Gluteus Maximus Ebooks Catalog
Anatomy is gradually disappearing from the medical curriculum. This is partly because the curriculum is overcrowded and something has to go. It is also because medical education assumes that anatomy's main value is forsurgery and will be learnt later by beginning surgeons. Yet anatomy for surgery is, paradoxically, the least of the reasons for doctors to know anatomy. There is, thus, a minor surgery of general practice that requires anatomy in situations where it cannot be looked up. The knife for a sebaceous cyst in the neck easily leads to paralysis of the trapezius if anatomical knowledge has gone (or never existed). The needle at the elbow or buttock readily causes problems if the simple anatomy is absent (or has disappeared). Even the finger (touching palpation) or the eye (looking observation) mislead if what is under the skin has been forgotten (or was never known).
Poikilodermatous mycosis fungoides is characterized clinically by atrophic red-brown macules and patches with prominent telangiectasias (Fig. 2.55). Sites of predilection are the breast and buttocks. Histology reveals an atrophic epidermis with the loss of rete ridges, an interface dermatitis with a superficial band-like infiltrate of lymphocytes and a thickened papillary dermis (Fig. 2.30). Necrotic keratinocytes may be a prominent finding. Widely dilated capillaries are present within the superficial dermis. This variant of the disease has been referred to as the 'lichenoid' type of mycosis fungoides.
Caused by the molluscum contagiosum virus (MCV) which is a member of the pox virus family. The incubation period for MCV is usually 2-3 months. MCV produces flesh-coloured papules which grow over several weeks to a diameter of 3-5 mm. They are smooth, firm and dome-shaped, with a characteristic central umbilication. Occasionally they can grow to 10-15 mm (giant mollus-cum). Papules generally appear on the thighs, the buttocks, the inguinal region and occasionally the lower abdomen. They are less commonly found on the external genitalia or the perianal area.
The dorsal surface of the sacrum is convex and irregular, with ridges and grooves. In the mid-line, there is the median sacral crest, consisting of three or four tubercles (rudimentary spinous process). At the inferior pole, the sacral hiatus is due to the failure of the fusion of the laminae of the fifth sacral vertebra. Laterally, the sacral crest just lateral to the sacral grooves comprises a row of four small tubercles representing the fusion of the articular processes. It forms the medial aspect of the posterior foramina. The lateral foramina correspond to the fusion of the transverse processes and are the site of insertion of the gluteus maximus muscle. The dorsal sacral foramina transmit the small dorsal rami of the sacral spinal nerves from the sacral canal to the deep back muscle compartment. The foramina are closed by a thin membrane. Small bony projections may be formed on the medial aspects of the foramina and are associated with muscle attachment points. The posterior...
Brook and Frazier (8) studied the microbiological and clinical characteristics of 83 patients with NF. Bacterial growth was noted in 81 of 83 (98 ) specimens from the patients. Aerobic or facultative bacteria only were recovered in 8 (10 ) specimens, anaerobic bacteria only in 18 (22 ) specimens, and mixed aerobic-anaerobic flora in 55 (68 ) specimens. In total, there were 375 isolates, 105 aerobic or facultative bacteria and 270 anaerobic bacteria (4.6 isolates specimen). The recovery of certain bacteria from different anatomical locations correlated with their distribution in the normal flora adjacent to the infected site. Anaerobic bacteria outnumbered aerobic bacteria at all body sites, but the highest recovery rate of anaerobes was in the buttocks, trunk, neck, external genitalia, and inguinal areas. The predominant aerobes were S. aureus, E. coli, and GABHS. The predominant anaerobes were Peptostreptococcus spp., Prevotella spp., Porphyromonas spp., B.fragilis group, and...
Niques with the gold standard of open surgical repair. Whatever modality is used, the underlying question should address whether any treatment is needed. For example, based on the natural history and rupture risk, most surgeons will consider treatment for an aneurysm of the abdominal aorta greater than 5 cm, but this decision may be modified in a high-risk patient. Similarly, an active middle-aged person with lifestyle-limiting buttock, and thigh claudication secondary to aortoiliac occlusive disease should be approached differently from an elderly patient who is bedridden.
We have far more muscular strength than we normally use. The gluteus maximus can generate 1,200 kg of tension, and all the muscles of the body can produce a total tension of 22,000 kg (nearly 25 tons). Indeed, the muscles can generate more tension than the bones and tendons can withstand a fact that accounts for many injuries to the patellar and cal-caneal tendons. Muscular strength depends on a variety of anatomical and physiological factors
Microbiology of nonbullous impetigo in 40 children (20). Aerobic or facultative anaerobic bacteria only were present in 24 patients (60 ), strict anaerobic bacteria only in 5 patients (12.5 ), and mixed anaerobic-aerobic flora was present in 11 patients (27.5 ). Sixty-four isolates were recovered 43 aerobic or facultative and 21 anaerobic. The predominant aerobic and facultative bacteria were S. aureus (29 isolates) and GABHS (13). The predominant anaerobes were Peptostreptococcus spp. (12), pigmented Prevotella spp. (5), and Fusobacterium spp. (2). Single bacterial isolates were recovered in 17 patients (42.5 ), 13 of which were S. aureus. S. aureus alone or mixed with GABHS or Peptostreptococcus spp. were isolated from all body sites. Mixed flora of Peptostreptococcus spp. with Prevotella or Fusobacterium spp. was mostly found in infections of the head and neck, while Escherichia coli mixed with Bacteroides fragilis and Peptostreptococcus spp. were isolated from infection of the...
Infections of the subcutaneous tissues may manifest as abscesses, ulcers, and boils. Staphylococcus aureus is the most common etiologic agent of subcutaneous abscesses in healthy individuals. Many subcutaneous abscesses contain mixed bacteria. To a large degree, the organisms isolated from subcutaneous abscesses depend on the site of infection. For example, anaerobes are commonly isolated from abscesses of the perineal, inguinal, and buttock area, whereas nonperineal infections are caused by mixed facultative aerobic organisms.
Gluteus maximus ( big rump muscle) Gluteus maximus ( big rump muscle) muscles in the gluteal (GLOO-tee-al) or rump region - the gluteus (GLOO-tee-us) maximus (MACKS-ih-mus) and the gluteus minimus (MIN-ih-mus). Study suggestion Which do you think is the larger muscle, the one with a more minimum, or the one with the more maximum, size
HARS develops gradually after several months, or sometimes years, of infection with the human immunodeficiency virus (110). It has been described in patients in whom the progression from HIV infection to AIDS is delayed naturally (111), although it is more common and worse in those treated with either or both major classes of antiviral drugs, nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs). HARS has been described in both sexes and in patients of all ages, including children infected perinatally (112), and can accompany constant, increasing, or decreasing body mass, with or without changes in average energy intake. Typical sites of hypertrophy are the intra-abdominal depots, probably mostly or entirely the omentum and mesentery, the breasts, and the buffalo hump around the neck, all sites in which adipose and lymphoid tissues are in intimate contact (113). These enlargements are usually accompanied by depletion of superficial adipose tissue...
Discoloration with gangrene of the right buttock following umbilical artery catheter placement. Figure 7.43. Discoloration with gangrene of the right buttock following umbilical artery catheter placement. Figure 7.44. The same infant 10 days later showed marked improvement of the buttock. Figure 7.44. The same infant 10 days later showed marked improvement of the buttock. Figure 7.45. Gangrene of the left buttock following umbilical artery catherization. The umbilical artery catheter was positioned in the iliac artery radiographical-ly. There is a well-known association between injection of medications into the umbilical artery and necrosis and gangrene of the buttock and sciatic nerve palsy. Figure 7.46. The same infant with unilateral gangrene of the buttock also had a sciatic nerve palsy as a result of the umbilical catheter being positioned in the iliac artery. Note the foot drop. Figure 7.46. The same infant with unilateral gangrene of the buttock also had a sciatic...
Weight gain and altered body habitus Steroids and ACTH result in an increased appetite. Their use can result in tremendous weight gain, even as high as 70 pounds in a few days. There is also a redistribution of body fat that women in particular do not like. Fat is deposited over the face and upper part of the chest and neck, abdomen, and buttocks. As easy as it is to gain the weight, it is difficult to take it off. When caloric intake is managed (restricted), the deposition of fat over the upper back, abdomen, and buttocks is minimized, but not eliminated. The alteration of body image may be traumatic, particularly to women. Acne often accompanies the use of steroids and ACTH. It can be easily managed with use of low doses of tetracy-cline antibiotics.
Frequently, no distinction is made between postoperative pain, pain associated with the device, referred pain, pain related to stimulation, neuropathic pain and psychological pain. In one study, placement in the upper buttock reduced the rate of revision surgery but not pain 95 . The symptoms of pain should always be thoroughly analyzed in order to treat it. - Device complications such as pain at the implant site 22 , device rejection 143 , early pulse generator failure 147 , stimulation-dependent pain in leg or buttock 22 and current-related problems.
Transient neurologic syndrome (TNS) was first described in 1993. Common findings include pain or dysesthesias in the buttocks radiating to the dorsolateral aspect of the thighs and calves. The pain has been alternatively described as sharp and lancinating or dull, aching, cramping, or burning. Usually symptoms improve with moving about, are worse at night, and respond to nonsteroidal antiinflammatory drugs. The pain is moderate to severe in at least 70 of the patients with TNS and diminishes over time, resolving spontaneously within approximately a week in about 90 of those affected. It is extremely rare for pain to continue beyond 2 weeks. It is significant to note that no objective neurologic findings are encountered.
Having the scrotum hanging from the lower torso has its disadvantages. The legs help protect it from blows from the side, and the buttocks shield it from the back. But every man, at some time in his life, has gotten or will get a frontal blow to the groin and scrotum that causes excruciating pain. Despite the natural tendency to coil up in a fetal position, the blow usually is not as bad as it feels. The testicles are capable of moving about inside the scrotum in response to a blow. They usually bounce back with no lasting effects because the tissues within the scrotum are spongy and flexible and can absorb a great deal of shock without sustaining permanent damage.
The rate of isolation of these organisms varies in each infection entity (Table 4) (156). BLPB were present in 288 (44 ) of 648 patients with skin and soft tissue infections, 75 harbored aerobic and 36 had anaerobic BLPB. The infections in which BLPB were most frequently recovered were vulvovaginal abscesses (80 of patients), perirectal and buttock abscesses (79 ), decubitus ulcers (64 ), human bites (61 ) and abscesses of the neck (58 ). The predominant BLPB were Staphylococcus aureus (68 of patients with BLPB) and the B. fragilis group (26 ).
Sharp pain associated with scant, bright red rectal bleeding is the hallmark of anal fissure disease. The pain occurs during and after passage of stool like passing a piece of glass. Pain may radiate into the rectum or buttocks and sometimes seems out of proportion to what would be expected given the small size of the lesion. If pain is severe enough, patients may have difficulty with urinary hesitancy, retention, or frequency. Anticipation of pain with bowel movements may discour- Anal fissures are best identified by careful inspection. The buttocks should be aggressively spread with special attention to the posterior midline. Marked tenderness and sphincter spasm may limit the ability to perform a digital exam or anoscopy even with topical anesthesia, but such tenderness itself suggests a fissure, particularly in the absence of an acutely thrombosed hemorrhoid or other lesion. A fissure can be identified as a small, linear tear oriented perpendicular to the dentate line. Fissures...
The symptoms of genital herpes usually appear within a week of infection in the form of itching, tingling, and soreness of a reddish patch on the skin in the groin area, which is followed shortly by small, red, painful blisters. In men these can occur on the penis, scrotum, buttocks, anus, or thighs. The blisters break, causing circular, open sores that develop a crust in a few days. During this time, walking may be painful and urination difficult. The person may develop a fever and feel ill. Within a week to 10 days the sores will scab over and heal until the next outbreak.
The nurse should take a gentle but confident approach to the examination, examining all areas (including the outer labia majora and inner labia minora, the clitoral hood, the introitus, the pubic hair, the tops of the legs buttocks, and perianal and anal areas) carefully and checking in skin folds. A dialogue should be maintained with the woman, with care taken to examine and feed back to her on any areas that she may be concerned about.
Celiac disease is a malabsorption disorder secondary to sensitivity to gliadin, the alcohol-soluble portion of gluten found in cereal grains. An eczematous dermatitis, dermatitis herpetiformis, has been reported to occur in some patients. Dermatitis herpetiformis is a highly pruritic skin rash that is characterized by a chronic papulovescicular eruption on the extensor surfaces and buttocks. This disorder is associated with celiac disease in up to 85 of patients. Treatment for celiac disease is life-long dietary avoidance of gluten-containing foods.
Rounded by dry skin that primarily occur on the buttocks and extensor surfaces of the upper arms and thighs. Both conditions may be seen in other skin disorders and in patients with otherwise normal skin. Their causes are unknown, but both remain only as benign nuisances.
Wear and tear on the hip can result in bursitis (the most common cause of hip pain see page 305) or osteoarthritis (see page 308). Bursitis can cause pain on the outer side of the hip that worsens after lying on that side, walking, or climbing stairs. Bursitis in the area of the upper buttocks is most noticeable while walking uphill or after sitting for a long period on a hard surface.
The largest muscle of the buttock, the gluteus maximus, serves in apes primarily as an abductor of the thigh that is, it moves the leg lat- Figure 8.42 Skeletal Adaptations for Bipedalism (continued). (d) In humans, the gluteus medius and minimus help to balance the body weight over one leg when the other leg is lifted from the ground. (e) The curvature of the human spine centers the body's weight over the pelvis, so humans can stand more effortlessly than apes. (f) The foramen magnum is shifted ventrally and the face is flatter in humans thus the skull is balanced on the vertebral column and the gaze is directed forward when a person is standing. Figure 8.42 Skeletal Adaptations for Bipedalism (continued). (d) In humans, the gluteus medius and minimus help to balance the body weight over one leg when the other leg is lifted from the ground. (e) The curvature of the human spine centers the body's weight over the pelvis, so humans can stand more effortlessly than apes. (f) The foramen...
A boil is a collection of pus beneath the top layer of skin. It is caused by bacterial infection of a hair follicle, the tiny pit in the surface of the skin in which a hair grows. Boils can cluster under the skin such a cluster is known as a carbuncle. Boils may result from infection of a cut or scrape in the skin, poor hygiene, cosmetics that clog the pores, exposure to chemicals, and friction from tight clothing or shoes. Perspiration contributes to the development of boils and carbuncles and can make them worse. Boils and carbuncles usually appear on the scalp, beard area of the face, arms, legs, underarms, and buttocks.
Fig. 2.8 Mycosis fungoides, plaque stage. (a) Patches and early plaques on the buttocks. (b) Note concomitant small patches ('parapsoriasis en plaques') on the abdomen and upper legs. Fig. 2.8 Mycosis fungoides, plaque stage. (a) Patches and early plaques on the buttocks. (b) Note concomitant small patches ('parapsoriasis en plaques') on the abdomen and upper legs.
Patches of mycosis fungoides are characterized by variably large, erythematous, finely scaling lesions with a predilection for the buttocks and other sun-protected areas (Figs 2.1 & 2.2). Loss of elastic fibres and atrophy of the epidermis may confer on the lesions a typical wrinkled appearance, and terms such as 'parchment-like' or 'cigarette paper-like' have been used to describe them (Fig. 2.3). Sometimes, these single patches have a yellowish hue, conferring a 'xanthomatous'-like aspect to the lesions (xanthoerythroderma perstans) (Fig. 2.4). In early phases, a 'digitate' pattern can be observed (alone or in combination with larger patches see also Small-plaque parapsoriasis, page 22) (Fig. 2.5). Fig. 2.1 Mycosis fungoides, patch stage. Early patches on the buttocks.
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