brachial artery, traveling between the brachial artery and the brachial vein. At the level of the insertion of the coracobrachialis in the middle third of the arm, the ulnar nerve pierces the medial intermuscular

2014 eMedicine Surgery

198. Brachial Plexus Injuries, Traumatic (Diagnosis)

Brachial Plexus Injuries, Traumatic (Diagnosis) Traumatic Brachial Plexus Injuries: Background, Anatomy, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTI2ODk5My1vdmVydmlldw== processing (...) usually are catastrophic for the affected individual. Loss of useful function of the upper extremity is common, but early repair and reconstruction are providing far greater restoration than was previously possible a few years ago. See , a Critical Images slideshow, to help diagnose and treat injuries from a football game that can result in minor to severe complications. Next: Anatomy The brachial plexus is formed from the spinal nerves or roots, the coalescence of the ventral (motor) and the dorsal

2014 eMedicine Surgery

199. Cystic Lesions About the Knee (Diagnosis)

of Popliteal (Baker) Cysts With Ultrasound-Guided Aspiration, Fenestration, and Injection: Long-term Follow-up. Sports Health . 2015 Sep. 7 (5):409-14. . Jobe CM, Wright M. Anatomy of the knee. In: Fu FH, Harner CD, Vince KG, eds. Knee Surgery. Baltimore, Md: Lippincott Williams and Wilkins. 1994: 48-9. Mao Y, Dong Q, Wang Y. Ganglion cysts of the cruciate ligaments: a series of 31 cases and review of the literature. BMC Musculoskelet Disord . 2012 Aug 3. 13:137. . . Hayashi D, Xu L, Roemer FW, Hunter DJ (...) or in bone. Benign or malignant masses must be distinguished from cystic lesions. This article discusses benign cysts that occur in the soft tissue around the knee or outside bone and that are filled with fluid or semisolid material. See the images below. Popliteal cyst. Courtesy of James K. DeOrio, MD, Laura W. Bancroft, MD, and Jeffrey J. Peterson, MD. Ganglion of the anterior cruciate ligament. Courtesy of James K. DeOrio, MD, Laura W. Bancroft, MD, and Jeffrey J. Peterson, MD. Meniscal cyst. Courtesy

2014 eMedicine Surgery

200. Skull Base, Petrous Apex, Infection

present with petrous apicitis, and the clinician needs to be wary of the condition's presenting features to prevent possible life-threatening complications. An image depicting skull base anatomy can be seen below. Internal anatomy of the skull base, lateral view, and base of the skull. Next: History of the Procedure Gradenigo syndrome, ie, petrous apicitis in combination with the clinical triad of , abducens nerve (cranial nerve [CN] VI) palsy, and otorrhea, is named after Giuseppe Gradenigo. In 1904 (...) or inflammation, typically in combination with mastoiditis. The proximity of the venous sinuses to the petrous apex is the reason for the historically high incidence of venous sinus thrombosis associated with petrous apicitis. The inflammation may extend into the Dorello canal, which transmits CN VI and the gasserian ganglion (CN V). Inflammation of the canal produces the triad of symptoms recognized by Gradenigo: lateral rectus (CN VI) palsy, retroorbital pain, and otorrhea. Pseudomonads are most often

2014 eMedicine Surgery

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