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Reproductive system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
From all three imaging methods, estimation can be made of: The transverse inlet diameter – the distance extending from side to side at the widest points of the pelvic brim.The bi-spinous diameter (interspinous) – the distance extending between the ischial spines.The antero-posterior inlet – the distance between the upper inner border of the symphysis pubis to the sacral promontory.The mid-plane, antero-posterior, extending from the middle of the inner border of the symphysis pubis to the middle of the third sacral segment.The antero-posterior outlet – the distance between the lower inner border of the symphysis pubis to the tip of the sacrum or, in the case of sacrococcygeal fusion, to the lower inner border of the first coccygeal segment.The oblique diameters, if required, extending from the iliopubic eminence on the one side to the brim at the sacroiliac articulation on the other side.
Abdomen
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
Psoas major - runs caudally from the sides of the T12-L5 vertebrae and intervening discs to pass into the thigh deep to the inguinal ligament and attach to the lesser trochanter of the femur. The lumbar plexus of nerves is embedded within the muscle and the major branches emerge from it (see below), with twigs from L1-L3 nerves innervating the muscle. It is a powerful flexor of the hip (p. 217) (or, if the lower limb is fixed, it can flex the trunk). The small and unimportant psoas minor (absent in 40% of individuals) arises from the sides of the T12 and L1 vertebrae and the intervening disc and has a long tendon that passes down over psoas major, attaching to the iliopubic eminence of the hip bone, and is a weak flexor of the trunk.
Lower Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The pelvis is formed by two hip bones (os coxae) connected posteriorly (dorsally) by the sacrum (which is part of the axial skeleton: See Section 6.1). Each hip bone is made up of three fused bones—the ilium, ischium, and pubis—that meet in the acetabulum. The ilium is the most superior bone, and the anterior superior iliac spine (at the anteriormost point of the iliac crest) is the bony protuberance you feel under the skin when you palpate the “hip bone.” The gluteal lines, iliac fossa, and arcuate line of ilium are muscle attachments. In the anterior midline, the pubic crestsof the left and right pubes are connected via the cartilaginous pubic symphysis. The superior pubic ramus meets the ischiopubic ramus inferiorly, surrounding the oval obturator foramen, which is covered by the obturator membrane. Other bony features of the pelvis include: iliopubic eminence, pecten pubis, pubic arch, posterior superior iliac spine, and pubic tubercle. The anterior sacroiliac ligament and posterior sacroiliac ligament reinforce the sacroiliac joint. As their names indicate, the sacrotuberous ligament and the sacrospinous ligament connect the sacrum to the ischial tuberosity and the ischial spine, respectively, and thus enclose the lesser sciatic notch and the greater sciatic notch to form the lesser sciatic foramen and the greater sciatic foramen, respectively. The latter two foramina are critical landmarks for the muscular and neurovascular structures of the pelvic region.
Comparison between pericapsular nerve group block and morphine infusion in reducing pain of proximal femur fracture in the emergency department: A randomized controlled study
Published in Egyptian Journal of Anaesthesia, 2023
Abdelrhman Alshawadfy, Ahmed M. Elewa, Mahmoud Ahmed Mewafy, Ahmed A. Ellilly
With the patient in the supine position, the ultrasound curvilinear (2.5–5 MHz) probe was placed on a transverse plane over the anterior superior iliac spine. Once the spine was identified, the transducer was aligned with the pubic ramus and rotated at approximately 45 degrees, parallel to the inguinal crease. The transducer was then slid medially along this axis until the anterior inferior iliac spine, iliopubic eminence, and the psoas tendon were identified, serving as anatomic landmarks. The head of the femur was exposed through sliding the probe distally or gently tilting caudally. After returning to the initial starting position, a standard B-Braun Stimuplex 22 G × 100 mm needle was inserted in-plane under ultrasound guidance, from lateral to medial, in the plane between the psoas tendon and the pubic ramus. All the blocks were performed in an aseptic setting with the patient observed.