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Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study

Year 2015, Volume: 9 Issue: 2, 66 - 71, 10.09.2015
https://doi.org/10.2399/ana.15.015

Abstract

Objectives: The lateral intermuscular septum (LIS) is dense and opaque in gross cadaver dissection. It was suggested as source of pain in elbows with lateral epicondylalgia (LE). The study aimed to measure the length of LIS and to describe the fascia orientation and density of LIS in upper extremities of human cadavers. .

Methods: 19 upper extremities of 10 formalin preserved human cadavers were dissected using the fascia sparing approach. The LIS was measured from the level of the lateral epicondyle up to the upper arm. The LIS was harvested 5 cm above and below the lateral epicondyle and submitted to a laboratory for histological staining. Prepared slides containing stained LIS were observed under high power microscope.

Results: In 17 out of the 19 upper extremities, the LIS attached from the brachioradialis to middle deltoid with a mean of 14.5 (13.8-15.1) cm. 68 out of the 72 fascia images of LIS were linearly oriented in relation to the lateral epicondyle. The LIS was dense on its distal (16/18) and loose (12/16) on its medial sides.

Conclusion: The fibers of LIS were linearly arranged near the lateral epicondyle in the upper arm connecting the brachioradialis and the deltoid. The LIS was dense and loose on its distal and medial sides, respectively. Considering the arrangement, connection and density of LIS in the upper arm, the LIS contributes to the inherent tightness of the elbow that may be important in handgrip activities. The connection between brachioradialis and middle deltoid by LIS is important in considering the changes in shoulder movement associated with lateral elbow pain in LE.

References

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  • Roles NC, Maudsley RH. Radial tunnel syndrome: resistant tennis
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  • -
  • Van der Wal J. The architecture of the connective tissue in the
  • musculoskeletal system—an often overlooked functional parameter
  • as to proprioception in the locomotor apparatus. Int J Ther
  • Massage Bodywork 2009;2:9–23
  • Bunata RE, Brown DS, Capelo R. Anatomic factors related to the
  • cause of tennis elbow. J Bone Joint Surg Br 2007;89:1955–63.
  • Oskarsson E, Gustafsson BE, Pettersson K, Aulin KP. Decreased
  • intramuscular blood flow in patients with lateral epicondylitis.
  • Scand J Med Sci Sports 2007;17:211–5.
  • Erak S, Day R, Wang A. The role of supinator in the pathogenesis
  • of chronic lateral elbow pain: a biomechanical study. J Hand
  • Surg Br 2004;29:461–4.
  • Fairbank SM, Corlett RJ. The role of the extensor digitorum communis
  • muscle in lateral epicondylitis. J Hand Surg Br 2002;27:
  • –9.
  • De Smet L, Van Raebroeckx T, Van Ransbeeck H. Radial tunnel
  • release and tennis elbow: disappointing results? Acta Orthop Belg
  • ;65:510–3.
  • Wilhelm A. Tennis elbow: treatment of resistant cases by denervation.
  • J Hand Surg Br 1996;21:523–33.
  • Muehlberger T, Buschmann A, Ottomann C, Toman N. Aetiology
  • and treatment of a previously denervated "tennis" elbow. Scand J
  • Plast Reconstr Surg Hand Surg 2009;43:50–3.
  • Dones VC III, Milanese S, Worth D, Grimmer-Somers L. The
  • anatomy of the forearm extensor muscles and the fascia in the lateral
  • aspect of the elbow joint complex. Anatomy & Physiology:
  • Current Research 2013;3:117.
  • Download MedCalc Version 15.2.2. (2015, February 27).
  • Retrieved April 19, 2015 from http://www.medcalc.org/download.php.
  • Stecco C, Porzionato A, Macchi V, Tiengo C, Parenti A,
  • Aldegheri R, Delmas V, De Caro R. A histological study of the
  • deep fascia of the upper limb. Ital J Anat Embryol 2006;111:105-
  • -
  • Abbott JH. Mobilization with movement applied to the elbow
  • affects shoulder range of movement in subjects with lateral epicondylalgia.
  • Man Ther 2001;6:170–7.
  • Myers TW. Anatomy trains. Myofascial meridians for manual and
  • movement therapists anatomy trains. 2nd ed. New York: Churchill
  • Livingstone; 2009. p. 148–69.
  • Langevin HM, Bouffard NA, Badger GJ, Iatridis JC, Howe AK.
  • Dynamic fibroblast cytoskeletal response to subcutaneous tissue
  • stretch ex vivo and in vivo. Am J Physiol Cell Physiol 2005;288:
  • C747–56.
Year 2015, Volume: 9 Issue: 2, 66 - 71, 10.09.2015
https://doi.org/10.2399/ana.15.015

Abstract

References

  • Vicenzino B, Cleland JA, Bisset L. Joint manipulation in the management
  • of lateral epicondylalgia: a clinical commentary. J Man
  • Manip Ther 2007;15:50–6.
  • Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: role of
  • occupation factors. Best practice and research. Best Pract Res Clin
  • Rheumatol 2011;25:43.
  • Lebrun C. What are the best diagnostic criteria for lateral epicondylitis?
  • In: Wright JG, editor. Evidence-based orthopaedics:
  • the best answers to clinical questions. London: Elsevier; 2008. p.
  • –57.
  • Albrecht S, Cordis R, Kleihues H, Noack W. Pathoanatomic findings
  • in radiohumeral epicondylopathy: a combined anatomic and
  • electromyographic study. Arch Orthop Trauma Surg
  • ;116:157–63.
  • Roles NC, Maudsley RH. Radial tunnel syndrome: resistant tennis
  • elbow as a nerve entrapment. J Bone Joint Surg Br 1972;54:499–
  • -
  • Van der Wal J. The architecture of the connective tissue in the
  • musculoskeletal system—an often overlooked functional parameter
  • as to proprioception in the locomotor apparatus. Int J Ther
  • Massage Bodywork 2009;2:9–23
  • Bunata RE, Brown DS, Capelo R. Anatomic factors related to the
  • cause of tennis elbow. J Bone Joint Surg Br 2007;89:1955–63.
  • Oskarsson E, Gustafsson BE, Pettersson K, Aulin KP. Decreased
  • intramuscular blood flow in patients with lateral epicondylitis.
  • Scand J Med Sci Sports 2007;17:211–5.
  • Erak S, Day R, Wang A. The role of supinator in the pathogenesis
  • of chronic lateral elbow pain: a biomechanical study. J Hand
  • Surg Br 2004;29:461–4.
  • Fairbank SM, Corlett RJ. The role of the extensor digitorum communis
  • muscle in lateral epicondylitis. J Hand Surg Br 2002;27:
  • –9.
  • De Smet L, Van Raebroeckx T, Van Ransbeeck H. Radial tunnel
  • release and tennis elbow: disappointing results? Acta Orthop Belg
  • ;65:510–3.
  • Wilhelm A. Tennis elbow: treatment of resistant cases by denervation.
  • J Hand Surg Br 1996;21:523–33.
  • Muehlberger T, Buschmann A, Ottomann C, Toman N. Aetiology
  • and treatment of a previously denervated "tennis" elbow. Scand J
  • Plast Reconstr Surg Hand Surg 2009;43:50–3.
  • Dones VC III, Milanese S, Worth D, Grimmer-Somers L. The
  • anatomy of the forearm extensor muscles and the fascia in the lateral
  • aspect of the elbow joint complex. Anatomy & Physiology:
  • Current Research 2013;3:117.
  • Download MedCalc Version 15.2.2. (2015, February 27).
  • Retrieved April 19, 2015 from http://www.medcalc.org/download.php.
  • Stecco C, Porzionato A, Macchi V, Tiengo C, Parenti A,
  • Aldegheri R, Delmas V, De Caro R. A histological study of the
  • deep fascia of the upper limb. Ital J Anat Embryol 2006;111:105-
  • -
  • Abbott JH. Mobilization with movement applied to the elbow
  • affects shoulder range of movement in subjects with lateral epicondylalgia.
  • Man Ther 2001;6:170–7.
  • Myers TW. Anatomy trains. Myofascial meridians for manual and
  • movement therapists anatomy trains. 2nd ed. New York: Churchill
  • Livingstone; 2009. p. 148–69.
  • Langevin HM, Bouffard NA, Badger GJ, Iatridis JC, Howe AK.
  • Dynamic fibroblast cytoskeletal response to subcutaneous tissue
  • stretch ex vivo and in vivo. Am J Physiol Cell Physiol 2005;288:
  • C747–56.
There are 60 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Valentin C. Dones Iıı This is me

Publication Date September 10, 2015
Published in Issue Year 2015 Volume: 9 Issue: 2

Cite

APA Dones Iıı, V. C. (2015). Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study. Anatomy, 9(2), 66-71. https://doi.org/10.2399/ana.15.015
AMA Dones Iıı VC. Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study. Anatomy. September 2015;9(2):66-71. doi:10.2399/ana.15.015
Chicago Dones Iıı, Valentin C. “Gross Anatomical and Histological Orientation of the Lateral Intermuscular Septum of the Upper Arm: A Descriptive Study”. Anatomy 9, no. 2 (September 2015): 66-71. https://doi.org/10.2399/ana.15.015.
EndNote Dones Iıı VC (September 1, 2015) Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study. Anatomy 9 2 66–71.
IEEE V. C. Dones Iıı, “Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study”, Anatomy, vol. 9, no. 2, pp. 66–71, 2015, doi: 10.2399/ana.15.015.
ISNAD Dones Iıı, Valentin C. “Gross Anatomical and Histological Orientation of the Lateral Intermuscular Septum of the Upper Arm: A Descriptive Study”. Anatomy 9/2 (September 2015), 66-71. https://doi.org/10.2399/ana.15.015.
JAMA Dones Iıı VC. Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study. Anatomy. 2015;9:66–71.
MLA Dones Iıı, Valentin C. “Gross Anatomical and Histological Orientation of the Lateral Intermuscular Septum of the Upper Arm: A Descriptive Study”. Anatomy, vol. 9, no. 2, 2015, pp. 66-71, doi:10.2399/ana.15.015.
Vancouver Dones Iıı VC. Gross anatomical and histological orientation of the lateral intermuscular septum of the upper arm: a descriptive study. Anatomy. 2015;9(2):66-71.

Anatomy is the official journal of Turkish Society of Anatomy and Clinical Anatomy (TSACA).