{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:45:20Z","timestamp":1789469120133,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>The epineurium has been accepted as the outer anatomical barrier of the peripheral nerves. Our objective was to characterize the microanatomy of the layers surrounding nerves using different tissue\u2010specific staining methods. Two hundred forty\u2010two cross sections of human sciatic and median nerves, and brachial plexuses of eight fresh unembalmed cadavers, were examined. The samples were fixed in formaldehyde solution and stained with hematoxylin\u2013eosin, Masson's trichrome, or epithelial membrane antigen under standard conditions. Because epithelial membrane antigen only stains the perineurium, we demonstrated using hematoxylin\u2013eosin and Masson's trichrome that there were different collagen layers inside and outside the nerves. All fascicles had a collagen layer that surrounded the perineurium and were in close contact with it, with no adipose tissue between them. Unlike the perineurium, this layer, an \u201cinternal epineurium,\u201d contained no cells, and it surrounded one or a small group of fascicles. Bundling these fascicles or small groups of fascicles together was the true epineurium, and between the true and internal epineurium, we consistently found an adipose\u2010containing compartment. More proximal to this, the tibial and common peroneal nerves were bundled together by another collagen layer, the circumneurium, which also had a fat\u2010cell\u2010containing compartment deep to it. There were scattered collagen fibers among the adipocytes. Using tissue\u2010specific staining, we were able to demonstrate a collagen layer, the \u201cinternal epineurium.\u201d Outside the nerves, we identified several fat\u2010containing concentric compartments. Those compartments were limited by collagen fiber layers that were also similar to the epineurium. Clin. Anat. 33:199\u2013206, 2020. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.23442","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T10:49:11Z","timestamp":1565002151000},"page":"199-206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Another (Internal) Epineurium: Beyond the Anatomical Barriers of Nerves"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9078-1020","authenticated-orcid":false,"given":"Miguel A.","family":"Reina","sequence":"first","affiliation":[{"name":"Department of Clinical Medical Science CEU San Pablo University School of Medicine  Madrid Spain"},{"name":"Department of Anesthesiology Madrid\u2010Montepr\u00edncipe University Hospital  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-1214","authenticated-orcid":false,"given":"Andr\u00e9 P.","family":"Boezaart","sequence":"additional","affiliation":[{"name":"Division of Acute and Perioperative Pain Medicine, Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida"},{"name":"Department of Orthopaedic Surgery University of Florida College of Medicine  Gainesville Florida"},{"name":"Alon P. 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Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Seattle Science Foundation  Seattle Washington"},{"name":"Department of Anatomical Sciences St. George's University  St. George's Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yury","family":"Zasimovich","sequence":"additional","affiliation":[{"name":"Division of Acute and Perioperative Pain Medicine, Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida"},{"name":"Department of Orthopaedic Surgery University of Florida College of Medicine  Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Fern\u00e1ndez\u2010Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Department of Clinical Medical Science CEU San Pablo University School of Medicine  Madrid Spain"},{"name":"Department of Maxillofacial Surgery Madrid\u2010Montepr\u00edncipe University Hospital  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Institute of Applied Molecular Medicine, School of Medicine University of CEU San Pablo  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9126-0179","authenticated-orcid":false,"given":"Xavier","family":"Sala\u2010Blanch","sequence":"additional","affiliation":[{"name":"Human Anatomy and Embryology Unit, Faculty of Medicine Universitat de Barcelona  Barcelona Spain"},{"name":"Department of Anesthesiology Hospital Clinic  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31825145f3"},{"key":"e_1_2_7_3_1","volume-title":"The Body Electric; Electromagnitism and the Foundation of Life","author":"Becker RO","year":"1985"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000149"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000125"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31825a9485"},{"key":"e_1_2_7_7_1","first-page":"655","article-title":"An electron microscope study of the connective tissues of human peripheral nerve","volume":"98","author":"Gambe HJ","year":"1964","journal-title":"J Anat"},{"key":"e_1_2_7_8_1","volume-title":"Studien in der anatomic des nervensystems und des bindegewebes","author":"Key A","year":"1876"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/1721045a0"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23028"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.redar.2013.06.006"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23253"},{"issue":"1","key":"e_1_2_7_13_1","first-page":"e1","article-title":"What's new in intraneural injections? 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