scholarly journals Novel body positioning maximizes femoral venous size in adults: An ultrasonographic evaluation

2018 ◽  
Vol 25 (6) ◽  
pp. 338-342
Author(s):  
Hong Joon Ahn ◽  
Jun Wan Lee ◽  
Seung Woo Yoo ◽  
Jee Hyun Kim ◽  
Kun Dong Kim ◽  
...  

Introduction: Increased femoral vein size may lead to a higher first pass success rate during central venous cannulation. The aim of this study was to evaluate the effects of body position on femoral vein anatomy for cannulation. Methods: This prospective study examined the femoral vein of healthy volunteers by ultrasound scanner. The changes in cross-sectional area and diameter of the femoral vein were evaluated. Right-sided measurements were taken at four different leg positions: neutral, frog leg, back-up, and back-up/frog leg position. Results: A total of 50 subjects were enrolled in the study. The mean femoral vein cross-sectional area were 0.57 ± 0.29 cm2, 0.90 ± 0.26 cm2, 1.05 ± 0.33 cm2, and 1.47 ± 0.34 cm2, and the mean femoral vein diameter were 0.75 ± 0.20 cm, 1.05 ± 0.28 cm, 1.25 ± 0.21 cm, and 1.46 ± 0.25 cm in order of neutral, back-up, frog leg, and back-up/frog leg position (p < 0.001). Conclusion: Performing the right femoral vein catheterization in back-up and frog leg position is associated with a greater cross-sectional area of the femoral vein.

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0182623
Author(s):  
Dorota Czyzewska ◽  
Andrzej Ustymowicz ◽  
Radoslaw Kowalewski ◽  
Anna Zurada ◽  
Jaroslaw Krejza

2019 ◽  
Vol 08 (03) ◽  
pp. 106-111
Author(s):  
Monika Lalit ◽  
Anupama Mahajan ◽  
Sanjay Piplani ◽  
Jagdev S. Kullar

Abstract Background and Aims Arcuate foramina (AF), the atlas bridges formed by a delicate bony spicule over the posterior arch of atlas, have been implicated in the compression of the vertebral artery during extreme rotation of head and neck movements. Reduction in the size of arcuate foramina as compared with foramen transversarium (FT) is also an important cause for the compression of vertebral artery. Aim of the present study was to determine the morphometric differences between complete AF and ipsilateral foramina transversaria. Materials and Methods Eighty dry adult human atlas vertebrae were obtained in the Department of Anatomy, Government Medical College and Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. Measurements were taken of the maximum dimensions of AF and ipsilateral FT and cross-sectional area was also calculated. Results The following results were obtained.The AF were seen in total 11 (13.75%) vertebrae, 3 (3.75%) on the right side, 6 (7.5%) on left side, and 2 (2.5%) bilateral.• The mean ventrodorsal (AFL) and superoinferior (AFH) diameter of AF was 8.79 mm and 5.98 mm, and 8.11 mm and 5.54 mm on the right and left sides, respectively, and the difference was found to be highly significant.• The mean ventrodorsal (FTL) and mediolateral (FTW) diameter of the FT 8.19 mm and 6.56 mm, and 7.31 mm and 6.86 mm on the right and left sides, respectively, with significant difference on the right side.• The mean cross-sectional area of AF was 41.32 mm2 and 35.38 mm2, and FT was 42.53 mm2 and 39.71 mm2 on the right and left sides, respectively, and AF has smaller area than ipsilateral FT. Conclusions Knowledge about the dimensions and cross-sectional area of the AF and ipsilateral foramina transversaria of the atlas vertebra can improve the success rate of surgeries, thus preventing damage to the adjoining vital structures.


protocols.io ◽  
2017 ◽  
Author(s):  
Dorota Czyzewska ◽  
Andrzej Ustymowicz ◽  
Radoslaw Kowalewski ◽  
Anna Zurada ◽  
Jaroslaw Krejza

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gernot Seppel ◽  
Andreas Voss ◽  
Daniel J. H. Henderson ◽  
Simone Waldt ◽  
Bernhard Haller ◽  
...  

Abstract Background While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon. Methods Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Calculation of the ratio between the upper half of the cross sectional area (CSA) and the total CSA was performed. Eleven MRI scans of patients with subscapularis atrophy following isolated subscapularis tendon tears were analysed and cross sectional area ratio (upper half /total) determined. To guarantee reliable measurement of the CSA and its ratio, bony landmarks were also defined. All parameters were statistically compared for inter-rater reliability, reproducibility and capacity to quantify subscapularis atrophy. Results The mean age in the control group was 49.7 years (± 15.0). The mean cross sectional area (CSA) was 2367.0 mm2 (± 741.4) for the complete subscapularis muscle and 1048.2 mm2 (± 313.3) for the upper half, giving a mean ratio of 0.446 (± 0.046). In the subscapularis repair group the mean age was 56.7 years (± 9.3). With a mean cross sectional area of 1554.7 mm2 (± 419.9) for the complete and of 422.9 mm2 (± 173.6) for the upper half of the subscapularis muscle, giving a mean CSA ratio of 0.269 (± 0.065) which was seen to be significantly lower than that of the control group (p < 0.05). Conclusion Analysis of typical atrophy patterns of the subscapularis muscle demonstrates that the CSA ratio represents a reliable and reproducible assessment tool in quantifying subscapularis atrophy. We propose the classification of subscapularis atrophy as Stage I (mild atrophy) in case of reduction of the cross sectional area ratio < 0.4, Stage II (moderate atrophy) in case of < 0.35 and Stage III (severe atrophy) if < 0.3.


2016 ◽  
Vol 52 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Ran S Sopher ◽  
Andrew A Amis ◽  
D Ceri Davies ◽  
Jonathan RT Jeffers

Data about a muscle’s fibre pennation angle and physiological cross-sectional area are used in musculoskeletal modelling to estimate muscle forces, which are used to calculate joint contact forces. For the leg, muscle architecture data are derived from studies that measured pennation angle at the muscle surface, but not deep within it. Musculoskeletal models developed to estimate joint contact loads have usually been based on the mean values of pennation angle and physiological cross-sectional area. Therefore, the first aim of this study was to investigate differences between superficial and deep pennation angles within each muscle acting over the ankle and predict how differences may influence muscle forces calculated in musculoskeletal modelling. The second aim was to investigate how inter-subject variability in physiological cross-sectional area and pennation angle affects calculated ankle contact forces. Eight cadaveric legs were dissected to excise the muscles acting over the ankle. The mean surface and deep pennation angles, fibre length and physiological cross-sectional area were measured. Cluster analysis was applied to group the muscles according to their architectural characteristics. A previously validated OpenSim model was used to estimate ankle muscle forces and contact loads using architecture data from all eight limbs. The mean surface pennation angle for soleus was significantly greater (54%) than the mean deep pennation angle. Cluster analysis revealed three groups of muscles with similar architecture and function: deep plantarflexors and peroneals, superficial plantarflexors and dorsiflexors. Peak ankle contact force was predicted to occur before toe-off, with magnitude greater than five times bodyweight. Inter-specimen variability in contact force was smallest at peak force. These findings will help improve the development of experimental and computational musculoskeletal models by providing data to estimate force based on both surface and deep pennation angles. Inter-subject variability in muscle architecture affected ankle muscle and contact loads only slightly. The link between muscle architecture and function contributes to the understanding of the relationship between muscle structure and function.


2004 ◽  
Vol 96 (2) ◽  
pp. 463-468 ◽  
Author(s):  
Eric Laffon ◽  
Christophe Vallet ◽  
Virginie Bernard ◽  
Michel Montaudon ◽  
Dominique Ducassou ◽  
...  

The present method enables the noninvasive assessment of mean pulmonary arterial pressure from magnetic resonance phase mapping by computing both physical and biophysical parameters. The physical parameters include the mean blood flow velocity over the cross-sectional area of the main pulmonary artery (MPA) at the systolic peak and the maximal systolic MPA cross-sectional area value, whereas the biophysical parameters are related to each patient, such as height, weight, and heart rate. These parameters have been measured in a series of 31 patients undergoing right-side heart catheterization, and the computed mean pulmonary arterial pressure value (PpaComp) has been compared with the mean pressure value obtained from catheterization (PpaCat) in each patient. A significant correlation was found that did not differ from the identity line PpaComp = PpaCat ( r = 0.92). The mean and maximal absolute differences between PpaComp and PpaCat were 5.4 and 11.9 mmHg, respectively. The method was also applied to compute the MPA systolic and diastolic pressures in the same patient series. We conclude that this computed method, which combines physical (whoever the patient) and biophysical parameters (related to each patient), improves the accuracy of MRI to noninvasively estimate pulmonary arterial pressures.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Qianru Li ◽  
Qi Zhang ◽  
Yehua Cai ◽  
Yinghui Hua

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p<0.001; H20: 0.31±0.10 vs 0.40±0.10, p=0.001; H50: 0.45±0.10 vs 0.53±0.08, p<0.001; Hratio: 1.01±0.25 vs 1.20±0.23, p=0.003). The THK and cross-sectional area of tendons in the study group were larger than those in the control group (p<0.05). Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.


2021 ◽  
Vol 20 (1) ◽  
pp. 50-54
Author(s):  
Thyago Guirelle Silva ◽  
Rodrigo Augusto do Amaral ◽  
Raphael Rezende Pratali ◽  
Luiz Pimenta

ABSTRACT Objective: To verify the effectiveness of indirect decompression after lateral access fusion in patients with high pelvic incidence. Methods: A retrospective, non-comparative, non-randomized analysis of 22 patients with high pelvic incidence who underwent lateral access fusion, 11 of whom were male and 11 female, with a mean age of 63 years (52-74), was conducted. Magnetic resonance exams were performed within one year after surgery. The cross-sectional area of the thecal sac, anterior and posterior disc heights, and bilateral foramen heights, measured pre- and postoperatively in axial and sagittal magnetic resonance images, were analyzed. The sagittal alignment parameters were measured using simple radiographs. The clinical results were evaluated using the ODI and VAS (back and lower limbs) questionnaires. Results: In all cases, the technique was performed successfully without neural complications. The mean cross-sectional area increased from 126.5 mm preoperatively to 174.3 mm postoperatively. The mean anterior disc height increased from 9.4 mm preoperatively to 12.8 mm postoperatively, while the posterior disc height increased from 6.3 mm preoperatively to 8.1 mm postoperatively. The mean height of the right foramen increased from 157.3 mm in the preoperative period to 171.2 mm in the postoperative period and that of the left foramen increased from 139.3 mm in the preoperative to 158.9 mm in the postoperative. Conclusions: This technique is capable of correcting misalignment in spinal deformity, achieving fusion and promoting the decompression of neural elements. Level of evidence III; Retrospective study.


1971 ◽  
Vol 15 (03) ◽  
pp. 231-245 ◽  
Author(s):  
C. M. Lee ◽  
J. N. Newman

A neutrally buoyant slender body of arbitrary sectional form, submerged beneath a free surface, is free to respond to an incident plane progressive wave system. The fluid is assumed inviscid, incompressible, homogeneous and infinitely deep. The first-order oscillatory motion of the body and the second-order time-average vertical force and pitching moment acting on the body are obtained in terms of Kochin's function. By use of slender-body theory for a deeply submerged body, the final expressions for the mean force and the moment are shown to depend on the longitudinal distribution of sectional area and added mass and on the amplitude and the frequency of the ambient surface waves. The magnitude of the mean force for various simple geometric cylinders is compared with that of a circular cylinder of equal cross-sectional area. The mean force on a nonaxisymmetric body is often approximated by replacing the section with circular profiles of equivalent cross-sectional area. A better scheme of approximation is presented, based on a simple way of estimating the two-dimensional added mass. It is expected that the effect of the cross-sectional geometry on mean vertical force and moment will be more significant when the body is very close to the free surface.


2018 ◽  
Vol 35 (2) ◽  
pp. 105-111
Author(s):  
Akram Asbeutah ◽  
Mohsen Dashti ◽  
Abdullah AlMajran ◽  
Aref Ghayyath

The objective was to evaluate the distribution of the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve (MN) in asymptomatic academic dentists using ultrasonography (US). Fifty academic dentists underwent US of the MN in transverse section at the pisiform bone level and the CSA (mm2) and FR were measured bilaterally. A CSA of <10 mm2 was considered normal. Paired t-test showed no statistical significance between either hand for CSA and FR ( P> .05). Two independent t-tests showed significant statistical differences ( P= .023) between males and females in the right dominant hand for CSA. Linear correlation analysis showed no significant correlation between CSA and FR for number of years of experience or number of working hours per day in either hand ( P>.05). The CSA was abnormal in the right dominant hand in 20 (40%) of the subjects. These male academic dentists were at increased risk of having an enlarged MN without symptoms.


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