• Title/Summary/Keyword: Extensor digitorum longus

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Sustantial Observation on Foot Taeyang Meridian Muscle in Human Lower Limb from a Anatomical Viewpoint

  • Park, Kyoung-Sik
    • Journal of Pharmacopuncture
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    • v.12 no.2
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    • pp.21-29
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    • 2009
  • Objective : This study was carried to identify the anatomical component of FTMM(Foot Taeyang Meridian Muscle) in human lower limb, and further to help the accurate application to real acupuncture. Methods : FTM at the surface of the lower limb was labelled with latex. And cadaver was stripped off to demonstrate muscles, nerves and the others and to display the internal structures of FTMM, being divided into outer, middle, and inner layer. Results : FTMM in human lower limb is composed of muscles, nerves, ligaments etc. The internal composition of the FTMM in human lower limb are as follows : 1) Muscle : Gluteus maximus. biceps femoris, semitendinosus, gastrocnemius, triceps calf, fibularis brevis tendon, superior peroneal retinacula, calcaneofibular ligament, inferior extensor retinaculum, abductor digiti minimi, sheath of flexor tendon at outer layer, biceps femoris, semimembranosus, plantaris, soleus, posterior tibialis, fibularis brevis, extensor digitorum brevis, flexor digiti minimi at middle layer, and for the last time semimembranosus, adductor magnus, plantaris, popliteus, posterior tibialis, flexor hallucis longus, dorsal calcaneocuboidal ligament at inner layer. 2) Nerve : Inferior cluneal nerve, posterior femoral cutaneous n., sural cutaneous n., proper plantar branch of lateral plantar n. at outer layer, sciatic nerve, common peroneal n., medial sural cutaneous n., tibial n. at middle layer, and for the last time tibial nerve, flexor hallucis longus branch of tibial n. at inner layer. Conclusions : This study proves comparative differences from already established studies from the viewpoint of constituent elements of FTMM in the lower limb, and also in the aspect of substantial assay method. We can guess that there are conceptional differences between terms (that is, nerves which control muscles of FTMM and those which pass near by FTMM) in human anatomy.

One-Stage Achilles Tendon Reconstruction Using the Free Composite Dorsalis Pedis Flap in Complex Wound (족배부 복합 피부-건 유리피판을 이용한 Achilles건의 일단계 재건술)

  • Kim, Sug Won;Lee, Won Jai;Seo, Dong Wan;Chung, Yoon Kyu;Tark, Kwan Chul
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.114-119
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    • 2000
  • The soft tissue defects including the Achilles tendon are complex and very difficult to reconstruct. Recently, several free composite flaps including the tendon have been used to reconstruct large defects in this area in an one-stage effort. Our case presents a patient reconstructed with free composite dorsalis pedis flap along with the extensor digitorum longus and superficial peroneal nerve for extensive defects of the Achilles tendon and surrounding soft tissue. A 36-year-old-man sustained an open injury to the Achilles tendon. He was referred to our department with gross infection of the wound and complete rupture of the tendon associated with loss of skin following reduction of distal tibial bone fracture. After extensive debridement, $6{\times}8cm$ of skin loss and 8cm of tendon defect was noted. Corresponding to the size of the defect, the composite dorsalis pedis flap was raised as a neurosensory unit including the extensor digitorum longus to provide tendon repair and sensate skin for an one-stage reconstruction. One tendon slip was sutured to the soleus musculotendinous portion, the other two were sutured to the gastrocnemius musculotendinous portion with 2-0 Prolene. The superficial peroneal nerve was then coaptated to the medial sural cutaneous nerve. The anterior tibial artery and vein were anastomosed to the posterior tibial artery and accompanying vein in an end to end fashion. After 12 months of follow-up, 5 degrees of dorsiflexion due to the checkrein deformity and 58 degrees of plantar flexion was achieved. The patient was able to walk without crutches. Twopoint discrimination and moving two-point discrimination were more than 1mm at the transferred flap site. The donor site healed uneventfully. Of the various free composite flaps for the Achilles tendon reconstruction when skin coverage is also needed, we recommand the composite dorsalis pedis flap. The advantages such as to control infection, adequate restoration of ankle contour for normal foot wear, transfer of the long tendinous portion, and protective sensation makes this flap our first choice for reconstruction of soft tissue defect including the Achilles tendon.

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The Changes of Electrolytes Composition in Skeletal Muscles by Food Restriction and Rehabilitation (식이 섭취량의 제한과 회복으로 인한 골격근육내 성분변화)

  • Lee, Jae-Hoon;Kim, Sook-He
    • Journal of Nutrition and Health
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    • v.14 no.4
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    • pp.162-174
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    • 1981
  • Fiftysix male weanling rats of the Sprague-Dawley strain weighing $52.6{\pm} 0.9g$ were fed with 77% starch-15% casein diet by ad libitum for four days to get them adapted and divided into eight groups. For three weeks, the body weight gain of rats was controlled in three different ranges. After the period of food restriction, the rats were recovered by being fed by ad libitum for seventeen days. During the experimental period, the amount of food intake and body weight were measured. And the experimental groups were compared when they reached at the same age and at the same body weight. Anterior Tibialis, Extensor Digitorum Longus, Soleus, Plantaris, Gastrocnemius were used as analytic items of skeletal muscle. Wet weight of muscle, muscle protein, water content were measured from each of five skeletal muscles. Sodium, potassium, magnesium content were measured from Anterior Tibialis, Extensor Digitorum Longus, Soleus ana Plantaris. Phosphorus was measured only from Gastrocnemius. The whole carcass protein except the skeletal muscles was also measured. During the period of food restriction, food intake was $311.7{\pm}19.5g$ for the control group. $130.2{\pm}1.5g$ for the second group and $161.7{\pm}2.1g$ for the third group. During the period of food restriction, body weight gain was $106.8{\pm}12.7g$ for the control group, $3.6{\pm}2.1g$ for the second group and $18.9{\pm}3.3g$ for the third group. Comparing the body weight when they reached at the age 66 days, the control group showed higher value than the other groups. In the concentration of electrolytes of skeletal muscles sodium and magnesium tend to increase and potassium and phosphorus tend to decrease by food restriction. But after their recovery, there was no significant difference between the groups. By the degree of food restriction, there was time difference in reaching at the same body weight. But when they reached at the same body weight, there was no significant difference in the value of electrolytes concentration. Regarding all the results of this study, the ages of rats which reached the same body weight were different by food restriction level during weanling. Once food·restricted rats reached the same body weight by recovery, the concentration of electrolytes and protein tend to become almost the same.

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Effects of Soluble Dietary Fiber on Skeletal Muscle GLUT4 Protein Contents in SHRSP Fed a High-Fat Diet (고지방식유래의 뇌졸중 유발 고혈압 흰쥐(SHRSP)에 있어서 수용성 식이 섬유의 급여가 근섬유 형태에 따른 GLUT4 발현에 미치는 영향)

  • 송영주
    • Journal of Nutrition and Health
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    • v.33 no.7
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    • pp.712-716
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    • 2000
  • The Purpose of this study is to investigate the effect of soluble dietary fiber psyllium on insulin sensitivity and skeletal muscle glucose transporter 4(GLUT4) protein expression in stroke-prone hypertensive rats(SHRSP) fed a high-fat diet containing 5% of psyllium or cellulose from five to nine weeks of age. Obtained results were as follows : (1) In the psyllium diet group fasting plasma glucose level was significantly reduced and glucose levels upon oral glucose tolerance test were significantly lower than cellulose diet group at 30 min(p<0.05) and 60 min(p<0.01) (2) Skeletal muscle GLUT4 contents were significantly increased in the soleus(slow twitch) and extensor digitorum longus(fast twitch) muscle of psyllium diet group. (3) However there was no difference in insulin levels in the fasting and oral glucose tolerance test. These results indicated that psyllium diet improves peripheral insulin sensitivity but not insulin secretion. In conclusion our present finding suggest that soluble fiber diet is effective to increase insulin sensitivity in SHRSP. From these results it was suggested that soluble dietary fiber supplementation effectively prevents insulin resistance.

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Pulsed Electromagnetic Fields to Influence Pain and Muscle Healing Following Muscle Injury in Rats

  • Koo, Hyun-Mo;Na, Sang-Su;Yong, Min-Sik
    • Journal of Magnetics
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    • v.20 no.4
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    • pp.377-380
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    • 2015
  • Muscle contusion has a negative effect on muscle function. Although several studies showed that pain control and muscle recovery is facilitated by pulsed electromagnetic fields (PEMF), there has not been much research regarding the specific effects of PEMF on them. The aim of the present study is to investigate effects of PEMF on pain and muscle recovery following extensor digitorum longus (EDL) contusion injury through measuring the expression of the c-fos proto-oncogene and nerve growth factor (NGF). Significantly reduced c-fos expression in the spinal cord was shown in PEMF groups compared with control (CON) groups. There was no significant difference between PEMF1 and CON1, but significantly increased NGF expression was shown in PEMF3 and PEMF5 compared with in CON groups, where the numbers in the group names are the days from contusion. In conclusion, PEMF could be used to not only reduce pain in muscle injuries by down-regulating c-fos expression in the spinal cord, but it could also influence muscle healing through increasing NGF expression in the injured muscle.

Tendon Transfer with a Microvascular Free Flap in Ijured Foot of Children (건 이전술 및 유리피편 이식술을 이용한 소아 외상성 족부 손상의 재건)

  • Hahn, Soo-Bong;Lee, Jin-Woo;Jeong, Jae-Hun
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.112-120
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    • 1996
  • We peformed tendon transfer with a microvascular free flap for recovery of handicapped function and reconstruction for the skin and soft tissue loss. We review the clinical data of 11 children who underwent these operation due to injured foot by pedestrian accident from January, 1986 to June, 1994. The mean age of patients was 5.6 years old(3-8). Five cases underwent tendon transfer and microvascular free flap simultaneously. Another 6 cases underwent operations separately. The time interval between tendon trasnfer and microvascular free flap was average 5.6 months(2-15 months). The duration between initial trauma and tendon transfer was average 9.6 months(2-21 months). The anterior tibial tendon was used in 6 cases. Among these, the technique of splitting the anterior tibial tendon was used in 5 cases. The posterior tibial tendon was used in 3 cases and the extenosr digitorum longus tendon of the foot in 2 cases. Insertion sites of tendon transfer were the cuboid bone in 3 cases, the 3rd cuneiform bone in 3 cases, the 2nd cuneiform bone in 1 case, the base of 4th metatarsal bone in 1 case, and the remnant of the extensor hallucis longus in 3 cases. The duration of follow-up was average 29.9 months(12-102 months). The clinical results were analysed by Srinivian criteria. Nine cases were excellent and 2 cases were good. The postoperative complications were loosening of the tranferred tendon in 2 cases, plantar flexion contracture in 1 case, mild flat foot deformity in 1 case and hypertrophic scar in 2 cases. So we recommend the tendon transfer with a microvascular free flap in the case of injured foot of children combined with nerve injury and extensive loss of skin, soft tissue and tendon.

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Study on Muscular System about Gall Bladder Channel of Foot Soyang Muscle (족소양담경근(足少陽膽經筋)에 대한 근육학적 고찰)

  • Ryu, Hyung-Sun;Kang, Jung-Soo
    • Journal of Acupuncture Research
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    • v.22 no.5
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    • pp.29-36
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    • 2005
  • Objectives : This study is performed to understand the interrelation between 'Foot soyang muscle of the Gall bladder channel' and 'muscular system' on the basis of the link between meridian muscle theory and myofascial pain syndrome. Methods : We have researched some of oriental medical books about meridian muscle theory and western medical books about anatomical muscular system. Results & Conclusion : 1. Myofascial pain syndrome is the medical treatment which finds the start point of the pain in fascia and then treats it on the basis of object and concrete anatomical theory, so its application is needed for objectification of the oriental medicine. 2. There is a wide difference between myofascial pain syndrome and meridian muscle theory in that the former explains each muscle individually, while the latter classifies muscles systematically in the view of organism. 3. Foot soyang muscle contains Dorsal interosseous m, Extensor digitorum longus m, Musculus peroneus brevis, longus and, tertius, lliotibial tract, Vastus lateralis m, Gluteus m, Aximus m, Piriformis m, Tensor fasciae latae m, Gluteus minimus m, Obliquus internus & externus abdominis m, External & Internal intercostal m, Serratus anterior m, Pectoralis major m, Sternocleidomastoid m, Auricularis posterior m, Temporalis m, Masseter m, Orbicularis oculi m etc. on the basis of function and the nature of a disease reflected in muscle. 4. Foot soyang muscle keeps the balance of left md right of the body on the outside, while the Gall bladder keeps the balance of the JangBuKiHyeul(臟腑氣血) on the inside.

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Anatomical Observation on Components Related to Foot Gworeum Meridian Muscle in Human

  • Park, Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.32 no.3
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    • pp.1-9
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    • 2011
  • Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.

Effects of Electroacupuncture and Electrical Stimulation on VEGF Expression After Muscle Crush Injury in Rats (전침 자극과 전기 자극의 적용이 근육압좌손상이 유발된 흰쥐의 골격근 내 혈관내피성장인자 발현에 미치는 영향)

  • Kim, Min-Hee;Lee, Hyun-Min;Park, Eun-Se;Nam, Ki-Won;Kim, Jin-Sang
    • Physical Therapy Korea
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    • v.13 no.2
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    • pp.9-15
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    • 2006
  • Skeletal muscle injury occurs frequently in sports medicine and is the most general form of injury followed by physical impact. There are growth factors which conduct proliferation, differentiation, and synthesis of myogenic prodromal cells and regulate vascular generation for the continued survival of myocytes. The purpose of the present study was to confirm the effects of electroacupuncture (EA) and electrical stimulation (ES) on muscle recovery processes according to vascular endothelial growth factor (VEGF) expression. Eighteen Sprague-Dawley rats were separated into 2 experimental groups and a controlled group. All animals had suffered from crush damage in the extensor digitorum longus for 30 seconds and were killed 1, 3, and 7 days after injury. 30 Hz and 1 mA impulsion for 15 minutes was applied to the EA experimental groups Zusanli (ST36) and Taichong (LR3) using electroacupuncture and the same stimulation was applied to the ES group using an electrical node. Hematoxyline-Eosin staining and VEGF immunohistochemistry were used to ascertain the resulting muscle recovery. There were few morphological differences between the EA and ES groups, and both groups were observed to have tendencies to decrease atrophy as time passed. In the controlled group, gradually diminishing atrophy could be observed, but their forms were mostly disheveled. There were few differences in VEGF expression between the EA and ES groups, and tendencies to have an increased quantity of VEGF with the lapse of time were observed in both groups. In the controlled group, a little VEGF expression could be observed merely 7 days after injury. In conclusion, EA and ES contributed to muscle recovery processes and could be used for the treatment of muscle injury.

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Classification of Muscles into Meridian Sinew: A Literature Review (근육의 경근 배속에 대한 국내 연구 고찰)

  • Mun, Sujeong;Kim, Sungha;Lee, Sanghun
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.83-96
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    • 2014
  • Objectives Although many studies explored the topic of meridian sinew in various perspectives and the term "meridian sinew" is widely used, the theory of meridian sinew is not applied for precise diagnosis and in-depth treatment in clinical practice. The aim of the study is to provide basic data classifying muscles into meridian sinew for future studies that investigate meridian sinew based on an anatomical basis. Methods Studies were identified with searches of six major Korean databases: OASIS, KoreaMed, KMBASE, KISS, NDSL and KoreanTK. Published primary studies classifying muscles into meridian sinew were included. Results A total of 20 studies met the inclusion criteria and were included in the analysis. Twelve studies conducted the classification of muscles into meridian sinew based on meridian/ acupoints distribution and six based on meridian sinew distribution, and two based on both. Muscles with fidelity level of 50 or more were 54 (85.7%) and muscles with 100 fidelity level were 7 (11.3%): occipitalis, adductor digiti minimi, frontalis, biceps femoris, rectus femoris, vatus lateralis and extensor digitorum longus. Conclusions Classification results of muscles into meridian sinew varied according to the classification criteria and interpretation of meridian sinew and acupoints distribution. To develop muscle sinew as a more useful theory in diagnosis and treatment, efforts should be made to reduce the gap between study results and build consensus on the anatomical entity of meridian sinew.