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NEURO VASCULAR BUNDLE RELATED:

ERA-Bi-Annual-Meeting 2021

Initially planned for this conference meeting was a one-dayworkshop

with Christoph Sommer and Konrad Obermeier on Thursday, April 15th 2021

“Bridging the developmental movement of the embryo with structural pathologies”.

Due to covid-related changes this plan morphed into a zoom event

on Saturday, April 17th 2021. Below you find the Text-Version of this

zoom-event-contribution by: Konrad Obermeier

“Leg development and the neuro-vascular-bundle (NVB)”.

A neuro-vascular-bundle (NVB) embryologically functions as a

developmental fulcrum guiding the growth-movement of

Structure and is morphologically contributing to manifesting

form. A NVB is wrapped in layered sheets of connective

tissues. We can manually address these original and central

tensional pathways, for example in the relationship of the

legs to the lumbar spine.

Epi-Perineurial Anatomy, Innervation, and Axonal Nociceptive Mechanisms

Geoffrey Bove, DC, PhD

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 01907

Published in final edited form as:

J Bodyw Mov Ther. 2008 July ; 12(3): 185–190. doi:10.1016/j.jbmt.2008.03.004.

 

Introduction

Body workers from all disciplines appreciate that maneuvers that move nerves often reproduce

radiating pain. This symptom reproduction has important implications for the diagnosis and

management of radiating pain symptoms.

In the presentation at Fascia 2007 from which this manuscript is derived, two videos that were

obtained with high resolution diagnostic ultrasound were presented that clearly showed median

nerve gliding during normal finger and wrist movements. The movements were independent

of the movements of the other surrounding structures. Such movements of the interface between

the nerve and the surrounding structures constitute but one mechanical stimulus that nerves

are susceptible to. Nerves are also bent around various structures, and indented by external

pressures. Nerves have many anatomical features that allow them to accommodate such

movements and mechanical stimuli. The reader is directed to books by Shacklock (Shacklock

2005) and Butler (Butler 2000) for full descriptions of nerve biomechanics.1

Intramuscular Connective Tissue Differences in Spastic

and Control Muscle: A Mechanical and Histological Study

Marije de Bruin1, Mark J. Smeulders1, Michiel Kreulen1,2, Peter A. Huijing3, Richard T Jaspers3*

1 Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands,

2 Department of Plastic, Reconstructive and Hand

Surgery, Red Cross Hospital, Beverwijk, The Netherlands,

3 Laboratory for Myology, MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands

 

Abstract

Cerebral palsy (CP) of the spastic type is a neurological disorder characterized by a velocity dependent increase in tonic stretch reflexes with exaggerated tendon jerks. Secondary to the spasticity, muscle adaptation is presumed to contribute to limitations in the passive range of joint motion. However, the mechanisms underlying these limitations are unknown. Using

biopsies, we compared mechanical as well as histological properties of flexor carpi ulnaris muscle (FCU) from CP patients (n = 29) and healthy controls (n = 10). The sarcomere slack length (mean 2.5 mm, SEM 0.05) and slope of the normalized sarcomere length-tension characteristics of spastic fascicle segments and single myofibre segments were not different from those of control muscle. Fibre type distribution also showed no significant differences. Fibre size was significantly smaller

(1933 mm2, SEM 190) in spastic muscle than in controls (2572 mm2, SEM 322). However, our statistical analyses indicate that the latter difference is likely to be explained by age, rather than by the affliction. Quantities of endomysial and perimysialnetworks within biopsies of control and spastic muscle were unchanged with one exception: a significant thickening of the

tertiary perimysium (3-fold), i.e. the connective tissue reinforcement of neurovascular tissues penetrating the muscle. Note that this thickening in tertiary perimysium was shown in the majority of CP patients, however a small number of patients (n = 4 out of 23) did not have this feature. These results are taken as indications that enhanced myofascial loads on FCU is one among several factors contributing in a major way to the aetiology of limitation of movement at the wrist in CP and the characteristic wrist position of such patients.