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Spinal Nerves: Plexus II01:21

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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
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The neuronal supply to the gastrointestinal (GI) tract is essential for regulating various functions, including digestion, absorption, and movement of food. This intricate network of nerves is known as the enteric nervous system (ENS), often referred to as the "second brain" of the body.
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Cranial Nerves: Types Part I01:14

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Cranial nerves are responsible for transmitting motor and sensory information between the brain and various parts of the body. There are twelve pairs of cranial nerves, with the first six being essential in sensory perception, motor control, and autonomic functions related to the head and neck.
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Cranial Nerves: Types Part II01:22

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Cranial nerves are responsible for transmitting motor and sensory information between the brain and various parts of the body. There are twelve pairs of cranial nerves. While the first six innervate the head and neck, the latter six nerves innervate the head and neck, as well as organs and tissues in the thoracic and abdominal cavities. They facilitate communication, expression, and autonomic control within the human body.
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Spinal Nerves: Anatomy01:23

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Spinal nerves are pivotal conduits in the nervous system, bridging the central nervous system (CNS) with the peripheral nervous system (PNS). These nerves enable a complex communication network between the brain, spinal cord, and the rest of the body, facilitating sensory input, motor output, and autonomic functions.
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Spinal Nerves: Plexus I01:22

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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Fluorescence Imaging of Nerves During Surgery.

Erika M Walsh1, Denzel Cole2, Kiranya E Tipirneni2

  • 1Michigan Ear Institute, Farmington Hills, MI.

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Summary

Developing ideal nerve-specific fluorescent agents for surgery is challenging. Current agents show promise but lack standardized data on nerve visualization and toxicity, hindering optimal intraoperative nerve identification.

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Area of Science:

  • Surgical Navigation
  • Medical Imaging
  • Biochemistry

Background:

  • Iatrogenic nerve injury is a significant surgical morbidity.
  • Current nerve identification methods (neurophysiologic stimulation) have limitations.
  • Intraoperative fluorescence imaging offers complementary tissue differentiation.

Purpose of the Study:

  • To review agents for fluorescence-guided nerve imaging in preclinical and clinical settings.
  • To identify factors for selecting nerve-specific fluorescent agents for surgery.
  • To assess the current state and challenges in developing ideal nerve imaging agents.

Main Methods:

  • PubMed search conducted in February 2018 for peripheral nerve fluorescence.
  • Key search terms included 'intraoperative, nerve, fluorescence, peripheral nerve, visualization, near infrared, and myelin'.
  • Article references were cross-checked to identify additional relevant studies.

Main Results:

  • Axonal transport tracers showed greatest specificity among nonspecific agents.
  • Nerve-specific fluorophores provide excellent nerve-to-background ratios.
  • Data on quantifying nerve-specific fluorescence and toxicity are limited across studies.

Conclusions:

  • Fluorescence-based nerve enhancement has advanced significantly.
  • An ideal agent should be perioperatively administered, non-blood-brain barrier crossing, and near-infrared emitting.
  • Systemic agents targeting nerve-specific moieties show promise, but optimal agent development remains challenging due to study heterogeneity.