China
Africa
Explore chapters and articles related to this topic
Distal Conduction Blocks
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The median nerve crosses the ulnary artery, from which it is separated by the deep head of the pronator teres muscle, at the upper part of the forearm. It descends through the forearm lying over the flexor digitorum profundus muscle, until reaching the flexor retinaculum, being accompanied by the median artery (Figures 1.31C, and 1.64). At the lower part of the forearm, it lies between the tendons of the flexor carpi radialis and the flexor digitorum sublimis muscles, behind and slightly lateral to the tendon of the palmaris longus muscle (Figure 1.67).
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
Flexor digitorum profundus muscle (Figure 11.1l) Innervation: Medial part: ulnar nerve (C8 and T1); lateral part: median nerve (C8 and T1).Function: Flexion of terminal phalanges of medial four digits after superficialis flexes third phalanges; flexion of wrist.Physical examination: The patient flexes the distal interphalangeal joint (arrow) against resistance while the middle phalanx is fixed.
Test Paper 1
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Cubital tunnel syndrome is the most common entrapment neuropathy of the elbow. It is seen in throwing sports, tennis and volleyball. Traction injuries to the ulnar nerve can occur secondary to the dynamic valgus forces. Compression of the ulnar nerve within the cubital tunnel occur secondary to direct trauma, repetitive stresses, or replacement of the overlying retinaculum with an anomalous anconeus epitrochlearis muscle. Recurrent subluxation of the nerve due to acquired laxity from repetitive stress or trauma can lead to friction neuritis. Finally, osseous spurring within the ulnar groove caused by overuse and posteromedial impingement in throwers can cause nerve irritation. Ulnar nerve thickening and increased T2-weighted signal are typical MRI features. Oedema-like signal changes or atrophy of the flexor carpi ulnaris and flexor digitorum profundus muscles may also be secondary to ulnar neuropathy.
Contralateral Transfer of the Phenomenon of Repeated Bout Rate Enhancement in Unilateral Index Finger Tapping
Published in Journal of Motor Behavior, 2020
Ernst A. Hansen, Søren Bak, Lasse Knudsen, Bo E. Seiferheld, Andrew J. T. Stevenson, Anders Emanuelsen
A better understanding of the behavior and control of human voluntary stereotyped rhythmic movements is beneficial in the work to improve performance, function, and rehabilitation of, for example exercising and injured individuals. Index finger tapping is frequently applied as a motor task for investigations of voluntary rhythmic movements in healthy individuals (Hammond & Gunasekera, 2008; Mora-Jensen, Madeleine, & Hansen, 2017; Wing & Kristofferson, 1973; Zentgraf et al., 2009) as well as in patients (Pitcher, Piek, & Barrett, 2002; Roche, Viswanathan, Clark, & Whitall, 2016; Teo, Rodrigues, Mastaglia, & Thickbroom, 2013). Index finger tapping consists of repeated alternating extension and flexion of the metacarpal phalangeal joint caused primarily by repeated alternating activation of the extensor digitorum muscle and the flexor digitorum profundus muscle.
A case of inclusion body myositis complicated by microscopic polyangiitis
Published in Scandinavian Journal of Rheumatology, 2018
S Yamada, H Yamashita, K Taira, A Hida, N Arai, J Shimizu, Y Miyaji, M Sonoo, A Yashima, Y Takahashi, H Kaneko
As the prednisolone dosage was tapered, the serum creatine kinase level began to increase, peaking at 363 U/L. In March 2016, the serum CRP level increased slightly and azathioprine was added for suspected MPA relapse; the CRP subsequently normalized. However, the serum creatine kinase level did not decrease. In May 2016, the muscle weakness was more prominent in the knee extensors than in the hip flexors and in the finger flexors than the shoulder abductors. Electromyography on the left flexor digitorum profundus muscle revealed denervation potentials and low-amplitude motor unit potentials with normal recruitment. Histopathological examination of the skeletal muscle biopsy specimen from the right tibialis anterior revealed chronic myopathic changes with scattered muscle fibres with rimmed vacuoles (Figure 1). Immunohistochemistry revealed the up-regulation of major histocompatibility complex class I (MHC-I) on the sarcolemma of all muscle fibres, deposits of p62/SQSTM1 in fibres with rimmed vacuoles, and scattered CD8-positive endomysial lymphocytes. Electron microscopy revealed cytoplasmic tubulofilamentous inclusions in fibres with rimmed vacuoles. These findings established a diagnosis of clinically defined IBM according to the 2011 European Neuromuscular Centre IBM research diagnostic criteria (1). Magnetic resonance imaging of the thigh showed muscle enhancement, especially the adductor longus and left quadriceps, corresponding to IBM. Anti-cN-1A antibody, which is positive in 33–76% of IBM patients (2, 3), was positive in a cell-based assay, but did not show typical staining. We continued glucocorticoids on a maintenance dose and administered azathioprine; these did not improve the muscle weakness.
Beetroot Increases Muscle Performance and Oxygenation During Sustained Isometric Exercise, but Does Not Alter Muscle Oxidative Efficiency and Microvascular Reactivity at Rest
Published in Journal of the American College of Nutrition, 2018
Stavros Papadopoulos, Konstantina Dipla, Areti Triantafyllou, Michalis G Nikolaidis, Antonios Kyparos, Panagiota Touplikioti, Ioannis S Vrabas, Andreas Zafeiridis
Upon arrival at the laboratory, the participants' height and body mass were measured using a conventional stadiometer and weighing scale (SECA, Hamburg, Germany). After a 15-minute seated rest, a blood sample was obtained from the antecubital vein prior to BRJ consumption. The participants then consumed the BRJnitrate or the BRJplacebo. Two and a half hours following BRJ ingestion a second blood sample was drawn. Participants were then connected to the experimental equipment for the assessment of muscle oxygenation, blood pressure, and heart rate (17,71). More specifically, the participants were first connected to the finger photoplethysmography apparatus (Finometer, Finapres Medical Systems, Amsterdam, The Netherlands). This device allows continuous, beat-to-beat tracing of systolic and diastolic blood pressure and heart rate. Measurements determined noninvasively with the Finapres device have been found in good correspondence with those obtained simultaneously using an intra-arterial catheter at rest and during exercise (26,56). The finger cuff was placed on the middle finger and the inflatable cuff was placed on the nonexercising arm at the heart's level. Next, the optodes of the NIRS device (Oxymon, Artinis, Netherlands) were placed longitudinally on the proximal third of the ulnar side over the region of the flexor digitorum profundus muscle (main muscle recruited during handgrip exercise), with an interoptode distance of 35 mm; a black bandage stabilized and covered the optodes. The site of the optodes placement was marked to ensure similar placement in second testing. Baseline values were recorded for 5 minutes and the occlusion-reperfusion maneuver was then performed. Briefly, the cuff was inflated to suprasystolic pressure (250 mm Hg) for 5 minutes to obstruct blood flow to the forearm muscles. NIRS noninvasively and continuously monitored the relative changes in O2Hb, HHb, and tHb in the microvasculature of the skeletal muscle (8), providing information for muscle oxygenation, fractional O2 extraction, and total red blood cell content (6,15,40). After 5 minutes of arterial occlusion, the cuff was rapidly deflated and reperfusion indices (O2Hb and tHb) were continuously recorded.