Anatomical position of the palmar/plantar nerves at the metacarpal/metatarsal distal level in horses: An in vivo study by means of ultrasonography.
Abstract: The neurovascular bundle of the equine distal cannon can dynamically vary with limb position, and this can affect the performance of low 4- or 6-point block. This study aims to identify and describe the anatomical position and variations of the lateral and medial palmar/plantar nerve at the metacarpal/metatarsal distal level in horses by ultrasonography. Eight mares underwent ultrasound examination on the lateral and medial palmar/plantar sides of the metacarpus/metatarsus. Images were obtained for measurements of the cross-sectional area of the nerve, distances between the nerve and the skin surface, branch of the suspensory ligament (SL), deep digital flexor tendon (DDFT) and superficial digital flexor tendon (SDFT) with limbs supported and elevated. The distance to the skin for forelimbs was higher on the lateral side when the limb was elevated (p < 0.001). The comparisons between supported and elevated limbs on the same side showed longer distances to the skin with the limb supported on the medial side (p < 0.001). Hindlimbs showed longer distances to the skin with the limb supported on the medial face (p = 0.027). The anatomical position of palmar/plantar nerves was similar between the lateral and medial sides of the limb, generally being in contact with the dorsal edge of DDFT. The strategy of elevating the limb during the injection of the low 4- or 6-point block can lead to a higher risk of puncture of the digital sheath.
© 2022 Wiley-VCH GmbH.
Publication Date: 2022-01-09 PubMed ID: 35000219DOI: 10.1111/ahe.12782Google Scholar: Lookup
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- Journal Article
- Anatomy
- Biomechanics
- Clinical Study
- Deep Digital Flexor Tendon
- Diagnostic Technique
- Equine Health
- Equine Science
- Horses
- Imaging Techniques
- In Vivo
- Metacarpal Bone
- Metatarsal Bones
- Musculoskeletal System
- Nerves
- Physiology
- Superficial Digital Flexor Tendon
- Suspensory Ligament
- Ultrasound
- Veterinary Medicine
- Veterinary Research
Summary
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This scientific research article investigates the anatomical positioning and variations of the lateral and medial palmar/plantar nerve in horses, using ultrasonography. The study explores how limb position can affect nerve block performance and describes potential risks when administering low 4- or 6-point block injections.
Study Purpose and Methodology
- The main goal of this study was to identify and detail the anatomical positioning of the lateral and medial palmar/plantar nerve in horses’ limbs and how these positions can change with differing limb positions. The researchers aimed to improve understanding of the neurovascular bundle’s dynamics in the distal cannon of a horse – a region of the equine lower limb.
- The study utilized ultrasonography for this purpose. Ultrasonography is a diagnosis method using high-frequency sound waves to construct an image of the body’s interior. In this study, eight mares underwent ultrasound examinations at various points around their limbs.
- Scientists measured the cross-sectional area of the nerves, the distances between the nerves and the horse’s skin, and the distances to a variety of other anatomical markers. Additionally, they conducted these measurements with limbs both supported and elevated to account for potential positional variance.
Key Findings
- Results showed significant changes in distance between the nerve and the skin based on the position of the limb. For forelimbs, the distance was higher on the lateral side when the limb was elevated. For elevated and supported limbs on the same side, researchers observed longer distances to the skin with the limb being supported on the medial side.
- For hind limbs, longer distances between the nerve and the skin were found when the limb was supported on the medial face. Observations showed the same anatomical position for the palmar/plantar nerves, whether they were on the lateral or medial sides of the limb – typically in contact with the dorsal edge of the DDFT.
- Of particular note is the finding that elevating the limb during the injection of a low 4 or 6-point block could increase the risk of puncturing the digital sheath – a structure that surrounds the digital flexor tendons in the horse’s limb.
Implications
- This study provides insights into the dynamic nature of the neurovascular bundle in the equine distal cannon – how it can change depending on the horse’s limb position, thereby affecting the performance of nerve block procedures.
- The findings offer important guidance for veterinarians and other professionals administering low 4- or 6-point block injections in horses. Knowing that the limb’s elevation presents higher risks of complications can help such professionals ensure greater safety during these procedures.
Cite This Article
APA
Maia BT, Vendruscolo CDP, de Souza AF, Zoppa ALDV.
(2022).
Anatomical position of the palmar/plantar nerves at the metacarpal/metatarsal distal level in horses: An in vivo study by means of ultrasonography.
Anat Histol Embryol, 51(2), 236-243.
https://doi.org/10.1111/ahe.12782 Publication
Researcher Affiliations
- Universidade Anhembi Morumbi, São Paulo, SP, Brazil.
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.
MeSH Terms
- Animals
- Female
- Forelimb / diagnostic imaging
- Horse Diseases
- Horses
- Metacarpal Bones / diagnostic imaging
- Metatarsal Bones / diagnostic imaging
- Metatarsus
- Ultrasonography / veterinary
Grant Funding
- Conselho Nacional de Desenvolvimento Cientu00edfico e Tecnolu00f3gico
- Coordenau00e7u00e3o de Aperfeiu00e7oamento de Pessoal de Nu00edvel Superior
References
This article includes 25 references
- Alexander K, Dobson H. Ultrasonography of peripheral nerves in the normal adult horse. Veterinary Radiology and Ultrasound 44(4), 456-464.
- Baccarin RYA, Brossi PM, Silva LCLC. Guia ilustrado para injeção perineural em membros locomotors de equinos. Quiron Comunicação .
- Barker W. Equine distal limb diagnostic anaesthesia: (1) Basic principles and perineural techniques. In Practice 38(2), 82-90.
- Bassage LH, Ross MW. Diagnostic analgesia. In M. W. Ross , & S. Dyson (Eds.), Diagnosis and management of lameness in the horse (2nd ed., pp. 93-124).
- Baxter GM, Stashak T. Perineural and intrasynovial anesthesia. In G. M. Baxter (Ed.), Adams’ and Stashak’s lameness in horses, 6th ed. (pp. 173-202).
- Cardenas JJ. Um erro comum nos bloqueios perineurais (BPN) palmar proximal e palmar distal (4 pontos altos e baixos). Revista Brasileira De Medicina Equina 9, 36-38.
- Coleridge M, Schumacher J, DeGraves F. Comparison of lameness scores after a low 4-point nerve block to lameness scores after additional desensitisation of the dorsal metatarsal nerves in horses with experimentally induced pain in the metatarsophalangeal joint. Equine Veterinary Education 32(4), 199-203.
- Denoix JM, Beaumont A, Bertoni L. Ultrasonographic guided block of the tibial nerve. Equine Veterinary Education 32(7), 372-377.
- Dyson S, Kidd L. A comparison of responses to analgesia of the navicular bursa and intra-articular analgesia of the distal interphalangeal joint in 59 horses. Equine Veterinary Journal 25(2), 93-98.
- Garcia ER. Complications of loco-regional anesthesia. In L. M. Rubio-Martinez , & D. A. Hendrickson (Eds.), Complications in equine surgery (pp. 118-134).
- Giannini S, Buda R, Di Caprio F, Agati P, Bigi A, De Pasquale V, Ruggeri A. Effects of freezing on the biomechanical and structural properties of human posterior tibial tendons. International Orthopaedics 32(2), 145-151.
- Kuga J, Hironaka A, Ochi K, Sugimoto T, Nakamori M, Nezu T, Maruyama H. Impact of anatomical variations on ultrasonographic reference values of lower extremity peripheral nerves. Muscle and Nerve 63(6), 890-896.
- Maia BT, Pascual CJ, Souza AF, Vendruscolo CP, Baccarin RYA, Zoppa ALV. Bloqueios perineurais diagnósticos em equinos: Revisão de pontos relevantes e a contribuição da ultrassonografia. Veterinária E Zootecnia 27, 1-10.
- Moyer W, Schumacher J, Schumacher J. Equine joint injection and regional anesthesia. Academic Veterinary Solutions .
- Nagy A, Bodò G, Dyson SJ, Compostella F, Barr ARS. Distribution of radiodense contrast medium after perineural injection of the palmar and palmar metacarpal nerves (low 4-point nerve block): An in vivo and ex vivo study in horses. Equine Veterinary Journal 42(6), 512-518.
- Nagy A, Bodo G, Dyson SJ, Szabo F, Barr ARSS. Diffusion of contrast medium after perineural injection of the palmar nerves: An in vivo and in vitro study. Equine Veterinary Journal 41(4), 379-383.
- O’Leary SA, Doyle BJ, McGloughlin TM. The impact of long term freezing on the mechanical properties of porcine aortic tissue. Journal of the Mechanical Behavior of Biomedical Materials 37, 165-173.
- Ozcelikkale A, Han B. Thermal destabilization of collagen matrix hierarchical structure by freeze/thaw. PLoS One 11(1), e0146660.
- Rantanen NW, Jorgensen JS, Genovese RL. Ultrasonographic evaluation of the equine limb. In M. W. Ross , & S. J. Dyson (Eds.), Diagnosis and management of lameness in the horse (2nd ed., pp. 182-205).
- Schumacher J, Boone L. Local anaesthetics for regional and intra-articular analgesia in the horse. Equine Veterinary Education 33(3), 159-168.
- Seabaugh KA, Selberg KT, Valdés-Martínez A, Rao S, Baxter GM. Assessment of the tissue diffusion of anesthetic agent following administration of a low palmar nerve block in horses. Journal of the American Veterinary Medical Association 239(10), 1334-1340.
- Souza AF, Pascual CJ, Maia BT, do Valle De Zoppa AL. Diffusion of dye after perineural injection of the palmar/plantar nerves in two different sites in horses: an ex-vivo study. Veterinary Research Communications in Press, 1-6.
- Stover SM. The epidemiology of Thoroughbred racehorse injuries. Clinical Techniques in Equine Practice 2(4), 312-322.
- Taylor A, McLeod G. Basic pharmacology of local anaesthetics. BJA Education 20(2), 34-41.
- Zarb F, McNulty J, Gatt A, Formosa C, Chockalingam N, Evanoff MG, Rainford L. Comparison of in vivo vs. frozen vs. Thiel cadaver specimens in visualisation of anatomical structures of the ankle on proton density Magnetic Resonance Imaging (MRI) through a visual grading analysis (VGA) study. Radiography 23(2), 117-124.
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