Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant
Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Iwanaga, Joe [verfasserIn] Fox, Michelle C. [verfasserIn] Rekers, Hans [verfasserIn] Schwartz, Lisa [verfasserIn] Tubbs, R. Shane [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Contraception - Amsterdam [u.a.] : Elsevier Science, 1970, 100, Seite 26-30 |
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| Übergeordnetes Werk: |
volume:100 ; pages:26-30 |
| DOI / URN: |
10.1016/j.contraception.2019.02.007 |
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ELV002473704 |
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| 245 | 1 | 0 | |a Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant |
| 264 | 1 | |c 2019 | |
| 336 | |a nicht spezifiziert |b zzz |2 rdacontent | ||
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| 520 | |a Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. | ||
| 650 | 4 | |a Neurovascular anatomy | |
| 650 | 4 | |a Contraceptive implant | |
| 650 | 4 | |a Etonogestrel implant | |
| 650 | 4 | |a Nerve injury | |
| 700 | 1 | |a Fox, Michelle C. |e verfasserin |4 aut | |
| 700 | 1 | |a Rekers, Hans |e verfasserin |4 aut | |
| 700 | 1 | |a Schwartz, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Tubbs, R. Shane |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Contraception |d Amsterdam [u.a.] : Elsevier Science, 1970 |g 100, Seite 26-30 |h Online-Ressource |w (DE-627)320440397 |w (DE-600)2004856-7 |w (DE-576)091017696 |x 1879-0518 |7 nnns |
| 773 | 1 | 8 | |g volume:100 |g pages:26-30 |
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10.1016/j.contraception.2019.02.007 doi (DE-627)ELV002473704 (ELSEVIER)S0010-7824(19)30041-1 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Iwanaga, Joe verfasserin aut Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. Neurovascular anatomy Contraceptive implant Etonogestrel implant Nerve injury Fox, Michelle C. verfasserin aut Rekers, Hans verfasserin aut Schwartz, Lisa verfasserin aut Tubbs, R. Shane verfasserin aut Enthalten in Contraception Amsterdam [u.a.] : Elsevier Science, 1970 100, Seite 26-30 Online-Ressource (DE-627)320440397 (DE-600)2004856-7 (DE-576)091017696 1879-0518 nnns volume:100 pages:26-30 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 100 26-30 |
| spelling |
10.1016/j.contraception.2019.02.007 doi (DE-627)ELV002473704 (ELSEVIER)S0010-7824(19)30041-1 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Iwanaga, Joe verfasserin aut Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. Neurovascular anatomy Contraceptive implant Etonogestrel implant Nerve injury Fox, Michelle C. verfasserin aut Rekers, Hans verfasserin aut Schwartz, Lisa verfasserin aut Tubbs, R. Shane verfasserin aut Enthalten in Contraception Amsterdam [u.a.] : Elsevier Science, 1970 100, Seite 26-30 Online-Ressource (DE-627)320440397 (DE-600)2004856-7 (DE-576)091017696 1879-0518 nnns volume:100 pages:26-30 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 100 26-30 |
| allfields_unstemmed |
10.1016/j.contraception.2019.02.007 doi (DE-627)ELV002473704 (ELSEVIER)S0010-7824(19)30041-1 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Iwanaga, Joe verfasserin aut Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. Neurovascular anatomy Contraceptive implant Etonogestrel implant Nerve injury Fox, Michelle C. verfasserin aut Rekers, Hans verfasserin aut Schwartz, Lisa verfasserin aut Tubbs, R. Shane verfasserin aut Enthalten in Contraception Amsterdam [u.a.] : Elsevier Science, 1970 100, Seite 26-30 Online-Ressource (DE-627)320440397 (DE-600)2004856-7 (DE-576)091017696 1879-0518 nnns volume:100 pages:26-30 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 100 26-30 |
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10.1016/j.contraception.2019.02.007 doi (DE-627)ELV002473704 (ELSEVIER)S0010-7824(19)30041-1 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Iwanaga, Joe verfasserin aut Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. Neurovascular anatomy Contraceptive implant Etonogestrel implant Nerve injury Fox, Michelle C. verfasserin aut Rekers, Hans verfasserin aut Schwartz, Lisa verfasserin aut Tubbs, R. Shane verfasserin aut Enthalten in Contraception Amsterdam [u.a.] : Elsevier Science, 1970 100, Seite 26-30 Online-Ressource (DE-627)320440397 (DE-600)2004856-7 (DE-576)091017696 1879-0518 nnns volume:100 pages:26-30 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 100 26-30 |
| allfieldsSound |
10.1016/j.contraception.2019.02.007 doi (DE-627)ELV002473704 (ELSEVIER)S0010-7824(19)30041-1 DE-627 ger DE-627 rda eng 610 DE-600 44.92 bkl Iwanaga, Joe verfasserin aut Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. Neurovascular anatomy Contraceptive implant Etonogestrel implant Nerve injury Fox, Michelle C. verfasserin aut Rekers, Hans verfasserin aut Schwartz, Lisa verfasserin aut Tubbs, R. Shane verfasserin aut Enthalten in Contraception Amsterdam [u.a.] : Elsevier Science, 1970 100, Seite 26-30 Online-Ressource (DE-627)320440397 (DE-600)2004856-7 (DE-576)091017696 1879-0518 nnns volume:100 pages:26-30 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.92 Gynäkologie AR 100 26-30 |
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Iwanaga, Joe @@aut@@ Fox, Michelle C. @@aut@@ Rekers, Hans @@aut@@ Schwartz, Lisa @@aut@@ Tubbs, R. Shane @@aut@@ |
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Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. 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Iwanaga, Joe |
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Iwanaga, Joe ddc 610 bkl 44.92 misc Neurovascular anatomy misc Contraceptive implant misc Etonogestrel implant misc Nerve injury Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant |
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610 DE-600 44.92 bkl Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant Neurovascular anatomy Contraceptive implant Etonogestrel implant Nerve injury |
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ddc 610 bkl 44.92 misc Neurovascular anatomy misc Contraceptive implant misc Etonogestrel implant misc Nerve injury |
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Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant |
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Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant |
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Iwanaga, Joe Fox, Michelle C. Rekers, Hans Schwartz, Lisa Tubbs, R. Shane |
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neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant |
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Neurovascular anatomy of the adult female medial arm in relationship to potential sites for insertion of the etonogestrel contraceptive implant |
| abstract |
Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. |
| abstractGer |
Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. |
| abstract_unstemmed |
Objective: Anatomic assessment of the medial upper arm to identify potential sites for insertion of the etonogestrel (ENG) implant.Study design: Forty female cadaveric arms were dissected. Two rows of 1×2-cm dissection windows were created in the inner arm overlying the triceps approximately 2–3 and 4–5 cm posterior to the bicipital sulcus (sulcus). The primary window was 8–10 cm proximal to the medial epicondyle and approximately 2–3 cm posterior to the sulcus. Neurovascular structures within each window were identified. The entire medial upper arm was dissected to visualize underlying structures.Results: Mean age (± SD) of cadavers at death was 72.0±11.0 years. Arm measurements at the primary window were circumference 28.2±4.8 cm [range: 21–41], skin thickness 0.6±0.2 mm [0.3–1.0] and subcutaneous tissue thickness: 12.3±4.9 mm [4.7–21]. The basilic vein and the medial brachial cutaneous, ulnar and medial antebrachial cutaneous nerves were located in 40%, 58%, 40% and 18% of the primary windows, respectively. No major neurovascular structures were located 3–5 cm posterior to the sulcus. More neurovascular structures were identified overlying the biceps than triceps. Elbow flexion with the hand underneath the head displaced the ulnar nerve anteriorly towards the sulcus.Conclusion: As no major neurovascular structures were identified overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus, ENG implant insertion at this location may minimize risk of injury associated with improper deep insertion. Elbow flexion deflects the ulnar nerve away from this area and may further decrease risk of injury secondary to inadvertent deep insertion.Implications: Although a limited cadaver study, this anatomic assessment provides rationale for insertion of the ENG implant overlying the triceps 8–10 cm proximal to the medial epicondyle and 3–5 cm posterior to the sulcus. This area is theoretically safer for insertion of the ENG implant than areas of the inner arm where major neurovascular structures are commonly located. |
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| score |
7.399392 |