scholarly journals Paracostal Eventration of a Pregnant Uterus in a Bitch

2020 ◽  
Vol 48 ◽  
Author(s):  
Nadyne Lorrayne Farias Cardoso Rocha ◽  
Mônica Vicky Bahr Arias
Keyword(s):  
Physical Examination ◽  
Fetal Death ◽  
Abdominal Muscle ◽  
Uterine Horn ◽  
Thoracic Wall ◽  
Gravid Uterus ◽  
Abdominal Muscles ◽  
Pregnant Uterus ◽  
Subcutaneous Space ◽  
External Oblique

Background: Traumatic abdominal hernias result from trauma which causes muscular and fascia rupture, with dislocation of viscera into the subcutaneous space without perforation of the skin. Paracostal eventration, occurs due to avulsion of the abdominal external oblique and abdominal transverse muscles from their insertion point at the ribs, resulting in dislocation of the abdominal viscera into the subcutaneous region, lateral to the abdominal wall; however, there are few reports in the literature describing this type of lesion in dogs, especially when the herniated content is a gravid uterus. The purpose of this paper is to report a case of traumatic paracostal hernia of a pregnant uterus in a dog.Case: A 2-year-old pregnant bitch weighing 8.9 kg was presented with a sudden increase in abdominal volume lateral to the left thoracic wall which, according to the owner, started after the dog was hit by a car. On physical examination, the dog had a greenish vaginal secretion and the increased volume on the left paracostal region mentioned above. Laboratory exams showed normocytic normochromic anemia, slight leukocytosis without a shift, and a discreet increase in creatinine, urea, and alanine aminotransferase. Abdominal radiographs showed a lack of continuity of the left abdominal muscle wall, with passage of the uterine horn into the subcutaneous space lateral to the rib cage. After stabilization of the patient with fluid therapy and analgesia, the bitch was anesthetized with propofol intravenously, and maintained with isoflurane diluted in oxygen. Cephazolin was administered intravenously 30 min prior to the surgery as prophylactic antibiotic therapy. An exploratory celiotomy was then performed, where a defect in the internal and external oblique abdominal muscles and transverse abdominal muscle was observed at their point of origin and insertion at the thirteenth rib. The left uterine artery and vein were also observed to be compromised, with several areas of hemorrhage noted on the left uterine horn. Surgical repair of the muscle defect was performed, anchoring the affected muscles to the rib. Ovariohysterectomy was performed after fetal death was confirmed. Patient recovery was uneventful after the procedure.Discussion: Paracostal eventration is the rarest type of herniation in small animals, and the fact that the uterus was dislocated in this case makes it even more atypical. A complete physical examination with special attention to the abdominal contour is extremely important in patients that have suffered trauma. The most characteristic sign of paracostal eventration is the change in abdominal and thoracic wall contours, as observed in the present report. Exploratory surgery is recommended as quickly as possible and as soon as the patient is stable enough to be anesthetized since this is an acute eventration with a risk of incarceration of the affected organs. In the present case, because it was a pregnant uterus, there was the risk of organ rupture or toxemia due to fetal death, which could bring more complications to the patient; these risks justify a ovariohysterectomy. The transverse abdominal and external and internal oblique abdominal muscles were anchored onto the last rib, as described in the literature. In conclusion, diagnosis of a paracostal eventration was possible from the medical history, physical exam, imaging studies, as well as exploratory celiotomy to evaluate the extent of the muscular defect and visceral damage and also to allow surgical correction. Suture of the abdominal musculature with anchorage to the thirteenth rib was an effective treatment.

Triangularis sterni muscle use in supine humans

1987 ◽  
Vol 62 (3) ◽  
pp. 919-925 ◽  
Author(s):  
A. De Troyer ◽  
V. Ninane ◽  
J. J. Gilmartin ◽  
C. Lemerre ◽  
M. Estenne
Keyword(s):  
Normal Subjects ◽  
Abdominal Muscle ◽  
Abdominal Muscles ◽  
Neural Activation ◽  
Trained Subjects ◽  
Rib Cage ◽  
Residual Capacity ◽  
External Oblique ◽  
Head Flexion ◽  
Static Head

The electrical activity of the triangularis sterni (transversus thoracis) muscle was studied in supine humans during resting breathing and a variety of respiratory and nonrespiratory maneuvers known to bring the abdominal muscles into action. Twelve normal subjects, of whom seven were uninformed and untrained, were investigated. The electromyogram of the triangularis sterni was recorded using a concentric needle electrode, and it was compared with the electromyograms of the abdominal (external oblique and rectus abdominis) muscles. The triangularis sterni was usually silent during resting breathing. In contrast, the muscle was invariably activated during expiration from functional residual capacity, expulsive maneuvers, “belly-in” isovolume maneuvers, static head flexion and trunk rotation, and spontaneous events such as speech, coughing, and laughter. When three trained subjects expired voluntarily with considerable recruitment of the triangularis sterni and no abdominal muscle activity, rib cage volume decreased and abdominal volume increased. These results indicate that unlike in the dog, spontaneous quiet expiration in supine humans is essentially a passive process; the human triangularis sterni, however, is a primary muscle of expiration; and its neural activation is largely coupled with that of the abdominals. The triangularis sterni probably contributes to the deflation of the rib cage during active expiration.

scholarly journals Subcutaneous herniation of fetuses after blunt force trauma in a cat

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692094657
Author(s):  
Alexandra G Collins-Webb ◽  
Ashley L Hanna ◽  
Lea R Mehrkens ◽  
Daniel J VanderHart
Keyword(s):  
Abdominal Wall ◽  
Soft Tissues ◽  
Motor Vehicle ◽  
Uterine Horn ◽  
Thoracic Wall ◽  
Whole Body ◽  
Gravid Uterus ◽  
Blunt Force ◽  
Blunt Force Trauma ◽  
The Right

Case summary A stray female domestic shorthair cat was presented to the emergency service after being hit by a car. The patient was recumbent and vocalizing, with a small wound over the right lateral thorax, and two palpably firm swellings in the right cervical and thoracic soft tissues. The patient was sedated and humanely euthanized to prevent further pain and suffering. Post-mortem whole-body radiographs and subsequent necropsy revealed abdominal wall rupture with herniation of two near-term fetuses within the subcutaneous tissues along the right ventrolateral thoracic wall and neck. Within the abdomen, the right uterine horn was ruptured and a third extra-luminal fetus was identified. The left uterine horn remained intact, containing a fourth fetus. Relevance and novel information Rupture of the abdominal wall or diaphragm are well-known potential complications of blunt force trauma, such as motor vehicle accidents. While traumatic uterine rupture and diaphragmatic herniation of the gravid uterus have both been reported in the veterinary literature, abdominal wall rupture with subcutaneous fetal herniation is highly uncommon.

Changes in the neural drive to abdominal expiratory muscles in hemorrhagic hypotension

1994 ◽  
Vol 266 (6) ◽  
pp. H2423-H2429 ◽  
Author(s):  
R. F. Fregosi
Keyword(s):  
Pulmonary Ventilation ◽  
Respiratory Rhythm ◽  
Abdominal Muscle ◽  
Rectus Abdominis ◽  
Abdominal Muscles ◽  
Neural Drive ◽  
Hemorrhagic Hypotension ◽  
Severe Hypotension ◽  
Expiratory Muscles ◽  
External Oblique

The purpose of this study was to test the hypothesis that hemorrhage-induced hypotension increases the neural drive to the abdominal expiratory muscles in chloralose-urethan-anesthetized cats that are studied under conditions of constant arterial PCO2 (PaCO2) and hyperoxia. A secondary aim was to describe in detail the concomitant changes in inspired pulmonary ventilation (VI) and the pattern of breathing under these conditions. The rectified and integrated electromyogram (EMG) of the external oblique and rectus abdominis muscles and VI were recorded in moderate and severe hemorrhagic hypotension, leading to reductions in mean blood pressure of approximately 30 and 60%, respectively. The PaCO2 was prevented from falling, and the arterial PO2 was maintained at a hyperoxic level (> 200 mmHg) by adding CO2 and O2 to the inspired gas mixture. VI increased by 2.5- and 5-fold in moderate and severe hypotension (P < 0.05). The changes in VI were mediated exclusively by changes in tidal volume, indicating that the reflex did not alter the activity of respiratory rhythm-generating structures. The EMG of external oblique muscles averaged 2, 44, and 100% in control conditions and in moderate and severe hypotension, respectively; corresponding values in rectus abdominis muscles were 10, 28, and 100% (P < 0.05 for both muscles). Bilateral cervical vagotomy caused a one- to three-fold decrease in the ventilatory response to hemorrhage and abolished the increase in abdominal muscle EMG activities. In conclusion, hemorrhagic hypotension reflexly increases pulmonary ventilation and the neural drive to the abdominal muscles. The reflex is vagally mediated, but the location of the receptors was not identified.

Posture effects on timing of abdominal muscle activity during stimulated ventilation

1999 ◽  
Vol 86 (6) ◽  
pp. 1994-2000 ◽  
Author(s):  
Tadashi Abe ◽  
Takumi Yamada ◽  
Tomoyuki Tomita ◽  
Paul A. Easton
Keyword(s):  
Muscle Activity ◽  
Muscle Activation ◽  
Moving Average ◽  
Abdominal Muscle ◽  
Transversus Abdominis ◽  
Emg Activity ◽  
Abdominal Muscles ◽  
External Oblique ◽  
End Tidal ◽  
Internal Oblique

In humans during stimulated ventilation, substantial abdominal muscle activity extends into the following inspiration as postexpiratory expiratory activity (PEEA) and commences again during late inspiration as preexpiratory expiratory activity (PREA). We hypothesized that the timing of PEEA and PREA would be changed systematically by posture. Fine-wire electrodes were inserted into the rectus abdominis, external oblique, internal oblique, and transversus abdominis in nine awake subjects. Airflow, end-tidal CO2, and moving average electromyogram (EMG) signals were recorded during resting and CO2-stimulated ventilation in both supine and standing postures. Phasic expiratory EMG activity (tidal EMG) of the four abdominal muscles at any level of CO2 stimulation was greater while standing. Abdominal muscle activities during inspiration, PEEA, and PREA, were observed with CO2stimulation, both supine and standing. Change in posture had a significant effect on intrabreath timing of expiratory muscle activation at any level of CO2stimulation. The transversus abdominis showed a significant increase in PEEA and a significant decrease in PREA while subjects were standing; similar changes were seen in the internal oblique. We conclude that changes in posture are associated with significant changes in phasic expiratory activity of the four abdominal muscles, with systematic changes in the timing of abdominal muscle activity during early and late inspiration.

The effects of abdominal hollowing and bracing on abdominal muscle thicknesses and pelvic rotation during active straight leg raise

2021 ◽  
pp. 1-6
Author(s):  
Eun-Joo Jung ◽  
Jin-Wook Sung ◽  
In-Joon Uh ◽  
Jae-Seop Oh
Keyword(s):  
Rotation Angle ◽  
Muscle Thickness ◽  
Abdominal Muscle ◽  
Abdominal Muscles ◽  
Pelvic Rotation ◽  
Maximum Benefit ◽  
Correct Execution ◽  
External Oblique ◽  
Straight Leg Raise ◽  
Internal Oblique

BACKGROUND: Active straight leg-raise (ASLR) is often performed to strengthen abdominal muscles. The correct execution and maximum benefit of the ASLR can be achieved using abdominal hollowing (AH) and abdominal bracing (AB) exercises. OBJECTIVE: To compare the effects of AH and AB on transverse abdominis (TrA), internal oblique, and external oblique thicknesses, as well as on the pelvic rotation angle, in healthy women during active ASLR. METHODS: The participants in this study were assigned randomly to either the AH (n= 15) or AB groups (n= 15). During ASLR, abdominal muscle thickness was measured using ultrasound and pelvic rotation was measured using a Smart KEMA device. Each trial was repeated three times for 5 s each. RESULTS: The thickness of the TrA was significantly greater during ASLR with AH than during ASLR with AB (p< 0.001). In contrast, there was no respective significant change in the thickness of the external oblique (p> 0.0.311) or internal oblique (p> 0.818). Pelvic rotation angle was significantly reduced during ASLR with AB, compared with ASLR with AH (p< 0.018). CONCLUSIONS: We recommend that AH be performed for the selective contraction of TrA during ASLR, and that AB be performed for the prevention of the pelvic rotation during ASLR. Therefore, AH and AB should be separately done in stabilization exercises.

Mechanical response to hyperinflation of the two abdominal muscle layers

1989 ◽  
Vol 66 (5) ◽  
pp. 2189-2195 ◽  
Author(s):  
A. M. Leevers ◽  
J. D. Road
Keyword(s):  
Functional Residual Capacity ◽  
Muscle Length ◽  
Abdominal Muscle ◽  
Transversus Abdominis ◽  
Abdominal Muscles ◽  
Lung Inflation ◽  
Residual Capacity ◽  
Length Changes ◽  
External Oblique ◽  
Internal Oblique

Abdominal muscle length changes and activity were directly examined in vivo with the use of the techniques of sonomicrometry and electromyography, respectively, in nine supine anesthetized dogs. Expiratory threshold loading was utilized to stimulate recruitment of the abdominal muscles, and lung inflations produced the passive relationships. The internal layer, consisting of the internal oblique and transversus abdominis, shortened more in expiration than the external layer, consisting of the external oblique and rectus abdominis. The internal oblique shortened to approximately 83% of its length at functional residual capacity vs. 98% for the external oblique (P less than 0.05). The results obtained during passive lung inflation indicate these internal muscles are also more influenced by changes in lung volume. The internal oblique lengthened to 115% of its length at functional residual capacity vs. 103% for external oblique at total lung capacity (P less than 0.05). The results suggest that anatomic division of the abdominal muscles into external and internal layers corresponds to functional differences in terms of both passive lengthening and active shortening during ventilation and that these differences imply variable functions of the two layers.

Abdominal muscle activity during hypercapnia in awake dogs

1994 ◽  
Vol 77 (3) ◽  
pp. 1393-1398 ◽  
Author(s):  
A. M. Leevers ◽  
J. D. Road
Keyword(s):  
Tidal Volume ◽  
Muscle Layer ◽  
Abdominal Muscle ◽  
Rectus Abdominis ◽  
Transversus Abdominis ◽  
Emg Activity ◽  
Abdominal Muscles ◽  
Co2 Rebreathing ◽  
External Oblique ◽  
Internal Oblique

We previously found the internal abdominal muscle layer to be preferentially recruited during expiratory threshold loading in anesthetized and awake dogs. Expiratory threshold loading increases end-expiratory lung volume and hence can activate reflex pathways such as tonic vagal reflexes, which could influence abdominal muscle recruitment. Our objectives in the present study were to determine the effects of hypercapnia on abdominal muscle activation and the pattern of recruitment in awake dogs. Five tracheotomized dogs were chronically implanted with sonomicrometer transducers and fine-wire electromyogram (EMG) electrodes in each of the four abdominal muscles: transversus abdominis, internal oblique, external oblique, and rectus abdominis. Muscle length changes and EMG activity were studied in the awake dog at rest and during CO2 rebreathing. CO2 rebreathing produced a tripling of tidal volume and activation of the abdominal muscles. Despite the increase in tidal volume, there was no significant change in abdominal muscle end-inspiratory length. Both tonic and phasic expiratory shortening were greater in the internal muscle layer (transversus abdominis and internal oblique) than in the external muscle layer (external oblique and rectus abdominis). We conclude that the internal abdominal muscles are preferentially recruited by hypercapnia and vagal reflexes probably do not contribute to this differential recruitment but that segmental reflexes may be involved. The mechanical consequences of this recruitment are discussed.

Abdominal muscle use during breathing in unanesthetized dogs

1989 ◽  
Vol 66 (1) ◽  
pp. 20-27 ◽  
Author(s):  
A. De Troyer ◽  
J. J. Gilmartin ◽  
V. Ninane
Keyword(s):  
Respiratory Muscle ◽  
Abdominal Muscle ◽  
Rectus Abdominis ◽  
Transversus Abdominis ◽  
Abdominal Muscles ◽  
Quiet Breathing ◽  
Sitting Posture ◽  
Cervical Vagotomy ◽  
External Oblique ◽  
Conscious Animals

The pattern of abdominal muscle use during breathing in unanesthetized dogs is unknown. Therefore, we have recorded the electromyograms of the rectus abdominis, external oblique, and transversus abdominis in eight conscious animals breathing quietly in the sitting, standing, and prone postures. During quiet breathing in the sitting posture, all animals invariably had a large amount of phasic expiratory activity in the transversus abdominis. In contrast, only four animals showed some expiratory activity in the external oblique, and only one animal had expiratory activity in the rectus abdominis. A similar pattern was observed when the animals were standing or lying prone, although the amount of expiratory activity was less in this posture. Bilateral cervical vagotomy in four animals did not affect the degree of transversus abdominis expiratory activation or the influence of posture. We conclude that in conscious dogs 1) the abdominal muscles play an important role during breathing and make spontaneous quiet expiration a very active process, 2) the transversus abdominis is the primary respiratory muscle of the abdomen, and 3) unlike in anesthetized animals, extrapulmonary receptors play a major role in promoting abdominal expiratory contraction.

Abdominal muscle activation by respiratory stimuli in conscious dogs

1993 ◽  
Vol 74 (1) ◽  
pp. 16-23 ◽  
Author(s):  
F. Yasuma ◽  
R. J. Kimoff ◽  
L. F. Kozar ◽  
S. J. England ◽  
T. D. Bradley ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Respiratory Muscles ◽  
Abdominal Muscle ◽  
Minute Volume ◽  
Transversus Abdominis ◽  
Emg Activity ◽  
Abdominal Muscles ◽  
Vagus Nerves ◽  
Peripheral Chemoreceptor ◽  
External Oblique

The responses of the diaphragm, external oblique, and transversus abdominis muscles to hyperoxic hypercapnia and isocapnic hypoxia were studied in four awake dogs to test the hypothesis that central and peripheral chemoreceptor inputs result in different patterns of respiratory muscle activation. The dogs were trained to lie quietly in place, and electromyographic (EMG) discharges of the diaphragm (EMGdi), external oblique (EMGeo), and transversus abdominis (EMGta) were recorded from chronically implanted electrodes. Both hypercapnia and hypoxia recruited EMGeo and EMGta activity, but at comparable levels of minute volume of ventilation the EMG activity of the abdominal muscles was greater during hypercapnia than during hypoxia. However the two chemical stimuli also resulted in different tidal volume (VT) and respiratory frequency responses at any given minute volume of ventilation. When EMG activity was reanalyzed as a function of VT, EMGeo and EMGta were the same for a given VT whether induced by hypercapnia or hypoxia, but EMGdi was consistently greater during hypoxia than during hypercapnia. When the vagus nerves were blocked by cooling exteriorized cervical vagal loops, all abdominal muscle EMG activity was abolished. The findings support the concept that stimulation of the central and peripheral chemoreceptors results in asymmetric activation of the inspiratory and expiratory respiratory muscles. The findings also indicate that afferent vagal stimuli play an important facilitatory role in activation of the abdominal expiratory muscles.

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