Abstract: Patients and Methods
Prepared by Tara Packham, OTReg(Ont), CSTP®, PhD
The point of vie... more Abstract: Patients and Methods Prepared by Tara Packham, OTReg(Ont), CSTP®, PhD
The point of view offered by this atlas is unique among its peers: while most start with a central focus and move towards the periphery, this atlas dares to do the opposite. It starts in the periphery at the origins of the sensation of touch, and maps this afferent transmission from the skin to the higher centres of somatosensory perception in the brain. The second, but no less unique, feature of this atlas is its origin in the clinical data derived from the assessment of 2519 persons with Neuropathic Pain (NeP), and 97 references based on clinical anatomy. Further, this is presented reflecting the diversity of the clinical realities, documenting the perimeter points of the largest known territory for the cutaneous distribution of any individual nerve branch. However, this information is anchored by designating the autonomous territory for each branch. Thus each diagram contains five key topographical elements : 1. The autonomous or unique territory of each cutaneous distribution, and 2. the most distal point ; 3. the most proximal point ; 4. the most medial point, and 5. the most lateral point forming the largest territory of cutaneous distribution of each nerve branch the borders. The combined visual representation of these clinically derived parameters can now be used by clinicians in medicine, surgery and rehabilitation as a valid reference for the most common clinical presentation: the axonal lesion (axonotmesis) resulting in NeP accompanied by a partial loss of sensation (hypoesthesia). Unlike the profound and more defined sensory loss seen with complete axonal transsections (neurotmesis), these partial losses reflect the individual variability of the degree and location of the dysfunction, resulting in less confidence for formulating the anatomically plausible hypothesis required for confirming a diagnosis of neuropathic pain.1 Further, the precise details for 240 branches covering the surface of the entire body are clearly organized for easy reference. 1 Haanpää M, Attal N, Backonja M et al. (2011). NeuPSIG guidelines on neuropathic pain assessment. PAIN®, 152(1), 14–27. Available from: http://dx.doi.org/10.1016/j.pain.2010.07.031.
This Atlas is the result of research about 3142 patients recruited prospectively and consecutivel... more This Atlas is the result of research about 3142 patients recruited prospectively and consecutively since 2004. As the clinic gives us opportunity to observe many more Aβ axonal lesions (axonotmesis) than transections (neurotmesis), the mapped hypoaesthetic territories are partial. The Authors, therefore, defined, for each cutaneous nerve branch, the autonomous territory and the boundary markers of the largest territory of cutaneous origin. Each anatomical plate of a cutaneous branch is the superposition of tens, even hundreds of observations seen in clinical practice - 3133 maps of cutaneous hypoaesthetic territories observed. We also cross-referenced these with data published in 99 anatomy books.
This 1st English edition - stemming from the previous 3rd French edition published by Sauramps Médical - illustrates the usefulness of anatomical knowledge for clinical practice.
Abstract: Patients and Methods
Prepared by Tara Packham, OTReg(Ont), CSTP®, PhD
The point of vie... more Abstract: Patients and Methods Prepared by Tara Packham, OTReg(Ont), CSTP®, PhD
The point of view offered by this atlas is unique among its peers: while most start with a central focus and move towards the periphery, this atlas dares to do the opposite. It starts in the periphery at the origins of the sensation of touch, and maps this afferent transmission from the skin to the higher centres of somatosensory perception in the brain. The second, but no less unique, feature of this atlas is its origin in the clinical data derived from the assessment of 2519 persons with Neuropathic Pain (NeP), and 97 references based on clinical anatomy. Further, this is presented reflecting the diversity of the clinical realities, documenting the perimeter points of the largest known territory for the cutaneous distribution of any individual nerve branch. However, this information is anchored by designating the autonomous territory for each branch. Thus each diagram contains five key topographical elements : 1. The autonomous or unique territory of each cutaneous distribution, and 2. the most distal point ; 3. the most proximal point ; 4. the most medial point, and 5. the most lateral point forming the largest territory of cutaneous distribution of each nerve branch the borders. The combined visual representation of these clinically derived parameters can now be used by clinicians in medicine, surgery and rehabilitation as a valid reference for the most common clinical presentation: the axonal lesion (axonotmesis) resulting in NeP accompanied by a partial loss of sensation (hypoesthesia). Unlike the profound and more defined sensory loss seen with complete axonal transsections (neurotmesis), these partial losses reflect the individual variability of the degree and location of the dysfunction, resulting in less confidence for formulating the anatomically plausible hypothesis required for confirming a diagnosis of neuropathic pain.1 Further, the precise details for 240 branches covering the surface of the entire body are clearly organized for easy reference. 1 Haanpää M, Attal N, Backonja M et al. (2011). NeuPSIG guidelines on neuropathic pain assessment. PAIN®, 152(1), 14–27. Available from: http://dx.doi.org/10.1016/j.pain.2010.07.031.
This Atlas is the result of research about 3142 patients recruited prospectively and consecutivel... more This Atlas is the result of research about 3142 patients recruited prospectively and consecutively since 2004. As the clinic gives us opportunity to observe many more Aβ axonal lesions (axonotmesis) than transections (neurotmesis), the mapped hypoaesthetic territories are partial. The Authors, therefore, defined, for each cutaneous nerve branch, the autonomous territory and the boundary markers of the largest territory of cutaneous origin. Each anatomical plate of a cutaneous branch is the superposition of tens, even hundreds of observations seen in clinical practice - 3133 maps of cutaneous hypoaesthetic territories observed. We also cross-referenced these with data published in 99 anatomy books.
This 1st English edition - stemming from the previous 3rd French edition published by Sauramps Médical - illustrates the usefulness of anatomical knowledge for clinical practice.
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Prepared by Tara Packham, OTReg(Ont), CSTP®, PhD
The point of view offered by this atlas is unique among its peers: while most start with a central focus and move towards the periphery, this atlas dares to do the opposite. It starts in the periphery at the origins of the sensation of touch, and maps this afferent transmission from the skin to the higher centres of somatosensory perception in the brain.
The second, but no less unique, feature of this atlas is its origin in the clinical data derived from the assessment of 2519 persons with Neuropathic Pain (NeP), and 97 references based on clinical anatomy. Further, this is presented reflecting the diversity of the clinical realities, documenting the perimeter points of the largest known territory for the cutaneous distribution of any individual nerve branch. However, this information is anchored by designating the autonomous territory for each branch. Thus each diagram contains five key topographical elements :
1. The autonomous or unique territory of each cutaneous distribution, and
2. the most distal point ;
3. the most proximal point ;
4. the most medial point, and
5. the most lateral point forming the largest territory of cutaneous distribution of each nerve branch the borders.
The combined visual representation of these clinically derived parameters can now be used by clinicians in medicine, surgery and rehabilitation as a valid reference for the most common clinical presentation: the axonal lesion (axonotmesis) resulting in NeP accompanied by a partial loss of sensation (hypoesthesia). Unlike the profound and more defined sensory loss seen with complete axonal transsections (neurotmesis), these partial losses reflect the individual variability of the degree and location of the dysfunction, resulting in less confidence for formulating the anatomically plausible hypothesis required for confirming a diagnosis of neuropathic pain.1 Further, the precise details for 240 branches covering the surface of the entire body are clearly organized for easy reference.
1 Haanpää M, Attal N, Backonja M et al. (2011). NeuPSIG guidelines on neuropathic pain assessment. PAIN®, 152(1), 14–27. Available from: http://dx.doi.org/10.1016/j.pain.2010.07.031.
This 1st English edition - stemming from the previous 3rd French edition published by Sauramps Médical - illustrates the usefulness of anatomical knowledge for clinical practice.
Prepared by Tara Packham, OTReg(Ont), CSTP®, PhD
The point of view offered by this atlas is unique among its peers: while most start with a central focus and move towards the periphery, this atlas dares to do the opposite. It starts in the periphery at the origins of the sensation of touch, and maps this afferent transmission from the skin to the higher centres of somatosensory perception in the brain.
The second, but no less unique, feature of this atlas is its origin in the clinical data derived from the assessment of 2519 persons with Neuropathic Pain (NeP), and 97 references based on clinical anatomy. Further, this is presented reflecting the diversity of the clinical realities, documenting the perimeter points of the largest known territory for the cutaneous distribution of any individual nerve branch. However, this information is anchored by designating the autonomous territory for each branch. Thus each diagram contains five key topographical elements :
1. The autonomous or unique territory of each cutaneous distribution, and
2. the most distal point ;
3. the most proximal point ;
4. the most medial point, and
5. the most lateral point forming the largest territory of cutaneous distribution of each nerve branch the borders.
The combined visual representation of these clinically derived parameters can now be used by clinicians in medicine, surgery and rehabilitation as a valid reference for the most common clinical presentation: the axonal lesion (axonotmesis) resulting in NeP accompanied by a partial loss of sensation (hypoesthesia). Unlike the profound and more defined sensory loss seen with complete axonal transsections (neurotmesis), these partial losses reflect the individual variability of the degree and location of the dysfunction, resulting in less confidence for formulating the anatomically plausible hypothesis required for confirming a diagnosis of neuropathic pain.1 Further, the precise details for 240 branches covering the surface of the entire body are clearly organized for easy reference.
1 Haanpää M, Attal N, Backonja M et al. (2011). NeuPSIG guidelines on neuropathic pain assessment. PAIN®, 152(1), 14–27. Available from: http://dx.doi.org/10.1016/j.pain.2010.07.031.
This 1st English edition - stemming from the previous 3rd French edition published by Sauramps Médical - illustrates the usefulness of anatomical knowledge for clinical practice.