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Pelvic Trauma
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Pelvic trauma is always a result of high-velocity trauma. It is one of the leading causes of death among youngsters and accounts for one-third of intensive care unit (ICU) admissions. Pelvic injuries account for 3% of traumatic skeletal injuries. The injuries can range from minor closed injuries to open injuries to life-threatening shock-like conditions. The pelvic cavity contains some vital organs (urogenital structures and hindgut structures), blood vessels (both arteries and veins) and nerves. The injuries to any of these can lead to significant morbidity. The injuries in children is severe as compared to adults due to greater plasticity of the immature pelvic ring, which requires very high velocity forces to disrupt the pelvic ring. Pelvic injuries are often associated with injuries to other body parts like the thorax, abdomen, spine and head injuries.
Skeletal Muscle
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
Skeletal muscle, which together with cardiac muscle is also known as striated muscle because of its distinctive appearance under the microscope as explained later, is the largest tissue in the body, accounting in humans for more than 40% of total body weight of a lean adult. Most of the approximately 640 skeletal muscles of the human body directly attach to the bony skeleton – but not all, as in the case of some tongue and abdominal muscles which attach to other muscles. Muscle size varies widely, from the tiny stapedius muscle of the middle ear to the gluteus maximus of the buttocks, whose volume is about 1000 ml in a human adult. The primary function of skeletal muscle is in the execution of movement and the maintenance of posture. In addition, skeletal muscle can serve important communicative functions, as in making facial expressions and in speech production, as well as some important secondary functions. For example, layers of skeletal muscle in the abdominal wall and the floor of the pelvic cavity protect and support the weight of visceral organs. Muscular contraction in the form of shivering is very effective in rapidly increasing heat production in the body to combat outside cold. Although skeletal muscle is essentially under voluntary control, it can be involved in many involuntary activities, such as eye blinking, breathing, shivering, and reflex action.
Diagnostic evaluation
Published in Seema Chopra, Endometriosis, 2020
Neha Agarwal, Seema Chopra, Arshi Syal
In the majority of the cases, the endometriosis remains confined to the pelvic cavity except the few exceptions of scar and thoracic endometriosis. In the order of decreasing frequency, the primary location of endometriosis are as follows: ovaries, uterine ligaments, pouch of Douglas, and peritoneal surfaces.
Factors influencing magnetic resonance imaging finding of endopelvic fascial edema after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids
Published in International Journal of Hyperthermia, 2022
Yuhang Liu, Yang Liu, Fajin Lv, Yuqing Zhong, Zhibo Xiao, Furong Lv
Magnetic resonance imaging (MRI) is widely used for the postoperative follow-up of USgHIFU ablation because of its excellent soft tissue resolution that can assess the target and surrounding tissue. Some studies showed that the sacrococcygeal fascial edema, which is significantly associated with postoperative sacrococcygeal pain, can be observed in MRI in certain patients after USgHIFU [6]. However, the endopelvic fascia is the continuous connective tissue network that covers the structures of the pelvic cavity and contains many fascia and space other than the sacrococcygeal region, such as the parietal component (covered musculoskeletal structures such as the pelvic floor and wall), visceral component (attached to the pelvic organs, including the bladder, uterus, and rectum), and connective tissue linking these two components [7]. Injury to fascia may irritate or compress the underlying nerves causing pain or paresthesia in the corresponding area [8]. Moreover, the surrounding fasciae may also be involved in the pathophysiology of pelvic floor disorders and play an essential role in the support and suspension of the female pelvic floor structures [7,9].
Endometriotic lung cyst causing catamenial hemoptysis; a case report and review of literature
Published in Acta Chirurgica Belgica, 2022
Evelyne Verhulst, Celine Bafort, Carla Tomassetti, Albert Wolthuis, Didier Bielen, Johan Coolen, Birgit Weynand, Lieven Platteeuw, Christel Meuleman, Dirk Van Raemdonck
In a recent study by Kyama et al. [11], aberrant mRNA expression of aromatase, cytokines and adhesion factors in endometrium and peritoneum were demonstrated. This suggests that both tissues are involved in the pathogenesis of endometriosis. According to the retrograde menstruation theory, menstrual debris arrives in the pelvic cavity. There it initiates an inflammatory response that may result in the release of diverse chemo-attractants such as MCP-1 and RANTES, which recruit peripheral blood mononuclear cells into the peritoneal environment. In women with endometriosis, aberrant alterations within the peritoneal microenvironment may precede or follow disease establishment. This could be an explanation as to why subpleural endometriosis cells start to bleed in lung parenchyma resulting in hemoptysis [11].
Urinary incontinence and impaired physical function are associated with expiratory muscle weakness in patients with multiple sclerosis
Published in Disability and Rehabilitation, 2022
Sandra Aguilar-Zafra, Tamara del Corral, Noelia Montero-González, Almudena de-Gabriel-Hierro, Ibai López-de-Uralde-Villanueva
The trunk stabilising system (TSS) has been proposed as a possible cause of gait disturbance in patients with MS, given they have impairments of this system [6]. Along these lines, there is evidence showing that deterioration of the TSS is related to poorer gait function. Even in the early stages of the disease when there are no evident gait instabilities, people who have been diagnosed with MS are less stable [7]. This system is composed of the abdominal, pelvic floor and diaphragm muscles, which act in a coordinated manner to provide stability to the abdominal-lumbo-pelvic cavity by modulating intra-abdominal pressure [8–10]. Hence, the TSS could be considered a key factor for the anticipatory and compensatory postural adjustments required during static and dynamic tasks such as ambulation [11,12]. Supporting this hypothesis, in the healthy population, the link between the strength of the respiratory and trunk muscles was demonstrated by the coordinated timing of trunk muscle and respiratory muscle activation during dynamic tasks [13,14].