Anatomical study of the nerve regeneration after selective neurectomy in the rabbit: clinical application for esthetic calf reduction / 대한해부학회지

The purposes of this study were therefore to characterize the degeneration and regeneration of nerves to the calf muscles after selective neurectomy, both macroscopically and microscopically, and to determine the incidence of such regeneration in a rabbit model. Seventy four New Zealand white rabbits were used. Selective neurectomy to the triceps surae muscles was performed, and the muscles were subsequently harvested and weighed 1-4 months postneurectomy. The gastrocnemius muscles were stained with Sihler's solution to enable the macroscopic observation of any nerve regeneration that may have occurred subsequent to neurectomy. The change in triceps surae muscle weight was measured along the time course of the experiment. After neurectomy, nerve degeneration was followed by regeneration in all cases. The weight of the triceps surae muscle decreased dramatically between completion of the neurectomy and 1 month postneurectomy, but increased thereafter. The nerve branches were weakly stained with Sihler's solution until 2 months postneurectomy, and then strongly stained after 3 months. The number of myelinated axons was decreased at 2 month after neurectomy compared to nonneurectomized controls, but then gradually increased thereafter. Although there are currently no reports on the incidence of recovery after calf reduction, it may be a very common occurrence in the clinical field based on our findings. The findings of this study provide fundamental anatomical and surgical information to aid planning and practice in calf-reduction surgery.

Inervación y localización biométrica de los puntos motores del músculo tríceps sural / Innervation and localization of the motor points of triceps surae muscle

La inervación de los músculos es descrita de forma general, faltando datos biométricos sobre el lugar donde penetran los nervios en el vientre muscular. Con el propósito de conocer la inervación y los puntos motores de los componentes del músculo tríceps sural en la población chilena, estudiamos 18 miembros inferiores de individuos, adultos, fijados en formaldehido al 10 por ciento. Se realizó disección por planos, identificando los nervios dirigidos a las cabezas lateral y medial del músculo gastrocnemio y al músculo sóleo, esquematizando y fotografiando los hallazgos. Se identificó el origen de los ramos, respecto a una línea trazada entre las partes más prominentes de los epicóndilos femorales (LBEC), así como también, los puntos de ingreso en el vientre muscular, clasificando estos ramos como principales (R) y secundarios (RS). En todas las muestras la inervación provino del nervio tibial. La cabeza medial del músculo gastrocnemio recibió un ramo (R1) en 15 casos y dos (R1 y R2) en 3 casos. El origen de R1 se localizó en promedio a 23,6 +/- 11,5 mm distal a la LBEC; en 15 casos el R1 se dividió hasta en 4RS. Los puntos donde ingresaron estos últimos respecto a LBEC fueron en promedio 40,4 +/- 11,1 mm el RS1 y 46,9 +/- 9,1 mm el RS2. La cabeza lateral recibió un ramo en 17 casos y dos en 1 caso; el origen de R1 se localizó en promedio a 35,6 +/- 11,8 mm distal a la LBEC; en 12 casos el R1 se dividió hasta en 4RS. Los puntos donde ingresaron estos últimos respecto a LBEC fueron 49,4 +/- 9,3 mm el RS1 y 52,4 +/- 10,6 mm el RS2. El músculo sóleo recibió su ramo de un tronco común con la cabeza lateral del gastrocnemio en 7 casos y un ramo directo R1 en 6 casos y dos ramos (R1 y R2) en 5 casos, de los cuales, en 3 de ellos, recibió un ramo anterior y uno posterior; el origen de R1 se localizó a 40,4 +/- 14,4 mm de LBEC; el origen del tronco común se ubicó a 20,2 mm de esta línea. El R1 se dividió hasta en 7 RS. Estos resultados son un aporte a la anatomía...

The knowledge of innervation of muscles is generally described, but we can complement the point where the nerves penetrate the muscle belly, from the biometric standpoint. In order to know the innervation and motor points in the components of the triceps surae muscle, 18 formolized lower limbs of adult Chilean individuals were studied. Planes dissection was performed by identifying the point nerve of the lateral and medial head of gastrocnemius muscle and soleus muscle. All specimens were schematized and photographed. We identified the source of the branches, about a line drawn between the most prominent parts of the femoral epicondyles (BECL), as well as the points of entry into the muscle belly, classifying these branches as principal (BR) and secondary ( SBR). In all samples the innervations came from the tibial nerve. The medial head of the gastrocnemius muscle received one branch (BR1) in 15 cases and two (BR1 and BR2) in 3 cases. The BR1 origin is located on average 23.6 +/- 11.5 mm distal to the BECL, in 15 cases the BR1 split up into four SBR. The points where these latter entered in muscular belly regarding BECL were on average: 40.4 + 11.1 mm (SBR1) distal to this line and 46.9 +/- 9.1 mm (SBR2). The lateral head received one branch in 17 cases and two in 1 case; the origin of BR1 was found on average to 35.6 +/- 11,8 mm distal to the BECL; in 12 cases the BR1 was divided up in four SBR. Regarding to BECL the SBR entered in muscle belly distal to this line, 49.4 +/- 9.3 mm (SBR1) and 52.4 +/- 10.6 mm (SBR2). The soleus muscle received his branch from a common trunk with the lateral head of the gastrocnemius in 7 cases and one direct branch BR1 in 6 cases and two branches (BR1 and BR2) in 5 cases, of which 3 of them received one anterior branch and posterior branch; the origin of BR1 was located 40.4 ± 14.4 mm distal to the BECL; the common trunk origin was located at 20.2 mm distal from this line...

Feathered fibres of human soleus muscle / Fibras penniformes del músculo sóleo humano

The large size of superficial group of muscles of back of leg is a characteristic feature of the musculature of man being related directly to its erect posture and mode of progression. Triceps surae is one of the powerful muscles of the body after Gluteus maximus and Quadriceps femoris. To make the muscle more powerful nature has devised a unique method of packing the fibers in a small space by pennation. There exists a bipenniform mass as a peculiarly human feature. Its feathered fasciculi arise from the deep (anterior) surface of the soleus muscle. Most of the textbooks of Anatomy and the available literature on the triceps surae or the tendoachillis do not appreciate and describe this fascinating aspect of the muscle. It was Schafer et al. (1923) who gave a detailed account of this muscle. Standring et al. (2005) have also described this muscle in great detail. We have studied the unique features of this part of soleus muscle. Bipennate arrangement was seen in 86 percent (right-83 percent; left-89 percent); and its maximum width was found to be 3.63 cm (Rt-3.71cm; Lt-3.55cm). Median tendinous septum was directed backwards and medially. Thus this muscle will further increase the power of contraction of soleus, which is so very important for a bipedal gait.

El gran tamaño de los grupos musculares superficiales de la parte posterior de la pierna es un rasgo característico de la musculatura del hombre siendo relacionado directamente con su postura erguida y el modo de progresión. El músculo tríceps sural es uno de los músculos más potentes del cuerpo después de los músculos glúteo magno y cuadríceps femoral. Para hacer al músculo más potente, la naturaleza ha ideado un método único de empaquetamiento de las fibras en un pequeño espacio por pennación. Existe una masa bipenniforme como una característica peculiarmente humana. Los fascículos pennados surgen desde la superficie profunda (anterior) del músculo sóleo. La mayoría de los textos de Anatomía y la literatura disponible sobre el músculo tríceps sural o el tendón de Aquiles no se aprecia ni se describe este aspecto fascinante que tienen los músculos. Fue Schafer (1923) quien dió una detallada descripción del músculo sóleo y posteriormente, Standring et al. (2005) también describieron detalladamente al músculo. Estudiamos las características únicas de esta parte del músculo sóleo, observando una disposición bipenniforme en el 86 por ciento de los casos (derecha 83 por ciento; izquierda 89 por ciento). El ancho máximo del músculo fue de 3,63 cm (derecha 3,71cm; izquierda 3,55cm). El septo tendinoso mediano se dirigió hacia posterior y medial, aumentando así aún más el poder de contracción del músculo sóleo, el cual es muy importante para la bipedestación.

Anatomical Locations of the Motor Points of the Triceps Surae Muscles

OBJECTIVE: To identify the range of the precise locations of the motor points of triceps surae muscles in relation to bony landmarks. METHOD: Eight limbs of four male cadavers were dissected. The number and location of the motor points from the tibial nerve to each head of the triceps surae muscle were identified related to the bony landmarks. Bony landmarks were medial and lateral epicondyles of the femur, and medial and lateral malleolli of the tibia. The length of the lower leg was defined as the distance from the intercondylar line of the femur to the intermalleolar line of the tibia. The locations of the motor points were expressed as the vertical distance from the intercondylar line, which was normalized to the length of the lower leg. RESULTS: The most proximal motor points of the medial gastrocnemius, lateral gastrocnemius, and soleus were located in 9.6+/-3.5%, 12.0+/-3.4% and 20.5+/-3.9% of the lower leg below the intercondylar line of the femur. The most distal points were in 37.5+/-5.5%, 37.9+/-2.3% and 46.7+/-3.6%. CONCLUSION: The identification of the locations of motor points related to the bony landmarks would increase the ease and accuracy of the motor point blocks to the triceps surae muscles.

Relationships between the gastrocnemius or soleus muscle thickness and the calcaneal bone stiffness in postmenopausal women / 体力科学

The gastrocnemius muscles are composed predominantly of type II B and II A fibers while the soleus muscle is composed of type I fibers. However, the relationships between the calcaneal bone stiffness and the triceps surae muscles consisting of the different types of skeletal muscle fibers are unknown. The purpose of this study was to investigate the relationships between the calcaneal bone stiffness and the gastrocnemius or soleus muscle thickness in 73 postmenopausal women. We measured the speed of sound (SOS) and the broad band ultrasound attenuation (BUA), using a ultrasonic measurement of the calcaneal and the gastrocnemius or soleus muscle thickness used to measure the B-mode ultrasound anatomy. There was a significant differences in age between the high-and low-SOS groups. In the high-BUA group, the body mass index, the lower leg girth and the triceps surae muscle thickness were significantly higher than those in the low-BUA group. This data indicated that SOS is related to ageing and BUA is related to the body mass or the muscle thickness. The other side, stiffness and SOS were significantly correlated with the gastrocnemius muscle thickness, but not with the soleus muscle mass. Therefore, this study suggests that the calcaneal bone stiffness is closely related to the muscle thickness, which may be related especialy to the fast twitch muscle.

Localization of the Motor Nerve Branches and Motor Points of the Hamstring Muscles and Triceps Surae Muscle

OBJECTIVE: To identify the precise locations of the motor branches and motor points of hamstring and triceps surae muscles to the bony landmarks. METHOD: Twenty-eight limbs of 14 adult cadavers were anatomically dissected. The adult cadavers were selected randomly without regard to gender and age. The cadravers which were unable to obtain a neutral position or which received a trauma to the posterior thighs or the lower legs were excluded from the study. The number and location of the motor branches and motor points from sciatic nerve to each hamstirng muscles and from tibial nerve to each triceps surae muscles were identified related to the bony landmarks. Bony landmarks were ischial tuberosity, medial and lateral epicondyles of femur, and medial and lateral malleolli of tibia. The length of femur was defined as the distance from the ischial tuberosity to the intercondylar line of femur and the length of lower leg was defined as the distance from the intercondylar line of femur to the intermalleolar line of tibia. The locations of the muscular branches and the motor points were expressed as the percentage of the length of femur and lower leg. RESULTS: One muscular branch from the sciatic nerve to the semimembranosus muscle and from the posterior tibial nerve to the soleus muscle, and one or two muscular branches to the biceps femoris, semitendinosus, and semimembranosus, medial gastrocnemius, lateral gastrocnemius and soleus muscle were located at 23.0+/-5.7%, 21.0+/-10.5%, 25.0+/-10.3% of the femur from the ischial tuberosity and 2.0+/-6.2%, 4.0+/-3.3% and 10.0+/-3.3% of the lower leg from the intercondylar line of femur. There were one to four motor points in the hamstring and triceps surae muscles. The motor points of biceps femoris, semitendinosus and semimembranosus were located at 33.0+/-7.8%, 28.0+/-14.5% and 48.0+/-19.0% of the femur. The motor points of the medial gastrocnemius, lateral gastrocnemius and soleus were located in 5.0+/-0.6%, 10.0+/-3.0% and 18.0+/-4.3% of the lower leg below the intercondylar line of femur. CONCLUSION: The identification of the locations of muscular branches and motor points related to the bony landmarks from this study would increase the accuracy of the motor branch blocks or motor point blocks to the hamstrings and triceps surae muscles.

Human body composition determined by cadaver dissection / 体力科学

Sixty-two embalmed cadavers of elderly Japanese individuals, ranged in age from 44-98 years (48 males, 14 females), were completely dissected, and the weights of skin plus subcutaneous adipose tissue (SSATW) and Triceps Surae Muscle (TSMW) determined. Then subcutaneous adipose tissue free weight (SSATFW) was determined by subtracting SSATW from body weight (BW) .<BR>SSATW and percentage of SSATW relative to BW in females (8.9 kg, 19.8%) were larger than those in males (6.1 kg, 12.7%) . On the other hand, TSMW and percentage of TSMW relative to BW in males (313.6 g, 0.65%) were larger than those in females (210.6g, 0.49%) . BW, SSATFW, TSMW were highly correlated (p<0.01) with each other in males. However, in females, TSMW was not significantly correlated (p>0.05) with those variables. The slopes of regression lines for SSATW against BW and SSATFW for females were about twice as steep as those for males.<BR>From these results, it was suggested that females carried a higher proportion of their adipose tissue externally than males and relationship between muscle weight and inner adipose tissue weight in females was more variable than in males.