Surgical and radiologic anatomy : SRA
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The sensory distribution in the dorsum of the hand was investigated in 150 formalin-fixed hands with the aim of outlining the most common innervation pattern of the superficial branch of the radial nerve (SBRN), dorsal branch of the ulnar nerve (DBUN) and the lateral antebrachial cutaneous nerve (LABCN). Although variable, the most common pattern found was SBRN innervation to the dorsal surface of the lateral 2½ digits and DBUN innervation to the dorsal surface of the medial 2½ digits. Dual innervation due to communicating branches or nerves overlapping was found in 41 cases. ⋯ The LABCN was closely associated, and occasionally overlapped, with the SBRN. There were significant differences in the sensory distribution of the dorsum of the right and left hands of the same cadaver. The sensory distribution in the dorsum of the hand is variable; however, understanding the most common innervation pattern and appreciating the possible variations to this pattern is important to avoid errors in interpretation of conduction velocity studies, misdiagnosis of nerve pathology signs and symptoms and inappropriate treatments.
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Following successful double-lumen endotracheal tube (DLT) insertion for pulmonary surgery, the body position of a patient is changed from supine to lateral. This change occasionally leads to the malposition of the DLT and difficulty in differential lung ventilation. ⋯ We recommend that the depth of DLT insertion should be advanced by approximately 0.5 cm from the best position, before changing from the supine to lateral position.