Appendicular Muscles of the Pelvic Girdle and Lower Limbs

Appendicular Muscles of the Pelvic Girdle and Lower Limbs tài liệu, giáo án, bài giảng , luận văn, luận án, đồ án, bài t...

Int. J. Med. Sci. 2011, 8 http://www.medsci.org 345 IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2011; 8(4):345-350 Case Report Foramen Magnum Arachnoid Cyst Induces Compression of the Spinal Cord and Syringomyelia: Case Report and Literature Review Haiyan Huang1*, Yuanqian Li1*, Kan Xu1*, Ye Li2, Limei Qu3, Jinlu Yu1  1. Department of Neurosurgery, First Hospital of Jilin University, Changchun, 130021, P. R. China 2. Department of Radiology, First Hospital of Jilin University, Changchun, 130021, P. R. China 3. Department of Pathology, First Hospital of Jilin University, Changchun, 130021, P. R. China * Haiyan Huang, Yunqian Li and Kan Xu contributed equally to the work.  Corresponding author: Jinlu Yu, +86043188782331, E-mail: jinluyu@hotmail.com © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/ licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. Received: 2011.04.21; Accepted: 2011.05.16; Published: 2011.05.27 Abstract It is very rare that a foramen magnum arachnoid cyst induces compression of the spinal cord and syringomyelia, and currently there are few treatment experiences available. Here we reported the case of a 43-year-old male patient who admitted to the hospital due to weakness and numbness of all 4 limbs, with difficulty in urination and bowel move-ment. MRI revealed a foramen magnum arachnoid cyst with associated syringomyelia. Posterior fossa decompression and arachnoid cyst excision were performed. Decom-pression was fully undertaken during surgery; however, only the posterior wall of the arachnoid cyst was excised, because it was almost impossible to remove the whole arachnoid cyst due to toughness of the cyst and tight adhesion to the spinal cord. Three months after the surgery, MRI showed a reduction in the size of the arachnoid cyst but syrinx still remained. Despite this, the symptoms of the patient were obviously improved compared to before surgery. Thus, for the treatment of foramen magnum arachnoid cyst with compression of the spinal cord and syringomyelia, if the arachnoid cyst could not be completely excised, excision should be performed as much as possible with complete decompression of the posterior fossa, which could result in a satisfying outcome. Key words: foramen magnum; arachnoid cyst; syringomyelia. Introduction The commonest type of arachnoid cyst that causes compression of the spinal cord and develop-ment of syringomyelia is the Chiari malformation type I [1]. Other types of arachnoid cysts can occur as an occupied lesion in the posterior fossa and in Dan-dy-Walker syndrome [2-10]. Occasionally, a posterior fossa arachnoid cyst can induce compression of the spinal cord and development of syringomyelia [11,12]. Common features of these lesions are secondary cer-ebellar tonsillar herniation with syringomyelia due to mass effect, Appendicular Muscles of the Pelvic Girdle and Lower Limbs Appendicular Muscles of the Pelvic Girdle and Lower Limbs Bởi: OpenStaxCollege The appendicular muscles of the lower body position and stabilize the pelvic girdle, which serves as a foundation for the lower limbs Comparatively, there is much more movement at the pectoral girdle than at the pelvic girdle There is very little movement of the pelvic girdle because of its connection with the sacrum at the base of the axial skeleton The pelvic girdle is less range of motion because it was designed to stabilize and support the body Muscles of the Thigh What would happen if the pelvic girdle, which attaches the lower limbs to the torso, were capable of the same range of motion as the pectoral girdle? For one thing, walking would expend more energy if the heads of the femurs were not secured in the acetabula of the pelvis The body’s center of gravity is in the area of the pelvis If the center of gravity were not to remain fixed, standing up would be difficult as well Therefore, what the leg muscles lack in range of motion and versatility, they make up for in size and power, facilitating the body’s stabilization, posture, and movement Gluteal Region Muscles That Move the Femur Most muscles that insert on the femur (the thigh bone) and move it, originate on the pelvic girdle The psoas major and iliacus make up the iliopsoas group Some of the largest and most powerful muscles in the body are the gluteal muscles or gluteal group The gluteus maximus is the largest; deep to the gluteus maximus is the gluteus medius, and deep to the gluteus medius is the gluteus minimus, the smallest of the trio ([link] and [link]) 1/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs Hip and Thigh Muscles The large and powerful muscles of the hip that move the femur generally originate on the pelvic girdle and insert into the femur The muscles that move the lower leg typically originate on the femur and insert into the bones of the knee joint The anterior muscles of the femur extend the lower leg but also aid in flexing the thigh The posterior muscles of the femur flex the lower leg but also aid in extending the thigh A combination of gluteal and thigh muscles also adduct, abduct, and rotate the thigh and lower leg 2/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs Gluteal Region Muscles That Move the Femur 3/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs The tensor fascia lata is a thick, squarish muscle in the superior aspect of the lateral thigh It acts as a synergist of the gluteus medius and iliopsoas in flexing and abducting the thigh It also helps stabilize the lateral aspect of the knee by pulling on the iliotibial tract (band), making it taut Deep to the gluteus maximus, the piriformis, obturator internus, obturator externus, superior gemellus, inferior gemellus, and quadratus femoris laterally rotate the femur at the hip The adductor longus, adductor brevis, and adductor magnus can both medially and laterally rotate the thigh depending on the placement of the foot The adductor longus flexes the thigh, whereas the adductor magnus extends it The pectineus adducts and flexes the femur at the hip as well The pectineus is located in the femoral triangle, which is formed at the junction between the hip and the leg and also includes the femoral nerve, the femoral artery, the femoral vein, and the deep inguinal lymph nodes Thigh Muscles That Move the Femur, Tibia, and Fibula Deep fascia in the thigh separates it into medial, anterior, and posterior compartments (see [link] and [link]) The muscles in the medial compartment of the thigh are responsible for adducting the femur at the hip Along with the adductor longus, adductor brevis, adductor magnus, and pectineus, the strap-like gracilis adducts the thigh in addition to flexing the leg at the knee 4/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs Thigh Muscles That Move the Femur, Tibia, and Fibula The muscles of the anterior compartment of the thigh flex the thigh and extend the leg This compartment contains the quadriceps femoris group, which actually comprises four muscles that extend and stabilize the knee The rectus femoris is on the anterior aspect of the thigh, the vastus lateralis is on the lateral aspect of the thigh, the vastus medialis is on the medial aspect of the thigh, and the vastus intermedius is between the vastus lateralis and vastus medialis and deep to the rectus femoris The tendon common to 5/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs all four is the quadriceps tendon (patellar tendon), which inserts into the patella and continues below it as the patellar ligament The patellar ligament attaches to the tibial tuberosity In addition to the quadriceps femoris, the sartorius is a band-like muscle that extends from the anterior superior iliac spine to the medial side of the proximal tibia This versatile muscle flexes the leg at the knee and ... Cách phát âm động từ -ed Các động từ có quy tắc ở các thì quá khứ đơn hay động tính từ quá khứ đều kết thúc bằng âm -ed. Ví dụ: work - worked - worked Những tính từ hình thành từ động tính từ quá khứ cũng kết thúc bằng âm -ed. Ví dụ: I like painted furniture. Câu hỏi đặt ra là chúng ta sẽ phát âm âm -ed này như thế nào? Có 3 cách phát âm là /Id/ /t/ và /d/ + Pronounce /t/ after voiceless sounds: /p, k, f, s, sh, ch, gh/. * Example: - Jump ----> jumped - Cook -----> Cooked - Cough -----> Coughed - Kiss -----> kissed - Wash -----> washed - Watch -----> watched + Pronounce /e(d/ after /d/ or /t/ sounds. * Example: - Wait -----> waited - Add -----> added + Pronounce /d/ after voiced sounds: /b, g, v, đ/th/, z, soft sound g, hard sound g/j/, m, n, ng, l, r/ and all vowels sounds * Example: - Rub -----> rubbed - drag -----> dragged - Love -----> loved - Bathe ------> bathed - Use ------> Used - Massage -----> massaged - Charge -----> Charged - Name -----> named - Learn -----> Learned - Bang -----> banged - Call -----> called - Care -----> cared - Free -----> freed nobody2008vn * Lưu ý là ở đây âm cuối cùng mới là quan trọng chứ không phải là chữ cái kết thúc. Ví dụ: "fax" kết thúc bằng chữ "x" nhưng đó là âm /s/ "like" kết thúc bằng chữ "e" nhưng đó là âm /k/Ngoại lệ: 1 số từ kết thúc bằng -ed được dùng làm tính từ phát âm là /Id/: * aged * blessed * crooked * dogged * learned * naked * ragged * wicked * wretched Muscles of the Arm and Elbow Actions of the Arm at the Elbow • Flexion: bending at the elbow • Extension: straightening at the elbow • Pronation: moving the arm in a palms down position • Supination: moving the arm in a palms up position Muscles that act to Flex at the elbow • Most of these muscles are located on the anterior side of the upper arm • Biceps brachii (prime mover) • Brachialis • Brachioradialis Biceps Brachii • Origin: – Long head: supraglenoid tubercle of scapula – Short head: coracoid process of the scapula • Insertion: – Radial tuberosity (radius) • Actions: – Flexion at the elbow – Supination at the elbow – Assists in flexion at the shoulder Brachialis • Origin: – Humerus • Insertion: – Coronoid process of the ulna • Action: – Flexion at the elbow Brachioradialis • Origin: – Humerus • Insertion: – Styloid process of the radius • Actions: – Flexion at the elbow, some pronation and supination at the elbow Muscles that act to Extend at the elbow • These muscles are located on the posterior side of the upper arm • Triceps brachii (prime mover) • Anconeus: – Major function is to stabilize elbow joint and allow for maximal ROM during extension Triceps Brachii • Origin: – Long head: infraglenoid tubercle of the scapula – Medial head: humerus – Lateral head: humerus • Insertion: – Olecranon process of the ulna • Actions: – Extension at the elbow – Long head: extension and adduction of the shoulder Anconeus • Origin: – Lateral condyle of the humerus • Insertion: – Olecranon process of the ulna • Action: – Extension of the elbow Muscles that act to Pronate the arm • Pronator teres • Pronator quadratus • Brachioradialis Pronator Teres • Origin: – Medial supracondylar ridge of humerus, ulna • Insertion: – Radius • Actions: – Pronation, assists with flexion at the elbow Pronator Quadratus • Origin: – Ulna • Insertion: – Radius • Action: – Pronation at the wrist Muscles that act to supinate at the elbow • Supinator • Biceps brachii • Brachioradialis Supinator • Origin: – Lateral epicondyle of the humerus, ulna • Insertion: – Radius • Action: – Supination [...]... ulna • Actions: – Extension at the elbow – Long head: extension and adduction of the shoulder Anconeus • Origin: – Lateral condyle of the humerus • Insertion: – Olecranon process of the ulna • Action: – Extension of the elbow Muscles that act to Pronate the arm • Pronator teres • Pronator quadratus • Brachioradialis Pronator Teres • Origin: – Medial supracondylar ridge of humerus, ulna • Insertion:... Muscles that act to Extend at the elbow • These muscles are located on the posterior side of the upper arm • Triceps brachii (prime mover) • Anconeus: – Major function is to stabilize elbow joint and allow for maximal ROM during extension Triceps Brachii • Origin: – Long head: infraglenoid tubercle of the scapula – Medial head: humerus – Lateral head: humerus • Insertion: – Olecranon process of the. .. humerus, ulna • Insertion: – Radius • Actions: – Pronation, assists with flexion at the elbow Pronator Quadratus • Origin: – Ulna • Insertion: – Radius • Action: – Pronation at the wrist Muscles that act to supinate at the elbow • Supinator • Biceps brachii • Brachioradialis Supinator • Origin: – Lateral epicondyle Int. J. Med. Sci. 2011, 8 http://www.medsci.org 345 IInntteerrnnaattiioonnaall JJoouurrnnaall ooff MMeeddiiccaall SScciieenncceess 2011; 8(4):345-350 Case Report Foramen Magnum Arachnoid Cyst Induces Compression of the Spinal Cord and Syringomyelia: Case Report and Literature Review Haiyan Huang1*, Yuanqian Li1*, Kan Xu1*, Ye Li2, Limei Qu3, Jinlu Yu1  1. Department of Neurosurgery, First Hospital of Jilin University, Changchun, 130021, P. R. China 2. Department of Radiology, First Hospital of Jilin University, Changchun, 130021, P. R. China 3. Department of Pathology, First Hospital of Jilin University, Changchun, 130021, P. R. China * Haiyan Huang, Yunqian Li and Kan Xu contributed equally to the work.  Corresponding author: Jinlu Yu, +86043188782331, E-mail: jinluyu@hotmail.com © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/ licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. Received: 2011.04.21; Accepted: 2011.05.16; Published: 2011.05.27 Abstract It is very rare that a foramen magnum arachnoid cyst induces compression of the spinal cord and syringomyelia, and currently there are few treatment experiences available. Here we reported the case of a 43-year-old male patient who admitted to the hospital due to weakness and numbness of all 4 limbs, with difficulty in urination and bowel move-ment. MRI revealed a foramen magnum arachnoid cyst with associated syringomyelia. Posterior fossa decompression and arachnoid cyst excision were performed. Decom-pression was fully undertaken during surgery; however, only the posterior wall of the arachnoid cyst was excised, because it was almost impossible to remove the whole arachnoid cyst due to toughness of the cyst and tight adhesion to the spinal cord. Three months after the surgery, MRI showed a reduction in the size of the arachnoid cyst but syrinx still remained. Despite this, the symptoms of the patient were obviously improved compared to before surgery. Thus, for the treatment of foramen magnum arachnoid cyst with compression of the spinal cord and syringomyelia, if the arachnoid cyst could not be completely excised, excision should be performed as much as possible with complete decompression of the posterior fossa, which could result in a satisfying outcome. Key words: foramen magnum; arachnoid cyst; syringomyelia. Introduction The commonest type of arachnoid cyst that causes compression of the spinal cord and develop-ment of syringomyelia is the Chiari malformation type I [1]. Other types of arachnoid cysts can occur as an occupied lesion in the posterior fossa and in Dan-dy-Walker syndrome [2-10]. Occasionally, a posterior fossa arachnoid cyst can induce compression of the spinal cord and development of syringomyelia [11,12]. Common features of these lesions are secondary cer-ebellar tonsillar herniation with syringomyelia due to mass effect, Muscles of the Pectoral Girdle and Upper Limbs Muscles of the Pectoral Girdle and Upper Limbs Bởi: OpenStaxCollege Muscles of the shoulder and upper limb can be divided into four groups: muscles that stabilize and position The Pelvic Girdle and Pelvis The Pelvic Girdle and Pelvis Bởi: OpenStaxCollege The pelvic girdle (hip girdle) is formed by a single bone, the hip bone or coxal bone (coxal = “hip”), which serves as the attachment point for each lower limb Each hip bone, in turn, is firmly joined to the axial skeleton via its attachment to the sacrum of the vertebral column The right and left hip bones also converge anteriorly to attach to each other The bony pelvis is the entire structure formed by the two hip bones, the sacrum, and, attached inferiorly to the sacrum, the coccyx ([link]) Unlike the bones of the pectoral girdle, which are highly mobile to enhance the range of upper limb movements, the bones of the pelvis are strongly united to each other to form a largely immobile, weight-bearing structure This is important for stability because it enables the weight of the body to be easily transferred laterally from the vertebral column, through the pelvic girdle and hip joints, and into either lower limb whenever the other limb is not bearing weight Thus, the immobility of the pelvis provides a strong foundation for the upper body as it rests on top of the mobile lower limbs Pelvis 1/11 The Pelvic Girdle and Pelvis The pelvic girdle is formed by a single hip bone The hip bone attaches the lower limb to the axial skeleton through its articulation with the sacrum The right and left hip bones, plus the sacrum and the coccyx, together form the pelvis Hip Bone The hip bone, or coxal bone, forms the pelvic girdle portion of the pelvis The paired hip bones are the large, curved bones that form the lateral and anterior aspects of the pelvis Each adult hip bone is formed by three separate bones that fuse together during the late teenage years These bony components are the ilium, ischium, and pubis ([link]) These names are retained and used to define the three regions of the adult hip bone The Hip Bone The adult hip bone consists of three regions The ilium forms the large, fan-shaped superior portion, the ischium forms the posteroinferior portion, and the pubis forms the anteromedial portion The ilium is the fan-like, superior region that forms the largest part of the hip bone It is firmly united to the sacrum at the largely immobile sacroiliac joint (see [link]) The ischium forms the posteroinferior region of each hip bone It supports the body when sitting The pubis forms the anterior portion of the hip bone The pubis curves medially, where it joins to the pubis of the opposite hip bone at a specialized joint called the pubic symphysis 2/11 The Pelvic Girdle and Pelvis Ilium When you place your hands on your waist, you can feel the arching, superior margin of the ilium along your waistline (see [link]) This curved, superior margin of the ilium is the iliac crest The rounded, anterior termination of the iliac crest is the anterior superior iliac spine This important bony landmark can be felt at your anterolateral hip Inferior to the anterior superior iliac spine is a rounded protuberance called the anterior inferior iliac spine Both of these iliac spines serve as attachment points for muscles of ... foot 6/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs Muscles That Move the Feet and Toes 7/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs The muscles in the anterior... lower leg 2/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs Gluteal Region Muscles That Move the Femur 3/12 Appendicular Muscles of the Pelvic Girdle and Lower Limbs The tensor fascia.. .Appendicular Muscles of the Pelvic Girdle and Lower Limbs Hip and Thigh Muscles The large and powerful muscles of the hip that move the femur generally originate on the pelvic girdle and