Agonist intercostals in the parasternal region and lower external intercostals also have a large inspiratory mechanical advantage [3-4], and they contract in a predictable manner at rest [1,5].
It has been noted that the inspiratory intercostals appear to remodel with chronic changes in motor demands.
We hypothesized that respiratory loads generated during ITTO would result in significant hypertrophy and myogenic activity in the parasternal intercostals when compared with a surgical control group.
These same animals were studied in an earlier acute investigation whose main aim was to develop a surgical technique to implant intramuscular electrodes provided with self-securing polypropylene anchors in the upper intercostals and abdominal-wall muscles .
([dagger]) Significant difference between diaphragm stimulation alone and simultaneous diaphragm and upper-thorax intercostals muscle stimulation (p = 0.05).
The main muscles of inspiration are the diaphragm, external intercostal muscles, and accessory muscles of the shoulder and the upper back.
Case 2: After accidental penetration by a iron rod, there was leakage of ruminal contents from 6th intercostal space.
Case 2: Longitudinal incision was given at 6th intercostal space and extended along fistulous tract upto 10th rib.
Flank bulge has never been reported following PCNL; however, flank bulge is a known potential complication of flank incisions for various retroperitoneal surgical procedures and has been reported in the urological,[sup.12] vascular[sup.13] and neurosurgical literature.[sup.14,15] Flank bulge due to laxity of the anterolateral abdominal musculature may be caused by damage to intercostal nerves.[sup.14] In a cadaveric and electrophysiological study, Fahim and colleagues showed that the most significant intercostal nerve contributions to the anterolateral wall came from the T11 and T12 nerves.[sup.14] They concluded that postoperative flank bulge was likely due to denervation of the abdominal musculature from injury to the T11 and T12 intercostal nerves.
McAllister and colleagues characterized key anatomical relationships relevant to PCNL through anatomical dissection of the 11[sup.th] intercostal space.[sup.10] They recorded the distance of the intercostal neurovascular structures from the 11[sup.th] rib at 3 sites: lateral border of the paraspinous muscle, the mid-scapular line and the posterior axillary line.
Zhang commonly reroutes one of the intercostal nerves that lead from the spinal cord around each rib to the sternum.
If the injury site is above the thoracic area where the intercostal nerves originate, other peripheral nerves can be selected.