Getting Powerful Shapely Glutes
Because early cervical cancer is usually asymptomatic, establish a thorough history with particular attention to the presence of the risk factors and the woman's menstrual history. Establish a history of later symptoms of cervical cancer, including abnormal bleeding or spotting (between periods or after menopause) metrorrhagia (bleeding between normal menstrual periods) or menorrhagia (increased amount and duration of menstrual bleeding) dysparuenia and postcoital bleeding leukorrhea in increasing amounts and changing over time from watery to dark and foul and a history of chronic cervical infections. Determine if the patient has experienced weight gain or loss abdominal or pelvic pain, often unilateral, radiating to the buttocks and legs or other symptoms associated with neoplasms, such as fatigue.
Single or multiple sharply defined, persistent, asymptomatic or sometimes painful subcutaneous plaques or nodules of varying sizes are the typical lesions of LEP (Costner et al. 2003, Peters and Su 1989). The overlying skin ultimately becomes attached to the firm lesions, producing a deep depression into the subcutis with a normal or erythematous, inflammatory surface (Fig. 6.16). Dystrophic calcifications or ulcerations within older lesions of LEP, leaving atrophic scars or sometimes resembling lipatrophy, may occur and at times can be a prominent clinical feature of the disease requiring surgical excision. In addition, LEP may produce breast nodules that can mimic carcinoma, clinically and radiologically (Holland et al. 1995, Peters 2000), and linear involvement of the extremities or the scalp has also been observed (Nagai et al. 2003, Tada et al. 1991). Most lesions of LEP are usually found in areas of increased fat deposition, such as the trunk, buttocks, and proximal upper and...
Patient-dependent problems can occur during the squeeze phase. Often patients squeeze the buttocks rather than the anal sphincters, leading to erroneous results and catheter displacement. Furthermore, maximal squeeze pressures are strongly dependent on the patient's cooperation and effort.
Often associated with history of sunbathing or walking barefoot on the beach tingling prickling, pruritus at site of exposure within 30 minutes of larvae penetration advancing, erythematous, often linear lesions, occurring on dorsa of feet, interdigital spaces of toes, anogenital region, buttocks, hands, and knees 2-3-mm-wide, ser-piginous, slightly elevated, erythematous tunnels, tracking 3-4 cm from penetration site vesicles with serous fluid occasional secondary impetiginization systemic signs peripheral eosinophilia and increased IgE levels
LyP is characterized by disseminated papules or nodules, which evolve and regress over a few weeks sometimes leaving behind scars. Often several papules are clustered (Fig. 1). The number of lesions in LyP can vary from few to hundreds (3). Although no definite predilection site has been identified, LyP lesions more often arise on the trunk, especially the buttocks, and extremities. In contrast to CD30+ LTCL, the face is less frequently involved in LyP. The individual LyP lesion starts as an erythematous, usually asymptomatic papule (initial stage). Within days or
Transient, circumscribed, highly variable, figurate erythematous patches, sometimes surrounded by a hypomelanotic halo, involving any part of the skin lesions most prevalent during childhood and sometimes becoming less frequent as the patient ages burning sensation sometimes preceding or accompanying erythema variably changing, brownish, hyperkeratotic plaques with geographic borders, symmetrically distributed over the limbs, buttocks, and trunk flexures, face, and scalp usually spared
A young mother seeks help for an uncooperative 5-year-old with a 7-day history of dermatitis of the right posterior thigh, right buttock, and right foot. Examination reveals patches of secondarily infected (impetiginized) dermatitis. Some areas are urticarial, while others are clearly vesicular. Excoriations are present, and the mother states that the eruption has gradually spread over several days. The vesicular eczematous areas and excoriations lead you to suspect toxicodendron exposure.
Macrodistribution Striae of puberty occur on the thighs and lumbosacral regions in boys. In girls, they occur on the thighs, buttocks, breasts, and upper posterior calves (see Figs. 9,10). Striae of pregnancy are distributed over the lateral abdomen, hips, thighs, and breasts (see Fig. 11). Striae secondary to prolonged lifting or stretching during exercise
The frequency of immune deposits in DLE depends on the biopsy site, past treatment, and the duration of a lesion. In lesional skin, immune deposits are present in about 60 -95 of DLE biopsy sample. IgG and C3 are most frequently detected. The pattern of the immune deposits can be linear in a continuous thick or thin band (Fig. 22.1) or discontinuous with coarse or fine granular deposits (Fig. 22.2). In addition to the deposits along the DEJ, cytoid bodies can be present in the papillary dermis, with positive staining mostly for IgM and IgA. In nonlesional skin, the LBT result is usually negative in sun-protected areas, eg, in biopsy samples taken from the buttock area of patients with DLE a recent study, however, described deposits of C3 and IgM in uninvolved skin of some patients with DLE (Cardinali et al. 1999).
Assess infant up to 2 months of age for frank breech birth, cesarean birth, hip joint laxity or dislocation (Ortolani or Barlow test), degree of dysplasia or dislocation, shortened limb on the affected side (telescoping), broadened perineum, asymmetry of thigh and gluteal folds with increased number of folds and flattened buttocks.
This classical open surgical procedure requires a long operation time (40-70 minutes), and for the IPG abdominal position, some patients complain of displacement or pain at the IPG site. A new modality of buttock placement of the IPG was proposed in 2001 to shorten operative time and reduce complications.3
Receive them on the lower legs or the forearms. Battered children tend to have injuries to the head. There may be patterned bruises of the extremities caused by the child's being gripped firmly with the fingers or patterned bruises of the trunk caused by the child's being hit with a belt or coat hanger (Figure 12.1). In some instances, however, the bruises are not visible in spite of beatings. Thus, in cases of deaths following suspected child abuse, long incisions should be made down the back, buttocks, and extremities to reveal underlying soft tissue hemorrhage. (Figure 12.2) One must be careful not to confuse the Mongolian spot, an area of hyperpigmented skin in the lumbosacral region in some young children, with a bruise. Rarely, death will be due solely to exsanguination from massive bleeding into the soft tissue, caused by a beating.
Decubitus ulcers are the breakdown of soft tissue due to prolonged physical pressure in patients kept lying too still for a prolonged period of time. It most commonly occurs in paralyzed patients and the debilitated elderly. Although other sites such as the elbows, heels, and shoulders are involved, the great majority of ulcers develop over the sacrum, ischial tuberosities, and femoral trochanters and buttocks. Local soft-tissue infection and bacteremia are common accompaniments. Staphylococcus aureus, Proteus mirabilis, and Escherichia coli are the chief offenders. Superficial pressure sores that extend to the dermis but not into the subcutaneous fat layer may progress to deep sores after penetration of the fat layer, spreading to and contaminating the underlying bone (Hendrix et al. 1981). Frequently, a sinus tract is formed that communicates with the skin. The accurate diagnosis of osteitis that complicates pressure sores is difficult because a number of other conditions overlap in...
Macrodistribution SCMN, MCMN, and AcpN are randomly distributed on the skin surface and may occur at any site. LCMN are often distributed over a large region, such as on the scalp, upper neck, and shoulders, or on the lower back, buttocks, genitalia, and proximal thighs. They may also cover a major anatomic structure such as a limb. This is the source of eponyms such as shawl nevi, bathing trunk nevi, and garment nevi (see Photo 25).
The Parastep system,26,76,77 marketed by Sigmedics, is the only commercially available system for the restoration of standing and walking in individuals with sustained paraplegia. This device has been implemented in over 600 individuals to date.78 The device consists of an external control unit, surface electrodes, and push-button switches that are mounted on a walker. This system is to be used in conjunction with the walker to provide upright stability and to move the individual forward. Six electrodes are used in this system, four to provide upright standing and two to elicit rudimentary stepping. Standing in the system is provided by the electrical activation of the quadriceps muscles to fix the knee in extension and activation of the paraspinals and the gluteal muscles to provide lower back stability and hip extension. Stepping is achieved by the stimulation of the peroneal nerve, as in the footdrop systems, to activate the withdrawal reflex. Control over stepping is achieved by...
Pressure ulcer is an irregularly shaped, depressed area that resulted from necrosis of the epidermis and or dermis layers of the skin. Prolonged pressure causes inadequate circulation, ischemic ulceration, and tissue breakdown. Muscle tissue seems particularly susceptible to ischemia. Pressure ulcers may occur in any area of the body but occur mostly over bony prominences that can include the occiput, thoracic and lumbar vertebrae, scapula, coccyx, sacrum, greater trochanter, ischial tuberosity, lateral knee, medial and lateral malleolus, metatarsals, and calcaneus. Some 96 of pressure ulcers develop in the lower part of the body, with the hip and buttock region accounting for almost 70 of all pressure sores.
Defining Characteristics (Specify redness edema irritation of skin, perianal area, buttocks excoriation or maceration of skin enforced bed rest induration or fissure in skin scratching rash scales crusting disruption of skin surface destruction of skin layers with or without necrosis open wound with drainage pressure from cast, splint, brace, or other appliance device prolonged placement in one position.)
Fig. 12.45A-C Compression rhabdomyolysis. A Anterior pinhole scan of the left hip in a 69-year old bed-ridden man with lung cancer reveals fusiform tracer uptake in the gluteus medius muscle (arrows) (fh femoral head). B Transaxial CT scan at the level of the femoral head top (fht) reveals low attenuation with hypodense foci in the gluteus medius muscle (pair of arrows) and gluteus maximus muscle (single arrow), denoting edema and necrosis. C Anteroposterior radiograph of the hip shows the gluteal muscles in question to be unremarkable (white arrows). Incidentally, there is calcific trochanteric bursitis (long arrow), which does not concentrate tracer. The lesion was asymptomatic
Figure 14.9 The buttocks and upper legs of this young boy are extensively contused. These injuries could not have occurred accidentally. figure 14.11 The buttocks were incised and blood in the soft tissues revealed. Microscopic sections may be helpful in determining the age of the trauma. figure 14.10 Blunt trauma to the buttocks may not be easily detected. Incisions into the buttocks should be performed to adequately evaluate the degree of trauma. See next photo. figure 14.11 The buttocks were incised and blood in the soft tissues revealed. Microscopic sections may be helpful in determining the age of the trauma. figure 14.16 The burn on this girl's buttock was caused by placing her on a stove as punishment for a minor offense. figure 14.16 The burn on this girl's buttock was caused by placing her on a stove as punishment for a minor offense.
Placing the active electrodes in the left and right anterolateral positions around the anal orifice and placing the reference electrode on the gluteus maximus or coccyx reduces artifact (Fig. 13.6). To obtain an evaluation, instruct the patient to simply relax, then to perform an isolated pelvic muscle contraction over a 10-second period, followed by performing a Valsalva maneuver this sequence is repeated two to four times for accuracy (Table 13.4).During contraction, the abdominal muscle activity should remain relatively low and stable, indicating the patient's ability to isolate PFM contraction from abdominal contraction (Fig. 13.7). During the Valsalva maneuver, PFM muscle activity should decrease below the resting baseline to
Dependent areas resting against a firm surface will appear pale in contrast to the surrounding livor mortis due to compression of the vessels in this area, which prevents the accumulation of blood. Thus, areas supporting the weight of the body, for example, the shoulder blades, buttocks, Figure 2.2 (continued) (B) Blanched areas of buttocks and shoulders due to compression of vessels by weight of body. (C) Infant with pale face from lying face down in crib. Figure 2.2 (continued) (B) Blanched areas of buttocks and shoulders due to compression of vessels by weight of body. (C) Infant with pale face from lying face down in crib.
Lateral radiographs of the pelvis produce glare in the area of the anal canal, due to the difference in radiolucency between air and the pelvis.12 Commodes used for defecography are designed to reduce the variation by employing a filtration device to absorb radiation below the seat and buttocks. Options include metal strips (usually copper) attached to the side of the commode or water-filled bottles or a doughnut below the seat. Commodes can be constructed of horizontally grained pine wood with steps up to a raised seat for ease of filming in a normal sitting position. Alternatively, a commode can be clamped to a horizontal x-ray table beneath a patient in the lateral decubitis position. With vertical movement of the table, the patient ends up sitting on the commode. This design allows filming of the patient during the movement from the supine to the sitting position, a distinct advantage among patients with fecal incontinence or significant genital prolapse, for example, who quickly...
The symptoms of genital herpes usually appear within a week of infection in the form of itching, tingling, and soreness of a reddish patch on the skin in the groin area, which is followed shortly by small, red, painful blisters. In men these can occur on the penis, scrotum, buttocks, anus, or thighs. The blisters break, causing circular, open sores that develop a crust in a few days. During this time, walking may be painful and urination difficult. The person may develop a fever and feel ill. Within a week to 10 days the sores will scab over and heal until the next outbreak.
This highly contagious infestation is caused by the Sarcoptes scabiei (0.2-0.4 mm in length). The infestation is transmitted by intimate contact or by contact with infested clothing. The female mite burrows into the skin, and after 1 month, severe pruritus develops. A multiform eruption may develop, characterized by papules, vesicles, pustules, urticarial wheals, and secondary infections on the hands, wrists, elbows, belt line, buttocks, genitalia, and outer feet.
In adults, the spinal cord begins ros-trally above the foramen magnum, where it is continuous with the medulla oblon-gata and extends caudally as far as the level of the first or second lumbar vertebrae. The spinal cord possesses along its length 31 pairs of spinal nerves, each of which is attached to the cord through dorsal sensory roots and ventral motor roots. (There is evidence that there are some sensory fibers in the ventral roots as well.) The cord is a continuous structure, but is divided into segments through the spinal roots. A segment may be thought of as the area of spinal cord which possesses one pair of dorsal and ventral roots. Each segment may also have a pair of dorsal root ganglia. An exception is C1, which may have no dorsal root ganglion. The cervical segments (C1-C7) supply the face, the neck, the arms, and the trunk the thoracic segments (T1-T12) supply the trunk and the sympathetic ganglia the lumbar segments (L1-L5) supply the legs the thora-columbar segments...
Genus Tunga penetrans (chigoe or jigger flea). Adults Smaller than most fleas, hairless, no head combs on compressed thorax. Diseases None burrow deeply into skin. Mechanism Gravid female burrows deeply into peripheral skin-soles, between toes, under fingernails and toenails, buttocks swells 1000x. Eggs 150-200 oviposited on mud hut floors from gravid female's genital opening, which remains exteriorized with anus. Larvae Hatch in 3 -4 days pupate in 2 weeks. Control Same chemical control extract gravid females aseptically.
If adults are struck by an automobile or light truck, rather than a truck with a high front, a different pattern of injuries occurs because victims are impacted below the center of gravity. With non-braking or late-braking automobiles at very high speed, the pedestrian is picked up and thrown over the top of the car. Examination of the automobile reveals either scuff marks or dents on the bumper, as well as denting of the front of the hood in most instances. There may be dents on the roof or trunk of the car, when the individual is hurled over it. The authors have seen this pattern in individuals struck at high speeds, i.e., the high 60s and 70s mph range. In these cases, there is often mangling of the body with partial or complete amputation of a limb by the massive blunt trauma (Figure 9.15). The skin in the groin area may show traumatic striae (stretch marks) if it has been violently stretched by impact at the buttocks (Figure 9.16). Striae might also be present on the neck because...
CLINICAL PRESENTATION The common blue nevus appears as a solitary, smooth surfaced, well-circumscribed oval lesion that is flat to slightly elevated. It is usually less than 1 cm in diameter. Blue nevi vary in color from blue to blue-black and may have a grey or whitish center. They occur most often on the back of the hands, face, and on the buttocks. While they usually occur in the skin, blue nevi can also be seen in the sclera, conjunctiva, and orbit. When present from birth the nevus typically remains unchanged throughout life, but most develop later in life and can show very slow growth.
The infant is grasped around the back with the left hand, and the right hand is placed, near the vagina, under the baby's buttocks, supporting the infant's body. The infant's body is rotated toward the operator and supported by the operator's forearm, freeing the right hand to suction the mouth and nose. The baby's head should be kept lower than the body to facilitate drainage of secretions.
When a person drowns, the body sinks, assuming a position of head down, buttocks up, and extremities dangling downward. Unless there are strong currents, the body will not move very far from its initial position. In relatively shallow water, the extremities or face may bump or drag against the bottom of the body of water, often causing postmortem injuries to the face, back of the hands, knees, and toes. The crown of the head and the buttocks can be seen at water level. In deeper water, the body stays below the surface until decomposition begins and gas forms the body then gradually rises to the surface. In very cold water, the body might stay submerged for months before decomposition creates enough gas to bring it to the surface. Depending on how long a body has been in the water, there might be evidence of animal activity, for example, fish, turtles, crabs, or shrimp. The authors have seen bodies that appear relatively intact but, when opened up, reveal complete absence of the...
Imperforate anus is caused by failure of the descent of the urorectal septum. High versus low imperforate anus is determined by where the rectum ends, above or below the levator ani. There is a high incidence of associated genitourinary anomalies, especially with high imperforate anus (VATER, VACCTERL). Diagnosis of this condition is by careful physical exam of the perineum, forchette, and vestibule. Low imperforate anus will present as a fistula that ends at the posterior forchette in females and at the median raphe of the penis or scrotum in males. Radiographic evaluation includes lateral x-ray with the buttocks up or pelvic x-ray with the infant held upside down. Treatment of high imperforate anus is colostomy with later posterior sagittal anorectoplasty, and for low imperforate anus, treatment may be performed by a perineal approach.
Either sacral or lumbar anesthesia is administered prior to positioning the patient. The surgeon should stand on the patient's left side. The patient is then placed in the prone jack-knife position with the buttocks retracted with adhesive straps, keeping the posterior median raphe in the midline. A low 3- to 5-cm midline incision is made from the posterior anal verge to the tip of the coccyx. A longer incision does not facilitate superior exposure. The incision is subsequently deepened by diathermy until the tip of the coccyx is exposed, as the coccyx is the landmark of the superior border of the puborectalis muscle. The surgeon's left index finger is introduced into the rectum and the puborectalis muscle is elevated into the surgical field. The superior border of the puborectalis muscle lies just beneath the tip of the coccyx, to which it is attached. Curved clamps are used to separate the puborectalis muscle posteriorly and laterally. Simultaneously, the finger in the rectum is...
Increased perineal descent can also be estimated during physical examination by observing the perineum during the Valsalva maneuver with the patient in the left lateral position with the buttocks separated. A perineometer, an instrument consisting of a freely moving graduated cylinder within a steel frame positioned on the patient's ischial tuberosities, has also been used. Neither method is physiologically appropriate, as evaluation is undertaken with the patient in the lateral decubitus position and during feigned, rather than actual, expulsion of intrarectal contents.40 Defecography criteria include perineal descent exceeding 3.0 cm during maximal push effort as compared to that measured at rest (increased dynamic perineal descent) and perineal descent exceeding 4.0 cm at rest (increased fixed perineal descent).41
Crops of red-yellow papules on buttocks and thighs EX presents as 1- to 4-mm reddish-yellow papules on the buttocks or extensor surfaces of the thighs and arms (Figure 31.1) (3). The lesions may be surrounded by an erythematous halo and usually occur in crops that may coalesce, forming plaques. Their presence is indicative of a triglyceride level that typically exceeds 2000 mg dL. Other clinical stigmata of EX include ocular, abdominal, and pulmonary findings. The most important ophthalmic complication is lipemia retinalis. On fun-doscopic examination, the retinal arteries and veins appear white and engorged. The risk of lipemia retinalis increases when serum triglyceride levels exceed 4000 mg dL. Abdominal pain is a common accompaniment to EX. The source of the pain may be due to acute pancreatitis or hepatosplenomegaly. Chest pain or dyspnea may also occur due to decreased pulmonary oxygen diffusing capacity that may be aggravated by abnormal hemoglobin oxygen affinity. The natural...
A boil is a collection of pus beneath the top layer of skin. It is caused by bacterial infection of a hair follicle, the tiny pit in the surface of the skin in which a hair grows. Boils can cluster under the skin such a cluster is known as a carbuncle. Boils may result from infection of a cut or scrape in the skin, poor hygiene, cosmetics that clog the pores, exposure to chemicals, and friction from tight clothing or shoes. Perspiration contributes to the development of boils and carbuncles and can make them worse. Boils and carbuncles usually appear on the scalp, beard area of the face, arms, legs, underarms, and buttocks.
Change diaper frequently as needed (in infant), expose buttocks to air and apply skin protective ointment to buttocks and perianal area in infants and anal area in children if irritated and sore wash area with warm water after each diarrhea episode (commercial wipes may be used if skin not irritated).
Download Unlock Your Glutes Now
Free version of Unlock Your Glutes can not be found on the internet. And you can safely download your risk free copy of Unlock Your Glutes from the special discount link below.