Posterior Arm Research Articles

Transdeltoid Approach to Axillary Nerve Repair: Anatomical Study and Case Series

In cases of isolated paralysis of the axillary nerve, dissection of the distal stump at the posterior deltoid border can be difficult because of scarring from an injury or previous surgery. To overcome this, we propose dissecting the anterior division of the axillary nerve (ADAN) using a deltoid-splitting approach. We investigated the anatomy of the ADAN as it pertains to the transdeltoid approach and report the clinical application of this approach in 9 patients with isolated axillary nerve injury. The axillary nerve and its branches were dissected in 9 fresh cadaver specimens. In the clinical series, 1 patient with a lesion confined to the ADAN underwent nerve grafting. In the remaining 8 patients, the ADAN was repaired by transferring the triceps lower medial head and anconeus (TLMA) motor branch via a single-incision or double-incision posterior arm approach. The posterior division of the axillary nerve does not travel around the humerus. It innervated the posterior deltoid and teres minor muscles. At the posterior margin of the humerus, the ADAN ran adjacent to the teres minor tendon. The ADAN's trajectory on the lateral side of the humerus was 65 mm (SD ± 8 mm) from the midpoint of the acromion. One centimeter from the origin, the ADAN offered a prominent branch to the middle deltoid and wound around the humerus anteriorly at the surgical neck just distal to the infraspinatus tendon. A transdeltoid approach was feasible in all our patients. The TLMA was reached without any tension in the ADAN. Middle deltoid strength in 1 patient who had received a graft scored M3, while anterior and middle deltoid strength in the remaining patients who underwent nerve transfers scored M4. With axillary nerve lesions, reinnervation of the ADAN is a priority. The transdeltoid approach between the posterior and middle deltoid offers a direct and feasible approach to the ADAN. Therapeutic V.

Intrauterine fetal death followed by shoulder dystocia and birth by modified posterior axillary sling method: a case report

BackgroundVarious manoeuvres such as McRoberts position, suprapubic pressure, rotational methods, posterior arm extraction and all-four position (HELPERR) have been proposed for relieving shoulder dystocia with variable success. Posterior axillary sling method using a rubber catheter was proposed in 2009 but has not been widely used. We modified this method using ribbon gauzes and a long right-angle forceps and report a successful case.Case presentationA 44 years old parity one Chinese woman with a history of a caesarean delivery and poorly controlled type 2 diabetes mellitus was admitted to the Accident and Emergency Department for advanced stage of labour at term. Upon arrival, intrauterine fetal demise was diagnosed with severe asynclitism causing obstruction at the perineum. Episiotomy resulted in birth of the fetal head. The fetal posterior right shoulder, however, remained very high up in the pelvis and HELPERR methods failed to extract the shoulders. We then tied two long ribbon gauzes together, and guided its knot to the anterior aspect of the posterior axilla. By using a long right-angle forceps (24 cm long) to grasp the knot on the posterior side of the axilla and pulling it through, a sling was formed. Traction was then applied through the sling to simultaneously pull and rotate the posterior shoulder. A stillbirth of 3488 g was finally extracted.ConclusionsWe modified the sling method by using two ribbon gauzes, tied together and a right-angle forceps with several advantages. Compared to a rubber catheter, ribbon gauze with a knot can be easily held between the fingers for easy guidance past the fetal axilla. It is also thin, non-elastic and stiff enough to ensure a good grip for traction. The long and slim design of the right-angle forceps makes it easy to pass through a narrow space and reach the axilla high up in the pelvis. We emphasize simultaneous traction and rotation, so that the shoulders are delivered through the wider oblique pelvic outlet dimension.

Physical Therapy for the Horizontal Semicircular Cupulolithiasis: A Prospective Interventional Case Series from an Otoneurology Center in South Rajasthan, India

Abstract Objective This article aims to study the effect of physical therapy in patients of horizontal semicircular cupulolithiasis with results audited in the short term. Design Nonrandomized prospective interventional study. Study Sample Four patients with horizontal semicircular cupulolithiasis. Results All four patients in whom diagnostic supine roll test (carried at least thrice to look for the sustainability as well as the polarity of the nystagmus) elicited apogeotropic horizontal positional nystagmus lasting more than 1 minute were subjected to therapeutic head-shaking maneuver (HSM). The results were audited immediately after the physical therapy, and at 1 hour. Follow-up by telephonic interviews for 4 weeks was done in all patients. Three out of four patients responded to HSM alone. One patient who did not respond to HSM was successfully treated with four other sequent physical therapies. Conclusion The response of physical therapy for horizontal semicircular cupulolithiasis occasionally indicates the side of the cupula to which otoconial debris is adherent (Cup-U or Cup-C). Occasionally, Cup-C variant of horizontal semicircular cupulolithiasis can be transformed by physical therapy to long posterior arm horizontal semicircular canalolithiasis—a disorder with better established treatment options.

Ultrasonographic anatomy of posterior antebrachial cutaneous nerve in healthy subjects.

The posterior antebrachial cutaneous nerve (PACN) is one of the cutaneous branches of the radial nerve, and receives sensory input from the posterior arm and forearm. The aim of this study is to describe the ultrasonographic anatomy of the PACN. PACN and its branches were scanned using ultrasonography in 30 healthy volunteers. The distances between the epicondylar line and the bifurcation site of each branch of PACN (A) point of separation of the radial nerve and the PACN, (B) point of separation of the anterior and posterior divisions, (C) point of bifurcation of the posterior division into the epicondylar and anconeus branches), cross-sectional areas and depths from the skin surface to each nerve at positions A, B, and C were measured. The mean distance from the epicondylar line to A, B, and C was 10.01 ± 0.82 cm, 7.46 ± 0.98 cm, and 4.02 ± 1.16 cm, respectively. The mean depth from the skin surface at A, B, and C was 1.00 ± 0.19 cm, 0.72 ± 0.19 cm, and 0.51 ± 0.12 cm, respectively. Ultrasonographic visualization of the PACN and its major branches was feasible. The reference values in this study may be helpful for more accurate sonographic assessment and electrophysiologic study, and contribute to safer interventions around the elbow region.

Site-Specific Muscle Loss in the Abdomen and Anterior Thigh in Elderly Males with Locomotive Syndrome.

Although locomotive syndrome (LS) is a condition of reduced mobility, little information is available regarding the loss of site-specific skeletal muscle mass. The aim of the present study is to examine site-specific muscle loss in elderly males with LS. A total of 100 men ranging in age from 65 to 74 years were divided into two groups (LS and non-LS) using LS risk tests including the stand-up test, two-step test, and the 25-question geriatric locomotive function scale Muscle thickness (MTH) at eight sites-anterior and posterior thigh (AT and PT, respectively), anterior and posterior lower leg (AL and PL, respectively), rectus abdominis (RA), anterior and posterior upper arm (AU and PU, respectively), and anterior forearm (AF)-was evaluated using B-mode ultrasound. Furthermore, the 30-s chair stand test (CS-30), 10-m walking time, zig-zag walking time, and sit-up test were assessed as physical functions. There were no significant differences in age and body mass index between the LS and non-LS groups. The percentage of skeletal muscle was lower in the LS group than in the non-LS group. Although there were no differences in the MTH of AU, PU, AF, PT, Al and PL, site-specific muscle loss was observed at RA and AT in the LS group. CS-30, 10-m walking time, zig-zag walking time, and sit-up test in the LS group were all worse than those in the non-LS group. The MTHs of RA and AT were both correlated to those physical functions. In conclusion, the LS group had site-specific muscle loss and worse physical functions. This study suggests that site-specific changes may be associated with age-related physical functions. These results may suggest what the essential characteristics of LS are.

Posterior arm flap for axillary coverage in the setting of bifid axillary vein resection.

Posterior arm flap for axillary coverage in the setting of bifid axillary vein resection.

28697 Generalized granuloma annulare-like eruption induced by recombinant varicella zoster virus vaccination

A 52-year-old Caucasian female presented to the clinic with a 10-day history of a red pruritic rash distributed on the arms and hands. History revealed that the patient had received a recombinant varicella zoster vaccination six weeks prior to the skin eruption. Physical exam revealed bright red to violaceous indurated papules and annular plaques distributed to the bilateral upper arms, palmar hands, and ventral wrists. Punch biopsy performed on the right superior posterior arm demonstrated granulomatous inflammation characterized by palisaded histiocytes and mucin deposition. No eosinophils or plasma cells were present. No evidence of viral cytological atypia or infectious organisms were identified. The patient failed treatment with four weeks of oral prednisone and topical clobetasol 0.05% ointment. Treatment with hydroxychloroquine 200 mg twice-per-day for four weeks, then 200 mg per day for four weeks resolved the condition. Six weeks after the second dose of recombinant varicella zoster vaccination, the granuloma annulare-like eruption reappeared in the areas previously affected. Therapy with hydroxychloroquine was repeated in the same manner with complete clearance of skin lesions. We present this case as a unique presentation of granuloma annulare-like eruption developing as a recall reaction to recombinant varicella zoster vaccination.

Lessons Learned from Post-COVID-19 Vaccination PET/CT Studies.

Vaccination against coronavirus 2019 (COVID-19) has created new challenges. Lymphadenopathy with increased uptake in patients undergoing PET/CT may mislead to unnecessary further evaluation. We have analyzed routinely performed PET/CT studies after Pfizer-BioNTech vaccination to familiarize ourselves with the PET/CT appearance of various PET tracers and to prevent the consequences of misinterpretation. Methods: We analyzed 1,018 PET/CT studies performed between January 1, 2021, and February 15, 2021. Information about the dates and sites of vaccination was collected. Visual and semiquantitative analysis of axillary-neck lymphadenopathy and arm uptake was correlated with immunization data. Results: Increased uptake in axillary lymphadenopathy was observed unilaterally in 66% of vaccinated patients, in 55% of patients vaccinated once, and in 69% of those vaccinated twice. The intensity of uptake decreased over time. Fifty-four of 274 patients (20%) had simultaneous increased activity in the posterior arm and ipsilateral axillary lymphadenopathy (double sign [DS]). The sensitivity, specificity, positive predictive value, and negative predictive value were 55.4%, 83.6%, 86.7%, 49.2%, respectively, for axillary lymphadenopathy and 38.6%, 100%, 100%, and 66.1%, respectively, for DS. No DS was observed later than 10 and 21 d after the first and the second vaccinations, respectively. None of the nonvaccinated patients had arm uptake or DS. Conclusion: Vaccination against COVID-19 frequently causes nonspecific axillary lymphadenopathy with increased PET tracer activity. In one fifth of our study population, this lymphadenopathy was associated with increased uptake at the vaccination site, DS. DS was 100% specific, with a 100% positive predictive value for postvaccination lymphadenopathy, hence enabling avoidance of misinterpretation of PET/CT studies and further unnecessary evaluation.

Older males exhibit reduced anterior upper leg and anterior abdominal muscle thickness compared to younger males when matched for relative appendicular lean tissue

Background Ageing-related muscle atrophy does not occur uniformly across the body; rather, atrophy occurs to a greater extent in specific muscle groups compared to others. However, site-specific comparisons of muscle mass between older and younger adults typically do not account for relative muscle mass (i.e., matched for age- and sex-specific percentiles), which may confound site-specific differences. Furthermore, the uniformity of ageing-related differences in muscle composition (e.g., intramuscular adipose tissue) across the body are not well characterized.Purpose To examine site-specific muscle mass and composition differences between younger and older males matched for relative muscle mass.Methods Younger (18–44 years old, n = 19) and older (≥65 years old, n = 19) males were matched for relative appendicular lean tissue index (NHANES age- and sex-specific Z-scores) measured using dual-energy x-ray absorptiometry. Site-specific differences in skeletal muscle size (thickness) and composition (echo-intensity) were evaluated using ultrasound for 8 distinct landmarks across the body.Results Relative appendicular lean tissue mass was well matched between younger and older males (Z-score difference: -0.02, p = 0.927). Compared with younger males, older males had smaller muscle thickness for the anterior upper leg (difference: -1.08 cm, p < 0.001) and anterior abdomen (difference: -0.53 cm, p < 0.001). However, older adults displayed higher echo intensity across all muscles (p < 0.05), except for the posterior upper arm (p = 0.377), in comparison to the younger males.Conclusions When matched for relative appendicular lean tissue, muscle thickness differences between younger and older males are not-uniform across the body, whereas echo intensity was more uniformly higher in the older males.

Asymmetry in the frequency and proportion of arm truncation in three sympatric California Octopus species

Octopuses have eight radially symmetrical arms that surround the base of a bilaterally symmetrical body. These numerous appendages, which explore the environment, handle food, and defend the animal against predators, are highly susceptible to truncation or loss. Here, we used scaling relationships specific to the arms of three sympatric octopus species of the genus Octopus, to calculate the proportion of arm truncation. We then compared the frequency and proportion of arm losses between different body locations. Truncated arms were found in 59.8 % of specimens examined, with individuals bearing one to as many as seven injured arms. We found a significant left side bias for greater proportion of arm truncation for all species and sexes except in O. bimaculatus males. We also found that sister species O. bimaculatus and O. bimaculoides had a greater proportion of their anterior arms (pairs 1 and 2) truncated, while in O. rubescens, posterior arms (pairs 3 and 4) were more truncated. The mean percent of arm that was truncated was 28.1 % overall but varied between species and by sex and was highest in O. rubescens females (56 %). The arms of O. rubescens also exhibited the steepest scaling patterns, and showed a positive correlation between body size and number of truncated arms. Overall, we show that arm injuries in our sampling of three intertidal species are frequent and asymmetrical, and that when injured, octopus on average lose a considerable proportion of their arm. Through quantifying the variation in arm truncation, this study provides a new foundation to explore behavioral compensation for arm loss in cephalopods.

Functional Specialization and Arm Length in Octopus bimaculoides

Although the functional specialization of octopus arms may seem unlikely due to the appearance of radial symmetry, there is significant evidence for preferential arm use in various species of octopus. For example, in O. maya, O. digueti, and O. vulgaris, the anterior arms are utilized more frequently for grasping prey and exploring (Lee, 1992; Voight, 1992; Byrne et al., 2006), while posterior arms are more frequently utilized for crawling in O. vulgaris (Levy et al., 2015). Additionally, O. aculeatus and O. marginatus preferentially use two of their posterior-most arms during camouflage walking (Huffard et al., 2005). Mazzolai and colleagues (2013) established a link between arm morphology and specialization, demonstrating that the longest arm was preferentially used in reaching movements in O. vulgaris. Given these observed functional differences and the potential for morphology to provide further insight into octopus arm specialization, the goal of this study was to determine if morphological differences exist between different arm identities (L1-L4, R1-R4) in O. bimaculoides. To test this hypothesis, the relationship between arm length and other factors including: arm identity, body mass, sex, anterior versus posterior location, and left versus right side was analyzed statistically. The data set included 111 intact arms from 22 wild-caught specimens of O. bimaculoides (11 males and 11 females). Simple linear regressions were performed to test for a relationship between these morphological features and arm length and an analysis of covariance was performed to test for differences in arm length by arm identity. Mass demonstrated a significant linear relationship with arm length and a one-way ANOVA demonstrated that arm identity is significantly correlated with arm length. Moreover, an analysis of covariance found that independent of mass, arm identity has a significant linear relationship with arm length. Thus, despite an overall appearance of radial symmetry, arms of different identities do not have statistically equivalent lengths in O. bimaculoides. Furthermore, differences in arm length do not appear to be related to sex, anterior versus posterior location, or left or right side. These results call into question the existing practice of treating all octopus arms as equivalent by either using a single arm measurement as representative of all eight, or calculating an average length, and suggest that morphological analyses of specific arm identities may be more informative. Further investigation into the functional specialization and morphology of octopus arms is warranted.

666 Autologous Skin Cell Therapy After Dermal Matrix with STSG in a 5-year-old African-American Female - How Adjunct Therapies are Refining the Dogmatic Treatment Approach to Burns

Abstract Introduction Split-thickness skin grafting (STSG) is the standard of care for the treatment of full thickness skin injuries. Skin grafts are associated with long-term morbidity including graft loss, adjacent structural injury, anesthetic complications, scarring, and scar contractures. Large surface area burns are additionally challenging due to limited donor site availability. Autologous skin cell suspension (ASCS) is a new adjunct for STSG using device that provides a suspension of non-cultured, autologous skin cells applied overtop of STSG. Dermal matrix templates are placed on wounds after burn excision and induces dermal regeneration in preparation for STSG, allowing for a thinner graft to be harvested and applied. This technique has been shown to require both smaller areas of donor skin as well as thinner skin harvest which improves both healing time and aesthetic outcomes of donor sites, enhancing the time-tested and well accepted technique of STSG. Methods We present the case of a 5-year-old African American female who suffered 18% TBSA deep partial thickness burns and full thickness burns to her abdomen, trunk and left back after her shirt was accidentally lit on fire at home. She was transferred from a local hospital to our burn center for further evaluation. She was evaluated by both the burn surgery and pediatric teams and admitted for wound cares and surgical planning. Results On hospital day five she underwent burn excision and placement of acellular dermal regeneration template. She returned to the operating room on hospital day 22 after daily wound cares for autografting with autologous skin cell suspension application to anterior and posterior torso and left arm, as well as to back and thigh donor sites. Her takedown on hospital day 29 showed excellent graft take. She was ultimately discharged on hospital day 47. She continued to undergo wound care in the outpatient burn clinic and daily physical and occupational therapy. Conclusions This case illustrates the use of dermal matrix and ASCS on a large burn with excellent aesthetic outcomes and improved healing time. This case is unique in highlighting the versatility of this therapy in a darker skinned patient. There are significant challenges with long term morbidity from STSG and the use of both dermal regenerative matrix and ASCS may provide surgeons with new approaches to decreasing depth and size of donor sites, as well as improving the length of hospital stay and overall aesthetic outcomes of donor and graft sites, specifically in darker skinned patients.

Solitary Subcutaneous Tissue Metastasis as Recurrence in a Case of Primary Angiosarcoma of Breast: Findings on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography.

Primary angiosarcomas of the breast are rare tumors, with a fatal outcome. We present a rare case of an operated primary angiosarcoma of the right breast in a 20-year-old female who showed disease recurrence in the right posterior arm subcutaneous tissue on 18F-fluorodeoxyglucose positron emission tomography-computed tomography after 1 year of surgery without any other visceral metastasis.

Modified Posterior Arm Flap for Axillary Hidradenitis Suppurativa.

Hidradenitis suppurativa (HS) is a chronic, inflammatory condition of the apocrine sweat glands present in 1% to 4% of the adult population, with twice greater prevalence in females. Surgical excision is the criterion-standard treatment for advanced, grade III disease, characterized by extensive and recurrent abscesses and interconnected sinus tracts. Numerous reconstructive methods have been used to cover the resulting defects, including secondary intention healing, use of skin grafts, and a wide range of locoregional flaps. The modified posterior arm flap has been developed for reconstruction of axillary defects after radical excision of HS. Based on perforating vessels from the axillary artery first identified by Masquelet, a brachioplasty-like incision is used to keep the donor site closure relatively hidden on the posteromedial aspect of the inner arm. Eight modified posterior arm flaps have been undertaken in 6 patients, all women (mean age, 35 years; range, 22-51 years) from 2014 to 2019. All patients had complete resolution of their HS symptoms with no incidences of recurrence at mean follow-up of 15 months. All reported satisfaction with the aesthetic and functional outcomes of the procedure. We present a novel modification of the posterior arm flap for the treatment of advanced axillary HS with good functional and aesthetic outcomes and no incidences of recurrence.

Autoaugmentation Brachioplasty: An Arm Contouring Method in Women with Massive Weight Loss.

Brachioplasty of deflated arms following massive weight loss (MWL) often results in too slim arms. These slimmer arms lack the natural proportion and contour. This study presents a novel method for such arms through standard skin excision and autoaugmentation by dermofat flap. During a period of 2 years, 21 women complaining of severe deflation deformity of upper arms following MWL were operated. At time of surgery, the BMI ranged from 20.5 to 33. 4 with a mean of 26.2 kg/m2. The mean value of weight loss was 47.8 kg over a mean period of 18 months. A de-epithelialized dermofat flap was preserved underneath the dissected and advanced anterior and posterior arm skin flaps. The bulk of the flap was tailored as to give an appropriate girth with balanced proportion and contour of the upper arm. During 14 months of follow-up, all patients reported a high satisfaction. Objective evaluation was based on measurement of the mid-upper arm circumferences (MUAC) and its ratio with the mid-forearm circumferences (MFAC) which was compared with those of arms of healthy volunteers with normal BMIs. Augmentation of the upper arm by autologous dermofat flap provides a well arm contour in appropriate balance with the forearm in women having severe arm deflation deformity following MWL. The findings were supported by the objective anthropometric measurements of the MUAC/MFAC of a normal weight healthy women which reached to a mean value of 1.366. The normal girth of upper arm should equal 1[Formula: see text] that of the forearm. This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

762 Factors associated with brachial plexus injury following shoulder dystocia

Brachial plexus injury is an adverse outcome of shoulder dystocia that is difficult to predict and prevent. This study sought to identify risk factors for brachial plexus injury in shoulder dystocia, particularly examining prioritization of delivery of the posterior arm. This was a retrospective, case-control study of deliveries with shoulder dystocia, comparing characteristics between those with and without associated neonatal brachial plexus injuries. All shoulder dystocia cases between January 1, 2010 and December 31, 2019 were identified from a contemporaneously maintained obstetrical database and confirmed via chart review. Maternal BMI, birth weight, delivery provider, number of shoulder dystocia maneuvers used, and prioritization of delivery of the posterior arm (defined as inclusion of posterior arm within the first three maneuvers), were examined. 639 cases of shoulder dystocia were identified. 55 (8.6%) were complicated by brachial plexus injury. Brachial plexus injury was significantly more common with use of more maneuvers and prioritization of the posterior arm. Maternal BMI (available for 602) and neonatal birth weight were higher in the group with brachial plexus injury than without (36.5 vs. 33.3, p = 0.0007 and 4058 vs. 3865, p = 0.001). There was no difference in brachial plexus injury rate based on delivery provider (resident, midwife, or attending p = 0.31, available for 378). After controlling for BMI and birth weight, prioritization of the posterior arm remained associated with increased odds of brachial plexus injury (OR 3.37, CI 1.06-10.75, p = 0.04). This study corroborated previously identified factors associated with brachial plexus injury. The increased odds of brachial plexus injury associated with prioritization of the posterior arm stands in contrast to earlier data, which has suggested this maneuver has similar rates of injury to others and has the highest rate of successful delivery. Further research is needed to elucidate the ideal balance between number and order of maneuvers, in order to optimize management of shoulder dystocia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Design and validation of an automated dual-arm instrumented intravaginal dynamometer.

(1) To present the design of a novel intravaginal dynamometer (IVD) capable of measuring vaginal closure force on both the anterior and posterior arms, (2) to use bench testing to validate the force, speed of arm opening, and positional accuracy of load measurement along the IVD arms, and (3) to present in vivo force measurements made with this device, comparing forces measured by the anterior and posterior arms. IVD load measurements were validated against an Instron® Universal Tester, arm opening speeds were validated using video analysis, and position-load accuracy was validated against calibration weights. In vivo IVD data were acquired from female volunteers during passive opening and pelvic floor muscle contraction tasks. Anterior and posterior IVD arm force outcomes were compared. Forces measured by the IVD and Instron® exhibited a strong linear relationship with excellent model fit. The speed control system was valid when tested under physiological loading conditions, however smaller antero-posterior opening diameters (25 and 30 mm) exhibited some error. The loading position along the IVD arms had no effect on force outcomes. In vivo data exhibited differences between force outcomes measured at the anterior and posterior aspects of the vagina during active contraction and passive elongation of the pelvic floor muscles. This IVD design demonstrates valid load measurement and speed control during bench testing. Active and passive forces measured are consistent with the literature. With dual instrumented arms, this device allows for further investigation into the source of measured vaginal closure forces.

A unique lpsilateral axillary artery variation

In an 87-year-old male cadaver received through the Gift Body Program at Saint Louis University School of Medicine, a common arterial trunk arose from the third part of the left axillary artery (AA) that divided into the subscapular artery (SA) and a common stem for the deep brachial artery (DBA), the anterior humeral circumflex artery (AHCA), and the posterior humeral circumflex artery (PHCA). Both the SA and AHCA appeared normal. The PHCA traveled through the quadrangular space and gave off the radial collateral artery (RCA) in the posterior arm which anastomosed with the radial recurrent artery. The DBA traveled through the triangular interval and continued as the middle collateral artery (MCA) in the posterior arm to anastomose with the interosseous recurrent artery. Lastly, the medial and lateral cord contributions to the median nerve formed posteriorly to the AA. Knowing anatomical variation of the AA has clinical and embryological significance.

Calculating the Percentage of Body Measurement Changes In Dynamic Postures In Order To Provide Fit In Skiwear

The aim of this study is to investigate the local body measurement changes in movements during Alpine skiing and to calculate these changes in "percentages" in order to use in garment pattern preparing process to achieve the best clothing comfort characteristics in alpine skiing suits. For that purpose, an anthropometric measurement study was conducted, which involved measuring 31 male volunteer’s body sizes in static and dynamic postures. Within this context, the sizes to be measured were identified as static and dynamic by specifying the anthropometric landmarks on the body using ISAK (The International Society for the Advancement of Kinanthropometry) practices as the base. It was found that percentage changes in the anterior knee length, anterior leg length, hip length, elbow length and posterior arm length were 43%, 2%, 35%, 40% and 9%, respectively, from the measurements collected from 31 male recreational Alpine skiers. Afterwards, regarding to the obtained data, the three body dimensions such as inseam, back waist rise and sleeve length were re-calculated to use in the preparing of pattern for tight-fitting garments. Ultimately, a base layer thermal bottom’s garment patterns were developed and evaluated using a 3D virtual try-on system. Consequently, it was found that the inseam length and sleeve length should be reduced while the back waist rise needs extra ease allowance. With respect to the virtual fitting, the developed pattern was more fit than the original pattern and had more ability to adapt dynamic postures.

Effects of asymmetrical exercise demands on the symmetry of skin temperature in archers

Objective: To analyse skin temperature asymmetries in response to asymmetrical exercise demand in archers. Approach: The skin temperature of the trunk and upper limbs was measured in 30 archers with an infrared camera at three different moments: before (Pre), immediately after (Post), and 10 min after (Post10) a simulated competition (18 warm-up shots and 72 qualifying round shots). Relative and absolute asymmetries were determined. Stepwise multiple linear regressions were performed using the variations of relative and absolute skin temperature asymmetries as predicting variables, and sex, age, experience, body mass index, bow mass, bow power, and rate of perceived exertion of competition as inputs. Main results: Relative symmetry values were lower, i.e. more negative values indicating more asymmetry (higher skin temperature on the bow side, p < 0.05 and ES > 0.5) in the Post than in the Pre moment in the upper back (95% CI [0.1, 0.4 °C]), posterior shoulder (95% CI [0.0, 0.5 °C]), posterior arm (95% CI [0.0, 0.6 °C]) and posterior elbow (95% CI [0.4, 0.9 °C]). Absolute asymmetries were higher (p < 0.01 and ES > 0.8) in the Post than in the Pre moment in the chest (95% CI [0.1, 0.4 °C]), upper back (95% CI [0.1, 0.3 °C]), posterior shoulder (95% CI [0.1, 0.5 °C]) and posterior elbow (95% CI [0.2, 0.7 °C]). The variation of asymmetries after competition could be explained by factors such as experience, effort perception, sex, and bow mass. Significance: Archery exercise results in skin temperature asymmetry related to higher temperature in the bow side, which plays a main role in sustaining muscle activation to keep position. The asymmetry characteristics may result from the archery technique.