• Investigative Magnetic Resonance Imaging
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• v.23 no.2
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• pp.142-147
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• 2019

Piriformis syndrome caused by an accessory belly of the piriformis muscle is very rare. Only a few cases have been reported. Here, we report a case of piriformis syndrome resulting from an extremely rare type of accessory belly of the piriformis muscle originated at the proximal third portion of the main piriformis muscle and attached separately to the greater trochanter inferior to the insertion of the main piriformis muscle. A definitive diagnosis of piriformis syndrome was made based on magnetic resonance imaging and magnetic resonance neurography findings that were consistent with results of nerve conduction study and needle electromyography.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.773-775
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• 2006

Purpose: The sternalis muscle is an accessory muscle of the anterior chest wall. This is a rare anatomic variant reported in approximately 8 percent of the population, with variation among races. While several anatomic studies of the sternalis muscle exist, nothing in the literature addresses the implications of this muscle on staged breast reconstruction with implant. Methods: We encountered two consecutive patients with a left sternalis muscle who underwent immediate staged breast reconstruction with a tissue expander. We offer a strategy for dealing with this rare, but known, anatomic variant during staged implant reconstruction. Firstly, recognizing the presence of a sternalis muscle mandates the elevation of the pectoralis major muscle and the sternalis muscle in continuity. Secondly, slight modifications must be made during the submuscular dissection to create a properly placed pocket for the tissue expander. Results: While our encounters with this anatomic variant are few, our experiences with two consecutive patients illustrate that the reconstructive surgeon must be familiar with the sternalis muscle and be prepared to adapt his or her technique for tissue expander placement when faced with this accessory muscle. Conclusion: To date, no reports exist in the literature describing the operative implications of this anatomic variant. We offer our technique for dealing with this accessory muscle during staged implant reconstruction of the breast.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.133-139
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• 2019

Purpose : This study aims to investigate the rating of perceived exertion (RPE) and muscle activity of the inspiratory primary and accessory muscle during breathing exercise with different air hole diameters of the inspiratory muscle trainer (IMT). Methods : The Borg's scale and surface electromyography (EMG) was used to collect data of the RPE and muscle activity of the inspiratory primary the external intercostal (EI) and diaphragm (DIA) and accessory muscles anterior scalene (AS), sternocleidomastoid (SCM), pectoralis major (PM), and upper trapezius (UT) muscles during breathing exercise with different air hole diameters (6 mm, 4 mm, and 2 mm) of the IMT in healthy young male subjects. Results : The RPE and muscle activities of the AS, SCM, and UT are increased significantly in accordance to the decreasing diameter of air hole of air tip in IMT. However, there are no differences in the muscle activities of the PM, EI, and DIA based on differences of diameters of air hole of air tip in IMT. Conclusion : The smaller the diametr of IMT air-hole, RPE and muscle activities of AS, SCM and UT were increased. Therefore, further study would be necessary to investigate the proper intensity and relaxation posture for the exercise protocol to strengthen the inspiratory primary muscles.

• Investigative Magnetic Resonance Imaging
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• v.20 no.2
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• pp.123-126
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• 2016

The flexor digitorum accessorius longus (FDAL) is the most common accessory muscle found in the posterior compartment of the ankle area. The accessory muscle in this area such as the FDAL may be incidentally identified on magnetic resonance images (MRI). There are some case reports about the FDAL in cadaver researches. However, the MRI findings about the FDAL have been reported in a few cases. In this paper, we report a case of the FDAL incidentally identified on MRI with review of the literature about the FDAL.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.3
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• pp.119-124
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• 2016

PURPOSE: The aim of this study was to evaluate activation of accessory respiratory muscles using electromyography during chest expansion upper extremity flexion, abduction, and external rotation exercises with an elastic band in children with cerebral palsy. METHODS: The subjects were 10 children with cerebral palsy. The inclusion criterion for participation was a Gross Motor Function Classification System level of I to III. The subjects were instructed to perform upper extremity flexion, abduction, and external rotation exercises with inspiration, and extension, adduction, and internal rotation exercises with expiration while seated on a chair without a backrest. PM (Pectoralis major), SCM (sternocleidomastoid), RA (rectus abdominis), and EO (external oblique) muscle activities were measured using electromyography. RESULTS: All tested muscles showed a statistically significant increase in activity after elastic band exercise. There were significant differences in PM, SCM, RA, and EO results after chest expansion exercise using elastic band. SCM showed the largest increase in activity after use of elastic bands, at $52.37{\pm}45.88$%, followed by the RA ($50.56{\pm}79.31$), EO ($35.42{\pm}35.45$), and PM ($31.72{\pm}25.64$). The increase in the SCM was greatest, followed by increases in the RA, EO, and PM CONCLUSION: These finding suggest that activity of accessory respiratory muscles increases with use of elastic bands during chest expansion exercise in cerebral palsy.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.98-101
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• 2021

Ulnar tunnel syndrome by anomalous muscles has not been reported in Korea because it is asymptomatic in most cases. The most common anomalous muscles are the accessory abductor digiti minimi and palmaris longus. This is a case report of a patient with ulnar tunnel syndrome at the wrist by the accessory abductor digiti minimi muscle. For patients with ulnar tunnel syndrome, it is important to consider that anomalous muscles can cause ulnar tunnel syndrome.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.440-443
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• 2022

Spinal accessory nerve (SAN) palsy is typically a result of posterior triangle surgery and can present with partial or complete paralysis of the trapezius muscle and severe shoulder dysfunction. We share an atypical case of a patient who presented with SAN palsy following an injury sustained playing competitive volleyball. A 19-year-old right hand dominant competitive volleyball player presented with right shoulder weakness, dyskinesia, and pain. She injured the right shoulder during a volleyball game 2 years prior when diving routinely for a ball. On physical examination she had weakness of shoulder shrug and a pronounced shift of the scapula when abducting or forward flexing her shoulder greater than 90 degrees. Manual stabilization of the scapula eliminated this shift, so we performed scapulopexy to stabilize the inferior angle of the scapula. At 6 months postoperative, she had full active range of motion of the shoulder. SAN palsy can occur following what would seem to be a routine volleyball maneuver. This could be due to a combination of muscle hypertrophy from intensive volleyball training and stretch sustained while diving for a ball. Despite delayed presentation and complete atrophy of the trapezius, a satisfactory outcome was achieved with scapulopexy.

• Journal of Convergence for Information Technology
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• v.11 no.12
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• pp.194-200
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• 2021

Recently, incorrect and unhealthy postures have become increasingly prevalent due to reasons such as smartphone use. Consequently, imbalanced muscle contraction occurs. In particular, if the oblique muscle is contracted, the accessory nerve will be compressed, causing ischemic pain in the upper trapezius muscle. To investigate the effect on pain in the upper trapezius muscle, this study applied the ischemic compression method to the accessory nerve capture point at the 1/3-point of the oblique cervical muscle. In this study, the ischemic compression method was applied to eight women twice a week for four weeks, and pain was evaluated before, immediately after, and three weeks after application. The visual analogue scale, McGill Pain Questionnaire, and pressure dynamometer were used to evaluate subjects' pain. As a result of this study, it was confirmed that the pain was significantly reduced after treatment, and that the pain reduction was still effective three weeks after completion of the intervention, indicating that the intervention on the accessory nerve compression point on the oblique cervical muscle was both effective and long-lasting for pain reduction in the upper trapezius muscle. Future studies should increase the number of subjects to check not only pain reduction in the upper trapezius muscle, but also improvement of neck function.

• Korean Journal of Applied Biomechanics
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• v.23 no.3
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• pp.279-284
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• 2013

The purpose of this study was to determine the effect of head posture and respiratory pattern on muscle activities of sternocleidomastoid (SCM) and scalene during maximal respiration. The seventeen subjects with upper-costal breathing pattern were participated in this study. Surface electromyography was used to measure the muscles activities of SCM and scalene. The volume and velocity of inspiration were monitored by using the spirometer in each subject. Each subject was performed the 3-cycle of respiration in each condition. The mean values of three peak muscle activity in each muscle were used in the data analysis. A2 (head posture: forward head posture: FHP vs. neutral posture) X 2 (breathing pattern: costal vs. diaphragmatic) repeated-measures analysis of variance (ANOVA) was used to compare the normalized muscle activities of the SCM and scalene. The results showed that the muscle activities of SCM and scalene in diaphragmatic breathing were significantly lower than those in costal breathing for each head posture (p<.0125). The muscle activities of SCM in neutral position were lower than those in forward head position during costal breathing (p<.0125). The diaphragmatic breathing in neutral position of head is recommended to decrease the tension of the accessory inspiratory muscles during respiration in neck-pain patients with FHP.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.45-47
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• 2010

Accessory tragus is an uncommon congenital anomaly of the external ear. The tragus derives from the first branchial arch. The accessory tragus can be found along the entire course of embryonic migration. Usually it appears as a small papules arising near the tragus, but rarely, along an imaginary line drawn back from the tragus to the angle of the mouth, or along the anterior edge of the sternocleidomastoid muscle and the sternoclavicular region. We experienced a case of accessory tragi on the suprasternal region in an 9 year-old-boy.