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Exercise and Fascial Movement Therapy for Cancer Survivors
Published in David Lesondak, Angeli Maun Akey, Fascia, Function, and Medical Applications, 2020
A female patient was looking for exercises to help with her hip pain. She was 60 years old. While completing her comprehensive health history screen, she revealed she had been diagnosed with breast cancer 9 months before. Her treatment included having a mastectomy with a Transverse Rectus Abdominus Muscle (TRAM) flap reconstruction. Her TRAM flap surgery involved making an incision along the lower abdomen and taking an oval section of skin, fat, blood vessels, and the rectus abdominis muscle from the lower half of the belly and rerouting it to the chest to form a breast. The rectus abdominis muscle mobilizes the trunk into flexion by pulling the ribs and pelvis inward, but it also serves as a facilitator in upright posture and, along with the deeper abdominal muscles, acts as a shield and protects the viscera. The absence of this muscle could result in movement compensation.
Ventricular Assistance as a Bridge to Cardiac Transplantation
Published in Wayne E. Richenbacher, Mechanical Circulatory Support, 2020
If an implantable LVAD is employed the sternotomy is followed by creation of a preperitoneal pocket and drive line tunnel. The patient is not anticoagulated until the surgical dissection is complete to minimize the potential for postoperative bleeding. We prefer a preperitoneal pocket to intraperitoneal implantation as there is no postoperative ileus and the possibility of an intraabdominal complication is virtually eliminated. Development of the preperitoneal pocket begins in the midline (Fig. 6.5). The left rectus abdominis muscle is elevated from the posterior rectus sheath. As the dissection continues laterally the abdominis oblique and transversus abdominis muscles are elevated from the transversalis fascia. The fascia is taken down from the caudad surface of the diaphragm and a diaphragmatic tunnel created as described above. Care is taken to achieve hemostasis within the pocket. Defects in the peritoneum are identified and repaired. The drive line must pass from the pocket through the abdominal wall muscles, soft tissue and skin. A skin button is created in the appropriate location and the drive line tunnel formed. The pocket and tunnel are packed with a vancomycin hydrochloride (1 gm in 1000 ml normal saline) soaked sponge. At this point the patient is heparinized.
Plastic reconstructive procedures
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Andrea L. Pusic, Richard R. Barakat, Peter G. Cordeiro
The rectus abdominis muscle inserts in the pubic tubercle and arises from the sixth, seventh, and eighth ribs. It plays a role in protecting the abdominal contents, breathing, and defecating, and stabilizes the pelvis during walking. The gracilis muscle arises from the pubic tubercle and inserts onto the medial tibia pes anserinus. It helps to stabilize the knee and laterally rotates the thigh. Loss of these muscles is usually compensated for by the remaining muscles in their functional group so that no significant motor defect remains.
Association of gross motor function and activities of daily living with muscle mass of the trunk and lower extremity muscles, range of motion, and spasticity in children and adults with cerebral palsy
Published in Developmental Neurorehabilitation, 2023
Mitsuhiro Masaki, Honoka Isobe, Yuki Uchikawa, Mami Okamoto, Yoshie Chiyoda, Yuki Katsuhara, Kunio Mino, Kaori Aoyama, Tatsuya Nishi, Yasushi Ando
In the present study, the self-care domain of the PEDI declined with decreased rectus abdominis muscle thickness, likely because the rectus abdominis muscle contributes to trunk flexion movement and postural control of the trunk on the sagittal or coronal planes during backward or lateral reaching motions of the upper extremities. Previous studies32,33 demonstrated that the rectus abdominis muscle, which starts to be active together with the onset of the upper or lower extremity lifting motion in the standing position, contributes to the postural control of the trunk. Thus, decreased thickness of the rectus abdominis muscle, which contributes to difficulty in postural control during upper extremity lifting motion such as eating or grooming and lower extremity lifting motion such as dressing in the sitting or standing positions, is assumed to lead to reduced scores in the self-care domain of PEDI in children and adults with CP. Although a previous study demonstrated the association between declined ADL, as assessed using the self-care domain of the PEDI, and decreased thickness of the quadriceps femoris muscle in children with CP,11 our findings clarified the association between declined self-care in ADL and decreased muscle thickness of the trunk flexor muscles in children and adults with CP.
Transversus abdominis plane block versus paravertebral block for post-operative pain following open renal surgeries: A randomized clinical trial
Published in Egyptian Journal of Anaesthesia, 2022
Khaled Abdel-Baky Abdelrahman, Essam Ezzat Abdelhakeem, Abdel-Rahman Hussein Ali, Eman Ahmed Ismail
This block was done by using SonoSite M Turbo (USA) with linear multi-frequency 6–13 MHz transducer (L25x6–13 MHz linear array) scanning probe and 21 G Toughy needle which used to inject the local anesthetic agent into the TAP space. The block was done for the patients in the supine position and before performing the supposed surgery for them. The ultrasound probe was placed just below the costal margin and parallel to it. The rectus abdominis muscle appeared and the transversus abdominis muscle posterior to it. The transversus abdominis plane (TAP) appeared as hyperechoic line just posterior to the skin and the subcutaneous tissue. The needle then placed in-plane of the probe and advanced from medial to lateral until reached the TAP space. Then, 20 ml of 0.5% plain bupivacaine (Sunnypivacaine®, Sunny pharmaceuticals, Egypt) was injected in the TAP space. The muscle layers appeared separating from each other which indicated the correct injection of the local anesthetic in the TAP space. After this nerve block had been performed in every patient in this group, the patient then was turned to lateral decubitus position and the site of surgery was cleaned and sterilized with povidone iodine and the patient was draped with sterile drapes and the supposed surgery was performed [8]. Before the end of the surgery, 1 gm IV paracetamol was given for all patients. Upon completion of surgery and reversal of the muscle relaxants, patients were extubated and sent to the recovery room and later to the ward.
Comparison of 30-degree and 0-degree laparoscopes in the visualisation of the inferior epigastric vessel, rectus abdominis muscle and bladder dome in gynaecologic laparoscopy
Published in Journal of Obstetrics and Gynaecology, 2022
Satit Klangsin, Nantaka Ngaojaruwong, Hatern Tintara
In the operating room, after the primary trocar penetrated at the infra-umbilical level, CO2 was insufflated at 15 mmHg. Before the ancillary trocar penetration, video recordings were made using 0-degree (26046AA Laparoscope Hopkins II, 0-degree Telescope 5 mm × 29 cm, KARL STORZ, Tuttlingen, Germany) and 30-degree (26046BA Laparoscope Hopkins II, 30-degree Telescope 5 mm × 29 cm, KARL STORZ, Tuttlingen, Germany) laparoscopes by an expert surgeon who did not assess the recordings at a later time. For each patient, the recordings were continuously taken from the insertion at the left round ligament of the abdominal wall (5–8 cm above the pubic symphysis) (Perrone et al. 2005; Deffieux et al. 2011) to the insertion at the right side in order to obtain direct visualisation of the three landmarks: (i) the inferior epigastric vessel, (ii) the edge of the rectus abdominis muscle and (iii) the upper border of the bladder dome. After completion of the video recordings, ancillary port insertion was performed, and the patient underwent surgery as planned.