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Sympathicolysis
Sympathicolysis is a procedure for temporary or long-term elimination of sympathetic innervation. It is used to improve blood circulation in the legs or arms. The sympathetic nervous system causes the balance of the autonomic system to lean towards narrowing of blood vessels, with elimination of its function resulting in vasodilatation. Completely blocked arteries are not opened again, but the collaterals are better supplied with blood. To improve the blood circulation to the upper extremities, an anesthetic block of the stellate ganglion is performed. Due to this blockage, in addition to vasodilatation, in the entire innervation area this leads to reduced sweating (anhidrosis) and Horner's syndrome. The latter is a sign of successful blockade. A temporary blockade of the stellate ganglion is performed for e.g. the treatment of advanced complex regional pain syndrome. Surgical elimination of the stellate ganglion (sympathectomy) is a treatment of last resort for Raynaud's disease. ...
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Sympathetic Innervation
The sympathetic nervous system (SNS) is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system. The autonomic nervous system functions to regulate the body's unconscious actions. The sympathetic nervous system's primary process is to stimulate the body's fight or flight response. It is, however, constantly active at a basic level to maintain homeostasis. The sympathetic nervous system is described as being antagonistic to the parasympathetic nervous system which stimulates the body to "feed and breed" and to (then) "rest-and-digest". Structure There are two kinds of neurons involved in the transmission of any signal through the sympathetic system: pre-ganglionic and post-ganglionic. The shorter preganglionic neurons originate in the thoracolumbar division of ...
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Vasodilatation
Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstriction, which is the narrowing of blood vessels. When blood vessels dilate, the flow of blood is increased due to a decrease in vascular resistance and increase in cardiac output. Therefore, dilation of arterial blood vessels (mainly the arterioles) decreases blood pressure. The response may be intrinsic (due to local processes in the surrounding tissue) or extrinsic (due to hormones or the nervous system). In addition, the response may be localized to a specific organ (depending on the metabolic needs of a particular tissue, as during strenuous exercise), or it may be systemic (seen throughout the entire systemic circulation). Endogenous substances and drugs that cause vasodilation are termed vasodilators. Such vasoactivity is necessary for h ...
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Stellate Ganglion
The stellate ganglion (or cervicothoracic ganglion) is a sympathetic ganglion formed by the fusion of the inferior cervical ganglion and the first thoracic (superior thoracic sympathetic) ganglion, which exists in 80% of people. Sometimes, the second and the third thoracic ganglia are included in this fusion. The stellate ganglion is relatively big (10–12 x 8–20 mm) compared to much smaller thoracic, lumbar and sacral ganglia, and is polygonal in shape (). Stellate ganglion is located at the level of C7, anterior to the transverse process of C7 and the neck of the first rib, superior to the cervical pleura and just below the subclavian artery. It is superiorly covered by the prevertebral lamina of the cervical fascia and anteriorly in relation with common carotid artery, subclavian artery and the beginning of vertebral artery which sometimes leaves a groove at the apex of this ganglion (this groove can sometimes even separate the stellate ganglion into so called vertebral gangli ...
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Anhidrosis
Hypohidrosis is a disorder in which a person exhibits diminished sweating in response to appropriate stimuli. In contrast with hyp''er''hidrosis, which is a socially troubling yet often benign condition, the consequences of untreated hypohidrosis include hyperthermia, heat stroke and death. An extreme case of hypohidrosis in which there is a complete absence of sweating and the skin is dry is termed anhidrosis. Causes Diagnosis Sweat is readily visualized by a topical indicator such as iodinated starch ( Minor test) or sodium alizarin sulphonate, both of which undergo a dramatic colour change when moistened by sweat. A thermoregulatory sweat test can evaluate the body’s response to a thermal stimulus by inducing sweating through a hot box ⁄ room, thermal blanket or exercise. Failure of the topical indicator to undergo a colour change during thermoregulatory sweat testing indicates hypohidrosis, and further tests may be required to localize the lesion. Magnetic resonance im ...
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Horner's Syndrome
Horner's syndrome, also known as oculosympathetic paresis, is a combination of symptoms that arises when a group of nerves known as the sympathetic trunk is damaged. The signs and symptoms occur on the same side (ipsilateral) as it is a lesion of the sympathetic trunk. It is characterized by miosis (a constricted pupil), partial ptosis (a weak, droopy eyelid), apparent anhidrosis (decreased sweating), with apparent enophthalmos (inset eyeball). The nerves of the sympathetic trunk arise from the spinal cord in the chest, and from there ascend to the neck and face. The nerves are part of the sympathetic nervous system, a division of the autonomic (or involuntary) nervous system. Once the syndrome has been recognized, medical imaging and response to particular eye drops may be required to identify the location of the problem and the underlying cause. Signs and symptoms Signs that are found in people with Horner's syndrome on the affected side of the face include the following: * ...
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Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS) is any of several painful conditions that are characterized by a continuing (spontaneous and/or evoked) regional pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. Usually starting in a limb, it manifests as extreme pain, swelling, limited range of motion, and changes to the skin and bones. It may initially affect one limb and then spread throughout the body; 35% of affected people report symptoms throughout their whole bodies. Two types exist: reflex sympathetic dystrophy (RSD) and causalgia. Having both types is possible. Classification The classification system in use by the International Association for the Study of Pain (IASP) divides CRPS into two types. It is recognised that people may exhibit both types of CRPS. Signs and symptoms Clinical features of CRPS have been found to be neurogenic inflammation, inflammation resulting from the release of certain proinflammat ...
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Sympathectomy
A sympathectomy is an irreversible procedure during which at least one sympathetic ganglion is removed. One example is the lumbar sympathectomy, which is advised for occlusive arterial disease in which L2 and L3 ganglia along with intervening sympathetic trunk are removed leaving behind the L1 ganglion which is responsible for ejaculation. Another example is endoscopic thoracic sympathectomy. Indications * * * Hyperhidrosis * Raynaud syndrome * * * Neuropathic Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. Damage to peripheral nerves may impair sensation, movement, gland, or o ... pain, although this is controversial * References {{surgery-stub Neurosurgical procedures ...
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Raynaud's Disease
Raynaud syndrome, also known as Raynaud's phenomenon, eponymously named after the physician Auguste Gabriel Maurice Raynaud, who first described it in his doctoral thesis in 1862, is a medical condition in which the spasm of small arteries causes episodes of reduced blood flow to end arterioles. Typically, the fingers, and less commonly, the toes, are involved. Rarely, the nose, ears, or lips are affected. The episodes classically result in the affected part turning white and then blue. Often, numbness or pain occurs. As blood flow returns, the area turns red and burns. The episodes typically last minutes but can last several hours. Episodes are typically triggered by cold or emotional stress. Primary Raynaud's, also known as idiopathic, means that it is spontaneous, of unknown cause, and unrelated to another disease. Secondary Raynaud's occurs as a result of another condition and has an older age at onset; episodes are intensely painful and can be asymmetric and associated wi ...
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Sympathetic Plexus
Sympathetic may refer to: * Sympathy, in psychology, a feeling of compassion or identification with another * Sympathetic detonation, a detonation, usually unintended, of an explosive charge by a nearby explosion * Sympathetic magic, in religion, magic, and anthropology, the belief that like affects like, that something can be influenced through its relationship with another thing * Sympathetic nervous system, in neurology and neuroscience, a part of the autonomic nervous system * Sympathetic resonance, a harmonic phenomenon wherein a body responds to external vibrations * Sympathetic strings, in music theory, strings on a musical instrument that resonate without contact * "Sympathetic", a song by Seether from ''Disclaimer II ''Disclaimer II'' is the second studio album by South African rock band Seether. It is a recompilation of the band's first album, ''Disclaimer'', from 2002. Although the 12 tracks from the original album are present, they have been slightly rem ...
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Interventional Radiology
Interventional radiology (IR) is a medical specialty that performs various minimally-invasive procedures using medical imaging guidance, such as x-ray fluoroscopy, computed tomography, magnetic resonance imaging, or ultrasound. IR performs both diagnostic and therapeutic procedures through very small incisions or body orifices. Diagnostic IR procedures are those intended to help make a diagnosis or guide further medical treatment, and include image-guided biopsy of a tumor or injection of an imaging contrast agent into a hollow structure, such as a blood vessel or a duct. By contrast, therapeutic IR procedures provide direct treatment—they include catheter-based medicine delivery, medical device placement (e.g., stents), and angioplasty of narrowed structures. The main benefits of interventional radiology techniques are that they can reach the deep structures of the body through a body orifice or tiny incision using small needles and wires. That decreases risks, pain, an ...
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Iohexol
Iohexol, sold under the trade name Omnipaque among others, is a contrast agent used for X-ray imaging. This includes when visualizing arteries, veins, ventricles of the brain, the urinary system, and joints, as well as during computed tomography (CT scan). It is given by mouth, injection into a vein, or into a body cavity. Side effects include vomiting, skin flushing, headache, itchiness, kidney problems, and low blood pressure. Less commonly allergic reactions or seizures may occur. Allergies to povidone-iodine or shellfish do not affect the risk of side effects more than other allergies. Use in the later part of pregnancy may cause hypothyroidism in the baby. Iohexol is an iodinated non-ionic radiocontrast agent. It is in the low osmolar family. Iohexol was approved for medical use in 1985. It is on the World Health Organization's List of Essential Medicines. Chemistry The osmolality of iohexol ranges from 322 mOsm/kg—approximately 1.1 times that of blood plasma—to 8 ...
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