DOCSLIB.ORG

Appendix Musculoskeletal Ultrasound Imaging Protocols

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Appendix Musculoskeletal Ultrasound Imaging Protocols Appendix Musculoskeletal Ultrasound Imaging Protocols Shoulder Date: History: Biceps—long head ___________________________________ Subscapularis _______________________________________ Infraspinatus ________________________________________ Supraspinatus _______________________________________ Posterior Labrum ____________________________________ Spinoglenoid Notch __________________________________ ACL Joint & Acromion _______________________________ Fluid: SASD1 Joint ____________________________ Bicipital Sheath ___________________ Other ___________________________ Cortical Margin2 ________________________________________________ Impingement: Supraspinatus _______________________________________ Subcoracoid ________________________________________ Other: Additional comments: Sonographer Note: Tendon tears should be measured in orthogonal planes, distance from key landmarks, e.g., rotator cuff interval for supraspinatus tears, involvement of musculo- tendinous junction, muscle belly atrophy/fat infiltration, description tear, e.g., partial, delaminating, etc. 1Subacromial-subdeltoid bursa. 2Greater and lesser tuberosities. 329 330 Appendix Elbow Date: History: Joints Space: Effusion Synovial Proliferation Cartilage Cortex Coronoid fossa Radial fossa Radial neck recess1 Olecranon fossa Anterior Biceps Tendon Brachialis Median Nerve Radial Nerve Medial Common Flexor Tendon Ulnar Collateral Ligament Medial Epicondyle Lateral Common Extensor Tendon Radial Collateral Ligament Lateral Epicondyle Posterior Triceps Tendon Olecranon/Fossa Ulnar Nerve Additional comments: Sonographer Note: Usually a dedicated study performed as per clinical request and/or symptoms. 1Includes the proximal radioulnar joint. Musculoskeletal Ultrasound Imaging Protocols 331 Wrist Date: History: Wrist Volar Flexor Tendons: FDS/FDP/FPL FCR/FCU Flexor Retinaculum Nerves: Median N Ulnar N Dorsal Compartments: 1 2 3 4 5 6 Scapholunate Ligament Lunotriquetral Ligament Triangular Fibrocartilage Complex TFC Ulnar Collateral Ligament Tendon Sheath Extensor Carpi Ulnaris Joint Effusion Synovial Proliferation Cartilage Cortex DRUJ Radiocarpal joint Additional comments: Sonographer Note: Usually a dedicated study performed as per clinical request and/or symptoms. 332 Appendix Hip Date: History: Joint: Effusion Synovial Proliferation Cartilage Cortex Anterior Labrum Anterior Femoral Triangle Iliopsoas Tendon and Bursa Sartorius Rectus Femoris Medial Pectineus Adductor Longus Adductor Brevis Adductor Magnus Gracilis Lateral Bursae around the Greater Trochanter Gluteus Maximus Gluteus Medius Gluteus Minimus Tensor Fascia Lata Iliotibial Band Posterior Gluteus Maximus Gluteus Medius Gluteus Minimus Hamstrings: Semimembranosus Conjoint Tendon Semitendinosus/Biceps Femoris Sciatic Nerve Additional comments: Sonographer Note: Usually a dedicated study performed as per clinical request and/or symptoms. Musculoskeletal Ultrasound Imaging Protocols 333 Knee Date: History: Anterior Quadriceps Tendon Patellar Tendon Patella Patellar Retinaculum ACL1 Superior Joint Recess Bursae Medial Semitendinous Gracilis Sartorius Medial Collateral Ligament Medial Meniscus (Anterior Horn and Body) Lateral Iliotibial Band Fibular Collateral Ligament Biceps Femoris Lateral Meniscus (Anterior Horn and Body) Common Peroneal Nerve Posterior Semimembranosus Gastrocnemius: Medial Head Lateral Head PCL ACL Bursae Posterior Horns Menisci: Medial Lateral Popliteal Fossa Vessels Tibial Nerve Joint: Effusion Synovial Proliferation Cartilage Cortex Additional comments: Sonographer Note: Usually a dedicated study performed as per clinical request and/or symptoms. 1ACL: may not be identifiable in all patients. 334 Appendix Ankle and Foot Date: History: Joint: Effusion Synovial Proliferation Cartilage Cortex Anterior Tibialis Anterior Extensor Hallucis Longus Extensor Digitorum Longus Peroneus Tertius Posteromedial Tibialis Posterior Flexor Digitorum Longus Flexor Hallucis Longus Flexor Retinaculum Posterolateral Peroneus Brevis Peroneus Longus Extensor Retinaculum Posterior Achilles Retrocalcaneal Bursa Retroachillean Bursa Kagar’s Fat Pad Ligaments Anterior Tibiofibular Distal Interosseous Membrane Lateral: Anterior Talofibular Calcaneofibular Posterior Talofibular1 Medial: Deltoid Additional comments: Sonographer Note: Usually a dedicated study performed as per clinical request and/or symptoms. 1May not be identifiable in all patients. Musculoskeletal Ultrasound Imaging Protocols 335 Soft Tissue Mass: Upper/Lower Limb Date: History: Site1 Overlying Skin Size AP Longitudinal Transverse Shape Contour2 Internal Echotexture3 Compressible4 Posterior Acoustic Enhancement Doppler Extension5 Surrounding Fluid Surrounding Tissues (Displacement/Invasion) Examine adjacent joint if in close proximity Additional comments: Sonographer Notes 1. Plane, e.g., subcutaneous, intramuscular, intermuscular. 2. Contour, e.g., smooth, lobulated, ill-defined, etc. 3. In/homogeneous, hyper/hypo/anechoic, calcification, air, vascularity. 4. Compressibility: also assess with Doppler. 5. Extension, e.g., along nerve or fascial plane. 336 Appendix Synovitis Protocol: Wrist and Hand Date: History: Distal Radioulnar Joint. 1 2 3 4 5 MCPJ PIPJ DIPJ Radiocarpal Joint Space Midcarpal Joint Space Carpometacarpal Joints Additional comments: Sonographer Notes 1. Usually a dedicated examination limited to the symptomatic joints is performed and agreed upon with referring clinicians. 2. Assess joints in longitudinal and transverse planes, volar and dorsal aspects, and, where accessible, the lateral joint recesses. 3. Assess the following: (a) fluid and synovium: compressibility and displacement, power Doppler; (b) articular cartilage; (c) cortex: smooth/irregular/erosions. 4. Overlying tendons and sheaths. Musculoskeletal Ultrasound Imaging Protocols 337 Synovitis Protocol: Ankle and Foot Date: History: Ankle Joint Intermetatarsal Joint Spaces 1 2 3 4 5 MTPJ PIPJ DIPJ Tarsometatarsal Joint Spaces Additional comments: Sonographer Notes: 1. Usually a dedicated examination limited to the symptomatic joints is performed and agreed upon with referring clinicians. 2. Assess joints in longitudinal and transverse planes, volar and dorsal aspects, and, where accessible, the lateral joint recesses. 3. Assess the following: (a) fluid and synovium: compressibility and displacement, power Doppler; (b) articular cartilage; (c) cortex: smooth/irregular/erosions. 4. Overlying tendons and sheaths. Index A attachment site of, 159, 186 magnetic resonance imaging of, Abductor digiti minimi muscle, ultrasound evaluation of, 174, 243, 251 126, 131, 249, 250, 253, 273, 193, 194 ultrasound evaluation of, 275 Adductor magnus muscle 256–279 accessory, 298, 299 anatomy of, 157, 160, 162, 163, anterior ankle, 257–260 Abductor digiti minimi tendon, 245 180, 181, 183, 184, 186, anterior joint, 260–261 Abductor hallucis muscle, 245, 187–188, 193, 194, 201, bones and joints of the foot, 249, 250, 252, 253, 273, 275 205, 206 277–279 Abductor pollicis brevis muscle, attachment site of, 159, 186, 203 clinical indications for, 110, 124, 126, 135, 137, 145 ultrasound evaluation of, 193, 243–244 Abductor pollicis brevis tendon, 194, 196 of the dorsum foot, 276–277 130 Adductor pollicis brevis tendon, imaging protocol for, 279 Abductor pollicis longus muscle, 130 muscle compartments, 257 106, 110, 123, 126, 127, 135, Adductor pollicis muscle, 123, 124, posterior ankle, 264 137, 145, 295 126, 132, 135 posterolateral ankle, 264–272 Abductor pollicis longus tendon, Adductor transverses hallucis postomedial ankle, 261–264 137, 138 muscle, 274, 276 sole of the foot, 272–276 Abscess, soft-tissue, 179 Adductor tubercle, 206 technical aspects of, 244 Acetabular ligament, transverse, Anatomical snuff box, 122 Annular ligament, 81 164 Anconeus epitrochlearis muscle, Arcade of Frohse, 112, 299 Acetabular notch, 158 87, 293 Arcuate ligament, 202 Acetabulum, 158 Anconeus muscle Arm, 55–75 Achilles tendon anatomy of, 56, 62, 78, 85, 87, anatomy of, 56–65 anatomy of, 225, 230–231, 250 104, 110 anterior (flexor) muscle as muscle insertion site, 235 function of, 62 compartment, 59–62 ultrasound evaluation of, 223, bones, 57–58 insertion site of, 82, 106 237, 245, 259, 272–273 fascia, 59, 63 as lateral elbow landmark, Acromioclavicular joint magnetic resonance imaging 97–98 anatomy of, 22, 30–31 of, 61, 111 Aneurysm, popliteal, 199–200 instability of, 47 muscles and tendons, 58–63 Anisotropy, in ultrasound, 15–16 ultrasound evaluation of, 47 nerves, 64–65, 285–294 of the knee, 211 Acromioclavicular ligament, posterior (extensor) muscle of the posterior cruciate 30–31, 48 compartment, 59, 61, ligament, 219, 220 Acromion 62, 63 of the semimembranosus anatomy of, 22, 31 quadrilateral space, 63 tendon, 217, 218, 219 fusion of, 47 surface anatomy, 56–57 of the shoulder, 42, 43 ultrasound evaluation of, 47, 48 triangular (interval) space, 63 Adductor aponeurosis, 130 of the tibialis posterior tendon, ultrasound evaluation of 262 Adductor brevis muscle, 160, 162, anterior compartment, 67–69 163, 174, 183, 184, 188, 193, Ankle and foot, 243–280 deltoid muscle, 65–66 194 anatomy of, 244–256 indications for, 55 Adductor canal, 180 blood vessels and nerves, 256 nerves, 70–74, 285–294 Adductor hallucis muscle, 249, bones and joints, 245–247 posterior compartment, 70 254, 274 ligaments, 254–255 technical aspects of, 55–56 Adductor insertion avulsion muscles and tendons, 244, technique, 65 syndrome, 192–193 247–252 Arthritis Adductor longus muscle nerves, 307–310 of the elbow, 77 anatomy of, 156, 157, 160,
Load more

Recommended publications
  • Ultrasound Evaluation of the Abductor Hallucis Muscle: Reliability Study Alyse FM Cameron, Keith Rome and Wayne a Hing*
    Journal of Foot and Ankle Research BioMed Central Research Open Access Ultrasound evaluation of the abductor hallucis muscle: Reliability study Alyse FM Cameron, Keith Rome and Wayne A Hing* Address: AUT University, School of Rehabilitation & Occupation Studies, Health & Rehabilitation Research Centre, Private Bag 92006, Auckland, 1142, New Zealand Email: Alyse FM Cameron - [email protected]; Keith Rome - [email protected]; Wayne A Hing* - [email protected] * Corresponding author Published: 25 September 2008 Received: 29 May 2008 Accepted: 25 September 2008 Journal of Foot and Ankle Research 2008, 1:12 doi:10.1186/1757-1146-1-12 This article is available from: http://www.jfootankleres.com/content/1/1/12 © 2008 Cameron et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: The Abductor hallucis muscle (AbdH) plays an integral role during gait and is often affected in pathological foot conditions. The aim of this study was to evaluate the within and between-session intra-tester reliability using diagnostic ultrasound of the dorso-plantar thickness, medio-lateral width and cross-sectional area, of the AbdH in asymptomatic adults. Methods: The AbdH muscles of thirty asymptomatic subjects were imaged and then measured using a Philips HD11 Ultrasound machine. Interclass correlation coefficients (ICC) with 95% confidence intervals (CI) were used to calculate both within and between session intra-tester reliability. Results: The within-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.99–0.99); medio-lateral width an ICC: of 0.97 (95% CI: 0.92–0.97) and cross- sectional area an ICC of 0.98 (95% CI: 0.98–0.99).
    [Show full text]
  • Adipose Tissue As Pain Generator in the Lower Back and Lower Extremity
    Lee et al. HCA Healthcare Journal of Medicine (2020) 1:5 https://doi.org/10.36518/2689-0216.1102 Clinical Review Adipose Tissue as Pain Generator in the Lower Back and Lower Extremity: Application in Author affiliations are listed Musculoskeletal Medicine at the end of this article. Se Won Lee, MD ,1 Craig Van Dien, MD ,2 Sun Jae Won, MD, PhD3 Correspondence to: Se Won Lee, MD Abstract Department of Physical Medicine and Rehabilitation Description MoutainView Medical Adipose tissue (AT) has diverse and important functions in body insulation, mechanical protection, energy metabolism and the endocrine system. Despite its relative abundance in Center the human body, the clinical significance of AT in musculoskeletal (MSK) medicine, partic- 2880 N Tenaya Way, 2nd Fl, ularly its role in painful MSK conditions, is under-recognized. Pain associated with AT can Las Vegas, NV 89128 be divided into intrinsic (AT as a primary pain generator), extrinsic (AT as a secondary pain ([email protected]) generator) or mixed origin. Understanding AT as an MSK pain generator, both by mechanism and its specific role in pain generation by body region, enhances the clinical decision-making process and guides therapeutic strategies in patients with AT-related MSK disorders. This article reviews the existing literature of AT in the context of pain generation in the lower back and lower extremity to increase clinician awareness and stimulate further investigation into AT in MSK medicine. Keywords adipose tissue; fat pad; musculoskeletal pain; connective tissue; lipodystrophy; lipoma; obe- sity; lipedema; pain generator Introduction lower extremity, focusing on its pathogenic role Mounting evidence supports the various func- as a pain generator as well as practical diagno- tions of adipose tissue (AT), most notably its sis and management.
    [Show full text]
  • Identification and Surgical Management of Upper Arm and Forearm Compartment Syndrome
    Open Access Case Report DOI: 10.7759/cureus.5862 Identification and Surgical Management of Upper Arm and Forearm Compartment Syndrome Adel Hanandeh 1 , Vishnu R. Mani 2 , Paul Bauer 1 , Alexius Ramcharan 3 , Brian Donaldson 1 1. General Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital Center, New York, USA 2. Surgery, Columbia University College of Physicians and Surgeons at Harlem Hospital Center, New York, USA 3. Surgery, Harlem Hospital Center, New York, USA Corresponding author: Adel Hanandeh, [email protected] Abstract Extremity muscles are grouped and divided by strong fascial membranes into compartments. Multiple pathological processes can result in an increase in the pressure within a muscle compartment. An increase in the compartment pressure beyond the adequate perfusion pressure has the potential to cause extremity compartment syndrome. There are multiple sites where compartment syndrome can occur. In this article, an arm and forearm compartment syndrome ensued secondary to a minor crushing injury that lead to supracondylar and medial epicondylar non-displaced fractures. A pure motor radial and ulnar nerve deficits noted on presentation, worsened with progression of the compartment syndrome. Ultimately, a surgical fasciotomy was carried out to release all compartments of the right upper arm and forearm. Categories: General Surgery, Orthopedics, Anatomy Keywords: upper arm compartment syndrome, fasciotomy, forearm compartment syndrome, condylar fracture, pediatric supracondylar humerus fracture Introduction In 1872, the first description of compartment syndrome was published by Richard von Volkmann. His publication described an irreversible contracture of muscles due to ischemic process resulting in the first documented nerve injury and contracture from compartment syndrome.
    [Show full text]
  • Exposure of the Forearm and Distal Radius
    Exposure of the Forearm and Distal Radius Melissa A. Klausmeyer, MDa, Chaitanya Mudgal, MDb,* KEYWORDS Henry approach Thompson approach Flexor carpi radialis approach Dorsal distal radius approach Distal radius approach KEY POINTS The use of internervous planes allow access to the underlying bone without risk of denervating the overlying muscles. The choice of approach is based on the injury pattern and need for exposure. The Henry and Thompson approaches are useful for radial shaft fractures. The distal radius can be approached volarly through the flexor carpi radialis (FCR) approach or dorsally through the extended Thompson approach. The extended FCR approach is useful for intraarticular fractures of the distal radius as well as mal- unions and subacute fractures. INTRODUCTION ANATOMY OF THE FOREARM Muscles Safe operative approaches to the bones of the forearm and wrist include the use of internervous The muscles of the forearm are split into 4 compart- planes. These planes lie between muscles that ments: The superficial volar, the deep volar, the are innervated by different nerves. By utilizing extensor, and the mobile wad (Table 1). The median these planes for dissection, extensive mobilization nerve supplies all of the volar muscles of the forearm of muscles and therefore large areas of exposure except the ulnar half of the flexor digitorum profun- may be obtained without the risk of muscle dus and the flexor carpi ulnaris that are supplied denervation. by the ulnar nerve. The radial nerve proper supplies A successful operative plan also must include the brachioradialis and extensor carpi radialis lon- consideration of the soft tissues, particularly gus.
    [Show full text]
  • High Lateral Portal for Sparing the Infrapatellar Fat-Pad During ACL Reconstruction
    Orthopaedics & Traumatology: Surgery & Research (2011) 97, 870—873 Available online at www.sciencedirect.com TECHNICAL NOTE High lateral portal for sparing the infrapatellar fat-pad during ACL reconstruction B. Sonnery-Cottet ∗, P. Archbold, R. Zayni, M. Thaunat, J. Bortolletto, J.-M. Fayard, P. Chambat Paul-Santy orthopaedic center, 24, avenue Paul-Santy, 69008 Lyon, France Accepted: 23 August 2011 KEYWORDS Summary During arthroscopic ACL reconstruction, intra-articular visualization can be com- Infrapatellar Fat Pad; promised by the interposition of the infrapatellar fat pad (IPFP) between the scope and the Anterior cruciate notch. In this technical note, we describe our technique of using lateral higher arthroscopic ligament portal, starting arthroscopy with the resection of the ligamentum mucosum and performing the reconstruction; tibial tunnel in 40◦ of knee flexion to optimise the intra-articular view without IPFP debride- Arthroscopy; ment. This technique was performed in 112 consecutive arthroscopic ACL reconstructions and Ligamentum compared to that in the previous 112 cases in which a conventional method was used. The use mucosum; of this technique was associated with a shorter operative time and no increase in the difficulty Arthroscopic portal in performing associated meniscal procedures. © 2011 Elsevier Masson SAS. All rights reserved. Introduction can influence patellar and knee kinematics [4]. Scarring of the anterior interval changes the mechanics of the anterior During arthroscopic ACL reconstruction, intra-articular visu- structures of the knee and may lead to refractory anterior alization can be compromised by the interposition of the knee pain [1]. Some studies have shown that the excessive infrapatellar fat pad (IPFP) between the scope and the resection of IPFP can have negative consequences on the notch.
    [Show full text]
  • The Branching and Innervation Pattern of the Radial Nerve in the Forearm: Clarifying the Literature and Understanding Variations and Their Clinical Implications
    diagnostics Article The Branching and Innervation Pattern of the Radial Nerve in the Forearm: Clarifying the Literature and Understanding Variations and Their Clinical Implications F. Kip Sawyer 1,2,* , Joshua J. Stefanik 3 and Rebecca S. Lufler 1 1 Department of Medical Education, Tufts University School of Medicine, Boston, MA 02111, USA; rebecca.lufl[email protected] 2 Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA 94305, USA 3 Department of Physical Therapy, Movement and Rehabilitation Science, Bouve College of Health Sciences, Northeastern University, Boston, MA 02115, USA; [email protected] * Correspondence: [email protected] Received: 20 May 2020; Accepted: 29 May 2020; Published: 2 June 2020 Abstract: Background: This study attempted to clarify the innervation pattern of the muscles of the distal arm and posterior forearm through cadaveric dissection. Methods: Thirty-five cadavers were dissected to expose the radial nerve in the forearm. Each muscular branch of the nerve was identified and their length and distance along the nerve were recorded. These values were used to determine the typical branching and motor entry orders. Results: The typical branching order was brachialis, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, supinator, extensor digitorum, extensor carpi ulnaris, abductor pollicis longus, extensor digiti minimi, extensor pollicis brevis, extensor pollicis longus and extensor indicis. Notably, the radial nerve often innervated brachialis (60%), and its superficial branch often innervated extensor carpi radialis brevis (25.7%). Conclusions: The radial nerve exhibits significant variability in the posterior forearm. However, there is enough consistency to identify an archetypal pattern and order of innervation. These findings may also need to be considered when planning surgical approaches to the distal arm, elbow and proximal forearm to prevent an undue loss of motor function.
    [Show full text]
  • Anatomical Study of Minimally Invasive Lateral Release
    FAIXXX10.1177/1071100720920863Foot & Ankle InternationalDalmau-Pastor et al 920863research-article2020 Article Foot & Ankle International® 1 –9 Anatomical Study of Minimally Invasive © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions Lateral Release Techniques for Hallux DOI:https://doi.org/10.1177/1071100720920863 10.1177/1071100720920863 Valgus Treatment journals.sagepub.com/home/fai Miki Dalmau-Pastor, PhD1,2 , Francesc Malagelada, MD, PhD1,2,3, Guillaume Cordier, MD2,4, Jorge Javier Del Vecchio, MD, MBA2,5,6 , Mauricio Esteban Ghioldi, MD7, and Jordi Vega, MD1,2,8 Abstract Background: Lateral release (LR) for the treatment of hallux valgus is a routinely performed technique, either by means of open or minimally invasive (MI) surgery. Despite this, there is no available evidence of the efficacy and safety of MI lateral release. Our aim was to study 2 popular techniques for MI LR in cadavers by subsequently dissecting the released anatomical structures. Methods: Twenty-two cadaveric feet were included in the study and allocated into 2 groups, 1 for each procedure: 1 group underwent a MI adductor tendon release (AR), and in the other group, an extensive percutaneous lateral release (EPLR) (adductor tendon, suspensory ligament, phalanx-sesamoid ligament, lateral head of flexor hallucis brevis, and deep transverse metatarsal ligament) was performed. Anatomical dissection was performed to identify neurovascular injuries and to verify the released structures. Results: Both techniques demonstrated to be effective in reproducing a MI LR. A satisfactory release of the adductor tendon was achieved equally in both techniques (P = .85), being partial in most EPLR cases and full in the majority of AR cases.
    [Show full text]
  • Neurology of the Upper Limb
    Neurology of the Upper limb Donald Sammut Hand Surgeon Kings Upper Limb Anatomy plus lecture notes The$Neck$ The$Nerve$roots$which$supply$the$Upper$Limb$are$C5$to$T1$ Pre<fixed$(C4$to$C8)$and$Post<fixed$(C6$to$T2)$plexus$not$uncommon.$ Also$common$contributions$from$C4$and$from$T2$in$a$normally$rooted$plexus.$ $ The$anterior$nerve$roots$emerge$between$the$vertebrae$and$immediately$pass$ $through$the$first$area$of$possible$compression:$ The$root$nerve$canal$is$bounded$$ Anteriorly$by$the$posterior$margin$of$the$intervertebral$disc$and$$ Posteriorly,$by$the$facet$joint$between$vertebrae.$ $ Pathology$of$the$disc,$or$joint,$or$both,$can$narrow$this$channel$and$compress$ $the$nerve$root$ The$roots$emerge$from$the$cervical$spine$into$the$plane$between$$ Scalenius$Anterior$and$Scalenius$Medius.$$ $ Scalenius*Anterior:** Origin:$Anterior$tubercles$of$Cervical$vertebae$C3$to$6$(C6$tubercle$is$the$Carotid$tubercle)$ Insertion:$The$scalene$tubercle$on$inner$border/upper$surface$1st$rib$ $ Scalenius*Medius:* Origin:$Posterior$tubercles$of$all$cervical$vertebrae$ Insertion:$Quadrangular$area$between$the$neck$and$subclavian$groove$1st$rib$ $ Exiting$from$the$Scalenes,$the$trunks$lie$in$the$posterior$triangle$of$the$neck.$ The$posterior$triangle$is$bounded$anteriorly$by$SternoCleidoMastoid$and$$ posteriorly$by$the$Trapezius.$ The$inferior$border$is$the$clavicle$.$ The$apex$of$the$triangle$superiorly$is$at$the$back$of$the$skull$on$the$superior$nuchal$line$ $ $ The$Posterior$Triangle$ SternoCleidoMastoid$ Trapezius$ Scalenius$Medius$ Scalenius$Anterior$
    [Show full text]
  • Contents VII
    Contents VII Contents Preface .............................. V 3.2 Supply of the Connective Tissue ....... 28 List of Abbreviations ................... VI Diffusion ......................... 28 Picture Credits ........................ VI Osmosis .......................... 29 3.3 The “Creep” Phenomenon ............ 29 3.4 The Muscle ....................... 29 Part A Muscle Chains 3.5 The Fasciae ....................... 30 Philipp Richter Functions of the Fasciae .............. 30 Manifestations of Fascial Disorders ...... 30 Evaluation of Fascial Tensions .......... 31 1 Introduction ..................... 2 Causes of Musculoskeletal Dysfunctions .. 31 1.1 The Significance of Muscle Chains Genesis of Myofascial Disorders ........ 31 in the Organism ................... 2 Patterns of Pain .................... 32 1.2 The Osteopathy of Dr. Still ........... 2 3.6 Vegetative Innervation of the Organs ... 34 1.3 Scientific Evidence ................. 4 3.7 Irvin M. Korr ...................... 34 1.4 Mobility and Stability ............... 5 Significance of a Somatic Dysfunction in the Spinal Column for the Entire Organism ... 34 1.5 The Organism as a Unit .............. 6 Significance of the Spinal Cord ......... 35 1.6 Interrelation of Structure and Function .. 7 Significance of the Autonomous Nervous 1.7 Biomechanics of the Spinal Column and System .......................... 35 the Locomotor System .............. 7 Significance of the Nerves for Trophism .. 35 .............. 1.8 The Significance of Homeostasis ....... 8 3.8 Sir Charles Sherrington 36 Inhibition of the Antagonist or Reciprocal 1.9 The Nervous System as Control Center .. 8 Innervation (or Inhibition) ............ 36 1.10 Different Models of Muscle Chains ..... 8 Post-isometric Relaxation ............. 36 1.11 In This Book ...................... 9 Temporary Summation and Local, Spatial Summation .................. 36 Successive Induction ................ 36 ......... 2ModelsofMyofascialChains 10 3.9 Harrison H. Fryette ................. 37 2.1 Herman Kabat 1950: Lovett’s Laws .....................
    [Show full text]
  • Hallux Varus As Complication of Foot Compartment Syndrome
    The Journal of Foot & Ankle Surgery 50 (2011) 504–506 Contents lists available at ScienceDirect The Journal of Foot & Ankle Surgery journal homepage: www.jfas.org Tips, Quips, and Pearls “Tips, Quips, and Pearls” is a special section in The Journal of Foot & Ankle Surgery which is devoted to the sharing of ideas to make the practice of foot and ankle surgery easier. We invite our readers to share ideas with us in the form of special tips regarding diagnostic or surgical procedures, new devices or modifications of devices for making a surgical procedure a little bit easier, or virtually any other “pearl” that the reader believes will assist the foot and ankle surgeon in providing better care. Please address your tips to: D. Scot Malay, DPM, MSCE, FACFAS, Editor, The Journal of Foot & Ankle Surgery, PO Box 590595, San Francisco, CA 94159-0595; E-mail: [email protected] Hallux Varus as Complication of Foot Compartment Syndrome Paul Dayton, DPM, MS, FACFAS 1, Jean Paul Haulard, DPM, MS 2 1 Director, Podiatric Surgical Residency, Trinity Regional Medical Center, Fort Dodge, IA 2 Resident, Trinity Regional Medical Center, Fort Dodge, IA article info abstract Keywords: Hallux varus can present as a congenital deformity or it can be acquired secondary to trauma, surgery, or deformity neuromuscular disease. In the present report, we describe the presence of hallux varus as a sequela of great toe calcaneal fracture with entrapment of the medial plantar nerve in the calcaneal tunnel and recommend that metatarsophalangeal joint clinicians be wary of this when they clinically, and radiographically, evaluate patients after calcaneal fracture.
    [Show full text]
  • On the Position and Course of the Deep Plantar Arteries, with Special Reference to the So-Called Plantar Metatarsal Arteries
    Okajimas Fol. anat. jap., 48: 295-322, 1971 On the Position and Course of the Deep Plantar Arteries, with Special Reference to the So-Called Plantar Metatarsal Arteries By Takuro Murakami Department of Anatomy, Okayama University Medical School, Okayama, Japan -Received for publication, June 7, 1971- Recently, we have confirmed that, as in the hand and foot of the monkey (Koch, 1939 ; Nishi, 1943), the arterial supply of the human deep metacarpus is composed of two layers ; the superficial layer on the palmar surfaces of the interosseous muscles and the deep layer within the muscles (Murakami, 1969). In that study, we pointed out that both layers can be classified into two kinds of arteries, one descending along the boundary of the interosseous muscles over the metacarpal bone (superficial and deep palmar metacarpal arteries), and the other de- scending along the boundary of the muscles in the intermetacarpal space (superficial and deep intermetacarpal arteries). In the human foot, on the other hand, the so-called plantar meta- tarsal arteries are occasionally found deep to the plantar surfaces of the interosseous muscles in addition to their usual positions on the plantar surfaces of the muscles (Pernkopf, 1943). And they are some- times described as lying in the intermetatarsal spaces (Baum, 1904), or sometimes descending along the metatarsal bones (Edwards, 1960). These circumstances suggest the existence in the human of deep planta of the two arterial layers and of the two kinds of descending arteries. There are, however, but few studies on the courses and positions of the deep plantar arteries, especially of the so-called plantar metatarsal arteries.
    [Show full text]
  • Maximum Toe Flexor Muscle Strength and Quantitative Analysis of Human
    Kurihara et al. Journal of Foot and Ankle Research 2014, 7:26 http://www.jfootankleres.com/content/7/1/26 JOURNAL OF FOOT AND ANKLE RESEARCH RESEARCH Open Access Maximum toe flexor muscle strength and quantitative analysis of human plantar intrinsic and extrinsic muscles by a magnetic resonance imaging technique Toshiyuki Kurihara1†, Junichiro Yamauchi2,3,4*†, Mitsuo Otsuka1, Nobuaki Tottori1, Takeshi Hashimoto1,2 and Tadao Isaka1 Abstract Background: The aims of this study were to investigate the relationships between the maximum isometric toe flexor muscle strength (TFS) and cross-sectional area (CSA) of the plantar intrinsic and extrinsic muscles and to identify the major determinant of maximum TFS among CSA of the plantar intrinsic and extrinsic muscles. Methods: Twenty six young healthy participants (14 men, 12 women; age, 20.4 ± 1.6 years) volunteered for the study. TFS was measured by a specific designed dynamometer, and CSA of plantar intrinsic and extrinsic muscles were measured using magnetic resonance imaging (MRI). To measure TFS, seated participants optimally gripped the bar with their toes and exerted maximum force on the dynamometer. For each participant, the highest force produced amongthreetrialswasusedforfurther analysis. To measure CSA, serial T1-weighted images were acquired. Results: TFS was significantly correlated with CSA of the plantar intrinsic and extrinsic muscles. Stepwise multiple linear regression analyses identified that the major determinant of TFS was CSA of medial parts of plantar intrinsic muscles (flexor hallucis brevis, flexor digitorum brevis, quadratus plantae, lumbricals and abductor hallucis). There wasnosignificantdifferencebetweenmenandwomeninTFS/CSA. Conclusions: CSA of the plantar intrinsic and extrinsic muscles is one of important factors for determining the maximum TFS in humans.
    [Show full text]