Cerebrospinal Fluid

Cerebrospinal fluid or CSF, is a bodily fluid that occupies the subarachnoid space (space between the arachnoid mater and the pia mater) and the ventricular system around and inside the brain.

It constitutes the content of all intra-cerebral (inside the brain, cerebrum) ventricles, cisterns, and sulci (singular sulcus), as well as the central canal of the spinal cord.

It acts as a “cushion” or buffer for the cortex, providing a basic mechanical and immunological protection to the brain inside the skull.

It is produced in the choroid plexus in ventricles of brain.

Normal flow of CSF is required for normal functions of brain and spine.

Spinal anaesthesia or subarachnoid block involves pushing the drug into this space.

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What Is Debridement

Debridement is defined as the removal of a patient’s dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.

The removal may be achieved by  autolytic (self-digestion), chemical and surgical. Maggot therapy is debridement where certain species of live maggots selectively eat only necrotic tissue.

Debridement is an important part of the healing process for burns and other serious wounds.

Autolytic Debridement

It uses  body’s own enzymes and moisture to re-hydrate, soften and finally liquefy hard eschar and slough.  Autolytic debridement can be achieved with the use of occlusive or semi-occlusive dressings  with hydrocolloids, hydrogels and transparent films. [Read more...]

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Carpus

Carpus is the region between metacarpals and distal ends of radius and ulna. It corresponds to the region of wrist.

the main role of the carpus is to facilitate effective positioning of the hand and powerful use of the extensors and flexors of the forearm, but the mobility of individual carpal bones increase the freedom of movements at the wrist.

Carpus has eight bones arranged in two rows, proximal and distal.

Carpal Bones - Distal and Proximal Rows Proximal: A=Scaphoid, B=Lunate, C=Triquetral, D=Pisiform Distal: E=Trapezium, F=Trapezoid, G=Capitate, H=Hamate

Proximal row has from lateral to medial side scaphoid, lunate, triquetral and pisiform
Distal row has trapezium, trapezoid, capitate and hamate

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Abductor Pollicis Brevis

The abductor pollicis brevis is an abductor of the thumb.

It is a thenar muscle, and therefore contributes to the bulk of the palm’s thenar eminence.

It originates from the flexor retinaculum of the hand, the tubercle of the scaphoid bone, and additionally sometimes from the tubercle of the trapezium.

Running lateralward and downward, it is inserted by a thin, flat tendon into the lateral side of the base of the first phalanx of the thumb and the capsule of the metacarpophalangeal joint.

It is supplied by median nerve. C8/T1

This muscle is abductor of the thumb. It also assists in opposition and extension of the thumb.

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Abductor Digiti Quinti

It is another name for Abductor Digiti Minimi.

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Abductor Digiti Minimi

There are two muscles with name of Abductor digiti minimi. One is in the hand and another is in the foot.

Abductor Digiti Minimi of Hand

Abductor Digiti Minimi of Hand

The Abductor minimi digiti or abductor digiti quinti is situated on the ulnar border of the palm of the hand.

It arises from the pisiform bone and from the tendon of the Flexor carpi ulnaris, and ends as a flat tendon inserts into the ulnar side of the base of the proximal phalanx of the little finger.

Abductor Digiti Minimi of Foot

Abductor Digiti Minimi of Foot

The Abductor digiti minimi of the foot lies along the lateral border of the foot. It arises from the lateral process of the tuberosity of the calcaneus, from the under surface of the calcaneus between the two processes of the tuberosity, from the forepart of the medial process, from the plantar aponeurosis, and from the intermuscular septum between it and the Flexor digitorum brevis.

Its tendon, is inserted into the lateral side of the base of the first phalanx of the fifth toe.

Its function is to flex and abduct the fifth (little) toe.

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Carpal Tunnel

In the human body, the carpal tunnel or carpal canal is the fibro-osseous [That consists of bones on one side of canal and fibrous band on other]  passageway on the palmar side of the wrist that connects the distal forearm to the middle compartment of the palm.

Structure

The carpal bones form an arch which is convex on the dorsal side of the hand and concave on the palmar side. The groove on the palmar side, the sulcus carpi, is covered by the flexor retinaculum. [Read more...]

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Anterior Compartment of Forearm

The anterior compartment of the forearm is also known as flexor compartment contains the muscles responsible for flexion and pronation.

The ulnar nerve and artery are also contained within this compartment.

The muscles contained are [See figure for arrangement of muscles]

  • Flexor carpi radialis
  • Palmaris longus
  • Flexor carpi ulnaris
  • Pronator teres
  • Flexor digitorum superficialis
  • Flexor digitorum profundus
  • Flexor pollicis longus
  • Deep pronator quadratus

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Capitate

Capitatetate bone is the largest of the carpal bones, and occupies  the distal row in the center of the wrist.

It has

  • A rounded portion or head, which is received into the concavity formed by the scaphoid and lunate bones
  • A constricted portion or neck
  • The body. The bone is also found in many other mammals, and is homologous with the “third distal carpal” of reptiles and amphibians.

Carpal Bones - Distal and Proximal Rows Proximal: A=Scaphoid, B=Lunate, C=Triquetral, D=Pisiform Distal: E=Trapezium, F=Trapezoid, G=Capitate, H=Hamate

Capitatus in Latin means having a head.

Left Capitate Bone

Surfaces & Articulations

The superior surface is round, smooth, and articulates with the lunate bone.

The inferior surface is divided by two ridges into three facets, for articulation with the second, third, and fourth metacarpal bones, that for the third being the largest.

The dorsal surface is broad and rough.

The volar surface is narrow, rounded, and rough, for the attachment of ligaments and a part of the Adductor pollicis muscle.

The lateral surface articulates with the trapezoid by a small facet at its anterior inferior angle.

The medial surface articulates with the hamate nt.

The capitate articulates with seven bones

  • Scaphoid and lunate proximally
  • Second, third and fourth metacarpal distally
  • Trapezoid on the radial side, and hamate on the ulnar side.

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Discectomy

A discectomy is a surgical procedure in which the central portion of an intervertebral disc, the nucleus pulposus is removed.

This surgery is done when disc prolapse occurs and causes pain by stressing the spinal cord or nerves.  In addition to traditional discectomy,  procedures like microdiscectomy, endoscopic discectomy and laser discectomy are now commonly done.

Discectomy may or may not carried with laminectomy depending upon surgeon’s preference.

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