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Spinal Cord and Reflexes
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
The largest and longest peripheral nerve, that is, a nerve outside the central nervous system, is the sciatic nerve. In humans, it is a flat thick band, about 2 cm wide, formed by the grouping of spinal nerves L4 to S3. It originates in the lower back, runs through the buttock and thigh, and divides, usually at the back of the knee joint, into the tibial nerve and the common fibular (or peroneal) nerve. The sciatic nerve directly controls the muscles of the posterior thigh and the hamstring portion of the adductor magnus muscle. Its branches control the muscles of the leg and foot. These branches also convey signals from the skin of the lateral leg and the foot.
Single Best Answer Questions
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Which nerve supplies the adductor magnus muscle?Obturator nerveSaphenous nerveFemoral nerveTibial nerveSural nerve
Gracilis flap
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Before entering the gracilis muscle, the vascular pedicle gives off small branches to the adductor longus muscle (Figure 26.3). These branches have to be ligated to get access to the full pedicle length. During this procedure it is helpful to pull up the adductor longus muscle with two small retractors placed proximally and distally to the vascular pedicle. Fine scissors and forceps are necessary to accomplish blunt release of the tiny branches from the adductor longus muscle surface. After elevation of the branches, haemostat clips are used for ligation. Electrocautery of the small vessels is not recommended in order to avoid thermal damage to the main pedicle. After separation of the branches, the adductor longus muscle can be pulled fully upwards giving way to the dissection along the pedicle to the profunda femoris vessels (Figure 26.5). There may as well be branches that run off into the underlying adductor magnus muscle. They have to be identified and ligated by carefully elevating the vascular pedicle from the muscle surface before the pedicle is separated from the profunda femoris vessels. During ligation of the pedicle, care must be taken not to compromise blood flow in the profunda fem- oris vessels. Therefore, a minimum distance of 5 mm from the junction between the pedicle and the profunda femoris artery and vein should be observed when the pedicle is cut. After completion of the dissection of the adductor artery and vein, a pedicle length of approximately 6 cm should be available. The diameter of the vessels can be expected to be between 2 and 2.5 mm on average.
Profunda femoris artery perforator flaps: a detailed anatomical study
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Hupkens et al. investigated proximal, middle, and distal part of the posterior thigh region anatomically using 12 fresh cadavers. Of the perforators, 69.1 and 30.9% consisted of the musculocutaneous and septocutaneous varieties, respectively. The primary origin of perforators was PFA 61.7%. Of the perforators, 52% were located in the middle third of the PTR. The PFA perforators were the longest with an average length of 13.7 ± 4.69 cm. The largest diameter of perforators was seen in the PFA (2.9 ± 0.98 mm). Musculocutaneous perforators consisted of 38.4% adductor magnus muscle, 23.0% gracilis muscle, and 23.07% biceps femoris muscle. However, this study included only perforators with a minimum diameter of 1 mm [2].
The evolution of breast reconstructions with free flaps: a historical overview
Published in Acta Chirurgica Belgica, 2023
Filip E. F. Thiessen, Nicolas Vermeersch, Thierry Tondu, Veronique Verhoeven, Lawek Bersenji, Yves Sinove, Guy Hubens, Gunther Steenackers, Wiebren A. A. Tjalma
The use of the posterior thigh as donor site for autologous breast reconstruction was introduced in 2012 by Allen et al. They were the first to use the profunda artery perforator (PAP) flap for breast reconstruction. This flap is the perforator version of the posterior thigh myocutaneous flap used to reconstruct pressure sores. It is based on a perforator of the deep femoral vessels (profunda femoris artery and vein) coursing through the adductor magnus muscle. Advantages compared to the TUG/TMG flap are a longer pedicle, sparing the muscles and orienting the skin island away from the lymph nodes in the femoral triangle. Disadvantages are related to the transverse orientation of the flap [70].
Comparison of hip extensor muscle activity including the adductor magnus during three prone hip extension exercises
Published in Physiotherapy Theory and Practice, 2019
Han-i Ko, Seung-yeon Jeon, Si-hyun Kim, Kyue-nam Park
The adductor magnus muscle (Amag) is another primary hip extensors, along with the Gmax and hamstring muscles, for the following reasons. First, the Amag has an extensor portion, originating on the ischium and ischial tuberosity, as well as an adductor portion, originating at the inferior ramus of the pubis (Takizawa et al., 2014). Second, muscle fibers of Amag are closely related to the origin of semimembranosus and the fiber orientation of Amag is similar with hamstrings (Philippon et al., 2014). Third, the posterior head of the Amag muscle has the greatest moment arm for hip extension relative to other hip muscles (Neumann, 2010).