Department of Physical Medicine and Rehabilitation, Korea University, College of Medicine, Seoul, Republic of Korea.
Clin Neurophysiol. 2010 Feb;121(2):228-32. doi: 10.1016/j.clinph.2009.10.011. Epub 2009 Dec 11.
To establish a reliable technique for nerve conduction study (NCS) of medial and lateral branches of the superficial radial nerve (SRN).
The distribution of SRN and its branches were examined in 10 cadavers. Based on the cadaveric study, anti-dromic nerve conduction studies were performed on 31 healthy subjects.
The SRN became superficial approximately 8.4 cm from the radial styloid process (RS) and divided into medial and lateral branches 4.9 cm proximal to RS. The medial branch divided into two branches: proximal to extensor pollicis longus (EPL) tendon in 16 hands. The lateral branch ran parallel and 0.2 cm lateral to abductor pollicis longus (APL) tendon. Sensory nerve action potential (SNAP) was significantly shorter in latencies when recording over snuff box, compared with that from the EPL and APL tendons. SNAP obtained from APL tendon was significantly smaller in amplitude, compared with those from snuff box and EPL tendon.
Anti-dromic stimulation of SRN should be performed 10 cm proximal to the recording electrode. The optimal recording position for each branch of SRN is snuff box for medial branch, and lateral to APL tendon for lateral branch.
The SRN can be evaluated appropriately by NCS of medial and lateral branches of SRN.
建立一种可靠的技术,用于检测桡浅神经(SRN)的内侧和外侧分支的神经传导研究(NCS)。
在 10 具尸体中检查了 SRN 及其分支的分布。基于尸体研究,对 31 名健康受试者进行了顺向神经传导研究。
SRN 在桡骨茎突(RS)约 8.4cm 处变浅,并在 RS 近端 4.9cm 处分叉为内侧和外侧分支。内侧分支分为两支:在 16 手中,在伸拇指长肌(EPL)肌腱近端。外侧分支与拇指外展长肌(APL)肌腱平行且位于其 0.2cm 外侧。在记录鼻烟窝时,感觉神经动作电位(SNAP)的潜伏期明显短于从 EPL 和 APL 肌腱记录时的潜伏期。从 APL 肌腱获得的 SNAP 的幅度明显小于从鼻烟窝和 EPL 肌腱获得的 SNAP。
应在记录电极近端 10cm 处进行 SRN 的顺向刺激。SRN 各分支的最佳记录位置为内侧分支的鼻烟窝,外侧分支为 APL 肌腱外侧。
通过对 SRN 的内侧和外侧分支进行 NCS,可以适当评估 SRN。