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Assessment – Nutrition-Focused Physical Exam to Detect Macronutrient Deficiencies
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
The gastrocnemius is the major muscle at the back of the lower legs and is responsible for plantar flexion of the foot and the ankle. Again, with the patient’s leg propped up, inspect the muscles in the calf area for thinning or bulking of the gastrocnemius muscles. Ask the patient to flex their toes to engage the muscles and palpate by grasping the calf region. Thin to minimally defined muscles may indicate muscle loss. See Figures 6.17–6.22.
Examination of Foot and Ankle in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Mandeep Singh Dhillon, Pratik M. Rathod
When the foot is in supination, the articulations of the midfoot are biomechanically locked, and the foot becomes a rigid structure; this is reversed in pronation and greater mobility is allowed at the Chopart’s joints. It is important to rule out hypermobile flatfoot associated with a short Achilles tendon. This condition, which is often familial, is evidenced by contracture of the gastrocnemius in association with the same clinical features as described previously. In the non-weight-bearing position, the normal arch is generally present. Contracture of the Achilles tendon is best assessed with the knee in extension and the talonavicular joint locked in inversion so that dorsiflexion is measured only at the ankle. These patients may also show evidence of hypermobility at the midtarsal joints, which allows the heel to touch the floor despite a contracted Achilles tendon.22
Tissue coverage for exposed vascular reconstructions (grafts)
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Kaitlyn Rountree, Vikram Reddy, Sachinder Singh Hans
The rotational gastrocnemius flap is a suitable source of viable tissue coverage of below-knee vascular bypasses, and is considered well within the capability of a vascular surgeon. More extensive or re-do flaps may necessitate the expertise and assistance of a plastic surgeon. As the most superficial muscle in the posterior compartment of the lower leg, the bellies of the gastrocnemius are readily identifiable and usually lie within the existing surgical field or wound. The medial head of the gastrocnemius is the traditional work horse of anterior knee and proximal tibial coverage; it is longer than its lateral counterpart and can be harvested without risk to the superficial peroneal nerve. The gastrocnemius can be harvested to suit the needs of the surgeon, with either the medial or lateral heads independently or together.
Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes syndrome: a case report
Published in Ultrastructural Pathology, 2023
Yong-Xin Ru, Li Ying, Shu-Xu Dong, Hui-Ming Yi, Liu Jing, Zhang Yongqiang
The patient was a 31-year-old male. He had complained of muscle weakness since childhood and his limbs (both upper and lower extremity) showed a significant loss of volume, making him appear emaciated. From the age of 20, he had a stroke-like episode once or twice a year, initiated by fatigue and complicated with headache, blurred vision, mental retardation, impaired movement of limbs and vomiting. These symptoms usually lasted more than one hour but the longest was 10 hours. He was hospitalized several times and the symptoms were often relieved by sedative and antispasmodic treatment. On July 1st, 2006, he experienced a similar stroke-like episode following a period of fatigue; there was progression to urinary incontinence, lethargy, and unconsciousness resulting in a fall. Following this, he was subjected to brain MRI and computed tomography, and a biopsy was taken from the gastrocnemius muscle.
A standalone computing system to classify human foot movements using machine learning techniques for ankle-foot prosthesis control
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Agonist and antagonist kinds of muscles exist in human joints such as the hip, knee, and ankle. In addition, several muscles usually activate such a human joint. The skeletal muscles can be divided into mono-articular and bi-articular. A movement can be generated in only one joint for mono-articular muscles, whereas movement can be created in two adjacent joints for bi-articular muscles (Zagrodny et al. 2018). For example, dorsiflexion/plantarflexion motion of the human ankle joint is mainly actuated by the gastrocnemius, soleus, and tibialis anterior muscles. Here, the only gastrocnemius is the bi-articular muscle, and it works on both the ankle and knee joints. The below-knee muscle activities have been investigated during daily ankle-foot movements such as dorsiflexion, plantarflexion, inversion, eversion, medial rotation, and lateral rotation to control the power-ankle-foot prosthesis based on the muscle's electromyographic (EMG) signals.
EMG median frequency shifts without change in muscle oxygenation following novel locomotor training in individuals with incomplete spinal cord injury
Published in Disability and Rehabilitation, 2022
Donal Murray, Randall E. Keyser, Lisa M. K. Chin, Thomas C. Bulea, Clinton J. Wutzke, Andrew A. Guccione
The current OLT program did not appear to influence the interaction between HHb/Mb and the EMG variables. One possible explanation is that the OLT program was not designed to focus solely on improving gross muscle activation or muscle oxygenation. The core principle of the OLT program was to create a training framework whereby the many systems involved in walking are integrated into the program [14]. Thereby, the 12-week OLT program used may have concealed specific changes to muscle activation as the overall OLT program integrated many physiological systems. A program specific to aerobic training, such as treadmill walking, may have yielded a more targeted adaptation. Finally, a muscle biopsy could have given a clearer sense of the specific fiber type associated with the gastrocnemius. Future studies should aim to utilize both EMG and muscle biopsy in the identification of specific patterns fiber type recruitment following OLT.