Access to abdominal cavity - open
P Ronan O’Connell, Robert D Madoff, Stanley M Goldberg, Michael J Solomon, Norman S Williams in Operative Surgery of the Colon, Rectum and Anus Operative Surgery of the Colon, Rectum and Anus, 2015
The most superficial layer is the skin. Immediately under the skin is the subcutaneous layer, consisting mainly of fat with areas of condensation called Camper’s (superficial) and Scarpa’s (deep) fascia, respectively. The most superficial muscle is the external oblique muscle. Its aponeurosis is well defined medially, while the muscle itself lies more laterally. Its fibers run obliquely in the direction outlined by slipping a hand in a pocket. The internal oblique muscle lies immediately under the external oblique muscle, and its fibers run at 90° with those of the external oblique muscle. The transverse abdominal muscle lies deep to the internal oblique muscle. Its fibers run transversely.
The Frankfurt technique of macular translocation
A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha in Vitreoretinal Surgical Techniques, 2019
After the circular opening of the conjunctiva and exposure of the superior rectus and superior oblique muscles, an 8–10 mm tuck is made by folding over a spatula. A nasal muscle strip of the superior rectus is prepared and brought under the superior rectus and attached to the superior insertion of the lateral rectus muscle with a double 6-0 Vicryl suture. The lateral rectus muscle is exposed; the 8–10 mm inferior oblique muscle is recessed according to the Fink method. The inferior oblique muscle is exposed. A temporal muscle strip is prepared; it is crossed under the residual rectus and reattached to the inferior insertion of the medial rectus muscle with a double-armed 6-0 Vicryl suture.
Myofascial and Visceral Pain Syndromes: Visceral-Somatic Pain Representations
Robert M. Bennett in The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Pain from liver and gallbladder disease is often referred to the right shoulder. The referral pattern from diaphragmatic irritation is mediated via the phrenic nerve that provides motor and sensory innervation to the diaphragm as well as to mediastinal and pleural tissues. The phrenic nerve is derived from C3-C5, so that pain referral to the shoulder in a C4-C5 distribution is really a segmental pain referral. Trigger points and a regional MPS affecting the shoulder that looks like an impingement syndrome or frozen shoulder can occur in persons with hepatic or gallbladder disorders. In addition, a local abdominal muscle wall myofascial syndrome can occur. In one instance, a 60-year-old woman presented with shoulder pain and restricted abduction and internal rotation of the arm of several weeks duration, seemingly the result of heavy household cleaning. Treatment of TrPs points in the shoulder muscles, including the infraspinatus, the subscapularis, the latissimus dorsi, and the trapezius muscles relieved her pain. There was no abdominal or right upper quadrant [RUQ] pain or tenderness. Within two weeks she developed right abdominal wall pain following further heavy physical household cleaning, again with no RUQ tenderness or evidence of hepatic enlargement. Local treatment of abdominal oblique muscle TrPs again eliminated her pain. The shoulder and flank pain recurred within two weeks, and this time she had RUQ tenderness made worse with deep breathing and an enlarged liver. Initial investigation showed normal gallbladder and pancreatic function and appearance. She had massively enlarged congenital hepatic cysts, one of which contained 1.5 liters of fluid. Drainage of the cysts resolved her regional MPS.
Inferior oblique muscle belly transposition and myopexy for diplopia
Published in Strabismus, 2021
Pilar Merino-Sanz, Amanda Chapinal, Pilar Gómez de Liaño Sánchez, Fabio Zavarse Fadul
The purpose of this technique is to correct deviation in primary gaze position and mild or moderate upshoot in adduction. The surgical effect is greater or weaker depending on the point at which the muscle is sutured to the sclera.1 The limited literature published has demonstrated that inferior oblique muscle fixation to sclera 5 mm posterior to the temporal pole of the inferior rectus can correct small-angle hypertropia <5 pd in straight gaze and mild-to-moderate upshoot in adduction. This technique creates a new muscle insertion diminishing the contact arch of the muscle as it does for the posterior fixation of a rectus muscle or as a recession-resection, producing minimal effect in the primary position but reducing muscle function in its specific gaze. Leaving the origin and the insertion intact, a transposition will make the muscle tighter. That it still works, could be caused by a different direction of pull of the muscle and by the trauma to the muscle, caused by the myopexia and because the part of the inferior oblique muscle that courses over the globe, has been fixed to the globe in an extended position. The functional origin of the inferior oblique muscle is near the temporal border of the inferior rectus where this muscle becomes attached by its sheath to the suspensory Lockwood ligament.9–11
Effects of diagonally aligned sitting training with a tilted surface on sitting balance for low sitting performance in the early phase after stroke: a randomised controlled trial
Published in Disability and Rehabilitation, 2021
Kazuhiro Fukata, Kazu Amimoto, Masahide Inoue, Daisuke Sekine, Mamiko Inoue, Yuji Fujino, Shigeru Makita, Hidetoshi Takahashi
Masani et al. [21] investigated postural reactions of the trunk muscles of healthy subjects to multidirectional perturbations when sitting. When the trunk was inclined diagonally forward to the right side, the activity of the erector spine muscle and abdominal oblique muscles of the left side were enhanced, while only the spine muscle or only the left oblique muscle was activated when the trunk was inclined forward or to the right, respectively. Thus, the diagonal inclination task promotes the activity of both the spine and abdominal muscles on the most affected side, so it is possible that training in a diagonal direction affects the trunk muscles more than forward- or lateral-direction tasks alone. In addition, Fujino et al. [17] recently found that repetitive lateral sitting training toward the least affected side, using a platform tilted toward the most affected side, improved trunk performance. Training also influenced the head angle and body axis when moving to the least affected side while sitting compared with sitting on a horizontal plane. Thus, movement in the opposite direction to the tilted surface influence the postural orientation.
Normative orbital measurements in an Australian cohort on computed tomography
Published in Orbit, 2023
Khizar Rana, Valerie Juniat, Wen Yong, Sandy Patel, Dinesh Selva
The superior oblique muscle was measured on a coronal plane perpendicular to the muscle belly. The inferior oblique was measured on a coronal plane and a quasi-sagittal plane parallel to the orbital axis, below the centre of the inferior rectus tendon. Similarly, by using high-resolution CT orbit studies, we were able to reconstruct the quasi-sagittal plane and measure the inferior oblique muscle under the centre of the inferior rectus tendon. Previous MRI studies measuring the inferior oblique muscle have used quasi-sagittal sequences with a higher 2–3 mm slice thickness.16,17 A 2–3 mm slice thickness would make standardisation of the slice under the inferior rectus tendon less reliable. Additionally, dedicated quasi-sagittal MRI sequences are not widely available and are limited to specific indications.18
Related Knowledge Centers
- Iliac Crest
- Inguinal Canal
- Inguinal Ligament
- Latissimus Dorsi Muscle
- Serratus Anterior Muscle
- Abdomen
- Aponeurosis
- Adipose Tissue
- Linea Alba
- Aponeurosis of The Abdominal External Oblique Muscle