Trendelenburg's Sign
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Trendelenburg's Sign
Trendelenburg's sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus. It is named after the German surgeon Friedrich Trendelenburg. It is often incorrectly referenced as the Trendelenburg test which is a test for vascular insufficiency in the lower extremities. The Trendelenburg sign is said to be positive if, when standing on one leg (the 'stance leg'), the pelvis severely drops on the side opposite to the stance leg (the 'swing limb'). The muscle weakness is present on the side of the stance leg. If the patient compensates for this weakness (by tilting their trunk/thorax to the affected side), then the pelvis will be raised, rather than dropped, on the side opposite to the stance leg. Ergo, in the same situation, the patient's hip may be dropped or raised, dependent upon whether the patient is actively compensating, as above, or not. Compensation shifts the centre of gravity to the affected side, and also decrea ...
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Abduction (kinesiology)
Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminology used describes this motion according to its direction relative to the anatomical position of the body parts involved. Anatomists and others use a unified set of terms to describe most of the movements, although other, more specialized terms are necessary for describing unique movements such as those of the hands, feet, and eyes. In general, motion is classified according to the anatomical plane it occurs in. ''Flexion'' and ''extension'' are examples of ''angular'' motions, in which two axes of a joint are brought closer together or moved further apart. ''Rotational'' motion may occur at other joints, for example the shoulder, and are described as ''internal'' or ''external''. Other terms, such as ''elevation'' and ''depression'', describe movement above or below the horizontal plane. Many anatomic ...
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Gluteus Medius
The gluteus medius, one of the three gluteal muscles, is a broad, thick, radiating muscle. It is situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeurosis, which separates it from the superficial fascia and integument. Structure The gluteus medius muscle starts, or "originates", on the outer surface of the ilium between the iliac crest and the posterior gluteal line above, and the anterior gluteal line below; the gluteus medius also originates from the gluteal aponeurosis that covers its outer surface. The fibers of the muscle converge into a strong flattened tendon that inserts on the lateral surface of the greater trochanter. More specifically, the muscle's tendon inserts into an oblique ridge that runs downward and forward on the lateral surface of the greater trochanter. Relations A bursa separates the tendon of the muscle from the surface of the trochanter over which it glid ...
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Gluteus Minimus
The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius. Structure It is fan-shaped, arising from the outer surface of the ilium, between the anterior and inferior gluteal lines, and behind, from the margin of the greater sciatic notch. The fibers converge to the deep surface of a radiated aponeurosis, and this ends in a tendon which is inserted into an impression on the anterior border of the greater trochanter, and gives an expansion to the capsule of the hip joint. It is also a local stabilizer for the hip. Relations A bursa is interposed between the tendon and the greater trochanter. Between the gluteus medius and gluteus minimus are the deep branches of the superior gluteal vessels and the superior gluteal nerve. The deep surface of the gluteus minimus is in relation with the reflected tendon of the rectus femoris and the capsule of the hip joint. Variations The muscle may be div ...
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Friedrich Trendelenburg
Friedrich Trendelenburg (; 24 May 184415 December 1924) was a German surgeon. He was son of the philosophy, philosopher Friedrich Adolf Trendelenburg, father of the pharmacology, pharmacologist Paul Trendelenburg and grandfather of the pharmacologist Ullrich Georg Trendelenburg. Trendelenburg was born in Berlin and studied medicine at the University of Glasgow and the University of Edinburgh. He completed his studies at the Charité, Charité - Universitätsmedizin Berlin under Bernhard von Langenbeck, receiving his doctorate in 1866. He practiced medicine at the University of Rostock and the University of Bonn. In 1895 he became surgeon-in-chief at the University of Leipzig. Trendelenburg was interested in the history of surgery. He founded the German Surgical Society in 1872. Trendelenburg was also interested in the surgical removal of pulmonary embolism, pulmonary emboli. His student Martin Kirschner performed the first successful pulmonary embolectomy in 1924, shortly befor ...
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Trendelenburg Test
The Trendelenburg Test or Brodie–Trendelenburg test is a test which can be carried out as part of a physical examination to determine the competency of the valves in the superficial and deep veins of the legs in patients with varicose veins. __TOC__ Procedure With the patient in the supine position, the leg is flexed at the hip and raised above heart level. The veins will empty due to gravity or with the assistance of the examiner's hand squeezing blood towards the heart. A tourniquet is then applied around the upper thigh to compress the superficial veins but not too tight as to occlude the deeper veins. The leg is then lowered by asking the patient to stand. Normally the superficial saphenous vein will fill from below within 30–35 seconds as blood from the capillary beds reaches the veins; if the superficial veins fill more rapidly with the tourniquet in place there is valvular incompetence below the level of the tourniquet in the "deep" or "communicating" veins. After 20 ...
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Gait Abnormality
Gait abnormality is a deviation from normal walking (gait). Watching a patient walk is the most important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion. Many common problems in the nervous system and musculoskeletal system will show up in the way a person walks. Presentation and causes Patients with musculoskeletal pain, weakness or limited range of motion often present conditions such as Trendelenburg's sign, limping, myopathic gait and antalgic gait. Patients who have peripheral neuropathy also experience numbness and tingling in their hands and feet. This can cause ambulation impairment, such as trouble climbing stairs or maintaining balance. Gait abnormality is also common in persons with nervous system problems such as cauda equina syndrome, multiple sclerosis, parkinson's disease, alzheimer's disease, vitamin B12 deficiency, myasthenia gravis, normal pressu ...
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Superior Gluteal Nerve
The superior gluteal nerve is a nerve that originates in the pelvis. It supplies the gluteus medius muscle, the gluteus minimus muscle, the tensor fasciae latae muscle, and the piriformis muscle. Structure The superior gluteal nerve originates in the sacral plexus. It arises from the posterior divisions of L4, L5 and S1. It leaves the pelvis through the greater sciatic foramen above the piriformis muscle. It is accompanied by the superior gluteal artery and the superior gluteal vein.''Thieme Atlas of Anatomy'' (2006), p 476 It then accompanies the upper branch of the deep division of the superior gluteal artery. It ends in the gluteus minimus muscle and tensor fasciae latae muscle. Function The superior nerve supplies: * tensor fasciae latae muscle.Platzer (2004), p 420 * gluteus minimus muscle. * gluteus medius muscle. * piriformis muscle. The superior gluteal nerve also has a cutaneous branch. Clinical significance Gait In normal gait, the small gluteal muscles on the sta ...
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Trendelenburg Gait
Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal gait. It is caused by weakness or ineffective action of the gluteus medius muscle and the gluteus minimus muscle. Gandbhir and Rayi point out that the biomechanical action involved comprises a Class 3 lever, where the lower limb's weight is the load, the hip joint is the fulcrum, and the lateral glutei, which attach to the antero-lateral surface of the greater trochanter of the femur, provide the effort. The causes can thus be categorized systematically as failures of this lever system at various points. Signs and symptoms During the stance phase, or when standing on one leg, the weakened abductor muscles allow the pelvis to tilt down on the opposite side. To compensate, the trunk lurches to the weakened side to attempt to maintain a level pelvis throughout the gait cycle. When the hip abductor muscles (gluteus medius and minimus) are weak or ineffective, the stabilizing effect of these muscles during gait ...
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Athletic Training
Athletic training is an allied health care profession recognized by the American Medical Association (AMA)"What is an Athletic Trainer?". The Board of Certification Website. 2003. Athletic training is also recognized by the Health Resources Services Administration (HRSA) and the Department of Human and Health Services (HHS) as an allied health care profession. Athletic trainers (ATs) are health care professionals who render service or treatment under the direction of or in collaboration with a physician, in accordance with their education, training and the state's statutes, rules and regulations. The practice of athletic training encompasses health promotion and wellness and examination, diagnosis, immediate care, and rehabilitation of clients/patients with emergent, acute, and chronic health conditions. As defined by the Strategic Implementing Team of the National Athletic Trainers' Association (NATA) in August 2007. that "encompasses the prevention, examination, diagnosis, tre ...
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