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Functional Anatomy
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The skeleton is formed from various bones that act as a scaffold, giving the body form and shape. The skeleton can be divided into two parts, the axial or central skeleton and the appendicular skeleton. The axial skeleton is found on the midline of the body and includes the cranium, spinal column, ribcage and sternum. Its primary function is to protect major organs. The appendicular skeleton includes the limbs and the pelvic and shoulder girdle, and has the primary function of enabling movement and locomotion. Between each bone is a joint that allows motion to occur.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The patient in the case vignette has osteogenesis imperfecta (OI). This is rare disorder due to a defect in type 1 collagen formation which causes brittle bones with a tendency to fracture. Typical radiographic features of the appendicular skeleton include poor bone density, bone deformity (e.g. shepherd’s crook deformity) and evidence of previous fractures. The presence of >10 wormian bones may be seen in OI. An important differential diagnosis is non-accidental injury. Subdural haematoma and optic nerve atrophy are not associated with OI. Ground glass appearance of the sphenoid wing may be seen in fibrous dysplasia. Widening of the diploe is seen in sickle cell anaemia and thalassaemia.
Osteoporosis: treatment options
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
Fluoride increases BMD by about 10% per year so that after 4 years the BMD is restored to premenopausal levels. The rigorously conducted studies by Riggs and colleagues and Kleerekoper and associates showed that this increase in BMD could not be assumed to reflect an increase in bone strength13,14. Fracture rates did not differ from controls in either study. Positive results have been reported in two other studies but the loss of bone from the appendicular skeleton and the increased rates of peripheral fractures remain concerns15,16
Static posturographic balance in neurotologic patients may be associated with middle–high-frequency hearing levels during ageing process
Published in Acta Oto-Laryngologica, 2022
Yukihide Maeda, Soshi Takao, Iku Abe-Fujisawa, Shin Kariya, Mizuo Ando
Several different hypotheses may explain how the effect of SNHL in ageing process is mediated toward impaired postural balance. One plausible hypothesis is that age-related degenerations of the cochlear and vestibular end organs share similar pathological processes [4]. For example, vestibular function (vestibulo-ocular reflex gain on video Head Impulse Test) in individuals >55 years old with presbyacusis was significantly decreased compared to that in individuals with normal hearing [9]. Another paper reported that presbyacusis in older adults was associated with an increased risk of sarcopenia (decrease in appendicular skeleton muscle), which may cause postural instability [10]. Lack of auditory cues in the environment to assist body orientation and balance may also lead to postural instability as measured by posturography [5].
Wheelchair backs that support the spinal curves: Assessing postural and functional changes
Published in The Journal of Spinal Cord Medicine, 2022
Jessica Presperin Pedersen, Cynthia Smith, Margaret Dahlin, Molly Henry, Janell Jones, Kelly McKenzie, Mitch Sevigny, Lindsey Yingling
The pelvis provides a foundation for stability and affects spinal positioning, which in turn supports the upper limbs through interaction of the axial and appendicular skeleton.3 Specific support for function is essential in cases where muscles of the trunk are denervated as in SCI.4 In comparison to healthy, able-bodied individuals, persons with SCI demonstrate decreased multi-directional stability.5 Postural changes can affect proprioception through effects on joint position. This occurs through alterations in muscle length/tension, fatigue, and pain and may be particularly relevant though the neck and shoulder girdle region.6 Postural alignment, including pelvic position, affect shoulder range of motion in persons with SCI.7 A more neutral upright trunk posture in comparison to a flexed trunk has been shown to improve upper extremity performance during both gross and fine motor functional tasks in healthy adults.3 Provision of effective pelvic and trunk support with the balance of adequate mobility is integral to an individual’s function.8
State-of-the-art, approved therapeutics for the pharmacological management of osteosarcoma
Published in Expert Opinion on Pharmacotherapy, 2021
Cristina Meazza, Sebastian Dorin Asaftei
The overall incidence of OS is 0.2–3/100,000 population a year, with a bimodal age distribution. It peaks first during adolescence (0.8–11/100,000 in 15- to 19-year-olds), then from the age of 60 years onwards [5,6]. It affects males more than females, with a ratio of 1.6:1 [6–9]. The body sites mostly involved are the long bones of the extremities, near the metaphyseal growth plates: the distal femur (45% of cases); the proximal tibia (20%); and the proximal humerus (10%) [6,10]. In patients over sixty, axial sites are more frequent and carry a worse prognosis than for appendicular skeleton OS [11]. In about 70–80% of patients localized disease is detected at baseline (presumably with micrometastases that are still subclinical or undetectable using current diagnostic methods [9,12]), while in 15–20% there is macroscopic evidence of dissemination at diagnosis (synchronous metastases) [3,5,13]. Since the mid-1970s, the treatment strategy for newly diagnosed OS has included: the ‘gold standard’ neoadjuvant chemotherapy based on three agents – doxorubicin (ADM), cisplatin (CDP), and high-dose methotrexate (HD-MTX), followed by leucovorin rescue – with or without ifosfamide (IFO) and etoposide (ETO); then surgical removal of the primary tumor, along with any clinically evident metastases; and finally systemic postoperative multidrug treatment [14–24].