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Lower Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Malynda Williams
Bersu et al. (1976) describe a male infant with Hanhart syndrome. The femora of this infant were normally developed but distal secondary ossification centers were absent. The left leg stump had a patella and a small rudiment of the proximal tibia but no fibular rudiment. The right leg stump was less developed and had a patella, smaller tibial rudiment, and no fibular rudiment. On both sides, obturator internus had normal origins. On the left side, it inserted onto the inferior aspect of the sacrotuberous ligament. On the right side, it inserted into the periosteum of the lesser sciatic notch.
Pelvis and perineum
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Ilium– iliac crest: between ant. sup. iliac spine (ASIS) and post. sup. iliac spine (PSIS)– iliac tuberosity– ant. inf. iliac spine, post. inf. iliac spine– greater sciatic notch– lesser sciatic notch– ischial spine separates greater sciatic notch from lesser sciatic notch– sciatic notches are divided into greater and lesser sciatic foramina by sacrotuberous and sacrospinous ligaments
Pelvic Exenteration: Radical Perineal Approaches and Sacrectomies
Published in P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams, Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
Peter J Lee, Michael J Solomon
Excision of the ischium can be performed as transection of the ischial spine through an abdominal approach only to give wider access to the lumbosacral trunk where it becomes the sciatic nerve as it exits the greater sciatic foramen to enter the thigh. This also exposes for the lateral resection of obturator internus and piriformis outside the pelvis with exposure of the gluteus muscle lateral to the bony pelvic margin. This procedure follows excision of internal iliac vasculature and dissection of the lumbosacral trunk free of the lateral bone of the ischial spine. This dissection is only possible after ligation of the internal pudendal vessels at the sciatic notch. Once this has been performed a large curved right angle (SEMBS modified 26 cm ligature carrier is good for this) is placed from greater to lesser sciatic notches and a Gigli saw brought back. A metal malleable spatula is placed between the Gigli saw and the nerve deep to the ischial spine prior to transaction for protection of the nerve.
The influence of musculoskeletal forces on the growth of the prenatal cortex in the ilium: a finite element study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Peter J. Watson, Michael J. Fagan, Catherine A. Dobson
On the gluteal surface the peak strains dissipate primarily in an anteriorly directed trajectory (Figure 5), however this is not consistent with the morphology of the gluteal cortex which reduces in thickness in a radial pattern from the greater sciatic notch (Cunningham and Black 2009c). The lack of strain dissipation in the superior regions could be linked to the development of a relatively thicker cortex in the gluteal surface, when compared to that of the pelvic surface (Figure 3). Cunningham and Black (2009c) suggest this is in response to the loading of the gluteal muscles. This study is unable to confirm this as the MSM predicted low activity of the gluteal muscles for the movements simulated (with the exception of the gluteus medius during abduction) (Table 1). Nevertheless, even with low activation of the gluteal muscles, the peak strains in the region of the gluteal attachments are between 100 and 1500 µε, indicating that bone remodelling is maintaining homeostasis (Martin 2000) in order to maintain the thicker cortex to resist the muscle loading. The high peak strains generated near the lesser sciatic notch on both surfaces are attributed to the low thickness of the cortex in this region (Figure 3) combined with the origin of the rectus femoris, which produces a high force during flexion and adduction (Table 1).