Additional plastic surgery procedures
J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan in An Atlas of Gynecologic Oncology, 2018
The harvest technique of the ALT flap has been well described (Wei et al. 2002, Yu 2004). Briefly, a line is marked between the anterior superior iliac spine (ASIS) and the superolateral patella, which approximates the intermuscular septum between the vastus lateralis and rectus femoris muscles. Since the majority of cutaneous perforators are concentrated within the midpoint of this line (Yu 2004), the ALT flap is typically tentatively centered on this point. A limited medial incision is made first, and then dissection performed from medial to lateral to identify the location of cutaneous perforators, after which the final flap skin paddle position may be shifted as necessary based on anatomy, and the remaining incisions made. If the ALT flap will be performed as a skin-only flap, then the perforator(s) to be included with the flap are dissected to the vascular pedicle. If the ALT flap will be performed as a myocutaneous flap, then the vastus lateralis is included without need for perforator dissection. The flap is usually tunneled beneath the rectus femoris and sartorius muscles to increase the reach of the flap for groin, pelvic cavity, and perineal defects (Figure 34.1A−C).
The hip
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Trendelenburg test In normal two-legged stance, the body’s centre of gravity is placed midway between the two feet acting from the centre of the second sacral vertebra. In normal single-legged stance, the centre of gravity has to shift so that it lies over the weight-bearing leg (i.e. the centre of gravity needs to be supported to stop you falling over). To allow this to occur efficiently, the pelvis is effectively pulled up (by the motor) on the unsupported side and the centre of gravity is shifted directly over the standing foot. In clinical examination this is revealed by localizing and placing a finger on each anterior superior iliac spine (ASIS). As the patient stands on one leg the finger on the ASIS of the unsupported leg will rise. This is a normal response and would be recorded as Trendelenburg negative.
Examination of Hip Joint in a Child
Nirmal Raj Gopinathan in Clinical Orthopedic Examination of a Child, 2021
The iliac crest and anterior superior iliac spine (ASIS) are visible in many children. At times it may be difficult to visualize them in obese children as they are localized beneath the abdominal fold at the waist. The examiner will be able to make out the ASIS on either side and must comment on whether they are at the same level or altered (Figure 9.3). Look for fullness or swelling, if any, in the anterior aspect. Apart from this, look for any erythema, scar (surgical or a puckered scar that has healed by secondary intention indicating suppuration), sinus, dilated veins, atrophy/spasm of nearby musculature, discoloration, etc. Asymmetry of the thigh folds can be seen in children with DDH (Figure 9.4) but is not pathognomonic of the disorder. Bilateral dislocations in syndromic disorders may be associated with widening of the perineum.
Recommended maximum holding time of common static sitting postures of office workers
Published in International Journal of Occupational Safety and Ergonomics, 2023
Somayeh Tahernejad, Mohsen Razeghi, Mohammad Abdoli-Eramaki, Hossein Parsaei, Mozhgan Seif, Alireza Choobineh
To adjust the trunk angles, the participant was first asked to maintain his/her lower back (lumbar spine) in a neutral position so that the angle between the thigh and the trunk was approximately 90°. Then, a point was marked on the iliac crest extending from the anterior superior iliac spine (ASIS) to the posterior superior iliac spine (PSIS). The proximal arm was placed along the imaginary line from the marked point, perpendicular to the chair seat. The distal arm was then rotated to the desired angles, and the participant was asked to bend so that the marked point was below the distal arm. To adjust the trunk angle in the lateral flexion position, the proximal arm was placed between the spinous process of the 12th thoracic vertebra (T12) and the beginning of the sacral curve perpendicular to the chair seat. The distal arm was then rotated to the desired angle and the subject was asked to bend so that the marked point was under the distal arm [29,30]. The examined trunk postures are shown in Figure 3.
Surgical options for meralgia paresthetica: long-term outcomes in 13 cases
Published in British Journal of Neurosurgery, 2019
Zeki Serdar Ataizi, Kemal Ertilav, Serdar Ercan
Meralgia paresthetica (MP) is an entrapment neuropathy of the lateral femoral cutaneous nerve (LFCN). It causes burning, coldness, pain, tingling, sensory loss, or local hair loss in the distribution of the lateral femoral cutaneous nerve. Meralgia paresthetica, also known as Bernhardt-Roth, was first described by Hager in 1885.1 The LFNC arises from the L2 and L3 spinal nerve roots. It travels downward lateral to the psoas muscle and then crosses the iliacus muscle. It divides into the anterior and posterior branches by entering the thigh below, through or above the inguinal ligament. Its anterior branch penetrates to the fascia lata approximately 10 cm inferior to the anterior superior iliac spine (ASIS) and carries sensation from the anterior and lateral sides of the thigh. The smaller posterior branch innervates the skin of the lateral aspect of the leg from the greater trochanter to the mid-thigh.2–5
The Effect of Predictability of the Perturbation Magnitude on Anticipatory and Compensatory Postural Adjustments during a Bimanual Load-Lifting Task
Published in Journal of Motor Behavior, 2022
Tippawan Kaewmanee, Huaqing Liang, Alexander S. Aruin
Bipolar disposable surface electrodes (Red Dot, 3 M, USA) were attached to the skin over the muscle belly of eight trunk and leg muscles bilaterally. These muscles included tibialis anterior (TA, at proximal one third from the fibula to the medial malleolus), medial gastrocnemius (MG, on the most prominent muscular bulge), rectus femoris (RF, midpoint from the anterior superior iliac spine (ASIS) to the superior part of the patella), long head of the biceps femoris (BF, midpoint from the ischial tuberosity to the lateral epicondyle of the tibia), external oblique (EO, midpoint between the 10th rib and ASIS), gluteus medius (GM, midpoint between iliac crest and the greater trochanter), rectus abdominis (RA, 3 cm lateral to the umbilicus), and lumbar erector spinae (ES, 3 cm lateral to the first lumbar vertebra) (Basmajian, 1980). The ground electrode was positioned on the right lateral malleolus. An accelerometer (Model 333B42, PCB Piezotronics, USA) was attached to the participant’s right wrist to record the initiation of the lifting movement.
Related Knowledge Centers
- Iliac Crest
- Inguinal Ligament
- Palpation
- Sartorius Muscle
- Subcostal Nerve
- Surface Anatomy
- Tensor Fasciae Latae Muscle
- Pelvis
- Ilium
- Iliac Tubercle