ABSTRACT
Healthy knees require full range squatting movements. Vastus medialis (VM) muscle regulates and adjusts the extensor apparatus that inf luences the patellofemoral function. This work was designed to investigate the anatomy and morphometry of vastus medialis oblique (VMO) muscle by widely used imaging techniques and investigate how VMO muscle participates in anterior knee pain. Ten dissected cadaveric specimens were examined, focusing on fiber orientations, origin, insertions and nerve supply of VMO muscle. Magnetic resonance imaging and ultrasound of VMO muscle were recorded. Anatomical cross-sectional areas of VMO muscle were determined in painless and painful knees and statistically analyzed. In cadaveric specimens, there was distinct separation between VM longus and VMO (change in fiber angle or fibrofascial plane). VMO inserted directly into the medial proximal margin of the patella, capsule of the knee joint and continuous with the patellar tendon. Separate branch of femoral nerve run along the anteromedial border of the muscle. Anatomical cross-sectional area was significantly decreased in painful knee by –17.2%±11.0% at lower end of shaft of femur, –21.1%±6.0% at upper border of patella, –36.7%±11.0% at mid-patellar level. VMO is distinct muscle within quadriceps femoris group. VMO muscle would track the patella medially and participate in last phase of knee extension. Assessment of the VMO muscle anatomical cross-sectional area by ultrasonography may constitute promising and reliable tool to evaluate patellofemoral pain syndrome staging.
ABSTRACT
Healthy knees require full range squatting movements. Vastus medialis (VM) muscle regulates and adjusts the extensor apparatus that inf luences the patellofemoral function. This work was designed to investigate the anatomy and morphometry of vastus medialis oblique (VMO) muscle by widely used imaging techniques and investigate how VMO muscle participates in anterior knee pain. Ten dissected cadaveric specimens were examined, focusing on fiber orientations, origin, insertions and nerve supply of VMO muscle. Magnetic resonance imaging and ultrasound of VMO muscle were recorded. Anatomical cross-sectional areas of VMO muscle were determined in painless and painful knees and statistically analyzed. In cadaveric specimens, there was distinct separation between VM longus and VMO (change in fiber angle or fibrofascial plane). VMO inserted directly into the medial proximal margin of the patella, capsule of the knee joint and continuous with the patellar tendon. Separate branch of femoral nerve run along the anteromedial border of the muscle. Anatomical cross-sectional area was significantly decreased in painful knee by –17.2%±11.0% at lower end of shaft of femur, –21.1%±6.0% at upper border of patella, –36.7%±11.0% at mid-patellar level. VMO is distinct muscle within quadriceps femoris group. VMO muscle would track the patella medially and participate in last phase of knee extension. Assessment of the VMO muscle anatomical cross-sectional area by ultrasonography may constitute promising and reliable tool to evaluate patellofemoral pain syndrome staging.
ABSTRACT
Uterine artery embolization is an effective alternative to surgery in fibroids and postpartum hemorrhage aiming to preserve the uterus and fertility. To compare between the effect of bilateral uterine artery ligation and bilateral ovarian artery ligation on the ovarian structure and function in rabbits. Twenty-eight adult female nonpregnant white New Zealand rabbits were divided into four groups [seven rabbits each]: group A [control], B [sham], C [subjected to bilateral ovarian artery ligation], and group D [subjected to bilateral uterine artery ligation]. After 2 months, all groups received a single dose of human chorionic gonadotrophin to induce ovulation and were then sacrificed 2 days later. Follicle stimulating hormone [FSH], luteinizing hormone [LH], and 17-beta-estradiol were measured. Ovaries were extracted bilaterally, weighed, and processed for microscopic and immunohistochemical studies. Group C showed a significant increase in FSH and LH, whereas 17-beta-estradiol and ovarian weight were significantly decreased. Moreover, there were only a few peripherally situated atretic follicles with no primary oocytes. Extensive apoptosis affecting the entire ovarian structure was detected. However, group D showed a significant increase in FSH and LH, with a nonsignificant decrease in 17-beta-estradiol and ovarian weight. Ovaries of group D showed delayed ovarian atresia. Granulosa cells showed pyknotic nuclei. Some atretic follicles still contained primary oocyte surrounded by indented zona pellucida. Apoptosis was detected especially in granulosa cells and corpus luteum. Uterine artery shares in the blood supply of the ovary. A countercurrent pathway exists between the ovary and the uterus. Ligation of the uterine artery compared with the ovarian artery ligation induced a delayed atresia in the follicles with preservation of the primary oocytes. Thus, uterine artery embolization could anticipate ovarian failure and early menopause