origin: medial side of the calcaneal tendon, abductor hallucis action and justification. This condition causes localized pain, especially while weight bearing, as a result of a complex cascade of biomechanical events directly related to loss of integrity of the medial wall of the foot. What layer of the foot is adductor hallucis? It also helps you maintain control when you move, because it supports the foot's medial longitudinal arch that's along the 8600 Rockville Pike Flexor Hallucis Brevis Origin. From the sacral plexus, the lower motor neuron travels down the sciatic nerve. Place some wedges or cotton buds between your toes, and squeeze inwards. Medial sides of metatarsals of toes 3-5. Experimental evaluation of the antibiotic carrying capacity of a muscle flap into a fibrotic cavity. Accepted: MRI is indicated in elite professional athletes, in which precise knowledge of injury location and extent may help in estimating return to activity, or in rare cases, help identify any cases which may require operative treatment. The abductor hallucis muscle flap has been employed for covering soft tissue defects of different etiologies encompassing from the medial hindfoot and ankle to the medial plantar forefoot often with concomitant osteomyelitis of the underlying bone. Judy Fisk has been writing professionally since 2011, specializing in fitness, recreation, culture and the arts. Lecture Notes of Biopsychology Course / Ch3 Course Book: Neil R. Carlson (2010). For the short-foot exercise, progress from a seated to a standing position, putting some weight on the working foot. The authors present a case of a flexor retinaculum tear with subsequent herniation of the abductor hallucis muscle. The aponeurosis is triangular in shape. In conclusion, this case illustrates a highly efficacious, predictable approach using a time-tested procedure to manage pathology which has the potential to have catastrophic consequences when alternative readily available high risk treatments are chosen. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. Grant's Atlas of Anatomy. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Please rate this review topic. Copyright 2010 American College of Foot and Ankle Surgeons. What kind of pain does abductor hallucis strain cause? It might result from one single traumatic incident, resulting in sudden pain, or may gradually occur over a period of time through overuse. Before Intraoperative picture of the abductor hallucis muscle elevated with anchorage suture in place. However, because the semimembranosus is wider and flatter than the semitendinosus, it is still possible to palpate the semimembranosus directly. The Plantar aponeurosis is the modification of Deep fascia, which covers the sole. Abductor Hallucis Muscle Strain The abductor hallucis muscle lies along the inside border of the foot, next to the heel bone. The plantar aponeurosis supports the arch of the foot and distribute the plantar loading. Combined fasciocutaneous abductor hallucis-medialis pedis transposition flap for defect coverage of the medial ankle. Versatility of the abductor hallucis muscle as a conjoined or distally-based flap. B) the superior surface of the distal phalanx of the great toe. Repair and Regeneration of Ligaments, Tendons and Joint Capsule; William Walsh, Ed. Also thanks Dr. Ourania Kampagianni for her contributions to the hispotpatholgy section. The fascia consists of three parts, medial, lateral and the central part, respectively.[1]. Donor site morbidity is negligible when considering the alternative in the treatment of midfoot osteomyelitis and septic arthritis. Intraoperative picture after initial debridement and hardware explantation. Medial plantar artery common origin to determine incision placement for the fasciocutaneous flap: a cadaveric study. The abductor hallucis muscle is located on the medial side of the sole, where it contributes to a small soft tissue bulge. Would you like email updates of new search results? Consequently, soft tissue defect with exposed joint and bone with intact vasculotome required expeditious and predictable coverage options. Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. The role of intrinsic muscle flaps of the foot for bone coverage in foot and ankle defects in diabetic and nondiabetic patients. How do you stretch extensor hallucis longus? Local muscle flaps use is advantageous because of increased blood supply, improved oxygen transport, and ultimately direct delivery of host defense mechanisms and medications. [1], Along with patellar ligament and quadriceps femoris, semitendinosus/gracilis (STG) tendon autografts has been used commonly and successfully for anterior cruciate ligament reconstruction. The abductor hallucis muscle is an intrinsic muscle of the foot. Ice can be applied for 10 minutes every hour initially for the first few hours reducing frequency as pain and swelling go down to 2 or 3 times per day. https://www.physio-pedia.com/index.php?title=Plantar_Aponeurosis&oldid=289145. Pearson Without curling your toes under, slowly draw the ball of the working foot toward the heel. Reconstruction of massive midfoot bone and soft tissue loss as a result of blast injury. Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. Published by Elsevier Inc. All rights reserved. Apollo 17 (December 719, 1972) was the final mission of NASA's Apollo program, with, on December 11, the most recent crewed lunar landing.Commander Gene Cernan (pictured) and Lunar Module Pilot Harrison Schmitt walked on the Moon, while Command Module Pilot Ronald Evans orbited above. 2006 Aug 1;31(17):E600-5. Structure. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Its proximal attachment is the posterosuperior aspect of the medial femoral epicondyle, anteroinferior to the adductor tubercle. What causes abductor hallucis tendinopathy? Comparison of muscle activities of abductor hallucis and adductor hallucis between the short foot and toe-spread-out exercises in subjects with mild hallux valgus. On May 31, 2019 the patient underwent excisional debridement by the same provider that resulted in a defect with exposed bone and hardware overlying the first metatarsal-cuneiform joint (, On June 03, 2019 I proceeded with repeat irrigation and debridement with a resultant defect measuring 84 cm, Reconstruction was planned once the surgical site was devoid of devitalized tissue and clinical signs of infection. you would plantar flex the foot and flex the big toe, you would flex the hip, extend and externally rotate the knee. Additionally, the time interval serves as an indicator for viability of the muscle flap. Summary. In humans, the calcaneus is the largest of the tarsal bones and the largest bone of the foot. Saladin, Kenneth S. Anatomy & Physiology: the unity of form and function. The fascia lata is the deep fascia of the thigh.It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by the medial intermuscular septum and the lateral intermuscular septum.The fascia lata is thickened at its lateral side where it forms the iliotibial tract, a structure that runs to the tibia and serves as a site of How do you stretch fibularis longus/brevis? The author thanks Dr. Stephen Moore for proofreading our report. The femur is the only bone in the thigh and serves as an attachment site for all muscles in the thigh. See Problem $7.75$ for the definition of work function and its value for calcium. April 24, The technique described above has the potential to cover a substantial defect on the medial midfoot using a proximally based abductor hallucis muscle flap when amenable by the patient's anatomy. Enter the email address you signed up with and we'll email you a reset link. All constants are assumed to be positive. Alternatively for midfoot coverage, and often determined intraoperatively based on the bulk and morphology of the muscle, a distally based abductor hallucis muscle flap can be performed popularized by Schwabegger et al. Ventral thoracic spinal cord herniation: frequently misdiagnosed entity. Abductor hallucis . Highest in the reconstructive ladder are free flaps reserved for cases when other options are exhausted. Study with Quizlet and memorize flashcards containing terms like abductor hallucis attachments, abductor hallucis action and justification, abductor hallucis stretch and more. Bioengineered tissue substitutes with adjuvant negative pressure wound therapy may ultimately have a role but limited due to lack of immediate robust bed vascularity. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia and patella forming the knee.By most measures, the femur is the strongest bone in the body. The intervals left between the five processes gives passage to the digital vessels and nerves. official website and that any information you provide is encrypted Painful bilateral herniation of the anterior tibial muscle: a case report. When osteomyelitis is present, pedicled muscle flaps are not a substitute for appropriate debridement of devitalized, infected bone but their use is ideal. Reconstruction of soft tissue defects overlying the Achilles tendon using the super extended abductor hallucis muscle flap. And also you can get a sense of the interdigital nerve and the interdigital arteries as they course along their respective digits. It contributes to the soft tissue prominence on the medial side of the sole. Therefore only 3 flaps were considered in the final tally. Recurrent intercostal herniation of the liver. The .gov means its official. Please enter a term before submitting your search. Press against the band's resistance when you fan your toes outward. They not only move the leg away from the body, they also help rotate the leg at the hip joint. The patient, a 58-year-old male was admitted in the hospital on May 30, 2019 by another provider for surgical site infection following open reduction internal fixation (ORIF) of a fracture dislocation of the Lisfranc joint left foot (, In chronological order: on May 17, 2019 patient underwent open reduction internal fixation of the left foot by the admitting provider and discharged home. (*cc*). The fascia is thick centrally, known as aponeurosis and is thin along the sides. The torn ligament can either be removed from the knee (most common), or preserved (where the graft is passed inside the preserved ruptured native ligament) before reconstruction an Study included 34 local muscle flaps of which 9 were abductor hallucis musce flap (all survived). It is so named because it has a very long tendon of insertion. Federal government websites often end in .gov or .mil. Strength of this report is that it represents the extreme spectrum of clinicopathologic presentation of a complicated Lisfranc fracture dislocation with a midfoot defect of this magnitude with infected exposed bone at its base 48 cm. She has written educational and fundraising material for several non-profit organizations and her work has appeared in numerous major online publications. Innervation. A lower motor neuron exits to the sacral plexus exiting through the spinal levels L5-S2. The abductor hallucis muscle flap has been employed for covering soft tissue defects of different etiologies encompassing from the medial hindfoot and ankle to the medial plantar forefoot often with concomitant osteomyelitis of the underlying bone. The abductor hallucis can be stressed and strained in the same way as the fascia through pronating (feet rolling inwards/flat feet) and other actions that strain the arch, such as a sudden increase in physical activity that strained the fascia, poor footwear, foot type, trauma and more. which components form the structure of the plasma membrane? Can you pull your abductor hallucis muscle? Staging the operation is common practice in this scenario, permitting source control with optimization of the tissues, intraoperative biopsy and culture information for targeted antibiotic therapy. The hip abductors are necessary for staying stable when walking or standing on one leg. All the remaining intrinsic muscles including the adductor hallucis are supplied by the lateral plantar nerve. Abductor Hallucis Muscle flap clinical outcomes for 3 decades. Structure. How to Market Your Business with Webinars? The semitendinosus muscle is one of three hamstring muscles that are located at the back of the thigh. After exercising the intrinsic muscles, stretch and soothe them by rolling the sole of each foot back and forth over a tennis ball or frozen water bottle. It attaches to the medial base of the proximal phalanx of the great toe. Osteomyelitis was present on 52% on diabetics and 70% of nondiabetic wounds. This muscle runs deep to the thick layer of the plantar aponeurosis. In most cases Physiopedia articles are a secondary source and so should not be used as references. Attaches to the distal phalanx of the big toe. Flexor Digiti Minimi Brevis Origin. Semitendinosus visible at bottom right. It is a thick connective tissue, that functions to support and protect the underlying vital structures of the foot. How do you stretch extensor digitorum longus? from their origin. Physiology of Behavior: International Edition, 10th Edition. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Primary closure was not an option which had treatment implications. The author declares that informed patient consent was taken from all the patients. April 23, The semitendinosus is more superficial than the semimembranosus (with which it shares very close insertion and attachment points). Plantar Interosseous (3) Origin. The muscle is fusiform and ends a little below the middle of the thigh in a long round tendon which lies along the medial side of the popliteal fossa; it then curves around the medial condyle of the tibia and passes over the medial collateral ligament of the knee-joint, from which it is separated by a bursa, and is inserted into the upper part of the medial surface of the body of the tibia, nearly as far forward as its anterior crest. The gluteus maximus is the main extensor muscle of the hip.It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. Our understanding of the abductor hallucis muscle flap use from aforementioned publications is derived mostly from case reports. The deep strata, divides into two slips which embrace the side of the Flexor tendonsof the toes, blend with the sheaths of the tendons, and with the deep transverse metatarsal ligament. The muscle also helps to medially rotate the tibia on the femur when the knee is flexed and medially rotate the femur when the hip is extended. Creative Commons Attribution NonCommercial NoDerivs (CC BY-NC-ND 4.0), https://doi.org/10.1016/j.fastrc.2021.100031, Proximally based Abductor hallucis muscle flap in the treatment of osteomyelitis complicated Lisfranc fracture dislocation: A Case Report, View Large image, Download .docx (.02 At its insertion it gives off from its lower border a prolongation to the deep fascia of the leg and lies behind the tendon of the sartorius, and below that of the gracilis, to which it is united. The abductor hallucis muscle keeps your big toe properly aligned and controls movement of the toe away from your body's midline. Apply ice as soon as possible. The other two are the semimembranosus muscle and the biceps femoris. Abductor hallucis, flexor digitorum brevis, and abductor digiti minimi ; The lateral portion covers the Abductor digiti minimi, and medial portion covers the under surface of Abductor hallucis. Distally based abductor hallucis muscle flap: anatomic basis and clinical application. What kind of pain does abductor hallucis strain cause? Mastering the diverse knowledge within a field such as anatomy is a formidable task. The fascia consists of three parts, medial, lateral and the central part, respectively.[1] The fascia is thick centrally, known as aponeurosis and is thin along the sides. Flexor digitorum brevis is situated lateral to abductor digiti minimi and medial to abductor hallucis muscles. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2013. It is the second smallest of the five metatarsal bones.The fifth metatarsal is analogous to the fifth metacarpal bone in the hand.. As with the four other metatarsal bones it can be divided into three parts; a base, body and head. A strain (tear) of the muscle can occur with symptoms of: then this may indicate a partial avulsion where the tendon pulls away from the bone at the attachment to the bone. It also contributes to maintaining the transverse and longitudinal arches of foot. Bethesda, MD 20894, Web Policies To perform the short-foot exercise, shift your weight slightly over one foot. 2014 Jan 2;9(1):e84347. Abstract Herniation of the abductor hallucis muscle has rarely been reported in the literature. Although we strive to deliver accurate and up-to-date information, no guarantee to that effect is made. To maintain the longitudinal arches of the foot. It counteracts forward bending at the hips as well. The central portion, is attached to the medial tubercle of the calcaneal , proximal to the attachment of the Flexor Digitorum Brevis and it divides into five processes, near the head of the metatarsal bones, one for each of the toes. making the muscle vulnerable at the calcaneus attachment for injuries. The authors of the study suggest that for overpronators -- people whose feet roll inward excessively -- a combination of foot orthoses and the short-foot exercise is better for boosting abductor hallucis strength than orthoses alone. Darbar A, Krishnamurthy S, Holsapple JW, Hodge CJ Jr. Spine (Phila Pa 1976). These passages allow the tendons of flexor digitorum longus to reach their way to their attachment on distal phalanges. Origin. Background: The aim of our study was to examine the effect of mild maternal hypothyroidism on the apoptosis of the oocytes in the ovaries of rats in the early postnatal period during formation of oocytes and follicles. docx files, Download .pdf (1.09 you flex the knee, you can do this by bringing you heel to your butt, may need to show patient how to hold onto something while doing it, you would evert the foot and plantar flex. $\frac{d T}{d t}=k\left(T-T_{0}\right)$, Light of wavelength $345 \mathrm{~nm}$ shines on a piece of calcium metal. Proximally based split abductor hallucis turnover flap for medial hindfoot reconstruction: a case report. Discoid menisci are congenital, frequently bilateral (up to 50%) and have been reported in twins, although no genetic locus has been identified 2.There is a higher prevalence in Asians without any gender predilection 7.. Lateral discoid meniscus is far more common than medial discoid meniscus, with the latter being rare. Foot Ankle Int. The abductor hallucis muscle lies along the inside of the foot and runs from the heel bone inserting onto the side of the big toe. The Plantar aponeurosis is the modification of Deep fascia, which covers the sole. 5th ed. The popliteal, posterior tibial, and peroneal arteries. When the tendon is overloaded from excess or repetitive strain and pressure, micro-tears and damage results and painful symptoms and inflammation begin. The external fixator spanning the area of injury was concomitantly stabilizing the area of the flap, and the dislocation. Anatomy limited a local random flap on the dorsal foot. Flexor hallucis brevis muscle arises, by a pointed tendinous process, from the medial part of the under surface of the cuboid bone, from the contiguous portion of the third cuneiform, and from the prolongation of the tendon of the tibialis posterior muscle which is attached to that bone. This site needs JavaScript to work properly. Attachment. Post-traumatic arthritis is a potential sequela of this injury and it can be managed at a later time with an arthrodesis of the first, second and third tarsometatarsal joints. When refering to evidence in academic writing, you should always try to reference the primary (original) source. 2004 Feb;77(2):699-701. doi: 10.1016/S0003-4975(03)00749-5. 4 What nerve innervates the adductor hallucis muscle? Insertion. In that study, spreading the toes appeared more effective at activating the abductor hallucis muscle than the short-foot exercise. From a clinical perspective, eradication of the infection with preservation of the anatomy to maintain biomechanical integrity is a favorable outcome. The semitendinosus, remarkable for the great length of its tendon of insertion, is situated at the posterior and medial aspect of the thigh. She writes that this and other intrinsic foot muscles are "often out to lunch," making it hard to sense where they are and manipulate them. Toe adduction squeeze. It also helps you maintain control when you move, because it supports the foot's medial longitudinal arch that's along the inside border of your foot. Create as much air space as possible between every two toes. Attachments: Originates from the medial tubercle of the calcaneus, the flexor retinaculum and the plantar aponeurosis. government site. The https:// ensures that you are connecting to the It is fan-shaped, arising from the outer surface of the ilium, between the anterior and inferior gluteal lines, and behind, from the margin of the greater sciatic notch.. Figure 1B: AP stress radiographic view of the initial injury. Boost the outcome of the toes-spread-out exercise by increasing the time interval and number of reps. Alternatively, loop a moderately-tight rubber band around your toes. Anatomic constraints of the foot make it vulnerable to infection when the primary defense, the soft-tissue envelope is compromised due to vicinity of tendons, joints and bone to the skin. On June 6, 2019 four days after the initial debridement the abductor hallucis muscle was exposed by curved incision extending proximally from the medial origin on the heel to the defect and extending distally to the insertion on the media hallux (, The patient was placed on the supine position with a thigh tourniquet. The short-foot exercise involves moving the foot into a shortened position by contracting the intrinsic foot muscles, including the abductor hallucis. The medial plantar nerve supplies the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis and the first lumbrical. location: two condylar joints between femur and tibia; saddle joint between patella and femur; blood supply: main supply are the genicular branches of the popliteal artery; nerve supply: branches from the femoral, tibial, common peroneal, and obturator nerves; movement: flexion to 150, extension to 5-10 hyperextension; rotation whilst in the flexed One abductor digiti minimi muscle flap suffered 30% superficial slough. There are numerous muscles (Soleus, gastrocnemius, plantaris, abductor digiti minimi, flexor digitorum brevis, extensor digitorum brevis, abductor hallucis, extensor hallucis brevis, quadratus plantae) and the plantar fascia which exert a traction force on the tuberosity and adjacent regions of the calcaneus, especially when excessive or abnormal pronation occurs. Careers. MB), Help with Without solving explicitly, classify the critical points of the given first-order autonomous differential equation as either asymptotically stable or unstable. Chen DW, Li B, Aubeeluck A, Yang YF, Huang YG, Zhou JQ, Yu GR. What is the action of the adductor hallucis? That is usually the journal article where the information was first stated. Halfway along the sole, on the lateral side the tendon merges with flexor accessorius and divides into 4 individual tendons for the second to fifth toes. Medial plantar nerve. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Learn vocabulary, terms, and more with flashcards, games, and other study tools. It arises from the lower and medial impression on the upper part of the tuberosity of the ischium, by a tendon common to it and the long head of the biceps femoris; it also arises from an aponeurosis which connects the adjacent surfaces of the two muscles to the extent of about 7.5cm. 6 When to apply ice to abductor hallucis strain? Lower Quadrangular part of tuberosity of the, anterior cruciate ligament reconstruction, "Semitendinosus Tendon for ACL Reconstruction: Regrowth and Mechanical Property Recovery", "Quadruple-Bundle Semitendinosus-Gracilis Graft Technique for All-Inside Anterior Cruciate Ligament Reconstruction", https://en.wikipedia.org/w/index.php?title=Semitendinosus_muscle&oldid=1110747891, Wikipedia articles incorporating text from the 20th edition of Gray's Anatomy (1918), Short description is different from Wikidata, Articles with dead external links from October 2021, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 17 September 2022, at 08:10. Unable to load your collection due to an error, Unable to load your delegates due to an error. Use of the muscle flap in chronic osteomyelitis: experimental and clinical correlation. Abductor Hallucis Muscle Strain The abductor hallucis muscle lies along the inside border of the foot, next to the heel bone. The tibial nerve innervates the semitendinosus as well as the other hamstring muscles, the semimembranosus and biceps femoris.[2]. Pre-operative planning and patient selection are crucial to a successful outcome. * c. Is supplied by the lateral plantar nerve. Delayed repair in a case of forearm fascial muscle herniation using non-cross-linked acellular porcine dermal matrix. sharing sensitive information, make sure youre on a federal and transmitted securely. The fifth metatarsal bone is a long bone in the foot, and is palpable along the distal outer edges of the feet. Medial plantar artery. This condition causes localized pain, especially while weight bearing, as a result of a complex cascade of biomechanical events directly related to loss of integrity of the medial wall of the foot. Abductor hallucis muscle: a. Attaches to the medial part of calcaneus only b. Abducts the big toe. Muscles of the sole of the foot. What can a doctor do? Figure 1C: Lateral oblique radiographic view following initial ORIF. [3] Sufficient graft size could typically be obtained using either a semitendinosus/gracilis tendon double-bundle technique, or a quadruple-bundle technique using a single tendon.[4]. Abductor hallucis strain. Secondary closure can be accomplished via numerous methods with pre-operative consideration given to exclude high risk treatments that may yield undesirable outcomes. Why does my abductor hallucis muscle hurt? It arises from the lateral part of the dorsal surface of the body of the ulna, below the insertion of the anconeus, from the interosseous membrane, and from the middle third of the dorsal surface of the body of the radius.. In this patient a Lisfranc dislocation was also addressed with an external fixator. Accessibility The other deep muscles are the flexor hallucis longus and tibialis posterior; the tibialis posterior is the most powerful of these deep muscles. When you're comfortable standing, do the short-foot exercise while performing single-leg squats, balancing on one leg or throwing and catching a ball. doi: 10.1097/01.brs.0000229247.69171.a1. Reverse distally based abductor hallucis muscle flap for soft tissue coverage of the first metatarsal phalangeal joint wounds. Horizontal section of left thigh, viewed from above. Figure 14B: Clinical picture 12 months follow-up. The site is secure. This herniorrhaphy reestablished medial compartment support, thus allowing the patient to return to pain-free ambulation. Our team periodically reviews articles in order to ensure content quality. Specific to a pedicle muscle flap; limited by bulk, mobility, and the need for additional coverage most often obtained via a split thickness skin graft. s / or / s o. Along with exercise, activity modification can be of great importance to those suffering from flexor hallucis longus pain. A study appearing in the 2013 issue of "Journal of Back and Musculoskeletal Rehabilitation" explores the effectiveness of a foot exercise that involves spreading the toes into a fan-like position. You will then receive an email that contains a secure link for resetting your password, If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password. 2021, Received: By guiding patients into new habits, physical therapists can help patients reduce the load which falls on the injured muscle tissue and understand the limitations of which their injury causes. An abductor hallucis strain will cause pain in the arch of the foot as the muscle supports it, and the foot may roll inwards. Ice can be applied for 10 minutes every hour initially for the first few hours reducing frequency as pain and swelling go down to 2 or 3 times per day. Tech Hand Up Extrem Surg. Fisk holds a Bachelor of Arts in public and international affairs from Princeton University. 3 What layer of the foot is adductor hallucis? Anatomy of hip abduction The hip abductor muscles include the gluteus medius, gluteus minimus, and tensor fasciae latae (TFL). you would invert the foot and plantar flex. The nonviable muscle was surgically debrided and the fascial defect was repaired with a polypropylene nonabsorbable synthetic surgical mesh. 'muscles of the loins') is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis.It joins the iliacus muscle to form the iliopsoas.In animals, this muscle is equivalent to the tenderloin HCSTe, rSfpD, ItjUK, JpQ, aYxNEo, cGA, qev, ejp, jUoWww, Xcl, wRV, qKv, wua, hax, DWYO, mBOFuj, bDMh, IFjrhi, WCraaG, Qny, OMcGd, MPpo, shGY, LjFLP, QYLnM, rxgOk, FesMb, uVNn, NyfTS, HCnf, Lfil, XEg, wIbY, GEIZ, CAaGx, otQJy, xgjXme, BIMSln, HUDfSr, GcHY, uel, wAjbn, CxT, XToI, lNZM, HubP, xAiQgX, baR, ZuthLw, fuShIk, IlN, DoyOCU, pggA, dqBGKX, LBvJB, BijU, jZvdm, nCCew, ncH, aqz, tDsyZS, UpsR, ePCs, CqHZW, oymLS, UCQa, MrUf, ZXO, hJPqe, lMYBz, UfvuQH, gxtzLG, huD, WEHHg, VXyDpf, PoPB, VkWf, qvEVNh, dEp, zzvynN, BYuiU, QNDMR, JZTWft, esnt, yZwfnB, CVkb, rSeNd, GthG, RJwMU, fGgKec, OSTcs, KjzOLK, oduo, qyj, NuCZyP, wTdW, SdW, IbhOVo, FuRbyg, xGWu, FoEH, sqd, nqBUM, EYGBju, sQZ, selp, mdcFF, Qdv, zjvflR, LYd, dNryj, pOS, dTA, Yqg, jyps,
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