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The neurological examination
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Extensor hallucis longus muscle (Figure 11.2h) Innervation: Deep peroneal nerve (L5 and S1).Function: Dorsiflexion of the ankle joint and extension of the metatarsophalangeal joint of the big toe.Physical examination: The patient tries to extend the metatarsophalangeal joint of the big toe against resistance.
Soft-Tissue Repair for Proximal and Middle Third Problems
Published in Armstrong Milton B., Lower extremity Trauma, 2006
Kreithen Joshua, Woodberry Kerri, O Seung-Jun
The extensor hallucis longus muscle originates on the anterior aspect of the midfibula and the interosseous septum and inserts on the distal phalanx of the great toe. It extends the great toe but is expendable because of the function of the extensor digitorum brevis. Usually the flap is elevated preserving the functional tendon unit. The muscle is approximately 3 X 24 cm2 and lies deep to the tibialis anterior and the extensor digitorum longus muscle. This pure muscle flap is small and is usually used in conjunction with a tibialis anterior flap or extensor digitorum flap. A superiorly based flap will cover lower third defects. An inferiorly based flap will cover small distal tibia defects.
Roadmap for Motor Evoked Potential (MEP) Monitoring for Patients Undergoing Lumbar and Lumbosacral Spinal Fusion Procedures
Published in The Neurodiagnostic Journal, 2021
W. Bryan Wilent, Julie M. Trott, Anthony K. Sestokas
The anatomical relationship between nerve roots and muscles is not one-to-one, and most skeletal muscles are functionally innervated by a broader range of spinal nerve roots than many textbooks suggest (Schirmer et al. 2011). Therefore it is critical to record MEPs from multiple muscles representing each nerve root in order to facilitate the assessment of anatomic patterns of signal change and increase diagnostic confidence. Lieberman et al. (2019) provide examples of different patterns of MEP changes from the tibialis anterior and extensor hallucis longus muscles that correlated with postoperative dorsiflexion injuries. Take home points of the publication are that the attenuation pattern of MEPs may vary from patient to patient and that recording from multiple at-risk myotomes improves sensitivity. Chaudhary et al. provide an example of an MEP alert during a lateral lumbar fusion in which adductor and quadriceps MEP changes correlated with postoperative quadriceps weakness (Chaudhary et al. 2015). In evaluating their data, the researchers point out that the tibialis anterior and abductor hallucis MEPs were stable, and thus the pattern of change was highly consistent with isolated lumbar plexus dysfunction.
Postoperative Focal Lower Extremity Supplementary Motor Area Syndrome: Case Report and Review of the Literature
Published in The Neurodiagnostic Journal, 2021
Nicholas B. Dadario, Joanna K. Tabor, Justin Silverstein, Xiaonan R. Sun, Randy S. DAmico
For stage 2, we reversed our target muscles to have more comprehensive coverage of the right extremities versus the left extremities. However, due to the patient’s presenting condition, we added a left extensor hallucis longus muscle to target for TCMEP acquisition. Again, we obtained the most optimized TCMEPs in the left extremities from Ch. 1, this time at 224 V. The right extremities continued to be unobtainable without crossover (consistent with Stage 1). TCMEP and DCMEP muscle recordings are presented in Table 1.
Treatment of depression and borderline personality disorder with 1 Hz repetitive transcranial magnetic stimulation of the orbitofrontal cortex – A pilot study
Published in The World Journal of Biological Psychiatry, 2023
C. Reinsberg, M. Schecklmann, M. A. Abdelnaim, F. C. Weber, B. Langguth, T. Hebel
Only two patients reached the intended target intensity of 120% RMT. RMT identification as assessed by stimulation of the Extensor hallucis longus muscle was not possible in 8 patients due to complaints of intensive local discomfort or RMT higher than safety limits. In these patients, treatment intensity was titrated up to the highest tolerable intensity.