Have you registered for the 4th International Symposium on Regional Anesthesia, Pain and Perioperative Medicine? We're coming back to Dubai, March 22-24 for yet another edition of this fabled symposium.
-Gain knowledge on latest developments in regional anesthesia and acute pain medicine -Understand best practices for postoperative management of patients having major joint replacement surgery -Learn the ultrasound-guided techniques to major peripheral nerve blocks -Learn the latest pharmacological advances in the field of acute and chronic pain medicine -Become familiar with the clinically relevant data from the latest research on perioperative medicine.
Excerpts from the New Edition of NYSORA RAPM Textbook, 2nd Edition available @ amzn.to/2xyCJKn From NYSORA NEW RAPM Textbook, 2017: Connective Tissue of Peripheral Nerves (authors: Reina M, Sala-Blanch X, Arriazu R, Prats-Galino A.
FASCICLES Nerves and their principal branches consist of parallel bundles of nerve fibers (nerve fascicles, fasciculi). The size, number, and pattern of fasciculi vary among nerves and at different distances from their origin. When the connective tissue of the peripheral nerve is removed, 20 or more tubular structures or fascicles are typically seen.
CONNECTIVE TISSUE SHEATHS OF PERIPHERAL NERVES The connective tissue inside nerves functions to support and protect nerves blood and lymphatic vessels. The connective tissue of peripheral nerves takes different names according to its location.1–3 On the outside of each peripheral nerve, there is collagenous tissue: epineurium. Surrounding every fascicle within the nerve is the perineurium. Individual nerve fibers within the fascicles are embedded in endoneurium, which fills the space bound by the perineurium.
(Picture 1)Sciatic nerve at the level of popliteal fossa. Scanning electron microscopy. Magnification ×25. (Reproduced with permission from Reina MA, Arriazu R, Collier CB, et al: Electron microscopy of human peripheral nerves of clinical relevance to the practice of nerve blocks. A structural and ultrastructural review based on original experimental and laboratory data, Rev Esp Anestesiol Reanim. Dec 2013;60(10):552-562.)
(Picture 2)Scanning electron microscopy image of the human tibial nerve fascicles and adipose tissue that between fascicles. Magnification ×75. (Reproduced with permission from Wikinski J, Reina MA, Bollini C, et al: Diagnóstico, prevención y tratamiento de las complicaciones neurológicas asociadas con la anestesia regional periférica y central. Buenos Aires: Panamericana Ed; 2011.)
(Picture 3) Sciatic nerve at the level of popliteal fossa. Hematoxylin-eosin. (Reproduced with permission from Reina MA, De Andres JA, Hernández JM, et al: Successive changes in extraneural structures from the subarachnoid nerve roots to the peripheral nerve, influencing anesthetic block, and treatment of acute postoperative pain. Eur J Pain. Suppl 2011;5(2):377-385.) ...
Visit the New York School of Regional Anesthesia at Anesthesiology 2017(October 21-25, Boston, USA) for more about our educational events and NYSORA’s revolutionary new Mini-Sims with ultrasound tissue simulation! We'll see you at booth 2718! BE THERE! ...