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Periacetabular Osteotomy (PAO) of the Hip
UW HEALTH SPORTS REHABILITATION Rehabilitation Guidelines For Periacetabular Osteotomy (PAO) Of The Hip The hip joint is composed of the femur (the thigh bone) and the Lunate surface of acetabulum acetabulum (the socket formed Articular cartilage by the three pelvic bones). The Anterior superior iliac spine hip joint is a ball and socket joint Head of femur Anterior inferior iliac spine that not only allows flexion and extension, but also rotation of the Iliopubic eminence Acetabular labrum thigh and leg (Fig 1). The head of Greater trochanter (fibrocartilainous) the femur is encased by the bony Fat in acetabular fossa socket in addition to a strong, (covered by synovial) Neck of femur non-compliant joint capsule, Obturator artery making the hip an extremely Anterior branch of stable joint. Because the hip is Intertrochanteric line obturator artery responsible for transmitting the Posterior branch of weight of the upper body to the obturator artery lower extremities and the forces of Obturator membrane Ischial tuberosity weight bearing from the foot back Round ligament Acetabular artery up through the pelvis, the joint (ligamentum capitis) Lesser trochanter Transverse is subjected to substantial forces acetabular ligament (Fig 2). Walking transmits 1.3 to Figure 1 Hip joint (opened) lateral view 5.8 times body weight through the joint and running and jumping can generate forces across the joint fully form, the result can be hip that is shared by the whole hip, equal to 6 to 8 times body weight. dysplasia. This causes the hip joint including joint surfaces and the to experience load that is poorly previously-mentioned acetabular The labrum is a circular, tolerated over time, resulting in labrum. -
The Pelvis Structure the Pelvic Region Is the Lower Part of the Trunk
The pelvis Structure The pelvic region is the lower part of the trunk, between the abdomen and the thighs. It includes several structures: the bony pelvis (or pelvic skeleton) is the skeleton embedded in the pelvic region of the trunk, subdivided into: the pelvic girdle (i.e., the two hip bones, which are part of the appendicular skeleton), which connects the spine to the lower limbs, and the pelvic region of the spine (i.e., sacrum, and coccyx, which are part of the axial skeleton) the pelvic cavity, is defined as the whole space enclosed by the pelvic skeleton, subdivided into: the greater (or false) pelvis, above the pelvic brim , the lesser (or true) pelvis, below the pelvic brim delimited inferiorly by the pelvic floor(or pelvic diaphragm), which is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. Pelvic floor separate the pelvic cavity above from the perineum below. The pelvic skeleton is formed posteriorly (in the area of the back), by the sacrum and the coccyx and laterally and anteriorly (forward and to the sides), by a pair of hip bones. Each hip bone consists of 3 sections, ilium, ischium, and pubis. During childhood, these sections are separate bones, joined by the triradiate hyaline cartilage. They join each other in a Y-shaped portion of cartilage in the acetabulum. By the end of puberty the three bones will have fused together, and by the age of 25 they will have ossified. The two hip bones join each other at the pubic symphysis. -
Anatomic Study of Innervation of the Anterior Hip Capsule: Implication
Regional Anesthesia & Pain Medicine: first published as 10.1097/AAP.0000000000000701 on 1 February 2018. Downloaded from CHRONIC AND INTERVENTIONAL PAIN ORIGINAL ARTICLE Anatomic Study of Innervation of the Anterior Hip Capsule Implication for Image-Guided Intervention Anthony J. Short, MBBS,* Jessi Jo G. Barnett,† Michael Gofeld, MD,‡ Ehtesham Baig, MD,‡ KarenLam,MD,‡ Anne M.R. Agur, PhD,† and Philip W.H. Peng, MBBS, FRCPC, Founder (Pain Medicine)‡§ develop painful hip OA by the age of 85 years.1 The management Background and Objectives: The purpose of this cadaveric study was strategies consist of pharmacologic treatments, physical therapy, to determine the pattern of anterior hip capsule innervation and the associ- interventional techniques, and surgery.2 Total hip arthroplasty is ated bony landmarks for image-guided radiofrequency denervation. considered for patients with advanced OA and moderate to severe Methods: Thirteen hemipelvises were dissected to identify innervation of symptoms.3 New, noninvasive treatment options need to be devel- the anterior hip capsule. The femoral (FN), obturator (ON), and accessory oped for patients who cannot undergo surgery and for those with obturator (AON) nerves were traced distally, and branches supplying the severe postoperative pain. Radiofrequency denervation (RFD), anterior capsule documented. The relationships of the branches to bony known to be effective for facet and sacroiliac joint arthritis,4 is landmarks potentially visible with ultrasound were identified. now emerging as a possible treatment for chronic hip pain. In a re- Results: The anterior hip capsule received innervation from the FNs and view article, Gupta et al5 described 8 case reports/case series ONs in all specimens and the AON in 7 of 13 specimens. -
CMM-314: Hip Surgery-Arthroscopic and Open Procedures Version 1.0.2019
CLINICAL GUIDELINES CMM-314: Hip Surgery-Arthroscopic and Open Procedures Version 1.0.2019 Clinical guidelines for medical necessity review of speech therapy services. © 2019 eviCore healthcare. All rights reserved. Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-314: Hip Surgery-Arthroscopic and Open Procedures CMM-314.1: Definitions 3 CMM-314.2: General Guidelines 4 CMM-314.3: Indications and Non-Indications 4 CMM-314.4 Experimental, Investigational, or Unproven 6 CMM-314.5: Procedure (CPT®) Codes 7 CMM-314.6: References 10 © 2019 eviCore healthcare. All rights reserved. Page 2 of 13 400 Buckwalter Place Boulevard, Bluffton, SC 29910 • (800) 918-8924 www.eviCore.com Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-314.1: Definitions Femoroacetabular Impingement (FAI) is an anatomical mismatch between the head of the femur and the acetabulum resulting in compression of the labrum or articular cartilage during flexion. The mismatch can arise from subtle morphologic alterations in the anatomy or orientation of the ball-and-socket components (for example, a bony prominence at the head-neck junction or acetabular over-coverage) with articular cartilage damage initially occurring from abutment of the femoral neck against the acetabular rim, typically at the anterosui per or aspect of the acetabulum. Although hip joints can possess the morphologic features of FAI without symptoms, FAI may become pathologic with repetitive movement and/or increased force on the hip joint. High-demand activities may also result in pathologic impingement in hips with normal morphology. s It ha been proposed that impingement with damage to the labrum and/or acetabulum is a causative factor in the development of hip osteoarthritis, and that as many as half of cases currently categorized as primary osteoarthritis may have an etiology of FAI. -
Tragelaphus Spekii
ORIGINAL COMMUNICATION Anatomy Journal of Africa. 2021. Vol 10 (1):1974-1979 GROSS ANATOMICAL STUDIES ON THE HIND LIMB OF THE SITATUNGA (Tragelaphus spekii). Kenechukwu Tobechukwu Onwuama, Sulaiman Olawoye Salami, Esther Solomon Kigir, Alhaji Zubair Jaji Department of Veterinary Anatomy, University of Ilorin, Ilorin, Nigeria Abbreviated title: Hind limb bones of the Sitatunga Corresponding address: Kenechukwu Tobechukwu Onwuama. Telephone number: 08036425961. E-mail address: [email protected] ABSTRACT The Sitatunga, Tragelaphus spekii, is a swamp dwelling antelope resident in West Africa. This study was carried out to document unique morphological and numerical information on the hind limb bones of this ruminant. Two (2) adults of both sexes were obtained as carcass at different times after post-mortem examination and prepared to extract the bones via cold water maceration for use in the study. The presence of a sharp pointed ilio-pubic eminence at the junction between the cranial border of the ilium and pubis; less prominent ischial tuber, inconspicuous ischiatic arch and a large oval obturator foramen were unique features of the Ossa coxarum that distinguished it from that of small ruminants. The Femur’s medial condyle was obliquely orientated, the fibula was absent while the long Tibia was typical of ruminant presentation. It was observed that the morphological features of the tarsals and Pes were also typical. However, the last Phalanges presented characteristic long triangular shaped bones with sharp pointed ends. The total number of bones making up the forelimb was accounted to be 45. In conclusion, this study has provided a baseline data for further biological, archeological and comparative anatomical studies. -
Musculoskeletal Surgical Services: Open Surgical Procedures; Hip: Open Surgery; Hip Fracture
Musculoskeletal Surgical Services: Open Surgical Procedures; Hip: Open Surgery; Hip Fracture POLICY INITIATED: 06/30/2019 MOST RECENT REVIEW: 06/30/2019 POLICY # HH-5698 Overview Statement The purpose of these clinical guidelines is to assist healthcare professionals in selecting the medical service that may be appropriate and supported by evidence to improve patient outcomes. These clinical guidelines neither preempt clinical judgment of trained professionals nor advise anyone on how to practice medicine. The healthcare professionals are responsible for all clinical decisions based on their assessment. These clinical guidelines do not provide authorization, certification, explanation of benefits, or guarantee of payment, nor do they substitute for, or constitute, medical advice. Federal and State law, as well as member benefit contract language, including definitions and specific contract provisions/exclusions, take precedence over clinical guidelines and must be considered first when determining eligibility for coverage. All final determinations on coverage and payment are the responsibility of the health plan. Nothing contained within this document can be interpreted to mean otherwise. Medical information is constantly evolving, and HealthHelp reserves the right to review and update these clinical guidelines periodically. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from HealthHelp. All -
H20/1, H20/2, H20/3, H20/4 (1000285 1000286 1000287 1000288) English
…going one step further H20/1 (1000285) H20/2 (1000286) H20/3 (1000287) H20/4 (1000288) H20/1, H20/2, H20/3, H20/4 (1000285_1000286_1000287_1000288) English H20/1, H20/2, H20/3, H20/4 H20/2, H20/3, H20/4 H20/4 1 Promontory 38 Anterior longitudinal 78 External iliac artery 2 Superior articular surface ligament 79 External iliac vein 3 Lumbar vertebra V 39 Obturator membrane 80 nternal iliac artery 4 Costal process 40 Sacrospinous ligament 81 Internal iliac vein 5 Intervertebral disc 41 Sacrotuberal ligament 82 Right common iliac artery 6 Crest of ilium 42 Inguinal ligament 83 Inferior vena cava 7 Wing of ilium 43 Anterior sacroiliac 84 Abdominal aorta 8 Anterior superior iliac ligaments 85 Left common iliac artery spine 44 Iliolumbar ligament 86 Sciatic nerve 9 Anterior inferior iliac spine 45 Interosseous sacro-iliac 87 Femoral artery 10 Acetabulum ligaments 88 Sacral plexus 11 Obturator foramen 46 Posterior sacro-iliac 89 Dorsal nerve of clitoris 12 Frame of ischial bone ligament 90 Pudendal nerve 13 Superior pubic ramus 47 Supraspinous ligament 91 Piriformis 14 Inferior pubic ramus 92 Inferior rectal nerves 15 Pubic tubercle 93 Perineal nerves 16 Pubic crest H20/3, H20/4 94 Posterior labial nerves 17 Pubic symphysis 48 Rectum 95 Femoral vein 18 Body of pubis 49 Ovary 96 Left common iliac vein 19 Sciatic tuber 50 Uterine tube 97 Superior gluteal artery 20 Ischial spine 51 Uterus 98 Inferior gluteal artery 21 Iliopubic eminence 52 Ligament of ovary 99 Internal pudendal artery 22 Coccygeal bone 53 Urinary bladder 100 ® Middle rectal artery -
Sex Determination Using the Distance Between Posterior Inferior Iliac Spine and Ischial Spine in Dry Human Innominate Bone K
Research Article Sex determination using the distance between posterior inferior iliac spine and ischial spine in dry human innominate bone K. Akshaya, Karthik Ganesh Mohanraj* ABSTRACT Aim: This study aims to determine the sex using the distance between the posterior inferior iliac spine and ischial spine. Introduction: Hip bone is taken into account because it is the most sexual dimorphic skeletal component in humans. The greater sciatic notch is very valuable as a result of its proof against damage and is extremely sexually dimorphic. Sexual dimorphism points to the contrasting features between male and female in relation to the size and appearance. Materials and Methods: In the present study, a total of 60 dry human pelvic bones of unknown sex and without any gross abnormality were collected from the Department of Anatomy, Saveetha Dental College, Chennai, for evaluation. With the help of Vernier caliper and ruler, the measurements such as maximum jugular length, maximum jugular breadth, and diameter were measured. The results obtained were analyzed, tabulated, and represented graphically. Results: The distance between the posterior inferior iliac spine and ischial spine is greater in females than in males amped that the depth of the sciatic notch is lesser in females. All these parameters help us distinguish female and males pelvis. Thus, the pelvic bone helps in the determination of sex and is highly sexually dimorphic. Conclusion: The distance between the posterior inferior iliac spine and ischial spine is greater in females than in males amped that the depth of the sciatic notch is lesser in females. All these parameters help us distinguish female and males pelvis. -
Developing Learning Models to Teach Equine Anatomy and Biomechanics
The University of Maine DigitalCommons@UMaine Honors College Spring 5-2017 Developing Learning Models to Teach Equine Anatomy and Biomechanics Zandalee E. Toothaker University of Maine Follow this and additional works at: https://digitalcommons.library.umaine.edu/honors Part of the Animal Sciences Commons, and the Veterinary Anatomy Commons Recommended Citation Toothaker, Zandalee E., "Developing Learning Models to Teach Equine Anatomy and Biomechanics" (2017). Honors College. 453. https://digitalcommons.library.umaine.edu/honors/453 This Honors Thesis is brought to you for free and open access by DigitalCommons@UMaine. It has been accepted for inclusion in Honors College by an authorized administrator of DigitalCommons@UMaine. For more information, please contact [email protected]. DEVELOPING LEARNING MODELS TO TEACH EQUINE ANATOMY AND BIOMECHANICS By Zandalee E. Toothaker A Thesis Submitted in Partial Fulfillment of the Requirements for a Degree with Honors (Animal and Veterinary Science) The Honors College University of Maine May 2017 Advisory Committee: Dr. Robert C. Causey, Associate Professor of Animal and Veterinary Sciences, Advisor Dr. David Gross, Adjunct Associate Professor in Honors (English) Dr. Sarah Harlan-Haughey, Assistant Professor of English and Honors Dr. Rita L. Seger, Researcher of Animal and Veterinary Sciences Dr. James Weber, Associate Professor and Animal and Veterinary Sciences © 2017 Zandalee Toothaker All Rights Reserved ABSTRACT Animal owners and professionals benefit from an understanding of an animal’s anatomy and biomechanics. This is especially true of the horse. A better understanding of the horse’s anatomy and weight bearing capabilities will allow people to treat and prevent injuries in equine athletes and work horses. -
Iliopsoas Muscle Injury in Dogs
Revised January 2014 3 CE Credits Iliopsoas Muscle Injury in Dogs Quentin Cabon, DMV, IPSAV Centre Vétérinaire DMV Montréal, Quebec Christian Bolliger, Dr.med.vet, DACVS, DECVS Central Victoria Veterinary Hospital Victoria, British Columbia Abstract: The iliopsoas muscle is formed by the psoas major and iliacus muscles. Due to its length and diameter, the iliopsoas muscle is an important flexor and stabilizer of the hip joint and the vertebral column. Traumatic acute and chronic myopathies of the iliopsoas muscle are commonly diagnosed by digital palpation during the orthopedic examination. Clinical presentations range from gait abnormalities, lameness, and decreased hip joint extension to irreversible fibrotic contracture of the muscle. Rehabilitation of canine patients has to consider the inciting cause, the severity of pathology, and the presence of muscular imbalances. ontrary to human literature, few veterinary articles have been Box 2. Main Functions of the Iliopsoas Muscle published about traumatic iliopsoas muscle pathology.1–6 This is likely due to failure to diagnose the condition and the • Flexion of the hip joint C 5 presence of concomitant orthopedic problems. In our experience, repetitive microtrauma of the iliopsoas muscle in association with • Adduction and external rotation of the femur other orthopedic or neurologic pathologies is the most common • Core stabilization: clinical presentation. —Flexion and stabilization of the lumbar spine when the hindlimb is fixed Understanding applied anatomy is critical in diagnosing mus- —Caudal traction on the trunk when the hindlimb is in extension cular problems in canine patients (BOX 1 and BOX 2; FIGURE 1 and FIGURE 2). Pathophysiology of Muscular Injuries Box 1. -
Psoas Muscle and Lumbar Spine Stability: a Concept Uniting Existing Controversies Critical Review and Hypothesis
Eur Spine J (2000) 9:577–585 © Springer-Verlag 2000 NEW IDEAS L. Penning Psoas muscle and lumbar spine stability: a concept uniting existing controversies Critical review and hypothesis Abstract Psoas muscle (PM) func- tate the LS, will be brought into Received: 12 February 2000 Revised: 12 May 2000 tion with regard to the lumbar spine more lordosis, with maintenance of Accepted: 22 May 2000 (LS) is disputed. Electromyographic vertical position, if a string fastened studies attribute to the PM a possible at its upper end is pulled downward role as stabilizer. Anatomical text- in a very specific direction. Con- books describe the PM as an LS versely, any increase of lordosis of flexor, but not a stabilizer. According the strip brought about by vertical to more recent anatomical studies, downward pushing of its top, will be the PM does not act on the LS, be- stabilized by tightening the pulling cause it tends to pull the LS into string in the same specific direction. more lordosis by simultaneously As this direction corresponded with flexing the lower and extending the the psoas orientation, the experi- upper region, but due to the short ments show that the PM probably moment arms of its fascicles, this functions as a stabilizer of the lor- would require maximal muscular ef- dotic LS in an upright stance by fort and would expose the LS motion adapting the state of contraction of segments to dangerous compression each of its fascicles to the momen- and shear. The findings of the pre- tary degree of lordosis imposed by sent study indicate that the described factors outside the LS, such as gen- opposite action of the PM on upper eral posture, general muscle activity L. -
A Study of Sexual Dimorphism of Human Hip Bone by Measurements Between Ileum and Pubis
Original article A study of sexual dimorphism of human hip bone by measurements between ileum and pubis Vijayeendra Kanabur1, Anita Deshpande2 1Associate Professor, Department of Anatomy, Al Ameen Medical College, Vijaypura, Karnataka, India 2Assistant Professor, Department of Physiology, Al Ameen Medical College, Vijaypura, Karnataka, India Abstract Background: Identification of sex of an individual from human skeletal remains is of great medicolegal significance. The hip bone is considered as an ideal bone for sex determination as it provides the highest accuracy levels for sex determination. Aim: The present study was done to find out important measurements between ileum and pubis that would significantly differentiate the sex of human hip bone. Methods: For this study 65 human hip bones (35 male and 30 female) of known sex were obtained from the department of Anatomy. Three parameters were used for determination of sex of human hip bone. These were 1) Distance between anterior inferior iliac spine to pubic tubercle 2) Distance between anterior inferior iliac spine to superior end of the symphysial surface and 3) Distance from the anterior inferior iliac spine to iliopubic eminence. These parameters were measured using the instrument vernier caliper. Results: In the present study significant statistical difference was seen in between the mean values of 1. Distance between the anterior inferior iliac spine to pubic tubercle. The mean value on the right side was found to be 8.86 cm in males and 6.93 cm in females. On the left side the mean value was found to be 8.12 cm in males and 6.20 cm in females.