牛排冷知識-看牛排複習anatomy

牛排冷知識

今天在邊界吃New york strip的時候，看著即將要吃的牛肉部位就是平常後開spine撥了個老半天的erector muscle，然後店員開心的解釋著此塊牛肉最好吃的部分就是帶筋的位置，猛然一看，這是我們後開spine要關傷口前要縫的fascia啊...
吃著吃著，我笑著對朋友比劃說要如何在這塊beef spine打入pedical screw。沒辦法，骨科宅到骨子裡，病入膏肓。老實說吃了這麼多牛排，如果能跟手術經過的肌肉群做連結，倒也可以自娛娛人...哎。回來一屁股坐著停下手邊本來要寫的paper，先來整理一下牛排與骨科的對照表吧！

以wiki為中心向中看齊的整理...

• Tenderlion - form Psoas major ,minor and iliacus muscle。菲力源自其中 <註> Beef tenderloin and Filet Mignon are almost exactly the same thing. Filet Mignon is actually a portion of the tenderloin. The Filet Mignon is the best part of the beef tenderloin and is considered to be a delicious meal.

• 菲力牛排Filet mignon - Psoas major muscle

• Sirlion - Gluteus medius and bicep femoris 

• 肋眼牛排Rib eye steak - longissimus dorsi muscle

• Striploin Steak(New york strip):和Rib eye系出同源，striploin較靠腰部切面，Rib eye較接近shoulder 切面，原則上都是以Longissimus dorsi為主要肌肉

• T-bone - 即New york strip + Filet + spine
• Porterhouse - 切的部位較T-bone下面，故面積較T-bone來的大。psoas部分>1又1/4 inch時就叫作porthouse

以後開刀叫出肌肉名時順便想想這是什麼食物！

AIN injury

今天遇到了一個AIN injury from distal radius fracture(?)
這是病人的OK sign

AIN支配-PQ,FDP,FPL motor, no sensory fibers

Common in - fractures of the "supracondylar humerus" and "proximal forearm" ( tendinous origin of deep head of pronator teres (most common))

PE - inability to make the “OK” sign. (DIP joint of the index finger and the IP joint of the thumb are hyperextended)

EMG: needle examination is difficult because of the deep location

Diff Dx:
-lateral cord lesion(anterior division of upper (C5, C6) & middle trunks (C7))
- FDP avulsion or avulsion of index profundus tendons;
- C-8 radiculopathy:
- Parsonage-Turner Syndrome(brachial neuropathy)

Tx:surgery should not be considered for at least 1 year, since late spontaneous recovery may occur.

***Median nerve video

FASCIOTOMY

THIGH FASCIOTOMY:

• The thigh consists of three muscle compartments—the quadriceps, hamstrings, and adductors.
  #surgical approach : depends on the compartment involved
• Quadriceps compartment + hamstring  : single anterolateral incision
• Adductor compartment : through a separate longitudinal incision along its length.

LOWER LEG FASCIOTOMY:

• PERIFIBULAR FASCIOTOMY- OPEN ALL FOUT COMPARTMENT
  Incision:from the head of the fibula and distally to the ankle, following the general line of the fibula
• DOUBLE-INCISION TECHNIQUE:
  1# Interval between the anterior and lateral compartments
  2# Centered 1 to 2 cm behind the posteromedial border of the tibia
  *Both from Knee to ankle

DOUBLE-INCISION TECHNIQUE

DOUBLE-INCISION TECHNIQUE

 PERIFIBULAR FASCIOTOMY

CAUTION FOR N/V !!!

FOOT FASCIOTOMY: