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Lymphatic anatomy: lymphatics of the breast and axilla
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
The pectoralis major muscle is a fan-shaped muscle with two divisions. The clavicular division originates from the clavicle and can be easily distinguished from the larger costosternal division that originates from the sternum and costal cartilage of ribs 2–6. These fibers converge on the greater tubercle of the humerus. The pectoralis minor muscle is located beneath the pectoralis major muscle and arises from the external surface of ribs 2–5. The posterior suspensory ligaments extend from the deep surface of the breast to the deep pectoral fascia. The subscapular muscle arises from the first rib near the costochondral junction and extends laterally to insert on the inferior surface of the clavicle.
Compression Neuropathy
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Jorge G Boretto, Ignacio Rellán, Franco L De Cicco
This space is less often encountered as a cause of the compression. This space is located below the coracoid process covered by the tendinous insertion of the pectoralis minor muscle. Overhead activities and arm abductions tense the pectoralis minor muscle and stretch the neurovascular bundle around the coracoid. External rotation of the scapula accelerates the compression. Also, the shoulder posture, repetitive strains, muscle imbalance and pectoralis minor contracture may contribute to TOS.
Infraclavicular Brachial Plexus Blocks
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The pectoralis minor muscle is the essential landmark. It divides the axillary artery into three parts: An upper (or first) part, which is the portion which lies between the clavicle and the upper border of the muscleA middle (or second) part, which is covered by the muscleA lower (or third) part, where it emerges from the lower border of the muscle and becomes the brachial artery
Modified Taohong Siwu decoction improves cardiac function after myocardial ischaemia and reperfusion in rats by promoting endogenous stem cell mobilization and regulating metabolites
Published in Pharmaceutical Biology, 2022
Wan-ting Meng, Zhong-Xin Xiao, Han Li, Ya-chao Wang, Yue Zhao, Yan Zhu, Hai-dong Guo
Sixty Sprague-Dawley (SD) rats (180–200 g) were purchased from the Experimental Animal Centre of Shanghai University of TCM (Shanghai, China). The rats were anaesthetized with isoflurane (Hebei Yipin Pharmaceutical, Co., Ltd., Shijiazhuang, China) at a flow rate of 0.25 L/min, and fixed on the surgical table in a supine position. After successful endotracheal intubation, the endotracheal tube was connected to a rodent ventilator (Harvard Apparatus; Holliston, MA, USA). Next, the rats were maintained under anaesthesia, and the ventilation rate was set to 120/min. A longitudinal incision was made and the pectoralis major and pectoralis minor muscle layers were separated until the ribs were exposed. To expose the heart, the thoracic cavity of the rats was opened using a chest expander in the intercostal space of the third rib. The lower edge of the left anterior descending coronary artery (LAD) was passed through a suture needle, and a latex tube was placed at the ligation site to avoid damaging the artery. After successful ligation, the outer surface of the left ventricle anterior wall became pale. The chest expander was removed, and the surgical opening was closed for 30 min of ischaemia. After the ischaemia was completed, a chest expander was placed to expose the heart again to untie the knot and remove the latex tube. The incision was closed and disinfected using iodophor. This study was approved by the Animal Ethics Committee of Shanghai University of TCM (No. PZSHUTCM190628003). We attempted to minimize the number of rats used and animal suffering during the experimental procedure.
Shoulder external rotation range of motion and pectoralis minor length in individuals with and without shoulder pain
Published in Physiotherapy Theory and Practice, 2019
Dayana P. Rosa, Rodrigo V. Santos, Vander Gava, John D. Borstad, Paula R. Camargo
The clinical examination of patients with shoulder pain usually includes range of motion (ROM) and soft-tissue length or tension measurements to identify impairments treatable by physical therapists. The pectoralis minor (PM) muscle length can be one of these measures because of the potential effect of its length on normal scapula kinematics (Borstad and Ludewig, 2005; Phadke, Camargo, and Ludewig, 2009) and on shoulder pain (Braun, Kokmeyer, and Millett, 2009; Castelein, Cagnie, Parlevliet, and Cools, 2016; Kibler and McMullen, 2003; Provencher et al., 2016; Rosa, Borstad, Pogetti, and Camargo, 2017). While the mechanisms contributing to shoulder pain need further clarification, a combination of soft-tissue and motor control alterations is proposed to explain the association between shoulder pain and altered scapula motion (Ludewig and Reynolds, 2009; Phadke, Camargo, and Ludewig, 2009). Scapular dyskinesis (Kibler and McMullen, 2003; Sanchez, Sanchez, and Tavares, 2016) and reduced subacromial space (Cholewinski et al., 2008; Michener et al., 2015; Seitz and Michener, 2011) are considered potential contributors to shoulder pain, but a consistent relationship between scapula kinematics and shoulder pain has not been empirically established (Desmeules et al., 2004; Mackenzie, Herrington, Horlsey, and Cools, 2015; Ratcliffe, Pickering, McLean, and Lewis, 2014; Timmons et al., 2012). Investigations evaluating specific biomechanical factors may help clarify the relationship between shoulder motion alterations and pain.
Trunk Control and Upper Limb Function of Walking and Non-walking Duchenne Muscular Dystrophy Individuals
Published in Developmental Neurorehabilitation, 2021
Ana Lucia Yaeko da Silva Santos, Flaviana Kelly de Lima Maciel, Francis Meire Fávero, Luis Fernando Grossklauss, Cristina dos Santos Cardoso de Sá
Based on the PUL scale, upper limb function and trunk control had a strong correlation. However, JTT showed they had a weak correlation, unlike Artilheiro et al.,32 who found a strong correlation between upper limb function, through the PUL scale, and, through JTT. We believe that is because JTT is a quantitative, timed test, it made it differentiates and have a weak correlation to SATCo and PUL, which are qualitative tests. Brogna et al.25 evidenced, through magnetic resonance imaging, that the trunk muscles are compromised, even though the proximal function of the upper limbs is scored on the PUL scale. The anterior serratus muscle plays an important role in stabilizing the scapula; the infraspinatus, subscapularis, pectoralis minor, in shoulder stabilization, and all of them together in the scapulohumeral rhythm, which allows the individual to be able to perform movements with shoulder elevation above 90 degrees.27 The anterior serratus muscle is also synergistic with the abdominal muscles in order to maintain trunk control.33,34 This joint activation with the muscles ensures balance, anticipatory postural adjustment, against the function of upper limbs such as reach or lower limbs such as gait. The biomechanical characteristics of movement control justify the qualitative correlations found in this study regarding trunk control, disease staging, and upper limb function. As the disease progresses, the trunk and upper limb muscles are compromised, which makes individuals with DMD dependent on their caregivers, because of the importance of muscle synergy for daily life activities.