Axis Scientific 27-Part Half Life-Size Muscular Figure A-105165
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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). -
Effect of Preservation of the C-6 Spinous Process and Its Paraspinal Muscular Attachment on the Prevention of Postoperative Axial Neck Pain in C3–6 Laminoplasty
SPINE CLINICAL ARTICLE J Neurosurg Spine 22:221–229, 2015 Effect of preservation of the C-6 spinous process and its paraspinal muscular attachment on the prevention of postoperative axial neck pain in C3–6 laminoplasty Eiji Mori, MD, Takayoshi Ueta, MD, PhD, Takeshi Maeda, MD, PhD, Itaru Yugué, MD, PhD, Osamu Kawano, MD, PhD, and Keiichiro Shiba, MD, PhD Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Fukuoka, Japan OBJECT Axial neck pain after C3–6 laminoplasty has been reported to be significantly lesser than that after C3–7 laminoplasty because of the preservation of the C-7 spinous process and the attachment of nuchal muscles such as the trapezius and rhomboideus minor, which are connected to the scapula. The C-6 spinous process is the second longest spinous process after that of C-7, and it serves as an attachment point for these muscles. The effect of preserving the C-6 spinous process and its muscular attachment, in addition to preservation of the C-7 spinous process, on the preven- tion of axial neck pain is not well understood. The purpose of the current study was to clarify whether preservation of the paraspinal muscles of the C-6 spinous process reduces postoperative axial neck pain compared to that after using nonpreservation techniques. METHODs The authors studied 60 patients who underwent C3–6 double-door laminoplasty for the treatment of cervi- cal spondylotic myelopathy or cervical ossification of the posterior longitudinal ligament; the minimum follow-up period was 1 year. Twenty-five patients underwent a C-6 paraspinal muscle preservation technique, and 35 underwent a C-6 nonpreservation technique. -
Scapular Winging Is a Rare Disorder Often Caused by Neuromuscular Imbalance in the Scapulothoracic Stabilizer Muscles
SCAPULAR WINGING Scapular winging is a rare disorder often caused by neuromuscular imbalance in the scapulothoracic stabilizer muscles. Lesions of the long thoracic nerve and spinal accessory nerves are the most common cause. Patients report diffuse neck, shoulder girdle, and upper back pain, which may be debilitating, associated with abduction and overhead activities. Accurate diagnosis and detection depend on appreciation on comprehensive physical examination. Although most cases resolve nonsurgically, surgical treatment of scapular winging has been met with success. True incidence is largely unknown because of under diagnosis. Most commonly it is categorized anatomically as medial or lateral shift of the inferior angle of the scapula. Primary winging occurs when muscular weakness disrupts the normal balance of the scapulothoracic complex. Secondary winging occurs when pathology of the shoulder joint pathology. Delay in diagnosis may lead to traction brachial plexopathy, periscapular muscle spasm, frozen shoulder, subacromial impingement, and thoracic outlet syndrome. Anatomy and Biomechanics Scapula is rotated 30° anterior on the chest wall; 20° forward in the sagittal plane; the inferior angle is tilted 3° upward. It serves as the attachment site for 17 muscles. The trapezius muscle accomplishes elevation of the scapula in the cranio-caudal axis and upward rotation. The serratus anterior and pectoralis major and minor muscles produce anterior and lateral motion, described as scapular protraction. Normal Scapulothoracic abduction: As the limb is elevated, the effect is an upward and lateral rotation of the inferior pole of scapula. Periscapular weakness resulting from overuse may manifest as scapular dysfunction (ie, winging). Serratus Anterior Muscle Origin From the first 9 ribs Insert The medial border of the scapula. -
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. -
Lower Extremity Focal Neuropathies
LOWER EXTREMITY FOCAL NEUROPATHIES Lower Extremity Focal Neuropathies Arturo A. Leis, MD S.H. Subramony, MD Vettaikorumakankav Vedanarayanan, MD, MBBS Mark A. Ross, MD AANEM 59th Annual Meeting Orlando, Florida Copyright © September 2012 American Association of Neuromuscular & Electrodiagnostic Medicine 2621 Superior Drive NW Rochester, MN 55901 Printed by Johnson Printing Company, Inc. 1 Please be aware that some of the medical devices or pharmaceuticals discussed in this handout may not be cleared by the FDA or cleared by the FDA for the specific use described by the authors and are “off-label” (i.e., a use not described on the product’s label). “Off-label” devices or pharmaceuticals may be used if, in the judgment of the treating physician, such use is medically indicated to treat a patient’s condition. Information regarding the FDA clearance status of a particular device or pharmaceutical may be obtained by reading the product’s package labeling, by contacting a sales representative or legal counsel of the manufacturer of the device or pharmaceutical, or by contacting the FDA at 1-800-638-2041. 2 LOWER EXTREMITY FOCAL NEUROPATHIES Lower Extremity Focal Neuropathies Table of Contents Course Committees & Course Objectives 4 Faculty 5 Basic and Special Nerve Conduction Studies of the Lower Limbs 7 Arturo A. Leis, MD Common Peroneal Neuropathy and Foot Drop 19 S.H. Subramony, MD Mononeuropathies Affecting Tibial Nerve and its Branches 23 Vettaikorumakankav Vedanarayanan, MD, MBBS Femoral, Obturator, and Lateral Femoral Cutaneous Neuropathies 27 Mark A. Ross, MD CME Questions 33 No one involved in the planning of this CME activity had any relevant financial relationships to disclose. -
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 ..................... -
Axis Scientific 9-Part Foot with Muscles, Ligaments, Nerves & Arteries A-105857
Axis Scientific 9-Part Foot with Muscles, Ligaments, Nerves & Arteries A-105857 DORSAL VIEW LATERAL VIEW 53. Superficial Fibular (Peroneal) Nerve 71. Fibula 13. Fibularis (Peroneus) Longus Tendon 17. Anterior Talofibular Ligament 09. Fibularis (Peroneus) 72. Lateral Malleolus Tertius Tendon 21. Kager’s Fat Pad 07. Superior Extensor 15. Superior Fibular Retinaculum (Peroneal) Retinaculum 51. Deep Fibular Nerve 52. Anterior Tibial Artery 19. Calcaneal (Achilles) Tendon 16. Inferior Fibular 02. Tibialis Anterior Tendon (Peroneal) Retinaculum 42. Intermedial Dorsal 08. Inferior Extensor 73. Calcaneus Bone Cutaneous Nerve Retinaculum 43. Lateral Dorsal Cutaneous Nerve 44. Dorsalis Pedis Artery 11. Extensor Digitorum 32. Abductor Digiti Minimi Muscle Brevis Muscle 04. Extensor Hallucis Longus Tendon 48. Medial Tarsal Artery 06. Extensor Digitorum 10. Extensor Hallucis Longus Tendons Brevis Muscle 41. Medial Dorsal Cutaneous Nerve 49. Dorsal Metatarsal Artery 45. Deep Fibular (Peroneal) Nerve MEDIAL VIEW 22. Flexor Digitorum 46. Arcuate Artery Longus Muscle 68. Tibia 12. Dorsal Interossei Muscle 21. Kager’s Fat Pad 48. Medial Tarsal Artery 69. Medial Malleolus 27. Tibialis Posterior 81. Nail Tendon 18. Flexor Retinaculum 29. Abductor Hallucis Muscle 36. Flexor Muscle POSTERIOR VIEW PLANTAR VIEW 01. Tibialis Anterior Muscle 03. Extensor Hallucis 70. Interosseous Longus Muscle Membrane 23. Flexor Digitorum 05. Extensor Digitorum Longus Tendons Longus Muscle 26. Tibialis Posterior Muscle 14. Fibularis (Peroneus) 20. Soleus Muscle Brevis Muscle 24. Flexor Hallucis Longus Muscle 25. Flexor Hallucis Longus Tendon 67. Proper Plantar 66. Proper Plantar Digital Artery Digital Nerve 65. Proper Plantar Digital Nerve 80. Sesamoid Bone 31. Flexor Digitorum Brevis Tendons 19. Calcaneal (Achilles) Tendon 36. Flexor Muscle 29. -
Pathogenesis, Diagnosis, and Treatment of the Tarsal-Tunnel Syndrome
CLEVELAND CLINIC QUARTERLY Volume 37, January 1970 Copyright © 1970 by The Cleveland Clinic Foundation Printed in U.S.A. Pathogenesis, diagnosis, and treatment of the tarsal-tunnel syndrome THOMAS E. GRETTER, M.D. Department o£ Neurology ALAN H. WILDE, M.D. Department of Orthopaedic Surgery N recent years many peripheral nerve compression syndromes have been I recognized. The carpal-tunnel syndrome, or compression of the median nerve at the wrist beneath the transverse carpal ligament, is the com- monest nerve entrapment syndrome. Less familiar but no less important is the tarsal-tunnel syndrome. Since the first case reports of the tarsal-tunnel syndrome by Keck1 and by Lam,2 in 1962, this syndrome is being diag- nosed with increasing frequency. Within the last two years 17 patients with the tarsal-tunnel syndrome have been treated at the Cleveland Clinic. Our report presents a review of the pathogenesis, diagnosis, and treatment of the tarsal-tunnel syndrome. Anatomy The tarsal tunnel is a canal formed on the medial side of the foot and ankle by the medial malleolus of the tibia and the flexor retinaculum. The flexor retinaculum spans the medial malleolus of the tibia and the medial tubercle of the os calcis (Fig. 1). The space beneath the ligament is divided by septae into four compartments. Each compartment contains one of the four structures of the tarsal tunnel. These structures are the pos- terior tibial tendon, flexor digitorum longus tendon, posterior tibial nerve, artery and veins, and the flexor hallucis longus tendon. Each tendon is invested with a separate synovial sheath. -
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. -
Anatomy of Abdominal Incisions
ANATOMY FOR THE MRCS but is time-consuming. A lower midline incision is needed for an Anatomy of abdominal emergency Caesarean section (where minutes may be crucial for baby and mother). The surgeon must also be sure of the pathol- incisions ogy before performing this approach. Close the Pfannenstiel and start again with a lower midline if the ‘pelvic mass’ proves to be Harold Ellis a carcinoma of the sigmoid colon! There are more than one dozen abdominal incisions quoted in surgical textbooks, but the ones in common use today (and which the candidate must know in detail) are discussed below. The midline incision (Figures 1–4) Opening the abdomen is the essential preliminary to the per- formance of a laparotomy. A correctly performed abdominal The midline abdominal incision has many advantages because it: exposure is based on sound anatomical knowledge, hence it is a • is very quick to perform common question in the Operative Surgery section of the MRCS • is relatively easy to close examination. • is virtually bloodless (no muscles are cut or nerves divided). • affords excellent access to the abdominal cavity and retroperi- toneal structures Incisions • can be extended from the xiphoid to the pubic symphysis. Essential features If closure is performed using the mass closure technique, pros- The surgeon needs ready and direct access to the organ requir- pective randomized clinical trials have shown no difference in ing investigation and treatment, so the incision must provide the incidence of wound dehiscence or incisional hernia com- sufficient room for the procedure to be performed. The incision pared with transverse or paramedian incisions.1 should (if possible): The upper midline incision is placed exactly in the midline • be capable of easy extension (to allow for any enlargement of and extends from the tip of the xiphoid to about 1 cm above the scope of the operation) the umbilicus. -
The Effect of Cervico-Thoracic Adjustments On
THE EFFECT OF CERVICO-THORACIC ADJUSTMENTS ON THE ACTIVITY OF THE LATTISIMUS DORSI MUSCLE AND ITS TRIGGER POINTS USING ELECTROMYOGRAPHY AND ALGOMETER READINGS RESPECTIVELY. A dissertation submitted to the Faculty of Health Sciences, University of Johannesburg, in partial fulfilment of the requirements for the Master's Degree in Technology: Chiropractic. By Nico Goosen (Student number 802013714) SUPERVISOR: oS og DR. M. MOODLEY DATE (M. Tech. Chiropractic (Natal)) DECLARATION I, Nico Goosen, do hereby declare that this dissertation is my own, unaided work except where otherwise indicated in the text. It is being submitted for the Degree of Master of Technology at the University of Johannesburg, Johannesburg. It has not been submitted before for any degree or examination at any other Technikon or University. Signature of Candidate: Date: °7 i&S—/Ok Signature of Supervisor: n/■,e■I'■-c•c>U2_s--k Date: S Dr. M. Moodley M.Tech. Chiropractic (Natal) ii DEDICATION This work is dedicated to my parents, Braam and Beneta Goosen, two extraordinary people whose love and support made everything possible. I am truly blessed to be your son and love you with all my heart. And To my wife, Terina Goosen, an amazing woman whose kindness and love is an example for us all. Thank you for all your support. Thank you for all the sacrifices you have made for me to reach my goals. You are a wonderful wife and friend. iii ACKNOWLEDGEMENTS First and foremost, praise and glory to our Lord and Saviour, Jesus Christ, through whom all things are possible. To Dr. Moodley, my supervisor, for her support and constant enthusiasm throughout this study. -
And Thoracic Outlet Syndrome
• Palpatory diagnosis and manipulative management of carpal tunnel syndrome: Part 2. 'Double crush' and thoracic outlet syndrome BENJAMIN M. SUCHER, DO 1( The physician treating carpal nificant. Ultimately, palpatory assessment was tunnel syndrome needs to be aware of the instrumental in guiding the author with initial or possible concomitant occurrence of thoracic subsequent methods (or both) of effective treat outlet syndrome, the so-called double crush syn ment. Palpatory monitoring was the key to clinical drome. Palpation is used to differentiate carpal management in all cases. tunnel syndrome from thoracic outlet syn drome. Such palpatory examination assists Methods the physician in planning the initial treat Patients with CTS were assessed as previously described.? ment, including osteopathic manipulation They all underwent electrodiagnostic testing, which and self-stretching maneuvers, targeted specif included a minimum of median and ulnar distal motor ically at the most clinically significant patho and sensory conduction studies. Needle electromyograms logic region. Supplemental physical medicine and more extensive conduction studies were also per formed if not done previously, or as clinically indicated. modalities such as ultrasound may enhance They were treated according to the outlined protocols the treatment response. Some illustrative for osteopathic manipulation and self-stretching exer cases are reported. cises.B,9 Palpatory assessment routinely included axial rota (Key words: Carpal tunnel syndrome, osteo tion. When restriction was noted for this motion, treat pathic manipulation, thoracic outlet syn ment included the "opponens roll"? technique. As a drome, double crush syndrome) self-stretch maneuver, the thumb is abducted with slight extension and rotated laterally (Figure 1). The primary The initial presentation of carpal tunnel syn limitations or precautions to this new self-stretch involve advanced degenerative changes in the first carpometacarpal drome (CTS) often is a diagnostic challenge, espe joint and bilateral CTS.